Senior Grey, Platelet Count Zero!

[kudzu]

My 12 yr old Grey, Venus, is in ICU at UGA vet school. Yesterday afternoon everything was fine. She was evenrunning in the yard. An hour later her front feet were swollen & painful. Was small improvement. Checked during the night & she was the same. By 6 AM all feet swollen, panting & in extreme discomfort. E-vet visit showed slightly low platelets & WBC. There was some brusing in area of swelling. No cause for swelling found Because Venus has SLO, vet was suspicious of autoimmune disorder.

 

By tonight blood was showing in eyes. Rushed back to e-vet. Platelets showed undetectable. WBC's dropping. Snap 4dx was negative. Blood polled in both eyes making my girl effectively blind. Xferred to UGA. Microscopic exam of blood smear showed no platelets. None. Not even one! Renal values not good. Elevated BUN, cre, phos. Not super high but like CRF even for a Greg. Unable to verify with urinalysis because they couldn't get sample. Won't do cysto with no platelets.

 

Autoimmune still possible but vets feel cancer more likely. Chest stay normal. When IM team gets in this morning they will do abdominal xray & we'll go from there. Right now V is on IV & under observation.

 

No platelets but other clotting factors are normal. Anyone think there's any hope? It looks very grim from here.

 

PS some minor bleeding from nose. Just a few drops here & there.

Edited November 29, 2013 by kudzu

[tbhounds]

Never decide to euth without trying corticosteroids. They will help with cancer and auto immune conditions. Red cells are normal?

[Charlies_Dad]

Good thoughts for Venus. I hope they can do something for her.

[BatterseaBrindl]

[DesiRayMom]

No help here, but lots of prayers coming........

[Neighsayer]

Hugs! Stay strong!

[kudzu]

Thank you, all! I don't want to give up on my girl but ... Oh, it looks so bad. Have never seen completely red eyes before. Nothing to see but blood. God bless, Venus. She is such a good girl & not the type to panic or flip out even though she doesn't seem to see. She stayed down in the cage when I told her to & laid her head back down while I was petting her. Made to try to get up again when I stopped & moved to leave, but again stayed down again on request. Things like ICU are one reason I'm glad she tolerates crating so well. It was a nice size cage with 3 people right there for her but it's still a cage in a huge room of kennels. Thankfully things were very, very slow there over holidays. She'll get lots of attention.

 

tbhounds, thanks for saying that. Though I'm not against advanced testing, I am not inclined to do tons in this case unless it would dramatically change the treatment plan. UGA had mentioned corticosteroids as the likely course of action today but that was Emergency Dept anticipating what Internal Medicine would be doing amidst all the testing. E-vet had mentioned pred or other immune mediating drugs that UGA would have but e-vet didn't. I called the local e-vet early this morning & talked to her. They were so wonderful yesterday & had asked that I please let them know how things are going. I told her it might sound crazy but at of that moment I was tempted to let UGA do the abdominal xray & then, if nothing obvious was found, just ask them to pump Venus full of pred without putting her through tons of other tests. E-vet said it didn't sound crazy at all. She said she was taught, "never let a dog die without trying lots of prednisone." She was making a generalization of course.

 

Red blood cells were high normal yesterday morning, meaning they looked OK for a Grey. Those were still within normal last night but e-vet said it had dropped 5% with she felt was significant. So that is another question to ask them when UGA calls this morning. Also left a message for our regular vet to call me to discuss all this. Had to call to cancel the 9AM appt I had made as they were closing Wed, when we first noticed V's swollen front paws. Made it saying we may end up at e-vet. And, of course, we did. Was thinking how blessed we are around here with so many vets & vet services available between Atlanta & Athens.

 

This hurts.

[4My2Greys]

White light and healing thoughts being sent for Venus.

And a hug for you

[Guest grey_dreams]

I'm so sorry to hear about your beloved Venus. Lots of prayers sent for a miracle

Edited November 29, 2013 by grey_dreams

[45MPHK9]

Thinking about you both this morning.

[KF_in_Georgia]

I'm so sorry to hear about Venus.

 

When this happened to Jacey (including the blood in her eyes), the e-vets put her on mountains of pred and doxy (in case it was a TBD). In her case, the ultrasound and x-rays didn't show cancer, and the eventual results from the tick panels didn't show a tick-borne disease; I lost her without knowing what triggered the crisis.

 

But the pred gave her her only chance.

 

I'll be thinking of you both today.

[Remolacha]

hoping you an find some answers and make things better

[galgrey]

[charbess]

How frightening for you and for Venus. So sorry to hear of this...praying for relief.

 

[tbhounds]

Her red cells may have dropped if she's receiving IV fluids. Curious if they saw spherocytes??

[tuff]

In my experience as a human hematopathologist, it would be almost unheard of to have 0 platelets due to cancer, especially at presentation, especially without severe anemia. Autoimmune sounds more likely. Hopefully steroids will help your sweet girl!

[KF_in_Georgia]

Oh--and I've just remembered. I'm not sure why, but the E-vet got very different platelet numbers depending on whether it was a machine count or a manual count.

 

On weekends, the ER was super-staffed. During the week, especially early in the day, there were fewer people on hand and so we wound up with a machine count on Monday morning, before the technician arrived. That count for Jacey was higher than other counts had been, and I was optimistic. The manual count later in the day was devastatingly accurate and showed we were losing the fight on her fourth day in the ER.

 

Moral of the story, then: you want to ask them whether it was a manual count or a machine count on blood values. Then at least you know whether you're comparing numbers tallied the same way each time.

[Batmom]

Thinking of you and your pupper and hoping for the best.

[kudzu]

Kathy, thank you for adding that. Sadly, both manual count and machine count are zero. Two different vets have checked blood smear. Not a single platelet found. I didn't even know this was possible. Your Jacey's story came to mind for me this morning when the UGA vet said "sometimes it's autoimmune but they [the dogs] just don't respond to treatment."

 

tbhounds, no spherocytes. The initial 5% drop was before IV's, but they said some of the initial drop after getting to UGA could be from IV fluids. Unfortunately her PCV is still slowly dropping. She's now anemic but not severe.

 

tuff, thank you for that info. platelet count went from slightly below normal to zero in just 12 hours. That based on tests run by same tech on same machine. It was shockingly fast. First signs, swelling of front paws, was right at 24 hours before blood started visibly filling her eyes.

 

So abdominal xrays were normal. They are concerned about remaining possibility of tick disease like ehrlichia in bone marrow instead of peripheral blood or RMSF. They pulled blood to test for RMSF. Then they started doxycycline. Also started steroids. Still no urination to get sample for urinalysis. Will recheck blood chem for kidney values. Our regular vet called & confirmed that Venus' 10/04/2013 blood work had normal renal values. Everything was normal. It's such a big change. I will take it day by day for the next couple days. At least Venus remains calm in her cage & is able to rest for now.

[Guest grey_dreams]

Hope she will respond well to the treatments

[greyhead]

Just seeing this and feeling so sorry you and Venus are going through this. Holding her in my prayers and close to my heart.

[galgrey]

[kudzu]

Waiting for UGA to call. Will leave here around 9 AM to go to Athens even if I haven't heard from UGA yet.

[galgrey]

Waiting for UGA to call. Will leave here around 9 AM to go to Athens even if I haven't heard from UGA yet.

Thinking of you.

[Batmom]

Thinking of you here, too.