JJNg Posted August 16, 2015 Share Posted August 16, 2015 I agree with tbhounds about consulting with an oncologist or Dr. Couto before proceeding with your vet's plan. Especially since he's not being forthcoming with detailed information, we have no idea what kind of chemo he is planning to inject, and there's no way anyone can address your question of what reactions to expect. Your vet should be the one giving you this information anyway. Administering chemo of any form is a serious and risky procedure, and I wouldn't be comfortable with a vet who isn't keeping you informed of exactly what the protocol and plan is. A hemangiopericytoma is a type of soft tissue sarcoma. Most of them behave similarly, so they are grouped together as soft tissue sarcomas. Quote Jennifer & Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On), Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted August 18, 2015 Share Posted August 18, 2015 Surprise did not have his Chemo today. YEA! The vet said that he needs to let his sites to heal a little more. I asked the office to give me a break down of how and what the treatments are going to be line, in a week by week basis. I got a copy of the lab report and it seems to me that the margins and edges were not as clear as I thought they were. So I really want the treatment plan in advance, so I will know what to expect. I do not think , now that I finally saw the actual report, that there should be any hesitation about getting chemo. It is state one. Just the question of what kind iis best for Surprise. catch up more tomorrow. Quote Link to comment Share on other sites More sharing options...
JJNg Posted September 4, 2015 Share Posted September 4, 2015 How is Surprise doing? I saw that he's going to start on oral chemo? What protocol are they going with? Quote Jennifer & Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On), Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted September 4, 2015 Share Posted September 4, 2015 Here is every thing that I covered with Dr. Rachel Rasmussen at the Hope Advanced Veterinary Center in Rockville:: (She also went to school with and is friends with Dr. Couto's daughter and knows of him and the work he has done with cancer in dogs.) You and my friend Bob who I met on greytalk, encouraged me to see an Bob also helped me consult with Dr. Couto, Dr. Couto saw the lab report and the following from Dr. Rasmussen:. Note Oncology Consult #fax Provider: Dr. Rachel Rasmussen Aug 27, 2015 Technician notes HISTORY: Surprise is an approximately 6 year old male neutered Greyhound. Surprise was seen by his primary care veterinarian at New Market Animal Hospital on July 23rd to have a mass checked on the left front leg. On exam the mass was 2.5 inches long by 1 inch wide and 1/2 inch deep. On palpation the mass was hard on the proximal aspect but soft on the distal aspect. Two other masses where found - on the left lateral neck and flank. On 7/27/15 Surprise had surgery to remove all 3 masses. Result of the biopsy from the mass on the left front leg came back and local chemotherapy was discussed with the owner. Sutures were removed on Aug 8th. Local chemo was scheduled for Aug 17th however the surgery site was not healed completely. - LW 8/27 - Since the surgery Surprise has been feeling great. The area/paw was swollen following surgery, but resolved within a week. No current medications. Eating well at home. - LW Prior blood work:7/24/15 - CBC, Chemistry - creatine 2.0H, T4 - wnl Biopsy and/or cytology report(s):7/28/15 - hemangiopericytoma, low grade (grade I), 3 mitotic figures/10 HPF. Margins of the neoplasm were poorly defined. Neoplastic cells abutted tissue margins. Date of initial diagnosis: 7/28/15 3 view thoracic radiographs: None Abdominal ultrasound:None Current diet: Current medications: None RR PHYSICAL EXAM: T: 101.1 F P: 85 bpm R: 35 brpm /0 Weight: 86.68 lbs. (39.4 kg) Eyes/Ears/Nose/Throat: Pink & moist mucous membranes, CRT<2 sec. Thorax: No abnormalities noted upon auscultation of the heart and lungs. No murmurs or arrhythmias appreciated. Pulses strong and synchronous. Information for Surprise DeLuca Page 1 of 3 nced Veterinary Center - Rockville rt MD 20850 228 Abdomen: Non painful upon palpation, no masses or organomegaly noted. Musculoskeletal: Ambulatory x4, no pain or lameness. Integument: Healing incision over the left antebrachium; no swelling or edema noted. Peripheral lymph nodes: Soft, small, and symmetrical. Neurological: No neurological deficits, full neurologic exam not performed. Rectal exam: Not performed. ASSESSMENT: As discussed, Surprise has been diagnosed with a hemangiopericytoma on the left front leg, which is a type of tumor that fits into the general category of soft tissue sarcomas. The histopathology report indicated that Surprises' tumor is low grade, meaning that it has a low potential to spread elsewhere in the body, particularly lymph nodes and lungs. Unfortunately, all of the tumors cells do not appear to be completely removed during surgery and so there is the potential that the mass could return/regrow at the original site on the left front leg. We discussed options for staging (determining extent of disease in the body) as well as treatment (radiation therapy, metronomic chemotherapy) to try and prevent tumor recurrence. General background soft tissue sarcoma tumors: Soft tissue sarcoma (STS) is a group name for a variety of tumors of the connective tissues. These tumors often grow passively along tissue planes by pushing tissue out of the way but they can also spread to distant sites such as regional lymph nodes and lungs. STSs are generally first noted as a lump that grows slowly over time. The mass usually feels fixed to the underlying tissue and its borders are indistinct due to the deep growth of the tumor. The tumor behaves like an "octopus" with deep tendrils that can grow into the underlying tissues. Symptoms are usually associated with the tumor pressing on surrounding tissues and can cause pain, swelling but can also affect movement. Recommended staging discussed today include: Tumors are staged with blood work (CBC, chemistry panel), urinalysis, thoracic radiographs (chest X-rays), and fine needle aspirates of regional lymph nodes to check for metastatic spread. Occasionally an abdominal ultrasound may be recommended if abdominal disease is suspected. In some cases a CT scan or MRI is used to determine the extent of any tendrils of the tumor into surrounding tissues (surgical or radiation planning). A biopsy is needed to determine the histological grade, which helps us predict the metastatic potential of the tumor. Treatment options discussed and to be considered: Surgery: Surgery is the most effective treatment approach for tumor control. However,usrgery is often incomplete because of the local invasiveness of the tumor. For low grade tumors, surgery can be curative, if all the cancer cells have been removed. With incomplete margins, the tumor is at risk for local and regional recurrence. In cases where the tumor is incompletely resected, a second (revision) surgery is recommended (if feasible) or adjuvant radiation therapy. Radiation Therapy: We discussed full course radiation therapy protocols and discussed side effects and the anesthesia this is required for radiation therapy. Adjuvant radiation is recommended for surgeries resulting in incomplete margins and can result in excellent long-term control of the cancer for Surprise DeLuca Page 2 of 3 nced Veterinary Center - Rockville rt MD 20850 228 for low-grade and even some high-grade tumors. Palliative radiation (not discussed during today's visit) is used to address symptoms caused by an inoperable tumor. Systemic Chemotherapy: We discussed general side effects of chemotherapy (bone marrow suppression and gastrointestinal signs), the frequency of treatment, and costs. Chemotherapy is recommended for high-grade tumors, which present the risk of metastatic spread. For high-grade tumors, injectable chemotherapy is considered most effective. Doxorubicin is generally our first choice chemotherapy, which is given every three weeks for a total of 5 doses. Newer approaches, include the use of oral chemotherapy given frequently at low doses on a regular basis ('metronomic therapy' using NSAIDs and cyclophosphamide) and have been reported to result in good outcomes for incompletely resected STSs if radiation is not feasible. Another option would be to use a tyrosine kinase inhibitor, such as Toceranib (Palladia), but these drugs are less well studied for the treatment of STSs. Other option such as palliative care to treat symptoms and make sure your pet is comfortable. It's important to continue to monitor for pain and quality of life issues, such as behavior or appetite changes. TREATMENT PLAN: You have considered you options and have elected to go home with this information and consider an appropriate treatment plan for you and for Surprise. Please do not hesitate to contact with any questions or concerns as you're reviewing this information and trying to come up with the best diagnostic and treatment plan. Surprise is certainly a very sweet dog and obviously an important member of the family. Treatments given:None Please schedule your next exam on:As needed, if you elected to return for recheck exams/monitoring, further diagnostics, and/or treatment. Please do not hesitate to call me if you have any questions or concerns after today's visit. Thank you for coming to the Hope Center and we look forward to seeing you again soon. End of her report. So next week we are scheduled for more blood work, chest xrays, test the lymph nodes, exam. Onco fine needle aspirate. if all goes well, she will call in the oral medication and we will start. She is using Compounded cytoxan (another name is cytoxan/piroxicam) We would like to do the radiation, but the cost is prohibitive. Cyber-knife radiation is even more expensive, but closer and less time and treatments. Dr Couto's email said he was comfortable with Dr. Rasmussen's choices. Quote Link to comment Share on other sites More sharing options...
JJNg Posted September 5, 2015 Share Posted September 5, 2015 Did Dr. Couto mention the 5-FU local injections at all? I had a greyhound foster with a soft tissue sarcoma on his wrist where we were unable to get margins. We did a very similar metronomic protocol using Cytoxan and Rimadyl (instead of the piroxicam). Did they talk to you about the possible bladder side effects with Cytoxan? My foster got adopted, and last I heard, he was still doing well with that protocol with no regrowth. Quote Jennifer & Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On), Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted September 5, 2015 Share Posted September 5, 2015 Yes, Dr. Couto did mentioned the 5-FU local injection. However, Dr. Rasmussen said she could not locate where it was published. She also had not used the 5-FU before and was not comfortable doing it the first time on surprise. Surprise also had two other small growths about the size of an eraser-one on his side and one on his chest that were removed and not previously tested. Just like your foster, their was not clear margins on the one removed on his leg.. They did tell me that there was about a 10 percent chance of possible bladder issues. Did your foster have any bladder issues? if so, can you share what they were ? Dr. Couto did express that he was confident with the treatments that Dr, Rasmussen offered. Sounds like the metronomic chemo worked great on your foster and I hope it works as well for surprise. Quote Link to comment Share on other sites More sharing options...
JJNg Posted September 5, 2015 Share Posted September 5, 2015 Unfortunately, the data on the 5-FU protocol hasn't been published. When I asked Dr. Couto about it, he said that the resident in charge of the project had left, and once the resident leaves, stuff usually doesn't get published. IMO, it's a shame as it seems to be an effective, and much less expensive option, for appropriately selected cases. Dr. Couto told me that he had data on a number of cases, and the results were as good, if not better, than radiation treatment. I trusted his experience, and my local oncologist was willing to try it with my whippet. He was the first case she did, and she's also used the protocol on a greyhound patient of mine since then. However, especially given the other 2 growths Surprise had that were tested, metronomic chemo sounds like the best way to go. The reason we had to use it on my foster was because after surgery, the skin around the scar was too tight for them to inject enough of the 5-FU chemo underneath. The last I heard, my foster hadn't had any bladder issues. Our oncologist told us that at the low doses used for metronomic chemo, the chances of that are extremely low. The bladder issues are seen more with traditional chemo that uses much higher doses of the Cytoxan. The oncologist I worked with also tried to further decrease the risk of the bladder problem happening by giving a dose of Lasix (furosemide), a 'water pill' that increases urine production with each dose of the chemo to flush out the bladder. Quote Jennifer & Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On), Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted September 5, 2015 Share Posted September 5, 2015 Thank you for the heads up on the Lasix. That sounds like an important thing to know. I am going to talk to Dr. Rasmussen about that for sure. If you have any other pointers, please feel free to speak freely. I can use all the advice I can get to learn. Quote Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted September 10, 2015 Share Posted September 10, 2015 Here is the report that we got from the Dr. Concerning Surprise and his Chemo treatment. The Dr. is going to retest Surprise again, before she does any treatment, as she says that his white blood cell count is low. However, a second opinion was given and we were told that his numbers were okay for a greyhound. So I am checking in with the folks on grey.talk to see if anyone knows what the range should be for a greyhound. Hope Advanced Veterinary Center - Rockville 1 Taft Court Rockville, MD 20850 (301) 637-3228 DeLuca, Linda Surprise Sex.......: MN DOB......: 02/22/2009 Species..: Canine Weight.: 0kg. Age......: 6 years and 7 months old Breed...: Greyhound Primary Hospital: New Market Animal Hospital Next Appointment: Primary Doctor: 09/08/2015 Note Oncology Recheck - Staging Provider: Dr. Rachel Rasmussen Sep 08, 2015 Presenting for: Staging tests and to start treatment with metronomic cyclophosphamide Diagnosis: Soft Tissue Sarcoma - left front leg 7/28/15 - hemangiopericytoma, low grade (grade I), 3 mitotic figures/10 HPF. Margins of the neoplasm were poorly defined. Neoplastic cells abutted tissue margins. Technician notes: History and side effects since last visit: Surprise has been doing since his last visit. Mom and dad have nothing to report - LW Current diet: Current medications: None RR PHYSICAL EXAM: T: 102.3 F P: 120 bpm R: pant Weight: 84.14 lbs. ( 38.7 kg) (1.15 m2) Previously: 39.4 kg Eyes/Ears/Nose/Throat: Pink & moist mucous membranes, CRT 1 sec. Thorax: No abnormalities noted upon auscultation of the heart and lungs. No murmurs or arrhythmias appreciated. Pulses strong and synchronous. Abdomen: Non painful upon palpation, no masses or organomegaly noted. Musculoskeletal: Ambulatory x4, no pain or lameness. Integument: Healing incision over the left antebrachium; no swelling or edema noted, no evidence of gross disease. Peripheral lymph nodes: Soft, small, and symmetrical. Neurological: No neurological deficits, full neurologic exam not performed. Rectal exam: Normal stool, no melena, no rectal masses noted. ASSESSMENT: Information for Surprise DeLuca Page 1 of 3 Hope Advanced Veterinary Center - Rockville 1 Taft Court Rockville, MD 20850 (301) 637-3228 Surprise presented to the Hope Center oncology service following his initial appointment for purposes of staging (determining extent of disease in the body) to then start treatment with metronomic chemotherapy in hopes of to trying to prevent tumor recurrence. Based on the chest X- rays and lymph node aspirates (though the samples were very minimally cellular) there is no evidence of metastatic disease, which is great. As discussed, one of Surprises' kidney values (creatinine) is mildly increased, though stable compared to previous blood work. We will continue to monitor this value on future rechecks. One change noted on today's blood work is the one of the white blood cells, specifically the neutrophils, were below reference range. Looking back on Surprises' previous blood work, his neutrophils have always been on the low end of normal. We discussed rechecking the neutrophil count with a CBC at the end of the week (either Thursday or Friday) to see if the number is somewhat improved before starting treatment with metronomic chemotherapy, since chemotherapy does have the potential to further decrease these white blood cells. You can either return to your primary care veterinarian for the CBC and fax the results to the Hope Center or we'd be happy to see Surprise for the blood work check. As discussed, the monitoring plan once a patient is receiving metronomic chemotherapy is as follows: Once starting metronomic chemotherapy a CBC should be checked two weeks after the start of treatment. Recheck exam, blood work (CBC/chemistry panel), and urinalysis should be performed one month after the start of treatment. These recheck visits can then be spaced out to every 2-3 months as long as Surprise is doing well at home. Chest X-rays should also be taken periodically while on metronomic chemotherapy. Results of today's tests: • Blood work: o CBC - HCT 55.9%, neutrophils 2,040/uL (ref range 2,940-12,670/uL), platelets 139,000/uL - mildly decreased neutrophil count, unclear of the cause at this time. o Chemistry panel - creatinine 2.0 mg/dL (ref range 0.5-1.5 mg/dL), glucose 126 mg/dL (ref range 63-114 mg/dL), potassium 3.5 mmol/L (ref range 4.0-5.4 mmol/L) - mildly elevated kidney values (creatinine), stable compared to previous blood work. • Urinalysis (free-catch) - SpG 1.039, pH 6.0, trace protein, no bacteria seen - unremarkable findings • Thoracic radiographs - Impressions/Conclusions: 1. Bronchointerstitial pattern consistent with age-related changes +/- some degree of chronic lower airway disease. There is no evidence of pulmonary metastatic disease. 2. Gastric material may represent partially digested food vs. foreign material. There is no evidence of gastric outflow at this time. • Fine needle aspirate with in-house cytology - left prescapular lymph node - minimally cellular sample, predominantly fat and blood, no neoplastic cells seen (not submitted for review by a clinical pathologist). TREATMENT PLAN: • Recheck CBC prior to starting treatment with metronomic chemotherapy Treatments given: None Information for Surprise DeLuca Page 2 of 3 Hope Advanced Veterinary Center - Rockville 1 Taft Court Rockville, MD 20850 (301) 637-3228 Please schedule your next exam on:Blood work (CBC) recheck at the end of the week Please do not hesitate to call me if you have any questions or concerns after today's visit. Thank you for coming to the Hope Center and we look forward to seeing you again soon. Quote Link to comment Share on other sites More sharing options...
JJNg Posted September 10, 2015 Share Posted September 10, 2015 That neutrophil count isn't that unusual for a greyhound. Sounds like the vet has already confirmed that, but if needed, this is a good scientific article on the topic:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816276/pdf/nihms496011.pdf Quote Jennifer & Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On), Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted September 22, 2015 Share Posted September 22, 2015 Thank you for the article. I printed out all 19 pages. Quote Link to comment Share on other sites More sharing options...
NeylasMom Posted September 22, 2015 Share Posted September 22, 2015 I would compare to a baseline count before he got sick. Easy enough to determine that this is a normal value for him that way. Quote Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart "The great thing about science is that you're free to disagree with it, but you'll be wrong." Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted October 15, 2015 Share Posted October 15, 2015 (edited) Surprise has been on chemo compounded capsels and compounded pain capsels for a couple of weeks now and we have taken him to his oncologist for testing to see how he is doing. I have attached the reports should anyone like to read them. Hope Advanced Veterinary Center - Rockville 1 Taft Court Rockville, MD 20850 (301) 637-3228 DeLuca, Linda Surprise Acct Number: Address........: Phone...........: Cell Phone....: Sex.......: MN DOB......: 02/22/2009 Species..: Canine Weight.: 0kg. Age......: 6 years and 8 months old Breed...: Greyhound Primary Hospital: New Market Animal Hospital Primary Doctor: Next Appointment: 10/06/2015 Note Oncology Recheck- metronomic emailed to rdvm - ABT Oct 06, 2015 Presenting for: Chemotherapy recheck exam Diagnosis: Soft Tissue Sarcoma - left front leg Provider: Dr. Rachel Rasmussen 7/28/15 - Hemangiopericytoma, low grade (grade I), 3 mitotic figures/10 HPF. Margins of the neoplasm were poorly defined. Neoplastic cells abutted tissue margins. 9/8/15 - Staged clean with thoracic radiographs and regional lymph node cytology. 9/16/15 - Started treatment with metronomic chemotherapy Technician notes: History and side effects since last visit:Surprise has been doing well at home. The first few days on the cyclophosphamide Surprise seemed lethargic and did not eat as well. But his appetite picked up quickly and he is feeling great. Mom noted that his urine seems dark, but his stool is normal (maybe a little soft at the end). Current diet: Same Current medications: Cyclophosphamide, Piroxicam RR PHYSICAL EXAM: T: 102.2 F P: 150 bpm R: pant Weight: 88 lbs. (40.0 kg) (1.18 m2) Previously: 38.7 kg Eyes/Ears/Nose/Throat: Pink & moist mucous membranes, CRT 1 sec. Thorax: No abnormalities noted upon auscultation of the heart and lungs. No murmurs or arrhythmias appreciated. Pulses strong and synchronous. Abdomen: Non painful upon palpation, no masses or organomegaly noted. Musculoskeletal: Ambulatory x4, no pain or lameness. Integument: Left antebrachium - no swelling or edema noted, no evidence of gross disease. Small, 0.5 cm, round cutaneous mass noted on the left neck region (in house cytology consistent with a mation for Surprise DeLuca Page 1 of 3 Hope Advanced Veterinary Center - Rockville 1 Taft Court Rockville, MD 20850 (301) 637-3228 cyst). Peripheral lymph nodes: Soft, small, and symmetrical. Neurological: No neurological deficits, full neurologic exam not performed. Rectal exam: Normal stool, no melena, no rectal masses noted. Results of today's tests: • Blood work: o CBC - HCT 57.2%, neutrophils 2,720/uL (ref range 12,670/uL), platelets 162,000/uL) o Chemistry panel - Glucose 122 mg/dL (ref range 63-114 mg/dL), creatinine 2.2 mg/dL (ref range 0.5-1.5 mg/dL), SDMA 15 ug/dL (ref range 0-14 ug/dL) • Urinalysis (free catch) - SpG 1.040, pH 7.0, protein negative, blood/hemoglobin negative, no bacteria seen ASSESSMENT: Surprise looks great today and we are so glad he is tolerating metronomic chemotherapy well. There is no evidence of gross disease at the left forelimb (antebrachium) and his lymph nodes palpate within normal limits. We performed fine needle aspirates (FNA) of the new mass identified on the left neck region, which was consistent with a cyst (samples were not submitted for review by a clinical pathologist). Blood work (CBC/chemistry panel) and urinalysis was ultimately very similar to previous results. He continues to have a very mildly decreased neutrophil count and mildly increased kidney values (creatinine and SDMA); we will continue to monitor these values on future blood work. No evidence of red blood cells was noted in the urine sample. We recommend continuing with the metronomic chemotherapy and scheduling a recheck exam, blood work (CBC/chemistry panel), and urinalysis in one month. TREATMENT PLAN: • Continue with metronomic protocol. • Next recheck and blood work (CBC/chemistry panel/UA) 1 month Treatments given: None Medications to continue at home: Cyclophosphamide(15 mg/m2) (17 mg) - Continue to give 1 capsule by mouth every 24 hours. - called into stokes - LW Piroxicam(11 mg) - Continue to give 1 capsule by mouth every 24 hours. - called into stokes - LW Please schedule your next exam oni:n 1 month for recheck, blood work (CBC/chemistry panel), and urinalysis. Please do not hesitate to call me if you have any questions or concerns after today's visit. Thank you for coming to the Hope Center and we look forward to seeing you again soon. Rachel Rasmussen, DVM, Practice Limited to Oncology Here is the lab reports: H============================================================================= Sex.......: MN DOB......: 02/22/2009 Species..: Canine Weight.: 0kg. Age......: 6 years and 8 months old Breed...: Greyhound Primary Hospital: New Market Animal Hospital Primary Doctor: Next Appointment: TOTAL HEALTH W/ UA, CHEM 27 w/ SDMA, CBC COMPREHENSIVE, URINALYSIS,TOTAL 10/06/2015 02:06 PM Requisition # 19997056 Accession # 2500045546 Panel Name Panel Name TOTAL HEALTH W/ UA CHEM 27 w/ SDMA ALP 20 5-160 U/L ALT 27 18-121 U/L AST 36 16-55 U/L CREATINE KINASE 99 10-200 U/L GGT 3 0-13 U/L AMYLASE 886 337-1469 U/L LIPASE 302 138-755 U/L ALBUMIN 3.4 2.7-3.9 g/dL TOTAL PROTEIN 6.2 5.5-7.5 g/dL GLOBULIN 2.8 2.4-4.0 g/dL TOTAL BILIRUBIN 0.1 0.0-0.3 mg/dL BILIRUBIN CONJUGATED <0.1 0.0-0.1 mg/dL BUN 28 9-31 mg/dL CREATININE 2.2HIGH 0.5-1.5 mg/dL CHOLESTEROL 180 131-345 mg/dL GLUCOSE 122HIGH 63-114 mg/dL CALCIUM 10 8.4-11.8 mg/dL PHOSPHORUS 3.4 2.5-6.1 mg/dL TCO2 (BICARBONATE) 18 13-27 mmol/L CHLORIDE 112 108-119 mmol/L POTASSIUM 4.3 4.0-5.4 mmol/L Information for Surprise DeLuca Page 1 of 11 SODIUM 147 142-152 mmol/L ALB/GLOB RATIO 1.2 0.7-1.5 BUN/CREATININE RATIO 12.7 BILIRUBIN UNCONJUGATED 0 0.0-0.2 mg/dL NA/K RATIO 34 28-37 HEMOLYSIS INDEX N Index of N, 1+, 2+ exhibits no significant effect on chemistry values. LIPEMIA INDEX N Index of N, 1+, 2+ exhibits no significant effect on chemistry values. ANION GAP 21 11-26 mmol/L SDMA 15HIGH 0-14 ug/dL SDMA is a new kidney function test. It increases earlier than creatinine in some animals with chronic kidney disease. Unlike creatinine, SDMA is not impacted by lean body mass. SDMA and creatinine should be interpreted together, along with a urinalysis.For more information go to www.idexx.com/SDMA.BOTH SDMA AND CREATININE ARE INCREASED which indicates kidney function is likely impaired. A complete urinalysis should be performed to evaluate for inappropriate specific gravity, proteinuria and other evidence of kidney disease. Panel Name CBC COMPREHENSIVE WBC 3.7LOW 4.5-7.5 K/uL RBC 8.12 5.39-8.70 M/uL HGB 20.4 13.4-20.7 g/dL HCT 57.2 50.0-65.0 % MCV 70 59-76 fL MCH 25.1 21.9-26.1 pg MCHC 35.7 32.6-39.2 g/dL % RETICULOCYTE 0.7 % RETICULOCYTE 57 10-110 K/uL % NEUTROPHIL 73.5 % % LYMPHOCYTE 21.7 % % MONOCYTE 2.7 % % EOSINOPHIL 2.1 % % BASOPHIL 0 % PLATELET 162HIGH 80-150 K/uL REMARKS SLIDE REVIEWED MICROSCOPICALLY.NO PARASITES SEEN NEUTROPHIL 2720LOW 2940-12670 /uL LYMPHOCYTE 803LOW 1060-4950 /uL MONOCYTE 100LOW 130-1150 /uL Information for Surprise DeLuca Page 2 of 11 OSINOPHIL 78 70-1490 /uL BASOPHIL 0 0-100 /uL Panel Name URINALYSIS COLLECTION METHOD FREE-CATCH COLOR YELLOW CLARITY HAZY SPECIFIC GRAVITY 1.04 GLUCOSE NEGATIVE BILIRUBIN NEGATIVE KETONES NEGATIVE BLOOD NEGATIVE PH 7 PROTEIN NEGATIVE Protein test is performed and confirmed by the sulfosalicylic acid test. WBC 0-2 0-5 HPF RBC NONE SEEN HPF BACTERIA NONE SEEN HPF EPI CELL RARE (0-1) HPF MUCUS NONE SEEN CASTS NONE SEEN HPF CRYSTALS NONE SEEN HPF OTHER LIPID DROPLETS PRESENT UROBILINOGEN NORMAL Requisition # 19997056 Accession # 2500045546 Panel Name TOTAL HEALTH W/ UA CHEM 27 w/ SDMA ALP 20 5-160 U/L ALT 27 18-121 U/L AST 36 16-55 U/L CREATINE KINASE 99 10-200 U/L GGT 3 0-13 U/L AMYLASE 886 337-1469 U/L LIPASE 302 138-755 U/L Information for Surprise DeLuca Page 3 of 11 ALBUMIN 3.4 2.7-3.9 g/dL TOTAL PROTEIN 6.2 5.5-7.5 g/dL GLOBULIN 2.8 2.4-4.0 g/dL TOTAL BILIRUBIN 0.1 0.0-0.3 mg/dL BILIRUBIN CONJUGATED <0.1 0.0-0.1 mg/dL BUN 28 9-31 mg/dL CREATININE 2.2HIGH 0.5-1.5 mg/dL CHOLESTEROL 180 131-345 mg/dL GLUCOSE 122HIGH 63-114 mg/dL CALCIUM 10 8.4-11.8 mg/dL PHOSPHORUS 3.4 2.5-6.1 mg/dL TCO2 (BICARBONATE) 18 13-27 mmol/L CHLORIDE 112 108-119 mmol/L POTASSIUM 4.3 4.0-5.4 mmol/L SODIUM 147 142-152 mmol/L ALB/GLOB RATIO 1.2 0.7-1.5 BUN/CREATININE RATIO 12.7 BILIRUBIN UNCONJUGATED 0 0.0-0.2 mg/dL NA/K RATIO 34 28-37 HEMOLYSIS INDEX N Index of N, 1+, 2+ exhibits no significant effect on chemistry values. LIPEMIA INDEX N Index of N, 1+, 2+ exhibits no significant effect on chemistry values. ANION GAP 21 11-26 mmol/L SDMA 15HIGH 0-14 ug/dL SDMA is a new kidney function test. It increases earlier than creatinine in some animals with chronic kidney disease. Unlike creatinine, SDMA is not impacted by lean body mass. SDMA and creatinine should be interpreted together, along with a urinalysis.For more information go to www.idexx.com/SDMA.BOTH SDMA AND CREATININE ARE INCREASED which indicates kidney function is likely impaired. A complete urinalysis should be performed to evaluate for inappropriate specific gravity, proteinuria and other evidence of kidney disease. Panel Name CC COMPREHENSIVE WBC 3.7LOW 4.5-7.5 K/uL RBC 8.12 5.39-8.70 M/uL HGB 20.4 13.4-20.7 g/dL HCT 57.2 50.0-65.0 % MCV 70 59-76 fL MCH 25.1 21.9-26.1 pg Information for Surprise DeLuca Page 4 of 11 MCHC 35.7 32.6-39.2 g/dL % RETICULOCYTE 0.7 % RETICULOCYTE 57 10-110 K/uL % NEUTROPHIL 73.5 % % LYMPHOCYTE 21.7 % % MONOCYTE 2.7 % % EOSINOPHIL 2.1 % % BASOPHIL 0 % PLATELET 162HIGH 80-150 K/uL REMARKS sLIDE REVIEWED MICROSCOPICALLY.NO PARASITES SEEN NEUTROPHIL 2720LOW 2940-12670 /uL LYMPHOCYTE 803LOW 1060-4950 /uL MONOCYTE 100LOW 130-1150 /uL EOSINOPHIL 78 70-1490 /uL BASOPHIL 0 0-100 /uL Panel Name URINALYSIS COLLECTION METHOD FREE-CATCH COLOR YELLOW CLARITY HAZY SPECIFIC GRAVITY 1.04 GLUCOSE NEGATIVE BILIRUBIN NEGATIVE KETONES NEGATIVE BLOOD NEGATIVE PH 7 PROTEIN NEGATIVE Protein test is performed and confirmed by the sulfosalicylic acid test. WBC 0-2 0-5 HPF RBC NONE SEEN HPF BACTERIA NONE SEEN HPF EPI CELL RARE (0-1) HPF MUCUS NONE SEEN CASTS NONE SEEN HPF CRYSTALS NONE SEEN HPF OTHER Information for Surprise DeLuca Page 5 of 11 UROBILINOGEN NORMAL CBC COMPREHENSIVE 09/16/2015 12:31 PM Requisition # 19725541 Accession # 2500044873 Panel Name CBC COMPREHENSIVE WBC 4LOW 4.5-7.5 K/uL RBC 8.02 5.39-8.70 M/uL HGB 20.4 13.4-20.7 g/dL HCT 56.3 50.0-65.0 % MCV 70 59-76 fL MCH 25.4 21.9-26.1 pg MCHC 36.2 32.6-39.2 g/dL % RETICULOCYTE 1.3 % RETICULOCYTE 104 10-110 K/uL % NEUTROPHIL 66.1 % % LYMPHOCYTE 28.5 % % MONOCYTE 3.2 % % EOSINOPHIL 2.2 % % BASOPHIL 0 % PLATELET 144 80-150 K/uL PLATELET COMMENTS SCANNING OF THE BLOOD SMEAR REVEALED ADEQUATE PLATELET NUMBERS. DUE TOCLUMPING, THE AUTOMATED PLATELET NUMBER CANNOT BE ACCURATELYDETERMINED. REMARKS SLIDE REVIEWED MICROSCOPICALLY.NO PARASITES SEEN NEUTROPHIL 2644LOW 2940-12670 /uL LYMPHOCYTE 1140 1060-4950 /uL MONOCYTE 128LOW 130-1150 /uL EOSINOPHIL 88 70-1490 /uL BASOPHIL 0 0-100 /uL comPREHENSIVE 09/16/2015 12:30 PM Requisition # 19725541 Accession # 2500044873 Panel Name Information for Surprise DeLuca Page 6 of 11 CBC COMPREHENSIVE WBC 4LOW 4.5-7.5 K/uL RBC 8.02 5.39-8.70 M/uL HGB 20.4 13.4-20.7 g/dL HCT 56.3 50.0-65.0 % MCV 70 59-76 fL MCH 25.4 21.9-26.1 pg MCHC 36.2 32.6-39.2 g/dL % RETICULOCYTE 1.3 % RETICULOCYTE 104 10-110 K/uL % NEUTROPHIL 66.1 % % LYMPHOCYTE 28.5 % % MONOCYTE 3.2 % % EOSINOPHIL 2.2 % % BASOPHIL 0 % PLATELET 144 80-150 K/uL PLATELET COMMENTS SCANNING OF THE BLOOD SMEAR REVEALED ADEQUATE PLATELET NUMBERS. DUE TOCLUMPING, THE AUTOMATED PLATELET NUMBER CANNOT BE ACCURATELYDETERMINED. REMARKS SLIDE REVIEWED MICROSCOPICALLY.NO PARASITES SEEN NEUTROPHIL 2644LOW 2940-12670 /uL LYMPHOCYTE 1140 1060-4950 /uL MONOCYTE 128LOW 130-1150 /uL EOSINOPHIL 88 70-1490 /uL BASOPHIL 0 0-100 /uL Requisition # 19725541 Accession # 2500044873 Panel Name CBC COMPREHENSIVE WBC 4LOW 4.5-7.5 K/uL RBC 8.02 5.39-8.70 M/uL HGB 20.4 13.4-20.7 g/dL HCT 56.3 50.0-65.0 % MCV 70 59-76 fL MCH 25.4 21.9-26.1 pg MCHC 36.2 32.6-39.2 g/dL % RETICULOCYTE 1.3 % Information for Surprise DeLuca Page 7 of 11 RETICULOCYTE 104 10-110 K/uL % NEUTROPHIL 66.1 % % LYMPHOCYTE 28.5 % % MONOCYTE 3.2 % % EOSINOPHIL 2.2 % % BASOPHIL 0 % PLATELET 144 80-150 K/uL PLATELET COMMENTS SCANNING OF THE BLOOD SMEAR REVEALED ADEQUATE PLATELET NUMBERS. DUE TOCLUMPING, THE AUTOMATED PLATELET NUMBER CANNOT BE ACCURATELYDETERMINED. REMARKS SLIDE REVIEWED MICROSCOPICALLY.NO PARASITES SEEN NEUTROPHIL 2644LOW 2940-12670 /uL LYMPHOCYTE 1140 1060-4950 /uL MONOCYTE 128LOW 130-1150 /uL EOSINOPHIL 88 70-1490 /uL BASOPHIL 0 0-100 /uL Requisition # 19725541 Accession # 2500044873 Panel Name CBC COMPREHENSIVE WBC 4LOW 4.5-7.5 K/uL RBC 8.02 5.39-8.70 M/uL HGB 20.4 13.4-20.7 g/dL HCT 56.3 50.0-65.0 % MCV 70 59-76 fL MCH 25.4 21.9-26.1 pg MCHC 36.2 32.6-39.2 g/dL % RETICULOCYTE 1.3 % RETICULOCYTE 104 10-110 K/uL % NEUTROPHIL 66.1 % % LYMPHOCYTE 28.5 % % MONOCYTE 3.2 % % EOSINOPHIL 2.2 % % BASOPHIL 0 % PLATELET 144 80-150 K/uL PLATELET COMMENTS SCANNING OF THE BLOOD SMEAR REVEALED ADEQUATE PLATELET NUMBERS. DUE TOCLUMPING, THE AUTOMATED PLATELET NUMBER CANNOT BE ACCURATELYDETERMINED. Information for Surprise DeLuca Page 8 of 11 Hope Advanced Veterinary Center - Rockville 1 Taft Court Rockville, MD 20850 (301) 637-3228 REMARKS SLIDE REVIEWED MICROSCOPICALLY.NO PARASITES SEEN NEUTROPHIL 2644LOW 2940-12670 /uL LYMPHOCYTE 1140 1060-4950 /uL MONOCYTE 128LOW 130-1150 /uL EOSINOPHIL 88 70-1490 /uL BASOPHIL 0 0-100 /uL TOTAL HEALTH W/ UA, CHEM 27 w/ SDMA, CBC COMPREHENSIVE, URINALYSIS 09/08/2015 11:21 AM Requisition # 19606040 Accession # 2500044503 Panel Name Panel Name TOTAL HEALTH W/ UA CHEM 27 w/ SDMA ALP 21 5-160 U/L ALT 24 18-121 U/L AST 31 16-55 U/L CREATINE KINASE 76 10-200 U/L GGT 3 0-13 U/L AMYLASE 631 337-1469 U/L LIPASE 270 138-755 U/L ALBUMIN 3.7 2.7-3.9 g/dL TOTAL PROTEIN 6.6 5.5-7.5 g/dL GLOBULIN 2.9 2.4-4.0 g/dL TOTAL BILIRUBIN <0.1 0.0-0.3 mg/dL BILIRUBIN CONJUGATED 0.1 0.0-0.1 mg/dL BUN 27 9-31 mg/dL CREATININE 2HIGH 0.5-1.5 mg/dL RESULT VERIFIED BY REPEAT ANALYSIS CHOLESTEROL 199 131-345 mg/dL GLUCOSE 126HIGH 63-114 mg/dL CALCIUM 9.9 8.4-11.8 mg/dL PHOSPHORUS 2.7 2.5-6.1 mg/dL TCO2 (BICARBONATE) 18 13-27 mmol/L CHLORIDE 111 108-119 mmol/L POTASSIUM 3.5LOW 4.0-5.4 mmol/L Information for Surprise DeLuca Page 9 of 11 Hope Advanced Veterinary Center - Rockville 1 Taft Court Rockville, MD 20850 (301) 637-3228 SODIUM 148 142-152 mmol/L ALB/GLOB RATIO 1.3 0.7-1.5 BUN/CREATININE RATIO 13.5 BILIRUBIN UNCONJUGATED 0 0.0-0.2 mg/dL NA/K RATIO 42HIGH 28-37 HEMOLYSIS INDEX N Index of N, 1+, 2+ exhibits no significant effect on chemistry values. LIPEMIA INDEX N Index of N, 1+, 2+ exhibits no significant effect on chemistry values. ANION GAP 23 11-26 mmol/L SDMA 8 0-14 ug/dL SDMA is a new kidney function test. It increases earlier than creatinine in some animals with chronic kidney disease. Unlike creatinine, SDMA is not impacted by lean body mass. SDMA and creatinine should be interpreted together, along with a urinalysis.For more information go to www.idexx.com/SDMA.SDMA IS WITHIN THE REFERENCE INTERVAL AND CREATININE IS INCREASED which indicates kidney disease is possible. Muscular dogs with normal kidney function may have a normal SDMA and creatinine just exceeding the reference interval. Assess body condition and complete urinalysis to help determine significance of these results.RESULT VERIFIED BY REPEAT ANALYSIS Panel Name CBC COMPREHENSIVE WBC 3LOW 4.5-7.5 K/uL RBC 7.86 5.39-8.70 M/uL HGB 19.9 13.4-20.7 g/dL HCT 55.9 50.0-65.0 % MCV 71 59-76 fL MCH 25.3 21.9-26.1 pg MCHC 35.6 32.6-39.2 g/dL % RETICULOCYTE 0.4 % RETICULOCYTE 31 10-110 K/uL % NEUTROPHIL 68 % % LYMPHOCYTE 24.6 % % MONOCYTE 4 % % EOSINOPHIL 3.4 % % BASOPHIL 0 % PLATELET 139 80-150 K/uL REMARKS E REVIEWED MICROSCOPICALLY.NO PARASITES SEENPLEASE NOTE NORMAL REFERENCE RANGE FOR GREYHOUNDS (NOT ITALIANGREYHOUNDS): Platelet Count: 80,000- 150,000/uL WBC Count: 4,500-7,500/uL PCV (HCT): 50-65% NEUTROPHIL 2040LOW 2940-12670 /uL Surprise DeLuca Page 10 of 11 738LOW 1060-4950 /uL MONOCYTE 120LOW 130-1150 /uL EOSINOPHIL 102 70-1490 /uL BASOPHIL 0 0-100 /uL Panel Name URINALYSIS COLLECTION METHOD FREE-CATCH COLOR YELLOW CLARITY HAZY SPECIFIC GRAVITY 1.039 GLUCOSE NEGATIVE BILIRUBIN NEGATIVE KETONES NEGATIVE BLOOD NEGATIVE PH 6 PROTEIN TRACE Protein test is performed and confirmed by the sulfosalicylic acid test. WBC NONE SEEN 0-5 HPF RBC NONE SEEN HPF BACTERIA NONE SEEN HPF EPI CELL RARE (0-1) HPF MUCUS NONE SEEN CASTS OCC HYALINE (0-1) HPF CRYSTALS NONE SEEN HPF UROBILINOGEN NORMAL Edited October 15, 2015 by SanTanSnuggles Quote Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted April 11, 2016 Share Posted April 11, 2016 (edited) Update on Surprise: Yesterday we found a 7 millimeter size hard lump on his leg just above where he had the previous growth removed. We check him every other day, so this came up very fast.Last night, Surprise started licking that leg. I called the Oncologist at the Hope Center and we have an appointment for him in the afternoon for her to take a look. I also noticed that on his ankle, on the same leg, that the bone appears to be sticking out a little more than the right front leg. He had an appointment for a full work up scheduled on the 26th of this month. Up until now he has been doing very good. We did notice that for the past couple of days, that he has been laying around a little more and playing less. Please say a prayer for our big boy that he will be fine and there is no problems for him. He is so sweet and friendly. This is a link to the video of him playing in the snow in February 2016, Just click the arrow on the video to see our big black and white Surprise play. He is now seven years old. http://s1040.photobucket.com/user/littlesix2010/library/ Edited April 11, 2016 by SanTanSnuggles Quote Link to comment Share on other sites More sharing options...
RaineysMom Posted April 11, 2016 Share Posted April 11, 2016 sending many prayers! :Hope Quote Kim and Bruce - with Rick (Rick Roufus 6/30/16) and missing my sweet greyhound Angels Rainey (LG's Rainey 10/4/2000 - 3/8/2011), Anubis (RJ's Saint Nick 12/25/2001 - 9/12/12) and Zeke (Hey Who Whiz It 4/6/2009 - 7/20/2020) and Larry (PTL Laroach 2/24/2007 - 8/2/2020) -- and Chester (Lab) (8/31/1990 - 5/3/2005), Captain (Schipperke) (10/12/1992 - 6/13/2005) and Remy (GSP) (?/?/1998 - 1/6/2005) at the bridge"Always do sober what you said you'd do drunk. That will teach you to keep your mouth shut." -- Ernest Hemmingway Link to comment Share on other sites More sharing options...
Rickiesmom Posted April 12, 2016 Share Posted April 12, 2016 Hoping whatever this is will be manageable. Watching for an update and sending white light. Quote Link to comment Share on other sites More sharing options...
Batmom Posted April 12, 2016 Share Posted April 12, 2016 Best thoughts for your darling boy! Quote Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in IllinoisWe miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10. Link to comment Share on other sites More sharing options...
4My2Greys Posted April 12, 2016 Share Posted April 12, 2016 Adding the best of wishes and white light for Surprise. Quote Link to comment Share on other sites More sharing options...
Patsy Posted April 12, 2016 Share Posted April 12, 2016 Of course! Quote Patsy and DH with the Humane Society specials, Linus & Jazz, in North Dakota Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted April 14, 2016 Share Posted April 14, 2016 hemangiopericytoma is back and Surprise is being operated on again this morning. The Hope Center in Rockville, MD will be attending the matter this time. Please pray for clean margins this time. We will learn of results by about Monday. Quote Link to comment Share on other sites More sharing options...
MP_the4pack Posted April 14, 2016 Share Posted April 14, 2016 Quote Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted May 12, 2016 Share Posted May 12, 2016 Back I am. Surprise again, did not get clean margins after the surgery. The growth removed was very small and it was removed just a couple of days later. I am working with my vet in Mount Airy Animal Hospital and she and Dr. Couto have gone over Surprise's information and she will be starting the chemo shots with the sesame oil late on Friday, May 13, 2016. I am hopeful and excited. I am so grateful to everyone on greytalk and my special friend B, because without them we would not have learned all that we have and we would not have had the opportunity to to know about Dr. Couto, and http://greyhoundhealthinitiative.org/. Quote Link to comment Share on other sites More sharing options...
JJNg Posted May 15, 2016 Share Posted May 15, 2016 Glad your vet is working with Dr. Couto, and I hope everything goes well. Quote Jennifer & Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On), Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice Link to comment Share on other sites More sharing options...
EllenEveBaz Posted May 15, 2016 Share Posted May 15, 2016 Adding even more good wishes Quote Ellen, with brindle Milo and the blonde ballerina, Gelsey remembering Eve, Baz, Scout, Romie, Nutmeg, and Jeter Link to comment Share on other sites More sharing options...
SanTanSnuggles Posted September 19, 2016 Share Posted September 19, 2016 Tomorrow evening Surprise goes yet again to get his leg examined. There seems to be a new lump on the same front left leg. Small, but in a slightly different place. It is in the very front of the leg and not on the inside of the leg like the other two that were removed. He did good on the shots the vet gave him to fight the 2nd lump. He had no reactions to the shots to write home about. We are praying this is not another problem. I am hoping that it could just be scar tissue or such. It was a year ago in July that these issues first began. surprise is eight years and seven months old on sept 22. Quote Link to comment Share on other sites More sharing options...
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