Low Platelet Count For Lacy - And Getting Lower

[tbhounds]

Oh-I forgot you already consulted with Osu--please update with their response. Hang in there.

[KF_in_Georgia]

Delighted to hear your girl's platelets are up.

 

Remember that warming food seems to make it more attractive to dogs. Even warm water added to kibble makes the kibble more attractive.

 

And you can feed vanilla Ensure: it's sweet, nourishing, and calorie-laden (350 calories in 8 oz). It's also lactose-free and gluten-free.

[Guest OurLacyandJax]

Vanilla Ensure? I would have never thought about that one! Thanks Kathy! Will see if she likes it.

 

Yeah, her kibble is almost always wet, with some hot water in it, shaken briskly for a few minutes that makes a little kibble juice gravy for her. She goes through it when she is hungry. I think it is a combination of the three meds that is making her not all that interested in food, unless it is some grilled chicken. I think both she and the boy Jax are also spoiled rotten by me, as my wife says..:-)

 

She seems to walk a lot better when i just took her out. Hardly a limp. Hmm. We shall see.

[juliemac]

I buy beef broth in large boxes, and pour a tablespoon on my dog's kibble when I need them to eat ... perhaps that will make it more appetizing?

 

Glad to hear the improvements ... and i hope your wife is recovering from HER injury.

[greytlucy]

I'm just reading this....my poodle got really sick about a year and a half ago, right before his first birthday. He'd had a long series of infection(we now suspect maybe something auto immune related to vaccine reactions) and next thign I knew he was really lethargic and not well. When I took him in his platelets were 18,000! All his lymph nodes were also enlarged along with high lymphocytes so lymphoma was suspected.

 

I took him to an internal specialist here in Phoenix...we never did figure out exactly what was wrong with him as everything did test negative and he did eventually get well. But some ATBs, a little pred, etc....and eventually he was better even if all the vets were still scratching their heads. Knock wood he hasn't had a relapse since(and only had a 3 year rabies vaccine since which he did have a reaction to).

 

I hope you have similar good turns with your dog. it was really scary when he was so sick and his platelets were so low...once he was feeling better it was REALLY hard to keep an 11mo old puppy down but I couldn't risk any sort of activity that might cause bruising.

 

Sounds like you guys are good in hands. Wishing all of you good health soon!

[EllenEveBaz]

Keeping all paws crossed here for your girl. (And sending cyber bandaids to your wife. Scary!)

[Guest OurLacyandJax]

Hmm. The CBC count shows a lymphocyte count of over 12000! That is from a value of 1961 from Nov 3rd. We are on a hold pattern with the current treatment of Pred and Doxy till next Monday, and then recheck and decide.

 

Not at all sure what to make of it. Sure it could be lymphoma but how in the world did all this happen from 11/3 till now, I have no idea.

 

The dog was running circles around the couch and eating well in the first week of November, and then when we accidentally noticed the low platelets, we ended up with the Pred and Doxy treatment, and ever since then, she has been so tired, her appetite went away (for kibble at least) and her numbers are all over the place.

 

I also remember a conv with my wife over the summer when we noticed that she was irritated above the tail on top of her rump, and it looked like she had gotten bitten by something. Apparently happened when my wife took her for her walk, and while on it, Lacy just whipped around to bite at her rump area, as if something was there. Wife noticed something moving ("could have been tick - not sure") but could not catch it before it fell into the grass. I know she got bit that time, and she had some skin irritation right there soon enough, which went away once the Frontline acted. And I didn't think anything much of it - because of my lack of knowledge of what these things can do.

 

That event is now sitting in my head bothering me - that she has something tick related. Not much to do about it now, but continue on the Doxy treatment and hope for the best.

 

Thanks to all the info guys about the food! She does love her Ensure. Wife is healing ok - sore still where the tetanus shot was. The bite does look like it is healing well.

Edited November 27, 2012 by OurLacyandJax

[KF_in_Georgia]

It may seem that this has all happened quickly, but in reality it has moved slowly enough that you've had time to deal with trouble as it arises, and that has kept Lacy with you.

 

Fingers crossed.

[Guest OurLacyandJax]

I don't know if I can stand to see our girl like this. She is wobbly when she stands. Lots of panting, peeing. Her poop has changed color to a dark brown. It could be because all she wants to eat (and that too less and less) are her TJ's treats. She still likes some grilled chicken.

 

I know she is suffering - i know just by how much weight she is losing. Her strength is practically gone. I can feel her every bone now, and the hip bones are looking pronounced. I look at her, all i can do her is hold her close and cry. Today has been just bad for both of us. I am trying not to make my wife upset at work.

 

I think I am going to take her to the specialist tomorrow and have a CBC done, and may be even another ultrasound if she recommends it.

 

I just had my first discussion with her primary vet about letting her go. Kills me. I mean how can I go through with this if she still eats some food? How do u make that call?

[Guest mld]

I thought that this was a good article;

 

http://greytarticles.wordpress.com/think-pieces/when-is-it-time-to-say-goodbye/

[Chicocat]

It's so difficult to make that final decision but foremost my decision has always considered quality of life.

 

"I know she is suffering"

[KF_in_Georgia]

Anil, I've been in that spot--wondering how I could put Jacey to sleep when her biggest problem at that point was that she wouldn't eat? Do you put a dog to sleep because it has an upset stomach?

 

I forget: is Lacy taking Cerenia to deal with nausea? And has your vet tried an appetite stimulant?

 

See if Lacy's blood count has risen enough that you can decrease the Prednisone. Don't worry too much about how she looks: Prednisone melts off muscle, and she can get that back if she gets well enough to eat. If her blood count hasn't improved (and you may want to ask for a manual count, not just a machine count), then it may be time to make that very hard decision.

 

I didn't make the decision initially when Jacey wasn't eating. For her sake, I'm sorry I didn't make it, but I had to give her a chance to turn the corner. We were still hoping for a better platelet count. (Jacey's count never improved as much as Lacy's did.) When it was obvious we weren't going to get better numbers on Jacey, making the decision was heart-breaking...but easier.

[Guest OurLacyandJax]

Thank you for the article. Yes, it helps. And Kathy, yes good advice, both of you.

 

Suffering is a tough word to quantify. Does she stand up and look me straight in the eye? Yes she does. She's wobbly, esp the hind quarters. Could that be the Tramadol?

 

She does pant - but that's gotta be the Prednisone. Right now, her eyes are closed, she's curled up, but her breathing is ragged and choppy. Fast. Is that just the Pred making her do that? Could be.

 

Her appetite is down for sure but she still managed to eat some kibble and wet dog food this morning, and a grilled chicken breast later, and some Ensure. May be that's all someone who's sick and drugged on the Doxy, Pred and Tramadol can eat.

 

So yes, I want to keep trying, but I am getting beaten down mentally by her plight. But then the terror of letting a dog who could be on the hard road to recovery go strikes me.

 

Yes, I will do a count tomorrow to see if there is a difference.

[JJNg]

Good advice above, but I just wanted to point out that it doesn't seem certain whether Lacy's signs are primarily side effects of pred or actually related to illness. Reading back through this thread, the low platelet count was an incidental finding from routine bloodwork, and she really didn't show signs of being sick until after she was started on medication. It's possible that this just coincided with progression of disease, but it may also indicate that her signs will improve when she can be weaned off the pred. I believe that whether the pet has a treatable or reversible condition also needs to be factored into the decision for euthanasia.

 

When Willow was so sick a couple years back with a suspected TBD, there was a period when I questioned whether to continue because she was in severe pain and obviously suffering. I even spoke with an animal communicator. Because we didn't have a definite diagnosis, and there was the chance that it was a treatable infection, we persisted through the rough days, and Willow made a complete recovery.

 

I know there isn't always a happy ending, but just wanted to point out that just because a dog is suffering doesn't necessarily mean euthanasia is the best or only option - we need to look at the whole picture. I hope that your next vet visit provides some answers that will help you with this difficult decision.

[Guest OurLacyandJax]

Thank you JJNg. Again, you all are so terrific in clearing the murkiness out. That is exactly the situation I am in.

 

I was thinking the same - as I sat here just now, feeding an entire raw chicken breast to her in pieces, which she ate, practically gobbled through her panting - that even if we had not put her on the Pred, she might still have bruised, or worse had an internal bleeding or something.

 

That coincidence you were talking about is what is making me question. May be this is a dog who doesn't take kindly to Pred. The specialist said that, and lowered the dose to 40Mg a day. For a sensitive dog - for any dog - that is still a high dose. So may be she will lower it some more if the count is going up. I mean - things just changed dramatically since she went on it including the super high lymphocyte count now..

 

I just hope the continued cycle on Doxy just saves her..or something - bad or good - will be revealed tomorrow in the ultrasound etc.

 

A few questions for you all. If she is liking only chicken breasts - raw or grilled - is it ok to just be on that, and hardly much of anything else?

Should I send her feces to lab just because the color is a lot darker? No obvious signs of any blood. Nothing at all. Just darker brown poop.

 

And for my other dog Jax - how do I prevent him licking an wound he managed to get on his thigh? It was all scabbed over, and he managed to lick it open, and now it is getting bigger because of his tongue. I have tried the band-aid route, but no good result, not to mention it sticks to his fur when I try to remove it.

 

And Kathy, no, no cerenia or appetite stimulant.. I just tease her with the chicken breasts, and she seems to go for it every time, at least the raw kind.

[3DogNite]

I haven't responded to any previous posts, but wanted to jump in now,, to offer what support I can.

 

17 months ago, my boy Lazer died in my back yard! I revived him... we have struggled thru MANY roller-coster ups and down, and twists and turns with his disease. He is ALIVE, happy and doing very well today!! Greyhounds have an AMAZING ability to re-bound, given the chance.

I went thru several episodes of - is this the medicine or the illness - and i have to say, i always went with my GUT FEELING. sometimes my

gut was not what the vet was saying,, sometimes it was.

 

I guess what I want to say is - You are doing the very best for your baby! Lacy knows this, she can feel it - Good WORK!!!!

I know how hard this process is.

Keep a diary - Read it daily - I still look back and shake my head and am thankful we've made it this far!!!

Stay strong - look for the small things to give you a sign.

 

My boy LIVED on Raw Hamburger - literally - for months - it was the only thing he would eat - and he still get's raw meatballs that hold all his pills - he takes them 2x day and i swear says "thank you mom" when he is done.

 

Good luck, stay strong! trust your instincts.

Lorinda

[KF_in_Georgia]

The darker poop could be more issues with her platelets. Jacey had that same thing going on. It won't hurt to take a sample to the vet when you go and let the vet decide whether to test.

 

The articles people posted and comments on quality of life are relevant when the dog in question is suffering from something that is inevitably--sooner or later--fatal (something like heart disease, kidney trouble, liver failure, cancer, etc.). My Jacey and your Lacy had/have something that has a better than 50-50 survival rate. It's not a question of extending the dog's life in hopes of getting a few more good days or weeks; it's a matter of extending the dog's life in hopes of turning this thing around completely. If you and Lacy want to fight, then keep fighting.

 

Regarding a diet of nothing-but-chicken: ask your vet about vitamins. My vet once recommended children's chewable vitamins for Sam--just make sure they aren't sweetened with Xylitol. But get your vet to confirm this in light of Lacy's meds.

 

As for Jax: boxer shorts. Put them on him backwards, and let his tail escape through the fly. You can stick a mini sanitary pad to the inside of the shorts to keep them from sticking to his wound and help absorb any oozing from the injury.

Edited November 29, 2012 by KF_in_Georgia

[Guest OurLacyandJax]

3DogNite, glad your Lazer is back and good! He looks like our Lacy girl. Great story there!

 

And yes, I am always looking for signs.. When she is super happy and healthy and happy to see me as she is laying on the landing, she sometimes gives me a couple gentle licks on my face when I talk about Daddy or Mommy. Her all time favorite words are "grandma" and "ride". I still get a look, a very alert stare from her with that one.

 

I think I will take her poop tomorrow for an analysis as well. And yes, I was concerned about vitamins and other minerals. I will ask the vet for supplements - the specialist is in fact an expert on nutrition as well.

 

Seriously, it is a yo-yo ride. Just took her out, and she walked strongly. I am thinking the Tramadol might have calmed her and helped her to doze off, but it did not help her stability earlier and makes her look weaker than she is.

 

Ah as much as we would love to see Jax in one of my boxers - i think hilarity would ensue, much needed today - it might not help with the issue. The wound is closer to his front knee, lower. And he is a fairly big boy. Part of his last band-aid I put in desperation is stuck to his fur and he winces when I try to peel it away. May be some warm water might help the removal. I tried stretchy wrap bandages, it lasted about a minute because of the narrowing part of his leg.

 

Thanks guys.

[KF_in_Georgia]

Okay, kid's pajama bottoms for Jax. Longer leg.

 

Tramadol is useful but sometimes--at higher doses--it causes panting and pacing and the appearance of anxiety. So if she's worse soon after her Tramadol meds, then better later, it might be the Tramadol causing the symptoms.

 

P.S. Hilarity is no bad thing. What I have in mind for Silver's pictures with Santa is going to be...interesting. (But how fast can I knit between now and 8 December?)

Edited November 30, 2012 by KF_in_Georgia

[tbhounds]

Remind me -why is she on the Tramadol? Regarding the dark stool--huge red flag for me! I would be very concerned about a gastric ulcer-could also be why her appetite is decreased. I really, truly believe your girl should be taking carafate 3 times a day and switched to Prilosec--of course I mention this because I have been down this same path before--obviously your vet needs to design you medication protocol.

I'm sorry your baby is having a tuff time with the pred-our hounds just don't do well with corticosteroids. I absolutely cringe when I hear another hound being placed on pred as I know what a tough time lays ahead for them. Pred is damned if you do and damned if you don't. Perhaps, you can discuss introducing another immune suppressant drug now like azathioprine or cyclosporine which would allow you to reduce the pred dose.

[Guest OurLacyandJax]

tbhounds, once again, I am going to take your advice very aggressively. I also want to tell you I mentioned to her last time (Monday) when we found the platelet counts on the rise, that she is taking Preds badly. She agreed of course - and she mentioned that she might be willing to reduce to dose and sub it with some other drug. I mentioned (mangled it of course) the azathioprine - and she corrected it and said, precisely.

 

Also - will certainly have her stool checked tomorrow, and mention carafate and Prilosec. Both safe for the hounds in the right dose?

 

And yes, Tramadol. We started her on it because she had so badly sprained her front right leg. No idea how it happened. I am guessing jumping off our bed while her muscles were weakening on the Pred. Or while aggressively carpet scratching.. And that started the downward slope for her, along with the 50mg dose of Pred, she was utterly miserable. So to control her pain, we put her on Tramadol, as well as to may be calm her down..

 

She has had no tramadol since this morning. I am done with it. And she does seem a lot better. A lot! We just went for a walk - she had woken up from a deep sleep, and wanted to pee and poop. Good quantity poop, formed, but still dark brown. But the walk was real nice.

 

She is sleeping again now.

 

Come what might happen to her, I just wanted to thank you all from pulling me out of the depths of my misery today, and put me on a path of fighting for my girl. This is an amazing place to be in.

[Guest OurLacyandJax]

tbhounds, not sure whether you read it earlier, Lacy is on pepcid (generic) 20 mg every 12 hours before her food. Does carafate and Prilosec work with the Pepcid, or is it one or the other?

[JJNg]

For Jax, I'd suggest using a muzzle with a stool guard (poop cup), or just duct tape over the end, to keep him from licking at the wound.

 

Keeping my fingers crossed that Lacy's recheck with the specialist brings good news.

[tbhounds]

tbhounds, not sure whether you read it earlier, Lacy is on pepcid (generic) 20 mg every 12 hours before her food. Does carafate and Prilosec work with the Pepcid, or is it one or the other?

Prilosec would substitute the Pepcid. Glad she seems better w/o the tramadol.

Keep us posted after your vet visit. :-)

[Guest OurLacyandJax]

Whew. She is looking and acting much better, since no more Tramadol has been given to her.

 

Here are the things in brief that happened today.

 

Met the specialist around 11. (Location and person: MVRC in Chesterfield, Vet is Dr Christine Wills-Mahn. She is really nice - for anyone in Missouri area). We did another ultrasound, and she said all look great, including the spleen, GI, kidneys,heart etc. Liver was enlarged and red - but that is what Pred does, according to both my vets.

 

Platelet count still the same. So not the best of news,but still, holding steady. Waiting on Lymphocyte count. If it's still climbing, we might be in for a rough ride. Still, the Doc said she is very hopeful. Ok.

 

Poop tested negative for blood. So she didn't want the dog to go on carafate or Prilosac. She said she doesn't feel like until there is clear evidence that the dog needs it, no point in doing so. To that logic, all i can do is agree,

 

Now, to the changes in medications. Lacy started on Azathioprine today. The idea being to be on it for 14 days, and then lower the Pred dosage. Poor thing - hoping no major side effects. She is also on something to stimulate her appetite, that seemed to work pretty fast. She kept coming into the kitchen looking at her bowl, but she was certainly not going to eat her kibble. She needed her chicken..:-)

 

Well, all in all, it's been a good day guys. Lacy is a much calmer and happier dog. She's alert, and when she sleeps, she sleeps good. Hoping we continue to improve.