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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Daisy update low platelets enlarged heart / liver
| Took Daisy for the check up and even with the 50m of Pred and the Imuran her platelets are now only at 12 and now her liver enzyme is at 270 and normal is 100-120. Her Red Blood cells are now normal In addition she has begun wheezing so with the live enzymes high they took some x-rays. Really can we ever catch a break or get good news, the x-ray shows an enlarged heart and liver along with fluid in her lungs. X-rays also show a mass by her heart and liver, the vet says that could be fat but note sure. So now I have to take her for an ultrasound so they can see what is causing the heard and liver to be enlarged and if the mass is fat. But again the vet is mystified that given all of the above, she is not showing other symptoms or acting sick. I need to find a vet that is like Dr House so they can figure out what is wrong with my baby. I am so tired of crying and getting bad news after bad news - my baby has been through so much in her 8 1/2 years. Does anyone have any ideas as to what could be wrong or what causes low platelets, enlarged heart, enlarged liver, high liver enzymes and the fluid in her lungs? I have been surfing the internet for hours and can’t find anything that fits all of the problems. Any help is greatly appreciated Thanks Tina & Daisy |
| tina ohio |
| Tina, I'm sorry things aren't going the way you'd like. This can be fairly complicated to deal with and the only way to tell for certain why the thrombocytopenia (low platelets) is present is to start with a checklist and start checking things off that don't belong. Usually the most common causes of thrombocytopenia is accelerated platelet destruction, decreased production (bone marrow), increased consumption (internal/external bleeding), and sequestration (splenic (enlarged spleen)). Probably sounds like quite a bit to deal with or remember but for a vet this should be fairly straightforward...or at least I would hope so. SO, the first thing I would do if I were you is cross off the ones that are not causes and the only way to do so would be by running appropriate testing. Let's start with the first one...platelet destruction. Platelet destruction....If I were you I would be asking for the PSAIgG assay which will detect IgG antibodies that are bound to the surface of the platelets. This is a newer test and is much better than the older ELISA test. This is similar to a coombs test that checks for antibodies on the red blood cells except it does so for the platelets. Since it's a newer test it may not be available everywhere. You may have to call around to different vet schools. Start with Ohio State vet school...they are very good. IN FACT...you'd be very wise to contact them and if you are close go there to see a hematologist. ANYWHO, second...decreased production....I'm assuming a bone marrow aspirate or biopsy would answer questions to this answer. Usually with bone marrow disorders you would see all lines of cells affected...rbc, wbc, and platelets...but not always. Increased Comsumption....I'm not really sure where to start with this one. If it were me and there were no signs and all clotting factors were normal then I'd be checking this one last possibly...after checking for destruction and production problems. Splenic Sequestration....usually the spleen will be enlarged. Usually the platelets circulating in the blood make up 2/3 of all the platelets and the rest are stored in the spleen. I think I mentioned to you before about having a full Tick Panel done. Have you looked into having this done. Tick born diseases are a major cause of thrombocytopenia and having these tests done will at leaest let you cross this one off. Off the top of my head Rocky Mountain Spotted Fever. You could also ask about using Vincristine. This causes a release of platelets from megakaryocytes in the bone marrow. I haven't heard much on htis but have heard others here talk about this. Another option...lower the azathioprine dosage. BUT I'd want to check the above to figure out why the platelets are low in the first place. Only then can you properly treat the condition. NOW....this is where Ohio State College of Veterinary Medicine may help. Usually you can save a lot of money by using schools like this and the service is usually much better. You get cutting edge technology at your fingertips and they are usually up to date on all protocols. I WOULD STRONGLY URGE YOU TO CONTACT THEM!!! It's a Saturday night and hockey is on so hopefully I didn't miss anything. If you have any questions just ask. I've got a super soft spot for cockers...I have 8 myself! One named Daisy also!!!! For the time being keep her really well rested and try your best to keep her still and inactive. The smallest bumps or bangs can cause BIG problems with platelets this low. Next test have them take the blood from the jugular. It's much more accurate this way! I'll be keeping YOUR Daisy in my thoughts and prayers. Keep us posted to how she's doing. Johnny & Tessy |
| Johnny |
| johnny-- thank you so much for your reply, i have printed a copy and will take it with me to the specialists on Monday. thank you for all the information, thoughts and prayers. tina and daisy |
| tina ohio |
| Tina, I hope you get some answers soon. Keeping you and Daisy in my thoughts and prayers |
| Penny Lytle Creek Calif |
| Just wanted to let you know that I am keeping Daisy in my prayers. Please let us know how she does tomorrow at her vet visit. Cheryl & Ginger |
| Cheryl & Ginger Pinevile Pa |
This thread was discussed between 10/04/2010 and 11/04/2010
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