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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Clyde-Our Springer Spaniel-UPDATE
| Hello All, It was suggested a new thread because the other was getting way long, so here it is... Petcare just faxed over Clyde's latest blood work. I have referenced his old numbers as well. New numbers are in the ( ). You know after his vet visit yesterday with his pack cell number 37...I don't know what I was thinking but thought that all his numbers would be normal on his chem panel. I know, clearly unrealistic! Total Protein (3/8: 6) 5.1 RR: 5.0-7-4 Albumin ( 3/8: 3.5) 2.9 RR: 2.7-4.4 Globulan (3/8: 2.5) 2.2 RR: 1.6-3.6 A/G Ratio (3/8: 1.4) 1.3 RR: 0.8-2.0 AST (3/8: 111 HIGH) 21 RR: 15-66 ALT (3/8: 472 HIGH) 23 RR: 12-118 ALK Phosphatase (3/8: 628 HIGH) 170 RR: 5-131 (this was 126 on 2/22) GGT (3/8: 19 HIGH) 6 RR: 1-12 Total Bilirubin (3/8: 0.3) 0.4 RR: 0.1-0.3 (this was 1.2 on 2/22) BUN (3/8: 24) 20 RR: 6-31 Creatinine (3/8: 0.6) 0.5 RR: 0.5-1.6 (this was 0.4 on 2/22) BUN/Creatine Ratio (3/8: 40 HIGH) 40 RR: 4-27 (this was 28 on 2/22) Phosphorus (3/8: 5) 4.2 RR: 2.5-6.0 Glucose (3/8: 121) 110 RR: 70-138 Calcium (3/8: 9.7) 8.6 RR: 8.9-11.4 (this was 8.2 on 2/22) Corrected Calicum No number (I think) 9.2 (it's blurry) Magnesium (3/8: 1.1 LOW) 1.3 RR: 1.5-2.5 (this was 1.3 on 2/22) Sodium (3/8: 146) 148 RR: 139-154 Potassium (3/8: 4.6) 4.3 RR: 3.6-5.5 Na/K Ratio (3/8: 32) 34 RR: 27-38 Chloride (3/8: 107) 112 RR: 102-120 Cholesterol (3/8: 155) 145 RR: 92-324 Triglyceride (3/8: 94) 65 RR: 29-291 Amylase (3/8: 267 LOW) 1384 RR: 290-1125 (this was 248 on 2/22) Lipase (3/8: 132) 255 RR: 77-695 CPK (3/8: 239) 107 RR: 59-895 WBC (3/8: 18.8 HIGH) 26.1 RR: 4.0-15.5 (this was 25.9 on 2/22) RBC (3/8: 4.8) 3.1 RR: 4.8-9.3 (this was 1.5 on 2/22) HGB (3/8: 12.2) 8.0 RR: 12.1-20.3 (this was 3.8 on 2/22) HCT (3/8: 42) 28 RR: 36-60 (This was 11 on 2/22) MCV (3/8: 88 HIGH) 90 RR: 58-79 (this was 74 on 2/22) MCH (3/8: 25.4) 25.8 RR: 19-28 MCHC (3/8: 29 LOW) 29 RR: 30-38 (this was 34 on 2/22) Hypochromasia: (3/8: no comment) Moderate (this was slight on 2/22) Anisocytosis: (3/8: Moderate) Marked (this was marked on 2/22 Polychromasia: (3/8: slight) slight (this was slight on 2/22) NRBC: (3/8: no number) 4 RR: 0-1 (this was 2 on 2/22) Platelet Count: (3/8: 187) 149 RR: 170-400 (this was 84 on 2/22) Platelet Est: (3/8: Adequate) Adequate Neutrophils: (3/8: 86 HIGH) RR: 60-77 21663 (High) RR: 2060-10600 Dohle Bodies: (3/8: no comment) Slight Bands: (3/8: no comment) 522 (high) RR: 0-300 Lymphocytes (3/8: 8 LOW) RR: 12-30 1568 RR: 690-4500 Monocytes (3/8: 4) 1566 (high) RR: 0-840 Eosinophils: (3/8: 2) 261 RR: 0-1200 Basophils: (3/8: 0) 0 RR: 0-150 Metamyolocytes (3/8: no comment) 522 (high) RR: 0-0 Absolute Neutrophils: (3/8: 16168 HIGH) RR: 2060-10600 Absolute Lymphocytes: (3/8: 1504) RR: 690-4500 Absolute Monocytes: (3/8: 752) RR: 0-840 Absolute Eosinophils: (3/8: 376) RR: 0-1200 Absolute Basophils: (3/8: 0) RR: 0-150 I think they must use different labs for their work because it always looks different on the results pages. So...here is his latest...I see some things are higher than they were before and some lower. Again, thank you everyone for your thoughts. Hugs and prayers, Kathy and Clyde |
| Kathy Northern California |
| Kathy, Quickly here. Your blood numbers are all very close to normal. Congratulations! The liver is beginning to complain about the prednisone, AST (3/8: 111 HIGH) 21 RR: 15-66 ALT (3/8: 472 HIGH) 23 RR: 12-118 ALK Phosphatase (3/8: 628 HIGH) 170 RR: 5-131 (this was 126 on 2/22) The liver needs some supplementation now to help it regenerate cells. Ask about Denamarin with your vet. I used this with Chance. I highly recommend it. The liver will regenerate from this damage once the prednisone dose is lowered. To give you an idea of how high these numbers can go, Chance's ALK was over 8600 at one point. It did eventually return to near normal! I do not like the continued poor BUN/Creatinine ratio, this reflects kidney function and not so good removal of wastes from the blood stream. While the BUN is within normal range and so is the Creatinine, the ratio of the two is high. This can possibly indicate a post-renal cause, this is called azotemia. (Not kidney problems) *Pointedly ask the vet about this.* I feel there may be some kind of kidney stones which would also go along with the high white blood cell count. BUN (3/8: 24) 20 RR: 6-31 Creatinine (3/8: 0.6) 0.5 RR: 0.5-1.6 (this was 0.4 on 2/22) BUN/Creatine Ratio (3/8: 40 HIGH) 40 RR: 4-27 (this was 28 on 2/22) White blood cells are still somewhat high, but you can see there is a gradual decline. However, they need to explain to you what they think is the most likely cause. Again, I have a feeling this is related to the high BUN/Creatinine ratio. my best patrice |
| Patrice NYS |
| Thank you so much Patrice! Your knowledge and explaination of Clyde's lab work is amazing! I am writing out a note and will drop off tonight. Dr. Davidson won't be back into the office until next week then she is gone for two weeks but she can respond to me via telephone. Starting tomorrow 3/10, Clyde's prednisone goes to 1 pill a day but we are adding aspirin back twice a week. I did ask Dr. Davidson today about going back on the carafate and she said that Clyde didn't need it but I told her that as long as it wasn't hurting him I would feel much better being proactive with his stomach rather than reactive is there is a problem. She said no problem and that I can start that back twice a day. I will report back tomorrow once she has called. Thank you again, you and everyone else on this site have just been so wonderful and helpful! Hugs and Prayers for everyone, Kathy and Clyde |
| Kathy |
| Hello All, I took a note over to Dr. Davidson last night and they faxed it to her at UC Davis this morning. I also sent her an email as well. So I am waiting to hear from her. On another note...I have a question. I don't know if this has any relevance at all to Clyde's problem. When we first took Clyde into the vet in February, she said she thought Clyde had-Discoid Lupus. Today I noticed that Clydes sister's nose is looking weird around the edges, dry, turning a lighter brown and looking like crust. We are going to take her into the vet to make sure...but do you think that this discoid lupus is the cause of Clyde's original problem? Thank you all Hugs and Prayers, Kathy and Clyde (Bonnie too) |
| Kathy |
| Hi Kathy, Interesting thought.... I am sure Patrice would have some more input. With my limited knowledge I would say that there could definitely be a connection. Lupus is an auto immune disease so it could be related to AIHA, be the underlying cause. I think if it comes right down to it, all our dogs have a compromised immune system, even if they seem healthy. The trigger, what ever it is will then cause the AIHA. A dog with a healthy immune system can take the trigger with no ill effect, but our dogs could not. This is the way I see it, but I am happy to have somebody correct me. I hope Clyde keeps improving! Best wishes, Brigitte |
| Brigitte BC Canada |
| Discoid lupus erythematosus is an autoimmune condition related to SLE systemic lupus erythematosus. However, while SLE is very serious (systemic or throughout the body (system)), DLE is generally localized to the skin of lips, eyes, ears, and maybe even the genitals. Treatments usually include sunscreen, staying out of the sun, dietary supplements like fish oil, antibiotics and prednisone. Where the difference lies is in the type of immune cell that causes the damage. The plasma cell is related to the T-lymphocyte cell, but is a poor cousin that does not commit the same kind of craziness that killer T-cells do. (They are the culprit in AIHA) Since there is not enough understanding of what actually causes these cell types to be different, it is probably not well understood whether this kind of minor autoimmune condition can blossom into something like AIHA. However, it is worth noting that Brittany Spaniels are commonly affected by DLE. Chance had severe allergies starting around 1.5 years old. I eventually had to have expensive allergy testing done and give him allergy shots for many years. Before this kind of treatment was available, some dogs were actually put down because the allergic symptoms were so severe that life was miserable. I was lucky to find a veterinary dermatologist specialist who treated him. He led a relatively normal life after that. But I am pretty sure that he had inherited tendencies to autoimmune disease and he definitely expressed that by eventually having total bone marrow failure. Why are there more pure bred dogs with autoimmune issues? Probably because breeding programs are not as carefully controlled as they could be. There is always a lot of pressure to produce dogs that look good and will sell future litters. It only takes a few breeders of a particular breed to pollute the genetic pool with serious diseases. I always mention the Dalmatian as a breed that is plagued with a serious genetic defect. At one time in the near past, nearly 70% of all Dalmatians were deaf. It is caused by a genetic defect of the inner ear structure and is directly related to coat color. In other words, the gene that carries the information for making the ear properly is related to the black pigment in the coat. Owners wanted their Dalmatians to be more white with less black and so breeders obliged by breeding them to be more white. Now-a-days the national organization is recommending that these deaf dogs be euthanized at birth. You can imagine it took some brave folks to decide to make a blanket statement like that! You can agree or disagree but regardless it will begin to remove that genetic defect from that breed. So I look at the Giant Schnauzer and I ask what baggage is this breed carrying around? How can I improve this situation? So this time I looked carefully at the breeders I had available to me and I waited for the right combination of two excellent breeding programs and made my pick. Does that make any guarantees? No. So what that you have a Springer Spaniel. Do you love him any less? Wish that you had picked another dog from the litter? A different breed? A Heinz 57? I'll bet not. I never like to mention when a particular breed is more prone to AIHA purely for this reason. They are all individual dogs with their own personality and we each love our own dog as our family member. I would not worry too much about this DLE, but if you want to be reassured, you can ask your vet if they would do a ANA test, antinuclear antibody. The DLE will usually return a negative result, while SLE with return a positive. my best patrice |
| Patrice NYS |
| Kathy: I'm not sure if Springer Spaniels have this same problem but our GSD/Cocker Spaniel mix, Sheba, started to develop "dry nose" and her paw pads started growing/getting dry, too. Our vet explained that as some cockers age, their noses and paw pads can start to grow and become dry. He said that it's like when your finger or toe nails grow. At that point Sheba hadn't been taking a fish oil supplement because we were having trouble finding one she would take. Once we found a new one and she'd been taking it for a bit, her nose got better. You might ask your vet about this to see if it's something similar. Rita, Mike and Sheba |
| Rita IA |
| How is Clyde doing, it has been awhile since your last update and I hope things are still going well for him. Sending our prayers Cheryl & Ginger |
| Cheryl & Ginger Pineville PA |
This thread was discussed between 09/03/2011 and 22/03/2011
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