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- Not producing enough red blood cells
Patrice and Vally, thank you both so much fir your help. Ginger had a second blood transfusion last weekend. As of Tuesday, her PCV went up to 36. We are getting her PCV checked again next week. She is eating well and walking much better. Her gums sometimes get pale after she has been lying down, but turn pink after she drinks water and moves around. She has not been tested for tick disease or thyroid. I did an online consultation with Dr. Jean Dodds, and she has suggested a thyroid test sent to her. We are going to do this. I do have a question about how to communicate with Dr. Dodds. The email I received won’t allow replies. The text box I filled for the original consultation was limited. I wanted to ask if there is anything else besides the prednisone and mycophenalate that we should have her on. She is also taking Pet Tabs Plus vitamins. She is due her heart worm medicine, but I don’t know if I should give that to her. She had received her vaccinations 47 days before. I know this may be a strange question, but we had put bird feeders in the yard and had many birds feeding. Do birds carry viruses that dogs can get? Ginger is an indoor dog but goes outside several times a day. Also, fir the thyroid test, is this something that I get our regular vet to do and then send it to Dr. Dobbs per her form? Any help you can give me is so appreciated.
Patrice and Vally, when I stated that her heart worm meds are due, I meant preventive. Thanks!
Hi Terri, with communication with Dr Dodds, did you do the full consultation? The one that allows attachments? As far as I know it was always possible to reply. Let me know if you did the full one, and if so, I’ll ask Patrice, the site owner, to see if things are still the same.
Heartworm medication, we always used Dr Dodds’ protocol, which is here:
https://www.secondchanceaihadogs.com/hemopetresources
The last item on the page.
Dosing is done every 45 days if needed and you’ll note she uses different dosing for different States of America. You have to be strict with the dosing days though, the monthly dosing is just to make it easier to dose. I mark it in my calender and I send myself a message on the phone on the date it’s due so as not to go over 45 days.
What brand are you using for heartworm. Don’t do anything that is for fleas, ticks and heartworm. Stick to just heartworm medication.
I believe it was more likely the vaccinations that has triggered this. Was it a full set of vaccinations? They are known triggers. I’m not sure about the birds – if it were me, I would probably put the feeders away for now until Ginger is better.
The gum colour is affected by what they are doing. The body is very clever, when they are resting, the gums will be much paler and pinker when they are active. The spleen releases the blood that is needed as it’s needed, so don’t check gums when she’s lying around.
Vally
Thank you. I did the full consultation with attachments. Ginger has had this for two weeks. She is eating and sleeping a lot. Do dogs with this usually continue to improve on meds?
Vally and Patrice, thank you both so much for the advice. I sent you a message saying that we purchased the full consultation for Dr. Dobbs with attachments, but we are not able to ask additional questions. After Ginger’s second blood transfusion last weekend, her PCV went up to 36. We are taking her in tomorrow or Tuesday for another PCV. I think it has dropped.
We need advice please. We have taken her to two vets, her regular vet and then the second vet at the emergency vet where they give transfusions. Our regular vet is willing to work with us and actually attended a lecture of Dr. Dobbs. The second vet immediately started her on prednisone, mycophenalate, omeprazole, doxycycline, and Pet Tab vitamins.
Ginger is producing red blood cells at a low normal range of 18%, and this vet said that is not enough. She was producing more when this first started. Dr. Dobbs said she is producing in a normal range for her age. They did not do a thyroid test because this second vet said that thyroid doesn’t cause AHMA. Dr. Dobbs has requested that we have the thyroid tested and sent to her, and we are going to do so.
I am asking if there is anything we need to do or have prescribed for her when we take her in to her regular vet tomorrow or Tuesday. She has had this for two weeks. How long does it take for the meds to work? Is there anything that can stimulate her red blood cell production? Is there any other medication she should be taking? Again, her vaccinations were 47 days before. They took xrays at our request that were negative. We are looking for any advice that you can give so that we can make sure we are giving her everything she needs. If her count is too low, we will ask for another blood transfusion. Thank you again for all of your help.
Your vet can directly consult with Dr. Dodds. They can either call her, see this page,
https://www.hemopet.org/contact/
Or they can email her at info@hemopet.org
They are busy folks. If you want to email her make the subject line clear with your name, the dog name, the consultation number from the statement.
It’s good that she is at 36% HCT PCV Dr. Dodds is correct. This is only 2% from normal and is a good reason why the reticulocytes have decreased, they are no longer needed in such great numbers.
I am not sure what the number 18% is? Reticuloyctes are measured in percentages, but the values to indicate regenerative or normal would be from 1%, normal, to very high, 5.8% for example. Perhaps this is not 18% but 1.8%?
The other value for reticulocytes is the absolute number as compared to all the other blood elements. So normal would be 60,000 reticulocytes and highly regenerative would be upwards of 500,000.
If you would get copies of the CBC and chemical screen I can help you read them. Use the Urgent Advice page on our site to upload the pages.
Vets often don’t understand the connection with the thyroid. But it is really simple physiology. The thyroid is the regulator of the body and controls many systems. One of those processes is the making of blood in the bone marrow. Dogs with low thyroid values can develop bone marrow failure, or as your vet thinks, she isn’t making enough RBC. Chance, my dog who this site is named after, developed bone marrow failure. A life threatening condition. He had hypothyroidism and one of the most important treatments to help him recover was to put him on thyroid supplementation. Many dogs are hypothyroid.
Here is a link to get a reference you can give to your vet that explains why thyroid can contribute to anemia: Thyroid Hematopoiesis, the contribution to anemia.
Go to this page
https://www.secondchanceaihadogs.com/canine-hypothyroidism-resources
At the bottom of the page you will see what a molecule with purple, black, white, blue and red. Click on the picture. It will open a new window with the article, you can click the arrow in the upper right hand corner to open it in a new tab where you can save and print it.
So to do the thyroid test with Dr. Dodds you can set up an appointment at your vets with a vet tech to draw the blood sample. Then you will pack it in a couple of ziplock bags and inside a bubble wrap and then into a sturdy box. You will mail it to Hemopet and they will do the test.
Go to this page to get the link to the order form.
https://www.secondchanceaihadogs.com/hemopetresources
On about the 4th row down you will see a form with pictures of Greyhounds at the top. This is the test request form and it will take you directly to the hemopet.org site.
Fill this out, including all your information as well and request Send An Email.
Select this test:
Thyroid Profile 4 (T4, free T4, T3, free T3)
Once you click on it, below it will be all the information the tech needs to draw and prepare the blood sample for you. You do not need an ice pack and that is included in these instructions. Take it to your post office and send it Priority mail. I’ve done this many dozens of times with my dogs.
On this page link below you can see 3 reports from my dog’s thyroid tests. You will notice that Hemopet evaluates by using multiple criteria: breed, age, sex, health. You are getting your dog compared to other dogs of the same breed, sex, age and health. This provides your dog’s specific thyroid value range. If you look carefully you will the first test was done at 6 yrs and the second test was done 3 months later and showed a significant decline in thyroid values. Three months is a short time! We started him on thyroid medicine and tested him 3 months later to find his values were now normal. I continue to repeat testing about every year or 10 months.
Two weeks is pretty early to be looking for full recovery. Your questions should be along the lines of “how stable is her health” “what can I do at home to improve her stability” “are you planning on adding a second immune suppressing drug like cyclosporine or Cellcept.” You need some day to day instructions about how to evaluate her and what to look for that is good vs not so good. We can help you with home care which is critical.
As Vally says, the spleen really stores most of the dog’s blood when they are resting. The spleen is doing some housekeeping, cleaning up old RBC and getting rid of the debris and doing some immune system work. Some vets call this state “nocturnal anemia.” But as soon as some stressor occurs, for instance the doorbell rings, the spleen uses very strong muscle contractions to squeeze all that blood back into circulation, like an “instant transfusion.” This is very normal.
However if you continually see grey white gums and under the lower eye lid, that is not good. Take your thumb and press it against the upper gum, then release. You should see a rapid refilling of color. If you do not then it would be time to take her back in for another PCV check. We don’t want her to get too low of a PCV and she is going to have lower blood pressure which will not feel good.
When you do any blood work make sure you have her on a fast for at least 8-10 hours before the blood draw. But plenty of water. Fat in the blood can cause artifacts in the sample that can confuse the automated analyzer and lead to incorrect values. Each test is critical and must be done absolutely correctly. Always ask for the tech that does this best and that Ginger likes. Being calm during a test is also important. Stress can affect the values as well.
Are there more question you need answered?
my best patrice
Patrice and Vally, thank you both so very much for the information. I can’t tell you how much I appreciate what both of you do. Again, Ginger’s PCV last week after her blood transfusion was 36. Yesterday it was 34, so I was glad it had not dropped as much as I thought it had. The vet said that her blood had some yellow in it, bilirubin, which made him think she may still be destroying some of her blood cells.
I also sent the blood yesterday to Dr. Dobbs for a thyroid test. Thank you for the instructions. Also, thank you for the instructions about how and when to take her in for her PVC.
I am now concerned that she may be getting a stomach ulcer. Today she has had diarrhea with a small amount of blood in it. I had been giving her omeprazole with her other pills because that was what I was instructed to do. I just read something someone else said that the stomach medication should be given an hour before eating, which I am now doing, and giving her the prednisone and mycophenalate with her food. Should I take her to the vet tomorrow because of this? Is there something else I can give her for this?
Ginger is eating well and sleeping a lot. I am looking forward to hearing from you.
Thank you
Terri
Terri,
Red blood seen in stool is due to an irritation in the colon. Bleeding higher up in the digestive tract will show up as black in stool.
Colitis is always a concern in dogs being treated with many drugs. You should explain what you have seen to the vet. We don’t want to see watery bloody diarrhea.
I can suggest that you provide a bland diet, preferably home made, and include a few teaspoons of plain pumpkin in meals. That will provide some bulk. We don’t want any roughage to irritate the colon. Other additions could be plain yogurt, scrambled eggs. Mixed together it’s like pumpkin custard.
The vet may prescribe metronidazole for this and that’s fine, it should resolve it quickly.
My best Patrice
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