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- sassy is relapsing.
You are totally on the ball Alyssa! About the clumping, that is Sheena’s territory I am sure she will give you an educated answer.
Brigitte
Hi Alyssa
What I very rudely forgot to say is that I am so happy Sassy is continuing to have a comfortable tummy! Great news.
Looked at the tests – lots of great news on here too – everthing looks really good. No pancreatitis signs at all. Slightly high neutrophils – these are the culprits for the high WBC count. Infection is the most common cause. Just keep a close eye on her. I am wondering if she has had a tummy bug actually. It would explain her discomfort etc. As Brigitte says, I would use a probiotic.
Don’t worry about the platelet clumping comment – this happens sometimes with the chemical (EDTA) used to prepare the slide, it is the mosy likely (common) cause, rather than what is happening inside Sassy herself. The note was added to tell us that the automatic counting machine figure might not be 100% accurate because of this – so not a problem. There would be a different comment if they had been concerned. Large platelets are also often due to the chemical EDTA, so are not in fact large at all. Sometimes, there are some larger platelets with auto-immune disease. A different chemical could be used to check the slide & count again, but I really wouldn’t bother – more money you don’t need to spend.There are funny sized red cells too – it used to freak me with Worzel, until I read about it & realised that it would take ages for all these size issues to settle down to normal & they are not important during the recovery process.
Hope this puts your mind at rest a little. I honestly can’t see much wrong. The only thing you need to watch is that possibility of infection from the high neutrophil figure.
Love Sheena xxxxx
Hi Alyssa
You are a star, and so is Sassy. Wonderful to read that she is feeling such a lot better, and what a relief you are not dealing with pancreatitis. Your vet sounds awesome – I wish they were all like yours, I really do.
Please give Sassy a cuddle from me. I’m so glad she’s doing better.
Much love,
Mary and Mable x
Back from checkup –
Still haven’t gotten the go-head to lower her meds. Her white count is still high. This is now after 2 weeks of Doxycycline. The in house test said 21%, however it might be wrong – we are sending it off and I’ll have those results in the morning. Last time their test said 22, and the lab said 16. So hopefully it will come back at 15. But that is still above her normal 8-10.
PCV was 43, it was 44 last time but I’m not too concerned with that, platelets were good 296.
I just don’t know about the white count. I’ll have the detailed results tomorrow but it’s probably still neutrophil. Do I need to be thinking about something like cancer at this point?
Just doing a bit of reading,
—–
Reasons Why Your Pet’s Neutrophil Count Might Be High (Neutrophilia) :
High levels of neutrophils occur in many infections. But other forms of inflammation, such as wounds and surgery can elevate their numbers as well.
Sudden stress that stimulates your pet’s adrenal glands to liberate corticosteroid and epinephrine also raise neutrophil numbers (stress leukogram).
Autoimmune and allergic reactions can liberate chemicals (inflammatory cytokines) that cause high neutrophil numbers as well.
Corticosteroid medication (eg prednisone) can also elevate neutrophil numbers.
—–
Sheena, you mentioned before I think steroids can actually cause a high white-count. That seems really weird to me, and that didn’t happen to her before however, before she was taking PredNISONE. This is PredNISOLONE. I realize it’s the same drug, but could this possibly be the cause?? That is the *only* thing different this round of treatment, med wise. Should I mention it to her vet? Should I switch to Prenisone?
She said if the idex results came back and are really at 21% (which to their test, would be up from 16 1.5 weeks ago, after a round of Doxy), that we’d need to start looking for infections – x-rays of lungs, ultrasounds, in other words, money money money. I’ll do it, if I need to. With the idex report tomorrow I will also have urinalysis results that are being run in the lab.
The ONLY other things I’ve added this time are supplements, being liquid sam-e drops in her food and simple digestive enzymes – the sam-e I’ve been doing for a while, the digest enzymes I’ve been doing since she had her weird tummy troubles and that hasn’t seemed to raise or lower her white count. The sam-e, I’m not so sure. I cannot remember exactly when I started using it. It very well could of been just before her white count went back up. I remember at once point it was showing 16 at the vets in-house test, then started going up from there. But I can’t find anything on sam-e causing elevated white cells in dogs or people. I did not give sam-e last time as her liver enzymes never went over about 800. I am also giving her powdered milk thistle, but this is something I gave her entire treatment last time.
That’s another thing – her liver enzymes are over 2,000 as of 2 weeks ago – now I know that’s not that bad, but for her, it’s another thing that is different. She was never above 800ish last time, even when I was not giving milk thistle – I started giving her thistle near the end of treatment. This time, I’ve been giving thistle AND sam-e since she started her meds, and her enzymes have still gone over 2,000. This is also with Prednisolne, which supposedly is less taxing on the liver? Is this something we should explore? I guess I should keep in mind that by this point last time we had stepped her meds down several times by now. She is still on full doses of both since Dec. 28th.
Sassy has just been great lately – she was very very happy at the vets this morning. Dr commented that this was the happiest she’d saw her since Fall. She was “happy” and calm and not just high-strung energetic crazy. She doesn’t seem sick at all, infection-wise, just the usual tiredness from Pred.
So I called and asked about prednisone causing high neutrophils and she said that while that can happen the whole white count value usually isn’t raised? The % of neutrohpils will be up, but overall the count would be normal. She did not seem to think this could be the cause.
Sigh, I’m just at a loss. How do you find an infection.
Hi Alyssa
Prednisone & prednisolone are exavtly as effective as each other. The only difference is that the liver converts prednsone into prednisolone, therefore there is a slight (I think insignificant) delay in action. I had never come across prednisone as we always are given prednisolone in europe – usually soluble, so it works even quicker.
Milk thistle can be given in quite high quantities, so have a look at this site (note Dr Dodds mentioned on here) so you could maybe up Sassy’s dose:
http://www.canine-epilepsy-guardian-angels.com/milk_thistle.htm
Word of warning – larger doses can causes tummy issues including diarrhoea, so increase it SLOWLY to give Sassy a chance to acclimatise to it.
I can see you are really trying to get your head round the WBC issue! And now you see how important it is to get individual numbers. Be careful not to scare yourself with blood test results though – it’s more a big picture – I explained that machine results can be skewed & manual counts are often needed (blood smear). Remember the most obvious cause of the results usually is the cause too – please don’t go off on a tangent & look at the least likely, or you’ll be climbing the walls.
It is true to say the drugs can elevate figures – but there is a big difference between slightly above normal & very high. If you are really interested in understanding the blood work, the best person to discuss it with in detail is your vet – I only had a general overview of bloodwork from my medical background & I have put a lot of hours in (I do mean a lot too!) to understand things more – and I was very lucky my specialist didn’t mind explaining further. I also have several very expensive haematology books, human & veterinary, which I still need to refer too. I don’t know anywhere near everything, Alyssa. I never will. There is a calculation for relationships between WBCs if only a granulocyte figure is given – it’s much better to have actual numbers though. Remember the cancer I think you are worried about (leukemia) presents many other symptoms apart from high neutrophils & Sassy wouldn’t get better, then relapse, plus your vets would have spotted it anyway. AND it is the least likely cause. Have a look at the link I will put in a separate message below which says “A high number of neutrophils does not cause symptoms. However, people often have symptoms of the disorder that is causing the increased number of neutrophils.” Dogs too!
What I do know is that we are very lucky our dogs have got better! And you know the most important thing? Does your dog seem ill? No, they seem fine – eating, happy, playful, comfortable – nothing much wrong there then. I worry when I know they are not right – if Sassy has been fine, then she’ s doing fine too.
So, I would look at Sassy & ask yourself – does she have any symptoms? Is she eating OK? Is she happy? Yes? Good! Just watch for any signs of infection in her wee, poo or eyes/nose & get it checked out if necessary.
Sheena x
https://www.msdmanuals.com/home/blood-disorders/white-blood-cell-disorders/neutrophilic-leukocytosis
Nice simple & common sense explanations of everything on this site if you look around
click on various neutrophil values on chart:
http://www.2ndchance.info/normaldogandcatbloodvalues.htm
Sheena x