Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Need help with Wylies platelet #

Hi everyone, can you please educate me on platelet numbers and the others I have mentioned Wylies platelet numbers have always been on the the high side but are now getting low maybe to much. I posted 2 weeks ago about Wylie being sick, drinking a ton of water, and lethergic and not wanting to eat. She had a temp of 104 They did a full cbc. Her WBC was 4.8 neutrophils wwere 81, and lymphocytes for 624. The vet put her on sepheplx, she responded immediately. She was back to her old self the next day and her temp was normal. Well I am now seeing a downward trend, even if its slight, her drinking is up and she is starting to pick at her food. I had my other dog Jake in this morning and was talking to the vacation vet. WOW, he is great, I told him I was concerned because her gums were also very tacky (but pink) He is concerned the above number and her platelet count at 225 He said the machine can be very innaccurate and a visual should be done, that it could be lower than this especially because of her previous high numbers here they are 11/1/08 702 12/6/08 532 1/10/09 717 3/16/09 798 4/6/09 607 6/17 815 9/15 292 12/15 225 He really wants to look at her platelets and do anohter cbc, or we can put her on doxy and see how she does, which really doesnt want to do unless he he sees her (again he is the vacation doc) but poor Wylie freaks. Laurie

Laurie CA

What drugs is Wylie taking currently? If I were you I'ld be more concerned with the WBC than the platelets. To me the platelets sounds right. If I were you I'ld do the best thing possible for Wylie and send blood to Dr. Dodds at Hemopet. They handcount most everything and are breed specific. Plus she'ld be able to give you her recommendations on what to do for this. It's been a couple of weeks since the last check so maybe htis might be a good coarse of action. Best of luck, Johnny & Tessy

Johnny

Hi Johnny, she has been med free since March. I think the vets concern is that the machine can show a high reading vs visual which is more accurate according to him. Her HCT is still good at 47 Laurie

Laurie CA

Laurie, A higher number of platelets is generally considered normal for a dog that doesn't have a spleen. The spleen is a location where platelets can be sequestered (stored) away from general circulation. If a dog with a spleen experiences some adrenal moment like chasing a cat etc, strong muscles around the spleen squeeze it tightly to release extra blood (and platelets) back into circulation. This provides the extra support needed for chasing, fighting and possible injury. You know this as "fight or flight." Since both Wylie and Chance don't have spleens, whatever they have for red blood cells and platelets, for the most part, is in general circulation. Some blood, of course, is stored in the liver and there is always blood in the heart and other organs like the pancreas.. It's not particularly dangerous to not have the spleen's storage, but it's more important to have the proper amount of fluid in the blood. This keeps the blood pressure normal. I am concerned at the gradual reduction in platelet numbers. In a dog with a spleen, it would be worrisome that the spleen might be abnormally sequestering platelets for some reason. This is sometimes in response to a tick disease or some kind of infection, or in many of our cases here, a site of abnormal autoimmune destruction of red blood cells and platelets. Obviously, we can discount this. So if this were Chance I would want to rule out a few things. The first thing I would think of is some kind of internal bleeding. And this is often a gastrointestinal thing with dogs. This kind of regular bleeding would cause a gradual depletion of platelets whose job is to go to the site of an injury to "fill it up." The next thing I would begin to wonder about is a general cause like infection. You have just finished treating him for one, and if this were me, I would want to know for sure that the infection was properly treated and is truly gone. Another worry, especially for Chance, would be a production and maturation deficit in the bone marrow. Is there something that is causing the bone marrow to slow down the production of just platelets? Remember, that all three lines of blood cells come from the same precursor cells in the bone marrow. So if there is some kind of contributing malnutrition factor (low B-12, folic acid, iron), it would most likely affect all three lines: RBC, WBC and platelets. Not necessarily always though. I would also want to check to see that the kidney is working properly as this secretes the hormone that is responsible to stimulate the bone marrow to make blood. So there are plenty of red blood cells. The white blood cells don't see to be diminishing either. So why just the platelets? Could this be some kind of autoimmune destruction at the bone marrow level? I might, after other tests have been done, ask for an ANA (antinuclear antibody) blood test to see if there are signs high autoimmune activity. And finally, I would look very carefully at Chance's tick disease tests to make sure that he doesn't have the slightest chance of having contracted any tick disease. This battle is normally fought in the spleen to start. You have some diagnostics to go through and the clinical experience of this nice vet will guide you as to the right path to take. my best patrice

Patrice NYS

Thanks Patrice, I was very surprised when she was in 2 weeks ago they didn't run the tick panel on her, and stupid me didnt ask. The vacation vet said because of her rapid improvement with the first round and possibly not getting thru the infection he sent me home with Doxy, she is 55 # and on 400 mg a day, and was also thinking about TBD, he also mentioned could be gastro issues. When you say are her kidney working properly, her BUN and creatnine levels were fine so if there is another test I need to ask about. Awhile back, About 3 months ago she had red blood in her stool for about 3 days. I took it in and they found nothing. I have not seen anything since. Is an ultrasound typical of GI problems? THank you Laurie

Laurie CA

Hi Laurie, coco is currently being seen by Dr. Merkle out next to Hawes Farms, its really strange because he has seen two other cases recently one out of happy valley and one in millville. I am calling him today as he is back in town and is really good about opening up to see us. Who do you see at Westside and are they knowledgeble about these types of disease? What tests did they run on wylie?

kelly redding

Arrgh, Ihad this lenghty post, Patrice, you mentioned gastro issues, what about pancreatitis? I did a search on low platelet counts and a cause can be pancreatitis, Her Serum spec CPL from the 15th was 379, with a range of 201-399. The lab note said she could have pancreatitis and have this rechecked in 2 weeks. One site said a cpl # over 200 is pancreatitis. It also said a high amylase points to this hers was high 1305 with normal being 450-1240 Any thoughts? Laurie

Laurie CA

Laurie, You are very very perceptive. If this is pancreatitis, she might be in some pain now and this could be causing other issues. If this were me I would actively pursue this now, before we get into the holidays. At the very minimum, find out from your vet the *exact dietary plan* you need to follow the next couple of weeks in case this is pancreatitis. Unchecked this could be very serious. I am glad you had the SPEC cPL (“specific canine pancreatic lipase”) test. This is the most accurate test you can get and does indicate a specific pancreatic cause. The lipase and amylase can indicate inflammation of other causes as well, so is not as specific a test. Once again, Marvistavet comes in handy with a wonderful page about this: http://www.marvistavet.com/html/body_canine_pancreatitis.html Read it carefully and make up a short list of questions for your vet to ask before the holidays are here. good luck patrice

Patrice NYS

Patrice thank you so much, I do have an appt in the morning since like you said we are going into the holidays/week-end. I always forget about the marastat site, always a wealth of info I was surprised to see they ran the pancreatic test. She had that done about 4 years ago when they suspected pancreatitis, it took 4 days and $200 alone for that test so they must have gotten the time and cost down considerably. Turns out she did not have pancreatitis, but her duodnum was swollen not letting any food down to digest, after a week it resolved itself, they never found a cause. Laurie

Laurie CA

This thread was discussed between 28/12/2009 and 29/12/2009

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