Hemangiopericytoma

[JJNg]

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.

[SanTanSnuggles]

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.

[JJNg]

How is Surprise doing? I saw that he's going to start on oral chemo? What protocol are they going with?

[SanTanSnuggles]

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

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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.

[JJNg]

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.

[SanTanSnuggles]

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.

[JJNg]

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.

[SanTanSnuggles]

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.

[SanTanSnuggles]

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.

[JJNg]

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

[SanTanSnuggles]

Thank you for the article. I printed out all 19 pages.

[NeylasMom]

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.

[SanTanSnuggles]

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

[SanTanSnuggles]

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

[RaineysMom]

sending many prayers! :Hope

[Rickiesmom]

Hoping whatever this is will be manageable. Watching for an update and sending white light.

[Batmom]

Best thoughts for your darling boy!

[4My2Greys]

Adding the best of wishes and white light for Surprise.

[Patsy]

Of course!

[SanTanSnuggles]

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.

 

[MP_the4pack]

[SanTanSnuggles]

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/.

[JJNg]

Glad your vet is working with Dr. Couto, and I hope everything goes well.

[EllenEveBaz]

Adding even more good wishes

[SanTanSnuggles]

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.