Blood Cancer? Please Help Me Brainstorm This

[dante2zoe]

Okay, I am freaking out right now and am trying to educate myself. My vet is wonderful and sight hound savvy and is appreciative that I am throwing this out here for your collective brain power. This will be long and I apologize in advance. Please bear with me because I don't know what is important.

 

Background - Brady will be 13 on June 3. I got him at age 11 in August 2012. He had corns, early LS and tendon damage to one hind leg from an attack a couple years earlier. He had also been treated for hooks during that summer by his group. I treated him again a couple times to make sure those nasty buggers were gone. His stool finally improved, so all was well. I raw feed. I routinely worm every fall, so he was wormed with the others last September. We have been battling soft stool again and it would improve with other protein sources than chicken, which is the staple of their diet. So, I played around and he is on a beef and potato kibble. He loves it, eats well. He is sensitive to sweet potato, too. Anyway, since October 2013, he has lost 6 pounds. My dogs all lose a little during the winter and this one was horrendous (Maryland-wise) so a little weight loss wouldn't concern me - except this is a lot. He has been slowing down and limping, but would improve with medications and hulling. I have never had a dog live to almost 13, so the slowing down didn't throw a red flag at me.

 

I took the dogs for a stroll on the C&O Canal Sunday. It was in the upper 70s and the path is in dappled shade. Not hot. He was panting up a storm, so we immediately relaxed and then turned around and went home. He spiked a fever and it immediately came down. His urine was fine and he seemed ok, just a little lethargic. I took him to my vet on Monday. That is when I found out he had lost another 3 pounds since December, the last time he had been at the vet. She was concerned about what had happened and ran blood work. She was thinking kidney issues, since his values were originally on the side but we treated and had improved in October. He has had a couple UTIs, which were treated and resolved. Here are the results that has her concerned, with the values from Oct. 2013 and Oct 2012. Most recent is listed first and then 10/13 and 10/12

 

WBC 3.0 4.5 7.5

RBC 7.6 7.2 7.8

Hgl 54% 53% 53.7%

plats 155 120 180

lymphocytes 300/ul1170 1500

 

We are most concerned about the bone marrow suppression and leukemia comes to mind. He is being tested for Lyme and ehrlichia - the results will be in tomorrow. If that isn't the answer, then x-rays of the spleen and long bones will be done.

 

Are we missing something? Is there something else to check? Could his history of hooks be related? I am trying to be educated so I know what to ask and see if anyone else has experience/knowledge about this. I am one that much prefers to flip out ahead of time and do my homework so that if the worst case scenario is true, I have a better idea of how to plan.

 

I do know, based upon personal experience with my son, that suppressed bone marrow makes one feel like cr@p. I am not going to do all kinds of things to him if he feels cruddy. He deserves better.

 

Thoughts? My heart is breaking. Thanks.

 

Cindy

 

 

 

 

[greysmom]

What are the reference ranges for the test results you listed? I would think more TBD than cancer, but I don't have any experience with leukemia.

 

{{{{{Hugs}}}}}

[dante2zoe]

Chris, leaving the ranges out really shows my inability to think straight! I would have posted the entire lab results, but cannot do so from my office.

 

Here are the ranges

 

WBC 4.0 - 15.5

RBC 4.8 - 9.3

hematocrit 36 - 60

platelets 170 - 400

lymphocytes 690 - 4500

 

I really don't do well with initial stressors! This is not what my vet or I expected to see. Gah.

[mychip1]

No advice.....just good thoughts....

[Remolacha]

I don't have enough medical knowledge to help with the blood work, but I did want to say for an older dog, upper 70's, even in the shade might be too hot. Many of them do become more sensitive to the heat as they get older. That would not explain the weight loss, of course. I hope you get some answers

[mom2four]

Many good thoughts are being sent to Brady, and you too of course Cindy.

[Fostr_Mom]

I cannot help with the medical, but am sending be well thoughts and prayers for Brady. Because of your sharing him with us, he has become very precious. I hope he is ok,

.

[MaryJane]

Doesn't seem to be enough stated lab work done to develop any theories...

 

Did they do a blood smear to look at the cells? Did they run a B12 to check absorption from the GI? What urine tests were done? What chemistry tests did they do?

[macoduck]

Cindy, the references look more for other breeds rather than greyhounds.

 

from your post above:

WBC 4.0 - 15.5

RBC 4.8 - 9.3

hematocrit 36 - 60

platelets 170 - 400

lymphocytes 690 - 4500

 

 

Here are the ranges for greyhounds:

WBC 3.5 - 6.5

platelets 80,000 - 200,000

RBC 7.4 - 9.0

Hgb 19.0 - 21.5

PCV 55% - 65%

 

 

You can find all of them at www.greythealth.com

Edited April 17, 2014 by macoduck

[carronstar]

No advice, just lots of prayers and good thoughts.

[Riverhound]

Cindy, we were in the mid-70's here on Sunday, dappled shade with a cool down in a stream partway through the walk, and a friend's teenage hound did NOT do well. I think it was just too warm, too fast for him after the horrible winter. I hope it was that for Brady, as well!

[GeorgeofNE]

You won't must like my response, but at that age, there isn't a lot I would do other than make sure he is happy and comfortable. You could test and test until the cows come home and either find out there is nothing you can do, never find out anything, or just spend a lot of time and money stressing you all out.

 

We above had one dog who lived into teen years. One. Ever.

 

So that's my two cents but you know I wish you and Brady more time and happiness.

[dante2zoe]

Susan, your response doesn't bother me. Sometimes, that is exactly what needs to be heard. I don't want to test him up one side and down the other, either. However, if it is something that I can fix without causing him much distress, then I want to do that. I don't want to do anything invasive or painful. I just don't think that he is ready to go yet and I want to give him more time, if I can. I am a believer in a day too early than a day too late, but today isn't the day. He is relatively happy, just tired. I believe he is comfortable, but it can be hard to tell sometimes. It is just hard - Saturday he was chasing another dog at playgroup and he still eats with gusto and demands a treat now and again.

 

Thanks for your good wishes, I truly appreciate them.

 

Also, my vet doesn't think the walk had anything to do with this. We had been out for maybe 20 minutes. But, it was enough to get him to the vet, so that is a good thing. She is perplexed with his presentation and values, too.

 

I will post the entire lab results when I get home - I cannot do that at the office and wanted to get as much info as quickly as I could before I speak with her

 

Thanks for all the good thoughts.

[sabrina]

Cindy when you go to GIG maybe during a Q &A after Dr Cooltoes speaks you can ask him

 

Caroline

[tbhounds]

I'm not seeing anything that would concern me. Looks like a "normal" gh values. Regarding the panting and fever--your hound may have laryngeal paralysis.

Edited to add--did your vet do and submit a blood smear? Also you can ask the lab to run a clin path on the whole blood you submitted. Still-I'm not sure I would be concerned --I would resubmit a CBC in a few weeks. Did you happen to run a chemistry too?

Edited April 18, 2014 by tbhounds

[dante2zoe]

The entire report is below. A blood smear was reviewed. I appreciate the help! I was not thinking very clearly earlier. I have actually expressed concern about LP before due to his amount of panting. But, the weight loss and dehydration and over-all picture concerned her more at the time. His symptoms are also consistent with Ehrlichia. I just want to know what I am up against. He feels pretty punk and is very lethargic. But, he still eats like a champ. Thanks for all your suggestions and support.

 

Superchem
Total Protein 5.6 g/dL 5.0-7.4
Albumin 3.6 g/dL 2.7-4.4
Globulin 2.0 g/dL 1.6-3.6
A/G Ratio 1.8 Ratio 0.8-2.0
AST (SGOT) 28 U/L 15-66
ALT (SGPT) 39 U/L 12-118
Alk Phosphatase 34 U/L 5-131
GGTP 11 U/L 1-12
Total Bilirubin 0.2 mg/dL 0.1-0.3
Urea Nitrogen 22 mg/dL 6-31
Creatinine 1.4 mg/dL 0.5-1.6
BUN/Creatinine Ratio 16 Ratio 4-27
Phosphorus 4.0 mg/dL 2.5-6.0
Glucose 95 mg/dL 70-138
Calcium 9.3 mg/dL 8.9-11.4
Magnesium 1.9 mEq/L 1.5-2.5
Sodium 150 mEq/L 139-154
Potassium 4.8 mEq/L 3.6-5.5
Na/K Ratio 31
Chloride 115 mEq/L 102-120
Cholesterol 153 mg/dL 92-324
Triglycerides 31 mg/dL 29-291
Amylase 430 U/L 290-1125
Lipase 418 U/L 77-695
CPK 177 U/L 59-895
Comment
Hemolysis 1+ No significant interference.
CBC
WBC 3.0 10^3/uL 4.0-15.5 LOW
RBC 7.6 10^6/uL 4.8-9.3
Hemoglobin 19.5 g/dL 12.1-20.3
Hematocrit 54 % 36-60
MCV 71 fL 58-79
MCH 25.7 pg 19-28
MCHC 36.1 g/dL 30-38
Blood Parasites None Seen
RBC Comment
RBC Morphology Normal
Platelet Count 155 10^3/uL 170-400 LOW
Platelet count reflects the minimum number due to platelet clumping.
Platelet EST Adequate ADEQUATE
Differential Absolute %
Neutrophils 2,610 /uL 87 2060-10600
Bands 0 /uL 0 0-300
Lymphocytes 300 /uL 10 690-4500 LOW
Monocytes 90 /uL 3 0-840
Page 1 of 2 FINAL 4/17/2014 9:51:55 AM
Accession No Doctor Owner PetName
NYAC23764689 Schoepp, Kara Mcnealy Mrs Brady
Test Results Adult Reference Range
Eosinophils 0 /uL 0 0-1200
Basophils 0 /uL 0 0-150
Comment
Blood smear reviewed by technologist.
Urinalysis
Collection Method
Not stated
Color DARK YELLOW
Appearance CLEAR *CLEAR
Specific Gravity 1.042 1.015-1.050
pH 6.5 5.5-7.0
Protein TRACE NEG
Microalbuminuria testing is recommended (if sediment is inactive) to help determine the clinical significance
of proteinuria.
Glucose NEGATIVE NEG
Ketone NEGATIVE NEG
Bilirubin NEGATIVE NEG TO 1+
Blood NEGATIVE NEG
WBC 0-1 HPF 0-3
RBC NONE HPF 0-3
Casts NONE SEEN LPF
Crystals NONE SEEN HPF
Bacteria NONE SEEN HPF NONE
Squamous Epithelia 0-1 HPF 0-3
Urine Microalbumin
(Canine Reflex)
Microalbuminuria 0.9 mg/dL <2.5

[tbhounds]

Still not seeing anything concerning. I would follow up with the possibly if LP. The good thing I see is normal calcium (high calcium can =cancer).

[MaryJane]

Most of the blood work looks OK although, there is a bit of protein in the urine which might or might not be a concern. You might want to cut back on the protein in the food or add white rice.

 

It could be IBD and if so, one of the diagnostic tools is a vitamin B12 level/folate blood level although this doesn't diagnose 100% - you would need a biopsy to do that. If it is IBD, there are numerous ways to attempt treatment - using a unique protein, giving probiotics, sometimes flagyl ... also steroids. Lucy is battling the same issue with weight drop and I've become a little bit of an expert over the last 6 weeks about diagnosis/treatment of IBD. Lucy also has seizures which adds a whole new dimension to trying to treat her and it's likely that in her case, the seizure meds had a hand in causing this issue.

 

 

Edited to add --- I forgot to mention the low lymph count - that might be attributable to inflammation in the body ... maybe the GI tract ... see link

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3261110/

 

you probably want to search on low lymphocytes and IBD to get more information

Edited April 18, 2014 by MaryJane

[LuvAPuppy]

Cindy when you go to GIG maybe during a Q &A after Dr Cooltoes speaks you can ask him

 

Caroline

Dr Cooltoes? I love autocorrect I've never met him but we should start calling him this

 

I have nothing useful to add except thoughts and prayers, and that from way back when while I worked at the vet lab. those values look predominantly normal - "blood cancer" which is leukemia or lymphoma would have mucho drastic skews in your WBC and the cells would look funny on the slide. Cell morphology was normal and the counts were fine. Platelet clumping is not uncommon, (it's particularly common in cats, cat slides were hard to read). Until late last year my 15yo IG and I used to walk a mile per day. She started slowing down last fall either from the CHF or the arthritis. She struggled to walk a block comfortably just this past weekend and it was in the 60s here. I need to keep her moving around because it's great for her heart failure and good to keep her joints from being too frozen, but I think her power walking days are over. We'll start slow and see what happens

[MP_the4pack]

When my Pearl had spikes in temp that came and went, and her blood values were normal, we did an ultrasound. She had fibrosarcoma of the spleen and liver. She was 12 at the time.

I hope it's nothing, but an ultrasound may be able to help.

The low lymphocytes is indicative of no infection and not cancer. Leukemia has an increase in odd looking lymphocytes depending on which leukemia it is. (I'm a med tech and used to look at blood smears for a living)

[dante2zoe]

Thanks for the suggestions and putting my fears on the back burner. I am waiting for the results of the tick test, which should be in by noon. I am still concerned about the trend of those lab values dropping, though. I don't have lab results from his first 11 years and don't really know what he received in his last placement.

 

Mary Pat, if the tick tests come back negative, then he will be getting x-rays or ultrasounds today.

 

The unknown really throws me for a loop. I would be so much better knowing what it is, regardless of how good or bad the results may be. On the other hand, I was freaked enough yesterday that my boss told me to just stay home from work today so I can hopefully get some answers and know the path to take. I am lucky to work in a very dog-friendly office!

 

Cindy

 

edited to get names correct! sorry about that.

Edited April 18, 2014 by dante2zoe

[45MPHK9]

Thinking good thoughts for Brady.

[Charlies_Dad]

Good thoughts for Brady.

[dante2zoe]

Well, the results are back. My vet ordered some additional testing to be done and all signs point to some type of neoplasm. His marrow is not producing cells as it should. A definitive diagnosis can be made with a bone marrow biopsy, but I am not going to do that. He will be given antibiotics and steroids and will continue to be a cherished hound until he lets me know that he has had enough.

 

I am blessed to be able to make sure that each day is truly a gift, because it is. Thanks for your good thoughts, I really appreciate them and hope that he has a good while with me yet.

 

[MP_the4pack]