Need Some Advice-Enlarged Spleen And Anemic

[Guest chillychill1207]

Hello. First major post here. I have been reading all your posts for years but now we need some advice over here.

 

Brief History (very)- Shep is 11.5 years old. He was limping for 2 years on and off. We did everything short of and MRI. specialists ,blood test.,exrays on spine and entire leg, Meds etc... He is currently on tramodol 2 pills twice a day and one 75mg Rimady for the last 6 months and has been doing well. Limping decreased due to the hot compresses and wrapping of the foot. For some reason it got better.? No visible corns and still able to climb the stairs and jump in bed. PHEW...

 

Another issue arose- The past 4 weeks something wasnt right. He was sleeping more and I kept telling myself this is a senior dog. All the books say its normal. Dont panic. I started to get more worried when he became a picky eater 2 weeks ago. (again maybe old age?) but after a handful of times panting for no reason in the middle of the night-I said its time to check this out. his gums looked pale for the past week too.

 

Today we took Shep to meet with Radiology for an Ultra sound on his belly and other organs.I did this because This is my first Dog and I wanted to see if anything bad showed up on organs. To me it was worth the 400.00 for knowing. Well... what showed was this-

Spleen-Massive Splenomegaly with diffuse,mixed echoic parenchymal echostructure alteration. A small localized,peri-capsular effusion is associated with the spleen. The spleen capsel is intact. There are mottled areas of parenchymal infraction in the splenic head region.

 

Basicly I was told this was a 90% chance of cancer.

 

Options- take fluid from the area and confirm this is cancer and see the options.- steriods,chemo,or time to say goodbye....Or removal of the spleen and start chemo. Either way he said 2 weeks to 5 months time frame.

 

To top it off he was then retested for his blood. His PVC/TS was 22/5.4 I think a greyhounds RBC is suppose to be at 77 says the Dr. He has severe anemia (which now explains the occasional panting and pale gums, lack of hunger.

The DR. said its causing his heart to beat irregularly and he is in a very weak state. (can i say shocked???????what??????) To even go forth with the aspiration he would need to get treated for the anemia first. Thats 12 hours monitired to see if he will accept a blood transfusion. If after the testing he wont produce red cells on his own, they would basicly assume or know this is coming from the bone. If he can accept a transfusion he should be ok for the fluid drawing in the spleen. But that is 1500-2000 later and lots of anxiety for him if it may only prolong his life for 4 months. I mean, the tumor is there no doubt. The liver is slightly enlarged. but the other organs look good- no masses or anything.

 

All this seems so much for me to take. He is my first greyhound.. My Best Friend.

This is the worst decision I ever had to make...

I didn't start crying yet. (every second I am fighting it. But I know once I start crying, i wont stop and it means I give up. Right now, Im in Mommy work mode trying to find any HOPE I can. Tomorrow after we get the additional blood results (to see if anything other wacky is showing up with his CBC) I will have to see which way to go.

 

 

Any suggestions?

[45MPHK9]

carrie, no advice just hugs. we're here if you need us.

[tbhounds]

First welcome and second-I'm sorry Shep is ill. Did your vet mention the fact that this could be the result of an over active spleen secondary to an immune mediated disease?? A big narly spleen doesn't always mean cancer. Many of the nodules seen just might be benign--not that all uncommon in our oldies. Don't want to give false hope but, I think it's something worth following up on.

His pcv%(HCT) is truly low but, the Total Solids (TS) is normal. You do need to see what the rest of the cbc shows--what's his rbc, wbc, platelets and if they see any spherocytes etc. I would also run a vector borne (tick) panel.

A transfusion would make him feel better immediately---I wouldn't hesitate to do so. Most of our hounds are DEA 1. neg It's usually done over a couple of hour period--his temperature will be monitored throughout the transfusion--if it spikes then you know he's rejecting the blood. Overall, it's a rather easy procedure but, he needs to be monitored.

I assume that this is a large university or referral hospital that you are working with?? If so, I personally would have the splenectomy performed. Splenectomy's are not a difficult surgery, however, in your boys case it may be presented with complications--so, having an ICU unit to recover in is necc.

Keep us posted.

[Batmom]

I'm so sorry you're facing this.

 

I really can't add much to what tbhounds said. I would probably start with doing the transfusion and taking some fluid from the area; I'm assuming that could be analyzed same day at your hospital? I'm not sure why he would need a transfusion before an aspirate (taking the fluid) is done unless, due to the location, the docs feel they must anaesthetize your boy.

 

Sending many hugs and prayers for you and your pupper.

[MP_the4pack]

I am so so sorry you're going thru this. I've lost two to splenic cancers. Brindle (my first) had hemangiosarcoma. She seemed fine that morning, was gone that night.

Pearl (my heart and soul)had Fibrosarcoma. We did the splenectomy. That cancer was already in her liver. Those masses grew an incredible centimeter a day. She lasted 2 weeks post surgery. It was an awful two weeks as we were trying chemo.

 

I'm sorry, I don't have better news. You can contact Dr. Couto at OSU, maybe he'll have a suggestion, but the fact your boy's anemic means he's already bleeding internally.

[Guest chillychill1207]

Hi its Thursday morning at 10:30.

Thanks for all your advice everyone. I did get the bloodwork just emailed to me. It was also emailed to my regular Vet who should be calling me by noon to go through it all with me.

 

Shep did ok last night. He always seems worse when he comes home from Vets offices which is why I try to be with him through the entire time. He ate all his food.(i put it down in his bed, and didnt take his tramodol well...so we kept trying to hide it in something..we got one in..At midnight.we went out for out last nightime walk. His back feet were draging under. He has NEVER dragged his feet like this. I thought two things-what the heck did they do to him? Did they agrivate something during the ultrasound? did he fall when they were taking blood? Then I thought, Maybe he is so depleted of red blood cells it causing his loss of balence. Not getting to the brain to make the choices to pick up the foot.

30 min later he walked himself upstairs to bed with us with no problem what so ever. He panted last night on and off for 2 hours. I rubbed his head and took a cold washcloth over his head. He always likes that and it calmed his breathing. At 4am, he jumped up in my bed and curled up on "his side of the bed" He is so calm...breathing slow. I call mornings these days our happiest times together where I can pet him.hug him without him flinching or being grumpy

 

Spoke to my Vet last night who called me after hours at 9pm-He has 3 greyhounds of himself. He said it doesnt look good and went through all the options again in 6th grade terms so I could really hear it this time. He was honest and I asked what would you do if this was YOUR dog...I knew today I would REALLY make a plan. Here are the blood results- As I said- Dr. didnt go through this with me yet. I will update u when he calls. Feel free to comment. Thanks everyone for reading.

 

heres the result- This is after 16 hours of fasting and 3 hours of no water- to me it looks terrible.... the range is for most breed. not suire what greyhound levels should be. Will have to look that up.. One thing is he has always had a high Bilirubin for the last 4 years (something he and I both had in common)

 

Test Value Units Range

 

Total Protein 5.9 g/dL (5.0 7.4)

Albumin 3.4 g/dL (2.7 4.4)

Globulin 2.5 g/dL (1.6 3.6)

Albumin/Globulin Ratio 1.4 Ratio (0.8 2.0)

AST (SGOT) 63 U/L (15 66)

ALT (SGPT) 55 U/L (12 118)

Alkaline Phosphatase 33 U/L (5 131)

GGTP <5 U/L (1 12)

Total Bilirubin H 0.4 mg/dL (0.1 0.3)

Urea Nitrogen 22 mg/dL (6 31)

Creatinine 1.1 mg/dL (0.5 1.6)

BUN/Creatinine Ratio 20 Ratio (4 27)

Phosphorus 4.0 mg/dL (2.5 6.0)

Glucose 100 mg/dL (70 138)

Calcium 9.4 mg/dL (8.9 11.4)

Corrected Calcium 9.5

Magnesium 1.9 mEq/L (1.5 2.5)

Sodium 151 mEq/L (139 154)

Potassium 4.6 mEq/L (3.6 5.5)

Na/K Ratio 33

Chloride 117 mEq/L (102 120)

Cholesterol L 89 mg/dL (92 324)

Triglycerides 40 mg/dL (29 291)

Amylase 1002 U/L (290 1125)

Lipase 108 U/L (77 695)

CPK 4 22 U/L (59 895)

 

Test Value Units Range

 

Hemoglobin L 7.4 g/dL (12.1 20.3)

Hematocrit L 23.9 % (36 60)

WBC H 20.6 10e3/uL (4.0 15.5)

RBC L 2.60 10e6/uL (4.8 9.3)

WBC CORRECTED FOR NRBC

MCV H 92 fL (58 79)

MCH H 28.5 pg (19 28)

MCHC 31.0 g/dL (30 38)

Platelet Count L 109 10e3/uL (170 400)

 

Neutrophils L 56 % (60 77)

Bands 0 % (0 3)

Lymphocytes H 33 % (12 30)

Monocytes 10 % (3 10)

Eosinophils L 1 % (2 10)

Basophils 0 % (0 1)

Hypochromia Slight

Anisocytosis Slight

Spherocytes None Seen

Polychromasia Moderate

Blood Parasites None Seen

NRBC H 12 /100 WBC (0 1)

WBC CORRECTED FOR NRBC

Comments

1+ Macrocytes

HOWELL JOLLY BODIES NOTED

Absolute Neutrophils H 11536 (2060 10600)

Absolute Bands 0 (0 300)

Absolute Lymphocytes H 6798 (690 4500)

Absolute Monocytes H 2060 (0 840)

Absolute Eosinophils 206 (0 1200)

Absolute Basophils 0 (0 150)

Edited December 16, 2010 by chillychill1207

[packmom]

Its horrible you have to go through this!

I can just relate our recent experience. Arwen had a mass in her liver and was clinically diagnosed with hemangiosarcoma. She had surgery to remove the mass and her sleen which looked "wonky". Her bloodwork had been off which was why they went looking for something, but I don't remember what her levels were. Pathologists cannot confirm the hemangiosarcoma but the doctors believe it was. This is Dr. Couto and the top surgeons and oncologists at OSU I'm talking about! So based on her symptoms we treated her with chemo. She is doing fine. Now, she was not in a very weakened condition before surgery so I really don't know what I'd do in your case. Chemo can be hard on some greys-they just don't tolerate it well. I've had 2 who had to stop their chemo early because they had lost too much weight. (those 2 did survive their cancer)

[TheFullHouse]

I've been through it myself. With our boy, the mass would rupture and he would bleed internally, the signs were pale gums, and absolutely no energy what so ever. He couldn't make it up the stairs by himself. The tumor would then seal itself and he would act fine until it ruptured a second time. That time he bled into his belly. We were left with the option of surgery, which our vet said would only give us about 3 more months or letting him go. We weren't going to put him through surgery for just 3 more months so we had to let our boy go.

 

I'm so sorry you're going through this. I wish for the best outcome possible for you.

[Burpdog]

Have you done a tick panel on him at Protatek?

[Guest chillychill1207]

Hello. Just an update.

 

Thursday Dec 16th- After hearing the blood results yesterday we came in the the specialist Docs at 2pm with Shep to talk to him more. I did bring a hamburger for Shep (His fist Mc D's ever) he didnt eat in the morning and didnt take his pills. Although signs pointed to cancer as the doctors mentioned , the only way to truly find out would be the spleen biopsy. For him to even be able to get the biopsy he would need to be treated for anemia first and some prior testing done (blood clotting time etc..) Shep ate his hamburger!...We decided to leave him there overnight- I told the DR. I needed a reason to put this dog down. an answer. a visual. Some may disagree but I would rather spend 1000 dollars to know, then put him down and spend my entire life wondering if I could have done more or have learned more or pursued this more. That being said He stayed in the ER last night and received a transfusion,ekg, and monitored. Tomorrow he will have the biopsy if all goes well.

 

 

Friday Dec 17th- I woke up bright and early and drove 30 min the the vet center to Visit with Shep. I wanted to make sure he was walking better and the new blood was getting levels back up and to see him before he went to have his small biopsy procedure. I arrived there at 730am and had to wait an hour because they were doing rounds. The nurse told me they wanted to speak with me first. I started to cry. I had a bad feeling. My feeling was right. Shep wasn't doing as great as I hoped. His Transfusion elevated the RBC's slightly which is good but all the other blood work looked terrible still. They said even the biopsy was risky. His heart was very weak and not beating properly.We thought the transfusion would help with the heart beat but It wasn't helping. His platelets were 81,000 and that was too low. They were not comfortable enough with him to go through the biopsy because if he began to bleed they wouldn't be able to stop it unless they wheeled him to major surgery for a splenectomy. - if he even survived that.My options were shot. They also said a splenectomy is major surgery and its risky for him, He would need 2 transfusions and they the tissue would be tested. In the meantime while were waiting for results, we are still dealing with the heart and anemia issue. They did offer us an option to do a fine needle asperation but that would only show problems like lymphoma. They also offered a possible bone marrow testing. If the bone marrow test came back cancer then its too late anyway unless we start on a aggressive does of chemo.(which I decided not to do) I opted not to do those 2 testings. At this point its noon,I had it all sink in...crying and knowing all the options. None looked great and if I tried it all, I may be 7000 in the hole with a sick dog they may or may not get better. They told me the platelets wouldn't go up.

 

With his spleen very enlarged, his breathing heavy, heart skipping and anemia they looked me in the eye and said your dog is very sick. I cried my eyes out because I knew it was time. Time to say Good bye. I know it was the right thing but I will always wonder if I could have done more or what demons were growing in him if any at all. I know he was very sick. I had a feeling for sometime he wasnt well and we all started mentally getting ready when he turned 11. Nothing gets you prepared for this. He did go in peace on his big fluffy bed we had brought in. We were there with him until the end. RIP SHEP

 

Shep you were my best buddy in the entire world. You came as a return to me at age 7. I saw you on pet finder and KNEW instantly you were my mate! You were my first Greyhound and you were the reason why I became a greyhound nut,advocate, fostered others and adopted Tori shortly after. Everyone that knows me knows that I put you before me or anyone else even my other half Dan. I will think of you everyday and REALLY hope I get to see you again. You took a CHUNK of my heart and I dont think I will be the same again.

 

 

shep turns 10 May 6,2009

 

 

[45MPHK9]

Reading this at work and crying. I am so,so sorry Carrie.

[TheFullHouse]

I'm so very sorry for your loss. You did everything you possibly could for him. This disease is a horrible one and unfortunately most of us don't find out until it's too late. My heart goes out to you. Godspeed Shep.

[HoundHeavenAZ]

I'm so sorry for your loss. Shep was a lucky boy to have such a loving Mom.

[greyhead]

Carrie, I'm so very sorry for your loss. I know you must be devastated. But for what it's worth, you gave Shep a very wonderful life that any hound could envy. And I'm so happy for him that he had that, as well as happy for you that he brought you into the world of greyhounds. You did all you could. Remember the good times.

:grouphug

[Hubcitypam]

[Batmom]

I'm so sorry.

 

Godspeed, beloved boy.

[tbhounds]

He was very sick and you made your decisions with love. Believe me, I truly know how much it hurts. I have been there recently myself and I had to come to the realization that some things just can't be fixed. We do the best we can for them and when it becomes time we must release them into other hands. I'm so very sorry.

[Guest Adrianne]

Oh, oh, oh......I am so sorry. It is so hard, I know, to hope and think that we can fix what's wrong and then come to the bitter realization that sometimes we can't, no matter what we're willing to do or how much we're willing to spend. I agree that everything you did was done with love.