Hematoma? Unknown Cause

[IansMom]

Hi all,

I noticed a pretty large area on Ian's leg today that looks very similar to the bruising he gets after a blood draw. It's really red and looks like he is bleeding under his skin. I have no idea what caused this. I know for sure that he didn't hurt himself in the yard or anything like that. I took him to the vet (a new one since we just moved). She said she was familiar with differences in greyhound bloodwork, citing thyroid levels. However, she said his platelets were low (138k). Per Dr. Suzanne Stack, normal for greyhounds is 80-200 (k) so I'm thinking this vet is not as greyhound savvy as she thinks, unless I'm missing something which is totally possible. She said white blood cells are low too. Tested him for lyme disease and ehrlicia, both of which were negative. She wants to recheck in a week. In the meantime, she gave me steroids and doxycycline. If I understood correctly, the cause could be "immune mediated." I am posting pictures. I welcome any insight and suggestions. Thank you!

 

 

[macoduck]

Was a clotting test done?

 

No personal experience with this: http://www.veterinarypartner.com/Content.plx?P=A&A=1412

 

I would suggest drawing a line at the margin with a Sharpie pen so you can get an idea if it is growing or shrinking.

 

Hoping it's just a bruise.

Edited April 29, 2014 by macoduck

[IansMom]

I'm not sure if they did a clotting test. I will find out tomorrow. I'm going to get all blood work results from the clinic tomorrow and plan on sending them to his vet in Houston along with the pictures. We have the utmost confidence in Dr. Miller, who is his vet in Houston, so I'm hoping he will have some insight into the matter. I will post the blood work as soon as I get it tomorrow. There is a whole lot about relocating that just sucks, but all of the issues surrounding Ian, Bella, and Petey (vet, boarding, day care) are the worst and most significant.

[Houndtime]

I get very nervous when I see photos like this. I lost two dogs to internal bleeding. Please watch and see if the areas grow. I don't want to scare you, but, please be dilligent and record any significant changes. It could be a tumor on his spleen or tic disease. I am praying that it is not. All good, positive, thoughts for your boy.

[krissy]

Depends on the actual numbers of course, but greyhounds routinely have low WBC and platelet counts. I would clarify if they were low compared to the lab reference ranges or low by greyhound reference ranges.

 

If you don't think he could have hurt himself I'd keep a close eye on what the bruise is doing and if new ones are starting. And definitely find out about the clotting test. But I've gotten bruises like that on my dogs that have been from bumping into something. Once Summit got a large one on his chest that we think was from falling off the bed and hitting the bed frame. Not saying that's the case for your boy, but they sure do bruise easily and fingers crossed that's all it is.

Edited April 29, 2014 by krissy

[greyhoundlady]

I am just reading this and hope all is going ok. I have recently had the scariest experience with clotting. My male grey went in for a routine dental and a minor removal of some skin that contained odd little bumps, while he was under anesthesia. The dental went fine, blood tests were done before and all came back fine, the biopsy was done and the skin stitched back together. Would have been routine as the vet has done many of these, but in Buca's case, the bleeding would not stop and he developed a big hematoma and bruising everywhere. He was in the hospital for three nights and they found he has Von Willebrand's disease - his blood would clot, but then his body would destroy the clot and he would bleed. Upon knowing this, I did a little research and found a paper that Dr Cuoto wrote on the topic of greyhound's bleeding. I have gotten an education and have shared it with my vet.

 

Thankfully, Buca is doing okay and tomorrow we go back to have his staples removed. This came out of the blue for me and the puzzle is that he was neutered before I got him and has had dentals before and the odd nicks, without problems, but we never had any surgery done and this was an eye opener. It was good in a way to find this out under these circumstances. The vet said he has plasma on hand at all times, so if there is a future problem he will be prepared for it.

 

I am just sharing my story so others might file this as information they might need. This may not be what is happening to your Ian, but do check about his clotting. Good luck!

[a_daerr]

How's he doing? Any updates? I've seen some really bad cases of immune-mediated thrombocytopenia on this board that unfortunately, did not end well.

 

ETA: This is the thread I'm reminded of (and the reason I cringe whenever I see a thread on weird and spontaneous bruising):

 

http://forum.greytalk.com/index.php/topic/293006-pugsley-has-bruisingblood-pooling-on-her-abdomen-what-is-this/

Edited April 30, 2014 by a_daerr

[JJNg]

greyhoundlady, von Willebrand's disease is a completely different condition from the greyhound bleeding issues studied by Dr. Couto. Was Buca specifically tested for von Willebrand's factor? It can be definitively diagnosed with clotting factor testing. On the other hand, greyhound bleeders usually have completely normal clotting tests, and normal von Willebrand's factor. Typical greyhound bleeders respond well to a medication called Amicar (aminocaproic acid) and don't need plasma transfusions.

 

For the OP, any updates on Ian?

[greyhoundlady]

JJNg - yes, ultimately Buca was tested specifically for von Willebrand when everyone was puzzled as to why he was still bleeding after the (minor) surgery. The results came back as type 2 in the 10% - if that makes sense. It was the first I had heard of this and it is usually found in Dobermans, from what I have been told. My vet practice had never seen it in greyhounds before.

 

Great news today when his staples were removed and all went smoothly. He is doing great now and now that we know he has this issue, we can be prepared in the future. I am really not too familiar with the studies that Dr Cuoto has done, and mostly I have seen reference to things regarding osteo. Here are two articles that I gave to my vet. I also told him about the Amicar. You might find them interesting to read, if you haven't seen them already. Thank you for your input.

 

http://cvm.osu.edu/assets/pdf/hospital/Greyhound/research/completed/2008/2008PostoperativeBleeding.pdf

http://www.deerhound.org/Health/Claymore_Articles/Claymore_Post-op_bleeding_2011-04.pdf

[IansMom]

Sorry for the delay in updating….things have gotten a little crazy around here, and by crazy, I mean a sewer line has been destroyed by tree roots and has to be replaced, but not before removing the tree-ugh! The never-ending joys of home ownership. I am posting Ian's blood work. It doesn't look like they did a clotting test. I looked at his previous CBC records from our previous vet and there isn't a whole lot that's different, so I feel a little better. I'm leaning toward it's just a bruise. See results below, and again, thanks!

[kudzu]

I'm no expert but that doesn't look like she is outside the normal range for an average Greyhound. However, without comparison to prior blood work there is no way to say if the above numbers are your dog's normal. If the bruising continues to spread without any other explanation then it does seem reasonable to search further for a cause & possibly start treatment based on symptoms. It would worry me though if the treatment were based entirely on the blood work & a limited area of non-progressive bruising. I would definitely make further inquiries with the vet. A simple question like, "Looking at the lab's norms, hat would you consider the normal Greyhound range for WBC & platlets?" That should help you feel more confident that your vet it keeping in mind the Greyhound differences on WBC & platelets.

 

Has the bruising spread or is it basically self-limiting?

[IansMom]

Sorry, I forgot to mention the bride or whatever it is has not gotten larger (I marked it with sharpie) amd there are no additional discolored areas.

I'm glad Buca is doing well!

[juliemac]

Oh, glad to hear that the bruise isn't worse, and that the bloodwork seems to be 'normal'. Hope Ian continues to heal.

[JJNg]

JJNg - yes, ultimately Buca was tested specifically for von Willebrand when everyone was puzzled as to why he was still bleeding after the (minor) surgery. The results came back as type 2 in the 10% - if that makes sense. It was the first I had heard of this and it is usually found in Dobermans, from what I have been told. My vet practice had never seen it in greyhounds before.

 

If Buca tested as having von Willebrand's disease, then that's completely different from the greyhound bleeding issue addressed by Dr. Couto's studies. Your earlier description of how "his blood would clot, but then his body would destroy the clot and he would bleed" sounded more like the greyhound bleeding issue and not von Willebrand's where the blood isn't able to clot normally from the start. Probably wouldn't hurt to give him Amicar too, but with von Willebrand's, he would definitely need to have a plasma transfusion for future problems. Here's a good article on von Willebrand's disease: http://www.veterinarypartner.com/Content.plx?A=1637

 

Glad to hear Ian's bruise has not gotten larger. Hopefully it starts resolving quickly.