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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Bad news for Joey
| Well just a rotten end to what's been a bad week.Joey's bloodwork came back but this time it's too high.His reticulytes (baby/new blood cells- wrong spelling)have gone up to 173 and his PCV is up to 45.My vet is concerned that they are being destroyed although at present he is compensating by making them up. We are now back to having monthly blood tests again.Please keep all fingers and paws crossed, Love and best wishes to all, Joey &Corrie.xx |
| Corrie cor28rie@aol.com |
| I wouldn't think a retic count of 173 is overly bad. This could be due to several things. I'd assume the vet either sent the sample out for analysis or at the very minimum looked at it under the scope. Do you know what his normal crit is? The thing that concerns me is the fact that the vet is concerned with these numbers but still insists on only doing monthly tests. IF it is the rbc being destroyed then waiting a month is a bad idea. I'm surprised they didn't run a chemical panel. I'd be wanting to know all the renal and hepatic values!!! This would be top of my list after a smear. Did they do any tests or just send you home??? Stool and urine all normal? I'd (myself) would also be curious of the other values ...mcv, platelets, hemoglobin (&concentrations), etc. Do you have these? Good luck and keep us posted. Johnny & Tessy |
| Johnny |
| Corrie That is terrible news! Please, do keep us updated on Joey. I've "crossed" everything I can for you, and will throw in a little prayer for good measure. Maureen and Mercedes |
| Maureen BC Canada |
| Corrie, Do you have the full lab results at home? I would like to know if there are any notations on the lab report about spherocytes. This would be very important to know. In autoimmune hemolytic anemia that is regenerative, the bone marrow continues to make new baby blood cells, reticulocytes, in response to a need for more oxygen to the body cells. Instead of letting them hang out in the bone marrow for about 3-4 days to mature into red blood cells, the body shoots them out into circulation immediately. They show up on the blood smear and to the automated analyzer as larger cells that contain RNA. That is how they are identified. What is somewhat confusing about this partial information is that you mention a PCV of 45, and with this, the hemoglobin count should be absolutely normal. This is the carrier of oxygen in the red blood cells. If this level is normal, then the body wouldn't be looking for new red blood cells to be made, right? There should not be reticulocytosis or the making of a lot of new red blood cells. What would cause this to happen? If the RBC currently in circulation are being destroyed, then the hemoglobin would not be providing oxygen to the body cells and there would be a call for new RBC. So let's find out first if this is really happening. And the two items on the blood test I would want to see if they are there are visible spherocytes in the blood smear and if there are high levels of bilirubin in the blood. Spherocytes are red blood cells that have a certain marker on them that identifies them to the immune system as "not self." The spleen will process these RBC and take a "bite" out of them in an attempt to destroy them. They show up as oddly shaped RBC, with a little half moon shape. There is no mistaking these cells. Bilirubin is the coloring of hemoglobin. We process a little of this everyday as we process old worn out RBC and it's not a problem. But when a lot of RBC are destroyed simultaneously, a large quantity of bilirubin is spilled into the body. This shows up as yellow in mucous membranes like the eyes or as a yellowish tinge to the skin. I would want to see these two things for sure before I would get very worried. What could be very well happening is that the new RBC are just larger than their regular cousins and the automated analyzer is seeing them not as RBC, but counting them as reticulocytes. This could happen if the vet is not looking at a blood smear and relying solely on the analyzer. Please post what you have so I can look at it. If this were me I would ask for a blood smear if possible. If your vet cannot do this for you, then ask for a proper lab pathology study be done on a blood sample. This would be done by a specialty lab or at a full service emergency vet office. They will VISUALLY examine the sample and count by hand all these items. There is no sense in you guessing what is happening. Your vet can theorize about what is happening but the tests do exist to determine this with good certainty. How is Joey behaving?? Does he seem like he is having problems? Or does he seem fine to you? my best patrice |
| Patrice NYS |
This thread was discussed between 23/09/2010 and 24/09/2010
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