Low Platelet Count For Lacy - And Getting Lower

[KF_in_Georgia]

I'm very glad she's doing better and feeling better.

[Guest mld]

Sounds like a much better day! Healing thoughts for lacy

[tbhounds]

Thanks for the update (though I gotta disagree with your vet about the carafate--it's also to help prevent an ulcer but, well she's the Dr).

Fingers crossed the rest of the CBC will be improved :-). Update when you can!

[EllenEveBaz]

Just sending more good thoughts.

[Guest OurLacyandJax]

Bad news to report with the latest blood work. Even with the blood work before this, some of the numbers were border line or low. Now, it is in the "definitely something very wrong" area.

Here are the numbers. Expected in parenthesis, and the next two are her last two blood work numbers, the first one from 11/26 and the second one from 11/30.

RBC - (7.4-9.0) - 4.3, 2.8 (trending down)

WBC - (3.5-6.5) - 19.3, 24.9 (trending up)

HGB - (19.0-21.5) - 10.7, 7.0 (trending down)

PCV-HCT - (55-65) - 32, 21 (trending down)

Platelets - (80k-200K) - 25,20 (trending down) - not manual count.

Lymphocyte (690-4500) - 12931, 16932 (trending up)

 

So there it is - not a single thing good in those numbers. My vet is almost certain that this is not immune mediated anymore, and could be secondary thrombo.

 

I am taking her in for a bone marrow aspirate today around noon. I would like to know what's making her so ill, you know. Will have to leave my girl there and pick her up a few hours later.

 

Over the weekend, she ate pretty decent with a decent show of appetite, had enough energy for a few good walks, had alert eyes, even took the stairs to the basement to follow mommy around.

[Guest grey_dreams]

I can't offer anything except hopes that they can find out what's wrong and that Lacy will get better

[Remolacha]

sorry things are not looking better I hope you can get some answers!

[Guest OurLacyandJax]

Thank you! She's at the vet now, and will go under in about an hour.

 

She's tired for sure, and it looks like even with the eating, her weight might have come down a bit (about a lb). Her eyes look alert though, and immediately got up in a hurry from her bed when I mentioned the word "ride". She even jumped off the high SUV load bed, since she hates me picking her up. Been a couple weeks or more since that happened. Little signs I tell myself that she will fight through. May be I am silly.

 

She had three instances of acid-reflex in the last 3-4 days. Just some froth and some water comes out. Still on Pepcid.

 

Will update later.

[Batmom]

Praying hard for your girl, and sending hugs to your worried self.

[Guest OurLacyandJax]

Just got the news - as feared, Lymphoma was seen in the bone marrow. Now what? I am at a loss to make a decision in terms of Chemo. Do we go through with it and hope it works, even though chances are rather small? My doc tells me Chemo is not that brutal on dogs as we fear, and that all we are looking to is to get a remission, and not a cure. She is leaving it up to me.

 

Please give me some advice. In the meantime I will dig into other threads here.

[3DogNite]

OH - I'm so sorry to hear this devastating news!

I have never had a dog thru chemo - do your research and trust in your instincts!

hugs to you and xoxox to miss Lacy!

[KF_in_Georgia]

Get an appointment with an oncologist. He/She will be able to give you advice and treatment recommendations. Also, talk to your contacts at OSU.

 

There's a thread here about osteosarcoma treatment. Your vet is correct that dogs seem to suffer fewer side effects from chemo than people do. You can see various suggestions in the osteo thread, and make some notes to have handy when you talk to OSU and an oncologist.

 

I'm so sorry you got this diagnosis for your girl.

Edited December 3, 2012 by KF_in_Georgia

[tbhounds]

Ugh--I'm now just seeing this-crud! To be honest I had wondered if there was something else going on besides primary imha--her platelets should have jumped up by now.

Typically, lymphoma is one of the easiest cancers to slap into remission. Without knowing it you already have been giving chemo--pred in higher doses is considered chemotherapy, however, your baby would need to be started on IV chemo drugs too. Dogs do amazingly well with chemo. You do not see the side effects that humans experience--vomiting, hair loss etc.. The dosages for dogs are designed to achieve remission not to be absolutely curative so side effects at those dosages just aren't experienced.

That said--if the cancer is already found in the marrow you may not see a favorable outcome even with aggressive chemo.

Please, absolutely contact OSU ASAP to get their take on this. Dr Couto may want to read the biopsy himself in which case your lab would need to send the slides up to Columbus.

What a punch in the gut--please give your baby a hug and update when you can.

[Batmom]

No advice, just hugs for you and your girlie. I'm sorry the news wasn't better.

[Guest OurLacyandJax]

Thanks tbhounds, and all. I have to ask - since I am confused. Lymphoma (found in bone marrow) is different from Osteo sarcoma, correct? Somehow they are treated the same? And lymphoma found in marrow some how doesn't present itself with swollen lymph nodes etc?

 

And can any of you recollect cases where chemo successfully put marrow lymphoma in remission? I guess I am searching for a reason here to put her on it - but I do not want her to go through this if as you said,tbhounds - and I appreciate your terrific responses -, the chances of her going in remission are rather weak.

 

I have emailed Dr Kellogg immediately on getting the news - have not heard back. Do you call, or do you typically communicate via email?

 

Now I might have to start another thread about my boy Jax and his elevated liver ALT values. Just got a call from my primary vet. Everything else looks great. ALT values (i think) are about 700 instead of the range they use at about 120 or so..:-(

[MP_the4pack]

search on lymphomas here in H&N. While I haven't had that particular cancer (I've had OS, hemangio and fibrosarcomas) I seem to think that lymphomas do go into remission.

 

And while my Diamond (OS) got a little upset tummy with chemo, she didn't seem the worse for wear once the nausea left her.

[tbhounds]

It sounds like your hound is in what they call Stage V lymphoma---to be completely honest the prognosis is usually considered poor.

BUT! Dr Couto has many tricks up his sleeve so, please wait for their response. Sometimes Dr Kellogg reads e-mails at night so hopefully, she'll respond quickly (but, I'm sure she'll want to speak to Dr Couto first).

I'm posting a link here that may answer some of your questions...

http://www.marvistavet.com/html/canine_lymphoma.html

[JJNg]

So sorry to read the news of Lacy's diagnosis. Did your vet send the bone marrow aspirate slides off to be read by a pathologist? Are you planning to consult with an oncologist locally? Hopefully you'll get more info from OSU too. If you're at all considering going after this aggressively, I would recommend doing both (having a pathologist read the slides, as well as consulting with an oncologist). That would give you more data to help make an informed decision.

 

The prognosis and chances of a good response to chemo somewhat depends on how much of the bone marrow is affected. If a small percentage of the bone marrow is affected, dogs with Stage V lymphoma can response about as well as a dog with the lower stages. But if the majority of the bone marrow has been taken over by cancer, then the prognosis is much worse. There are also other factors that oncologists look at to determine prognosis, not just whether or not the marrow is affected. Keep in mind that even a good response to chemo when treating lymphoma only gets you a median survival time of around 12-18 months, as most dogs will come out of remission within that time frame.

 

As others have also confirmed, your vet is right about chemo being less difficult for dogs than for people because the goals, and the dosages used, are different. I asked our local oncologist about this one time, and she said that about 50% of the dogs she treats with chemo don't experience any side effects at all - you'd never know they were getting chemo. Of the other 50%, most only experience mild side effects that can be managed at home with anti-nausea and anti-diarrheal medication. And less than 10% have side effects serious enough to need more aggressive treatment like hospitalization. And because the goal is not to cure the cancer, but to maintain quality of life, if a veterinary patient gets sick on chemo, there is always the option of decreasing the dose or stopping treatment completely.

 

And yes, lymphoma and osteosarcoma are 2 completely different types of cancers. However, there are many cancers that respond to the same chemo drugs. While swollen lymph nodes are the most common presentation of lymphoma, it doesn't always show up that way. Lymphoma that primarily shows up in the bone marrow is not very common, and consulting with oncologists is the best way to get statistical information about the chances of achieving remission.

 

Sending good thoughts for both you and Lacy (as well as Jax) as you face this difficult decision.

[Guest OurLacyandJax]

Thank you for the information there. Yes, I have a consult with the Oncologist early tomorrow. And the slides are sent to the Pathologist, I expect to hear back in 2-3 days. Lacy is rather out of it right now, unfortunately, a side effect of her anesthesia. All panting, panicky, anxious, wild eyed, and quite unsteady gait. Reminds me of her Tramadol days. Hoping she gets over it overnight. I hate to traumatize her again tomorrow early morning with another trip to the Oncologist though (long drive and all) so either he will have to see me by myself, or I will cancel.

 

The more we think about it, neither my wife and nor I want to try and go the way of chemo in the hope of a remission. She's already skin and bones with 10 lbs gone. I just don't feel it in my gut that we will be doing the right thing by trying to prolong the life of a physically old dog, no matter how playful she was even about a month ago.

 

Hoping tomorrow brings some clarity.

 

Poor Jax is all confused but he definitely knows things are all off-kilter in the household. He is careful around Lacy - well, almost all the time. :-) He is too rambunctious of a boy to be 100% good.

 

Will keep you updated.

[Remolacha]

I am so sorry

[Guest mld]

So sorry to hear about Lacy's diagnosis

[Guest OurLacyandJax]

I think it is time. She bled from her nose around 5:00Am. It is all around her, and still bleeding. She was fine at 4:30am when i took her out. We are about to take her to the vet..Prayers needed for this journey guys,.

[Batmom]

My thoughts are with you.

[Guest undergreysspell]

Sending you strength and prayers for Lacy.

[dante2zoe]

I am so sorry. You are in my thoughts. May your travels on this path be peaceful. Hugs to you and your wife. It is so hard.