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- My 13 yr old just diagnosed
Terri,
After reviewing your latest CBC, I can say that he has improved quite a bit and his HCT hematocrit was at 31.7 (low normal is 37). Another important value, the hemoglobin inside the red blood cell, has improved to 11.8. The low normal for this value is 12 so he is as close as can be to normal. That is important because it indicates he only has a mild anemia. Your vet is correct, there is a high white blood cell count that is most likely not related to a disease like IMHA or AIHA.
Dr. Dodds is also actually right about what she has said. It is, however, complex to explain and complex to understand. This is called anemia of chronic disease.
The body is very carefully managed to make sure everything runs properly at all times. It likes to be in something called homeostasis, balanced in all body systems.
However, when the body is faced with some condition that it feels is threatening health it will attempt to resolve the imbalance by changing conditions in the body in an effort to remove the challenge to the body. It may compromise certain systems in order to focus on this battle.
A good example of this is how the body keeps the inner organs functioning properly. If you are outside in very cold weather and your body begins to chill, the brain will begin to reduce blood flow to the limbs in order to conserve heat at the core. It is willing to sacrifice your fingers and toes, if necessary, to keep your internal body warm because that will keep you alive.
Right now there is an inflammatory process occurring inside Kobe to fight “something”. We can see that represented by the white blood cell count. Not all high WBC conditions are necessarily cancer. The body is attempting to control something with the immune system and is willing to raise these WBC levels to do that.
What are some common conditions we have seen? In dogs ureter, bladder or kidney infections can lead to an inflammatory response. Dogs with pancreatitis or gall bladder blockages may respond similarly and there are other similar conditions. Combining conditions like these with a body that is de-conditioned from using certain drugs and we end up with a weakened dog attempting to fight an internal battle.
You have run out of funds to do some serious testing and your vet has thrown his/her hands up, unable or unwilling to find the diagnosis. That doesn’t mean that this is hopeless. He has shown some recovery so that means his body has been somewhat successful.
So let’s focus on what YOU can do at home to support his body’s efforts to get healthier. Remember, his body is doing the hard work to accomplish this, you just need to apply good nursing skills.
The first assignment is to sit down with all the medications and supplements and write down what each one does. If you don’t know what it does, ask here. We are going to attempt to reduce or eliminate every drug or supplement that is either not necessary or may even actually be doing some harm.
Next your job is to develop an anti-inflammatory diet regimen. Let’s begin a high protein and lower carbohydrate diet. It is also important to increase omega-3 fatty acids, especially DHA, and decrease omega-6 fatty acids, found in plant oils.
So let’s include higher levels of healthy fatty acids, including fish oil fatty acids in high dosages. A high dosage of fish oil (body oil, such as salmon oil or EPA oil, not cod liver oil) is an amount that supplies 300 mg combined EPA and DHA per 10 lbs of body weight daily. Give 400mg vitamin E when you supplement with fish oil. I give both my Giant Schnauzers 3-4 fish oil capsules each day (these are considered triple strength.) Split these doses between two meals. I like Nature Made Fish Oil which I can often buy one get one free. Between the dogs and me we go through about 12 capsules a day. Do not skip this part of the diet, it is extremely important.
Next we need to carefully examine all sources of carbohydrates in the diet and reduce them to as low as possible. This includes any grains, pastas, high sugar vegetables, soy, corn and sugars. Well, most anything that makes dog kibble formed into pellets. This is often done in cancer diets. We are going to be feeding only real food, prepared at home.
Then let’s add in high quality proteins. His liver is probably still compromised if his ALKP was high. I don’t know what that value is currently. If you are continuing to use Denamarin then that will help significantly. I also have some bottles of Country Life Liver Support Factors that were donated to Second Chance and you can have some of those for free, just let me know. I used this supplement with Chance.
Dr. Dodds uses a liver sparing diet in many dogs to support the liver. She uses some form of steamed white fish combined with potatoes and something like steamed green beans. I am going to suggest you use fish, moderate amounts of skinless chicken breast, occasional scrambled or boiled eggs or egg whites for a period of about 2 weeks. Avoid highly red meat like beef etc.
It is important to make sure he is getting enough calories with this diet so try feeding smaller meals more frequently. I know you work crazy schedules but try making up little snack kits for him so you can “treat” him with by using part of his meals. Make some hard boiled eggs and keep them in the fridge, use them as treats. Give him a few spoonfuls of cottage cheese and yogurt. Keep a container with bits of sliced cooked chicken breast. Teach him a little trick with the incentive of getting some of this good smelling cooked chicken. I use those roasted deli chickens for my dogs when they have had surgery, it sure gets their appetite started!
Make sure he has plenty of clean water or home made chicken broth. If you have some kind of pressure cooker or slow cooker, put bony chicken backs in water and cook for a very long time to make a calcium rich broth.
Plenty of rest combined with moderate walks, massages, play and limit visitors to the house. This is doggie spa month.
In about 2-3 weeks have his blood values evaluated and ask if they can do a mini chem screen just for the liver functions. Many clinics will do this for less cost.
How does this sound to you?
my best
patrice
I’ll write this all down and implement it today. Will grocery shop. I’m going back to the vet today to request the referral. Ill get his latest cbc and I’ll report back.
One thing…I decided to give the weeks worth of Clavamox and his wbc is down in the 20s. There were changes made last week from his 31.7 hct. Upped his pred to 15 bid and gave a week of clavamox. I was thinking about reducing his pred back down to where he was steadily improving.
Thanks for the plan B attack. Ill do my best.
Yes it feels like such a fight. ..images of holding a dying baby, banging on glass hospital doors that say “sorry we’re closed” and nurses with white hats shooing me away have been in my head all night.
Koda’s current list of med/supp per Patrice
Denamarin-liver AM
Prednisone 15mg BID -immune
Fish oil 420mg (EPA 150 DHA 180) was giving 2. How many should he have?
Vitamin E 400
B-right B Complex -Kidney
Pet tinic
Dasuquin- arthritis
I stopped the bioprep and erythro pro blood support last week.
White fish is very expensive around here or it’s Tilapia from China. Any suggestions appreciated.
He has been eating grain-free kibble and canned. He used to be raw fed but that became costly also.
I make raw food for my cats using Dr. Pierson’s recipe but I can’t swing homemade for the dogs due to cost and space. I will manage cooked meals. He’s eating twice as much as he used to yet lost another 1.5lbs over last week. I’m going to add another meal to his day this week.
That alone doesn’t sound good. He has developed the hollow temple look and the vet says 98% of the time, that look alone suggests cancer and x-rays usually confirm. His abdominal x-ray 3 weeks ago looked ok though. She can’t find cancer anywhere.
I just don’t know what to believe anymore. 9lbs lost since Jan 5th. :(
Terri and Koda
Hi Terri,
You are a true warrior! I am glad you are doing what you do. Patrice is amazing, she too will never give up. Where there is life There is hope. As for the way Koda looks, I would say that is absolutely a side effect of the prednisone! We sometimes lovingly call it “the pred head”. It will disappear once you are able to slowly reduce the prednisone. Even if Koda does not have AIHA this is the pred side effect. And also even if it is not AIHA the pred needs to be reduced slowly over a long time or you could run int serious problems. I don’t quite understand why you would need to get a referral to see an other vet. But then I live in rural Canada where vets are always happy to see clients and I would not need a referral not even for a specialist.
Keep troding on Terri one step after an other, one day at a time.
Best wishes,
Brigitte
Ah..pred head. I had no idea. This is all new to me.
The referral is to a specialist. Here, they won’t see you unless referred. I can go to any other vet on my own…but that’s a blind risk. I was checking out another clinic in town and although they are state of the art, the reviews weren’t that great and say they are way over priced.
I’m gun-shy about vets.
One of my cats was misdiagnosed as having bone cancer and I was urged to put her to sleep. A second opinion (my current vet) found she had tore her ACL and she repaired her leg and she lived on for years more.
I don’t trust vets. I don’t run to them for every little thing and only seek them out for serious situations like this. My faith has further dwindled. This specialist is my last option in my opinion.
Perhaps I just don’t have very good vets around me. Bad luck. So many people just accept what they’re told and move on. I often wonder just how many pets are needlessly euthanized due to ignorance and/or laziness. I bet the number is astounding. So sad.
It’s a confusing coincidence that the week I stop the blood support his HCT drops to 28. I wish I had a crystal ball.
Terri