Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - cocos blood test results

These is cocos lab results from 12/19: total protein 6.4 albumin 3.3 globulin 3.1 a/g ratio 1.1 alt(sgpt) 64 (vet said ok) alkaline phosphatase 232 (high) total bilirubin 0.3 bun 9 (vet said ok) creatinine 0.6 bun/creatinine ratio 15 phosphorous 2.7 glucose 48 (low but vet said ok) calcium 8.9 corrected calcium 9.1 sodium 143 potassium 3.5 (low)due to vomiting na/k ratio 41 (high)due to vomiting chloride 93 (low)due to vomiting cholesterol 141 cpk 75 wbc 12.7 rbc6.7 hgb 17.2 hct 49 mcv 73 mch 25.6 mchc 35 anisocytosis +2 neutrophils 10795 (high) lymphocytes 762 monocytes 889 (high) eosinophils 254 If anyone out there can translate this for me please do, my vet tried to explain but I didn't retain much.

kelly redding

I left off some information: basophils 0 platelet count 78 platelet clumps are present I hope this is enough information for someone to dicipher(correct spelling?) for me. As to the stomach protectants they need do you mean something like pepto-bismol or mylanta? or do you mean a type of prescription?

kelly redding

Hi Kelly This is interesting. The HCT (which is basically the PCV) is 49 which is normal! Platelets at 78 is low I think - normal is 200 to 500. Please anyone correct me if i am wrong. I am no expert at this because Millie was destroying red blood cells not platelets. Sounds like Coco has Immune Mediated Thrombocytopenia where the immune system attacks the platelets. Destruction of platelets in large numbers can result in pinpoint bleeding in the skin and guns or a nose bleed may occur. If bleeding is excessive I guess anemia may occur. I am not sure if the treatment for ITP in terms of meds dosage is the same so maybe seek a second opinion on the advice i gave about the pred dosage as I assumed IMHA. I am sure someone will add to this soon. Samantha and Millie.

Samantha Geelong Australia

Hello Samantha, my vet explained it to me like this if I remember correctly...somehow something was able to enter and attach itself to cocos platelets tricking the wbcs into attacking and destroying the platelets(she did have an weird growth on her side which had an open wound which was removed by her vet about a month earlier I don't know if this has anything to do with this new illness or not)When I took her in she was listless, would eat very little and was throwing up very often(mainly bile looking stuff)and had lost alot of weight. I thought when I took her in he would find soemthing obstructing her intestinal track or something like that but he found nothing and ordered the bloodwork. When he got the blood work back he based his treatment on the elevated monocytes and neutrophils and the very low platelets. He had two other cases in recent months. Does it still sound like imt to you? the only bleeding I noticed has been what I think was blood in her stool.Her gums are REALLY pale tonight.

kelly redding

Hi Kelly Yes definitely sounds like ITP. Your vet explained it correctly. We can never be sure of the trigger so it could be something to do with the procedure you mentioned. My Millie's was her vaccination we think. The immune system thinks the red blood cells and the platelets are foreign in cases of ITP and IMHA. I am concerned the Coco has pale gums which could indicate red blood destruction that occurred after this blood test or that she is bleeding internally as a result of the platelet destruction. I think it is critical to get her to a vet for further testing soon as possible. Is there an Emergency Clinic you can get her to instead of waiting for your regular vet? I feel time is of the essence here. Samantha.

Samantha Geelong Australia

Hi Kelly I just posted in the other thread and here you are with the numbers! I agree with everything Samantha has said - including the urgent need to seek treatment in regard to the pale gums. My Riley started with IMT and was not anaemic, but had a bleed which threw him into anaemia. The pale gums are usually an indication of low red blood cells which carry oxygen through the body. High monocytes and neutrophils indicate that there could be some kind of internal infection going on. The normal PCV is a good sign. Others may have some further information for you. As far as I know the treatment is the same for both - Riley was placed on prednisone, azathioprine, and also cyclosporine which has recently been increased. All the very best to you and Coco Silka

Silka Melbourne Australia

Kelly I am very worried about Coco. I am not sure what time it is in California, but I am concerned that Coco might be bleeding internally. If her gums are pale she would almost certainly be anemic. She may require a blood transfusion. Please see a vet urgently. Pale gums are not good at all. Samantha.

Samantha geelong australia

Kelly, It sounds like Coco may have immune mediated thrombocytopenia (IMT/ITP) rather then AIHA/IMHA. AIHA/IMHA is a disease of the red blood cells while IMT/ITP is a disease of the platlets. IMT/ITP is treated basically the same as AIHA/IMHA except some vets sometimes add another drug called Vincristine. You can learn more about Vincristine here: http://www.marvistavet.com/html/vincristine.html You might also want to read about "Midnight the Miracle ITP Dog" who had ZERO platlets when she was diagnosed with ITP. You can read about Midnight here: http://www.cloudnet.com/~jdickson/midnight.htm Midnight is currently doing well and I plan on updating her story again as soon as my schedule allows. Be assured I am keeping both you and Coco in my thoughts and prayers during these most very difficult days.

Joanne MN

Forgot to mention that at the end of Midnight's story there are are couple of links to sites with info on ITP/IMT that you might want to read.

Joanne MN

Kelly, I am in Redding too. who is treating Coco? My Wylie was diagnosed 4/08 and in remission but still has ongoing problems. Igo to Westside, Have you been to the Asher Emergency clinic? Laurie

Laurie CA

hello Laurie, Coco is being seen by Dr Merkle out by Hawes Farms. How do you like Westside? Is that the office next to 273 and Railroad Ave? Do they seem to know what they're doing? Please get back to me so I can get her in to see them, I tried reaching her vet but he will not be available until Jan 5. On the upside I increased her predisone to her original dosage,started her on multi-vits and altered her diet to rice,cottage cheese,scramble egg and a lil pumpkin.She seems to have more energy today, definitely is eating well and has a little more color in her gums. I would like to have more blood work done though.

kelly redding

Kelly, I'm so sorry you have to deal with this. If she seems to have more energy, is eating well and the color is coming back to her gums then those are all good things. I'ld also get more blood work done if I were you. Maybe they could take the blood from the jugular if the platelets are clumping. The bigger the vein the better in this case. Keep us posted on any news and if you have any concerns just ask. Prayers and strong healing vibes for Cocos. Johnny & Tessy

Johnny

Kelly, Westside is just up from one on Railroad and 273, they are great. I am concerned your vet dropped the pred so fast and so much, that can cause otherbad complications. I am not very familiar with ITP/IMT but Wylie may be experiencing it now as she has always had very high platelet counts and the last few months they have dropped dramatically. They want to do a visual platelet count, have you had that done? Laurie

Laurie CA

Johnny, Thanks for the support,I honestly didn't realize how many dogs were affected by these types of diseases. My prayers are with you and Tessy. Laurie, I will give them a call today, thanks for the quick response. They did a blood smear, is that what you were refering to by a visual platelet count?

kelly redding

Kelly I just saw your response on my post, you really have to be your pets advocate and ask lots of questions, I do and my vet is very responsive to me. he is Dr Ginno, I saw Dr Dave yesterday since Ginno is on vacation. I really like them, but have also questioned some treatments that I learned here. Again he is very receptive. I mentioned about your vet dropping the pred, ask him to explain why he did and wouldnt there be a concern to the adrenal funtion? Also have they done a visual of the blood that will help confer the other number. They must have if they see clumping. Also keep a spreadhsheet, this is very important with these diseases. I admit my vet wasnt concerned about Wylies low platelets, since she was in the normal range so he wasnt looking for a problem. But if you see my post on my question, I have those numbers in an excel spreadsheet that gives a snapshot a big rapid decline and I brought it up. Laurie

Laurie CA

This thread was discussed on 29/12/2009

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