My 13 yr old just diagnosed

[admin]

Hi again Terri

Koda is just gorgeous! He doesn’t look his age either, the lovely fella.

Yes – send me everything you have – don’t worry if it’s all you’ve got. Yes please – full panel as soon as you can & press them on whether they did the blood smears/slides & what they saw. If they didn’t, can you get them to do it this time. We also need to know about reticulocytes – this gives a picture of how many new baby red cells are being made – Koda should be pumping them out at a rate of knots to make up for the shortfall! I am not 100% sure Koda has IMHA yet, but let’s assume the he has for now. It would be lovely if he hasn’t! And yes, you are still in the right place for help, no matter what. You know we will always support you no matter what it is – we are all in the same boat, so to speak.

I was looking at Koda’s platelets – they are a little low, but are coming up – that’s good too. I assume from your drug list that you’re not giving the aspirin? We don’t have any information from the vets about whether Koda has abnormal clotting risks either. Again, another thing to press them on – print out this
https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/
& take it with you – ask about whether Koda has hemolysis, spherocytes or agglutination please. We know his platelets are not high, so he is not at risk from that.

High creatinine & BUN – could they please do a kidney function test & a urine test – see the following
http://dogaware.com/health/kidneytests.html
and get them to include creatinine, BUN, phosphorous, calcium, potassium/sodium ratio, total albumen & total protein. The total protein is normal in what you sent me.
Kidneys are very important. They monitor the oxygenation level in the blood & produce something called erythropoeitin which is what triggers the bone marrow to produce new red blood cells as necessary. We need to know all is well with Koda’s kidneys. Older dogs sometimes have a decline in kidney function, but infections and these horrible drugs also can have an effect on their function too, so don’t panic about this, but we need to know what is happening. If I hadn’t seen the blood tests, I would not have spotted this little problem – that’s why they are so important to get a good overall picture. Also, if it turns out he has a little kidney problem, now is the time to treat it – the earlier the better.

I apologise if I repeat myself sometimes, but I don’t want to miss anything!

[Terri]

Sheena,
Thank you!
I sent you the previous 3 days’ tests. I didn’t give him aspirin yet. I’m not sure I’m supposed to.
I have kidney support supplement ordered. He will be on it early next week. (Standard process). She did mention compromised kidneys.
The Dr. Isn’t in today. I’ll get with her tomorrow on the slide information or I can wait til Monday when I go in.
We don’t have ticks in this area but I suppose anything is possible as probable cause to what may have caused all this.
Vally,
Thank you for the med list. I will follow it as closely as possible. It helps a lot.
Terri and Koda

[admin]

Hi Terri

Had a chance to look at the blood tests. Patrice & I are not convinced that the WBC figure is correct, & possibly the platelets – it could easily be a machine counting error. Without blinding you with the boring science bit, machines are not very good at counting cells properly when the cell sizes are abnormal & some cells are incorrectly counted as the wrong type. This happens often in anaemia as lots of funny sized cells can be present. This is why we need to get your vets to do a proper blood smear & do a manual cell count – the slide could reveal a completely different picture of the blood cells from the counting machine – I bet it does.

We are also concerned about the platelets (abnormalities at the bottom of the tests) & both think Koda will be heading toward a clotting problem very soon, so an anti-coagulent must be added to the medicines. Dosage of aspirin (0.5 mg/kg daily) or clopidogrel (0.5 – 1.0 mg/kg daily). Please don’t panic about this, but remember that clotting is the biggest risk. Anti-coagulents are the answer. When giving anticoagulents, they can irritate the tummy – this is another reason not to stop the sucralfate.

Hope this helps

Love & hugs
Sheena x

[terri]

I gave him 1/8 of a baby aspirin. I don’t understand the kg vs. lb. and how that calculates. he is about 55lbs. How much would he need and how often?

[Vally]

Terri, 55lbs is about 25kg, so I calculate 25kg x 0.5 = 12.5mg.

Vally
xxx

[admin]

Hi Terri

Can you not give any more aspirin until we have seen the next blood test results please. This is MY fault, not yours. Because of Koda’s platelets being slightly lower than normal, it is best not to give it for now. We will have to wait & see what comes up with the tests regarding any abnormal clotting risks.

My sincere apologies – we have been discussing this & I really think this is the best way for now.

Sheena xxx

[admin]

Terri

I have been looking back through your information just now & saw RIMADYL – did your vet mention Rimadyl can cause blood disorders? Here is the link to the Pfizer drug leaflet:
http://www.fda.gov/downloads/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/DrugLabels/UCM050406.pdf
You will have to magnify it up to read it. Top right is the important bit.

Here is the important extract from that leaflet. “Hematologic: Immune-mediated hemolytic anemia, immune-mediated thrombocytopenia, blood loss, anemia, epistaxis.”

If Koda was OK before the Rimadyl, could this be the cause? I wonder if this is the answer. I hope I am on to something. It would also explain the low platelets (thrombocytopenia).

Love Sheena x

[Terri]

Unfortunately, Koda was crashing before rimadyl was even introduced which is what brought me to the vet in the first place. I didn’t even give him but a few doses due to my paranoia about the drug and it’s effects. I’m thinking about switching vets pretty soon. I don’t think my vet is working very hard for him. He is doing ok though. His appetite is back and ill be using slippery elm syrup to replace the sucralfate that she only provided for 10 days. Sheesh. I’m disappointed. We’re plugging away and will retest on Monday.