sassy is relapsing.

[Sheena]

Funny Vally should mention nipples – my friend took her cat to the vet with a “tick” they couldn’t remove – to their embarassment, it was his nipple! Always best to be sure, though.

Alyssa, please be certain that spring water does not contain any nasties such as bacteria or eggs/worms parastites etc. Personally, I’d stick to the bottled variety as it has been tested for nasties. We had a horrible incident in our village with some hunt dogs drinking from some well water that was pumped into a trough. It was contaminated. Most of them died – it was so very sad. I hate hunting, but that’s what people do here, sadly. Not the dog’s fault.

I know I’ve said before that Worzel also has lots of interesting lumps, bumps, warts & I’m sure it is the drugs, as Vally says. I always check withe vet if something new appears, or if they grow rapidly or look red/angry. He also has a thing that looks like a giant nipple – it’s a wart – not attractive, but harmless!

Hope you slept well – we all get wound up about anything & everything. Great to hear she’s feeling better & she is a hungry girl.

[Vally]

Alyssa, I actually thought the same thing about the water – if you don’t want to use tap water, maybe use bottled to be sure about the quality. Better to be safe than sorry.

Vally xxx

[alyssa]

I understand the concern – I’m not real sure how I feel about it personally. I’ve lived here 22 years and have never heard of anyone getting sick off the water – it’s not like well water. It’s very very hot springs, the water comes out too hot to touch – it’s scorching. They aren’t even sure if it’s hot from a volcano or just really, really hot rocks in the earth. Then it’s got tons of minerals.

I’m still not sure of it myself, but I do know it basically comes out as boiled water. Still, I likely wouldn’t have the courage to give it to her until she’s off immune suppressants.

[Alyssa]

Not good news at the vet today. And we don’t really know what to do now.

Sassys WBC has continued to rise. It is now 41, up from 33 on Monday, despite having Amoxicillian since then 2x a day. I wasn’t renewed any antibiotic because he doesn’t think it is an infection.

In addition, her platelets went from 599 to 273. With this relapse, she had went after her platelets first. There is major concern that is what she is doing now. And we can’t suppress her immune system further.

She shows no signs of infection and the dr doesn’t think it is one, rather it is something to do with this disease. Pretty much we were sent home with a “wait and see”.

Her PCV DID come up from 29.8 to 33.33. But as I said, she went after her platelets first…

The only thing different about this test was that I fastest Sassy. Usually she would have eaten right before hand. I know you get more accurate results so I fasted her this time. It was about 8hrs without food. Would that effect platelets? But we still don’t have a reason for the continued white cell increase.

Another symptom that has surfaced in the past day is she no longer wants to jump at all. She used to hop right on the couch or in the car even with a 14% PCV. Started yesterday she will start to hop on the couch, stop, and pull herself up slowly. We had to help her in the car because she just didn’t want to do it. I told the dr this but he did not seem really concerned. And said we can’t really give her pain meds because of what she is already taking. Would this be a pred side effect to come on suddenly like that?

The black mass – it pretty much rubbed off like a scab when he touched it and there was no growth inward to her body. So he thinks it was a blood blister or something like that.

She is still eating & drinking like crazy. Wagging her tail. Peeing & pooping. Wants to be pet. Alert.

http://i.imgur.com/Ce9ZExI.jpg
HERE is her test from today.

http://i.imgur.com/YKlIbKp.jpg
Here was Monday.

[Sheena]

Hi Alyssa

Oh poor you – I can tell you are worried sick still. I think actually there is a lot of GOOD news!!! Her PCV is going up nicely & her platelets have dropped into normal levels, after being slightly high. They are not low, they are normal! Lovely news! I know you are a bit panicky about the platelets which is completely understandable after what’s happened, but remember they do vary quite a lot even in normal dogs. I sent you Worzel’s results once to demonstrate how much they go up & down. I promise that is normal. You only need to worry when they go 1 million or over, or when they drop to 150k. Even 150k is not serious (can be normal for dogs such as my greyhounds actually) but because of what’s happened you definitely do need to keep a close eye. Her haemoglobin is getting close to normal too, great news, so please be positive sweet lady!

Thinking about the WBCs, some dogs have problems at the vets with high levels – caused by stress – you mentioned she gets really freaked out & I wonder of this is part of the problem. The spleen can pump loads of blood out really fast, including WBCs when they are highly stressed. Prednisone / prednisolone also causes higher levels at high doses. Her lymphocytes are controlled beautifully – they should be fairly low as they are the culprits for cells destruction (T-lymphocytes) so the drugs are doing their job. Unfortunately, there are no individual figures for each type of WBC – please could you ask them to break them down so we can see neutrophils, eosinophils, basophils as well as lymphocytes & monocytes next time – it would help us to decipher what is going on. Her monocytes are a bit high, showing possible inflammation, but again it could be the drugs doing this.

There is another possibility – abnormal sized cells (very common during recovery) are skewing the machine results. This happens sometimes & the only real way to tell would be to have a look under the microscope. Also nucleated (baby) red cells can often be miscounted by a machine for leucocytes, which are types of white blood cell. This is common in dogs who are producing loads of baby red cells in response to anaemia. A blood smear should be done for Sassy next time if you could please ask – then a manual count of each type of cell carried out would help us too. Sometimes, the vet can also see any anomalies, which helps with diagnosis. Worzel always had a blood smear done in the early days, until he got into normal levels.

So, no need to be down – she is getting better on the anaemia & platelet front & that is the main thing. I hope her WBCs will come down next time – try not to worry too much. If she’s eating, happy & perky, she’s getting better!

Love Sheena x

[Sheena]

Hi Alyssa

How is Sassy? I was worried as we haven’t heard back from you

Sheena x

[Alyssa]

Hi everyone, we seem to be doing okay –
I was going to ask for all of those results today, Sheena, but her blood work was actually a lot better.

Over the weekend her dr called me and said he consulted again with his old teacher, who is an internist that specializes in AIHA, it’s like his lifes work. He basically told us the same thing you did – with the bone marrow indiscriminately spitting out cells in recovery, stress, prednisone all effecting whites. And that vincristine will cause a spike and rapid level out, as we saw.

I wasn’t sure what to expect today because she was more tired than usual and not so happy to see everyone, but I think she was just starving (I fasted her again, since I did last time)

So today –

Whites 25.42, Down from 41.30
(LYM 0.25, down from 0.41)
(MON 1.25, down from 2.59)
(GRA 23.92, down from 38.30)
(LY 1.0, same)
(MO 4.90, down from 6.3)
(GR 94.1, up from 92.7)

HCT/PCV 39.44, up from 33.33
(RBC 4.73 up from 3.91)
(HGB 12.6, up from 11)
(MCV 83, down from 85)
(MCH 26.6, down from 28.1)
(MCHC 32.0, down from 32.9)
(RDWc 14.8. down from 15.4)

PLT 270, down from 273
(PCT 0.31, down from 0.34)
(MPV 11.8, down from 12.4)
(PDWc 40.7, up from 40.2)

Compared to last week here:
http://i.imgur.com/Ce9ZExI.jpg

The plan now is, two weeks. Unless I feel I need to come in. And after that, lowering the pred by 25%. Does this sound good to everyone?

[Sheena]

Looking REALLY good Alyssa – great improvements all round on the blood results. I always feel really mean starving Worzie for so long, but at least it saves me clearing up loads of sick in the car – and there is always sick of some variety, even a poo sometimes, often on the vet’s waiting room floor! Worzel gets very stressed, like Sassy.
So happy to see she is improving every time.

Love Sheena x