Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Presa Canario Lymphocite >100,000

My Presa was boarded at my local vet during the last week of April. When he came home I noticed a tiny white worm in his stool (tapeworm). My vet gave him 5 droncit pills. Two hours later he was vomitting. We took him back to our vet and she kept him for a week. She said the droncit could not cause this type of reaction (I have since found out that it can occur). Meanwhile, she pulled a blood panel and found that his white blood cell count was at 100,000 and 92,000was lymphocytes. We then took him to our local Animal Hospital and the vet did an ultra-sound of Magnus' abdomen. His spleen is grossly enlarged without any sign of blood or tumors. It is so enlarged that his intestines are being forced underneath his left rib cage. He wanted to pull a bone marrow biopsy to show type of Leukemia but I chose to get a third opinion before that painful procedure. Yes, this is all happening very fast! My third vet did another blood panel and his L-cell count was at 116,000 as of Friday May 15, 2009. Our next step is to go to Auburn University to speak with an Oncologist. I called Magnus' breeder (breeding for 20 years and is the only North American breeder to ship pups back to the Canary Islands for their bloodlines are most pure) She told me that cancer has not been detected in anyof the other 56 litters Mags' father produced nor is the preed predisposedto cancer. She was more concerned with the deworming medication Mag was given and so am I. Magnus is age 6 1/2, 140 lbs, full of energy without any sign of ilness....so, anyone with any advice????? Thank you so very much for anything you can tell me.... Shannon Johnson- Florida

Shannon Johnson United States

Shannon, I am so sorry to hear about your Presa's serious illness. It sounds very complex at this point. I do urge you to continue to work with your vet but also explore treatment with experts. However, there can be positive reasons to use a university veterinary program and negatives. The positive is that they have vets on staff who have done extensive research in certain areas that might bring light to the problem. The negative tends to be that the staff sometimes view treating an unusual case as an opportunity to study. This might lead to focusing on tests and other observations rather than simply treating the dog as quickly as possible. Only you will be able to sort that situation out from your perceptions while talking with the vet at the university and finding folks to ask about their experiences there. I belong to an email forum of people around the world who explore tick diseases. We have a number of experts on this list, including a vet, who are tireless in their goal of helping dog owners who have suddenly found their dog has a serious tick disease. While I am not diagnosing your dog as having a tick disease, some of the symptoms you describe are setting off alarm bells in my head. I urge you to make sure your vet has at least done a preliminary in house test called SNAP 4DX. This tests for heartworm and three common tick disease, including Lyme. However, where you are located, in Florida, there can be other tick diseases. These can be tested for by using the services of a specialty lab, Protatek, by sending them a blood sample. I am including a link to a website about tick diseases that was developed by a member of Tick-L. This website is the best comprehensive examination of tick diseases that exists. http://blackgsd.googlepages.com/home In addition I have included a link to a particular page and I have pasted a section from that page that discusses one particular tick disease, Ehrlichia canis, and the discussion of symptoms. What would be of interest for you to note is that spleen enlargement and an abnormally high white blood cell count can be a symptom of the early stages of this tick disease. If your dog was kenneled somewhere in Florida, the risk may be higher that it would be exposed to ticks at some point. http://blackgsd.googlepages.com/quietkillers snip> "Ehrlichia canis, found world-wide, is the most common and one of the most dangerous tick-borne disease organisms known to infect dogs; as it has been the object of the most study and as many of the TBDs follow its general pattern, it will be discussed in more depth than the rest. Parasitic bacteria which share some of the traits of viruses, E. canis proliferate inside the white blood cells manufactured in the bone marrow. As the disease they cause progresses, it cripples the ability of the white blood cells to replicate correctly or, in the end, at all, and the immune system is effectively destroyed. But that's not the end of it; the list of symptoms and conditions that can be caused by E. canis seems almost endless; it can be mistaken for or cause leukemia, heart disease, cancer of the spleen, the brain and other organs, to name only a few of its possible consequences. This is a dangerous, treacherous organism. In the first, or acute stage of E. canis, the outlook for cure is best, but symptoms can be vague and easily missed or put down to a mild viral infection. If a dog is feverish, if his lymph glands are enlarged and he's generally off-color, a vet looking further may find the characteristic signs of early TBD: an *enlarged spleen*, an abnormal decrease in blood platelets, an abnormal decrease in white blood cells, and/or nonregenerative anemia. *And just to make things more complicated, a high white cell count may be seen instead*. Testing for TBD is useless for two or three weeks after a dog has been infected, however, as the immune system will not have had time to make the antibodies that register on a test until enough time passes. But a correct diagnosis depends on much more than numbers on a sheet of paper. Some dogs with E. canis never do mount a detectable titer and some have a very low titer that, by itself, would not indicate the need for treatment. It is your vet's knowledge and experience of TBD that can make all the difference then." If anything rings a bell for you here and you feel that you would benefit from joining Tick-L to ask questions go to this link: http://saluqi.home.netcom.com/ticklinks.htm and click on this: Managing your TICK-L subscription options, etc. Subscribe, sign off, change options, or search the list archives from the TICK-L home page my best patrice

Patrice NYS

Thank you so much for your response Patrice!!! I will look at all the great information you gave me!! I will read everything over after I get home from work tonight. My (3rd) vet actually mentioned Ehrlichia and prescribed Doxycycline just in case that is what this may be. He dudn't do the SNAP test in hoise (not sure why) but sent it off to be tested at Colorado University where they will also run tests for 12 other infectious diseases. I'm trying not to get excited but I am!!! Thank you Thank you Thank you!!!! -Shannon and Magnus

Shannon Florida

Shannon, Your third vet (!) is a very smart cookie. Stay close to him/her. SNAP 4DX is a simple yes/no test that is an excellent and inexpensive beginning diagnostic test. The testing your vet sent out is more complex and tests for many more tick diseases. The results here are not as simple as yes/no and sometimes require professional opinions for diagnosis. Also, posting these results on Tick-L would allow folks to help you understand them better. Be sure you ask for a copy of the complete report. Also keep an open mind to other possibilities. There can be other causes so it's good to ask the vet many questions. Keep a notepad to write things down and research them later on the internet. If you need help with something, write here and I will try to help you. In order for the doxycycline to be effective, The dosage recommended on Tick List is an aggressive one: 5 mg. of doxy per pound of body weight given every 12 hours for 8 weeks. For a 140 lb dog that is 700 mg every 12 hours. That is a whopping 1400 mg a day. It is believed that hitting these tick diseases hard and early for a prolonged time is preferable to them lingering in the body only partially removed. They can return with a vengeance if the treatment is not successful the first time and treating a recurring case is much harder. Doxy can be very hard on dogs and it can cause inappetence. Be sure to give this with meals. However, dogs can associate the sick feeling they get from doxy with their food. So it is best to disguise the doxy in some very smelly treat that is offered *during* the meal. I have used smelly canned fish. I make a little sandwich, using a small piece of bread. I put a bit of sardines etc in the bread and drop the doxy inside on top of the fish. WASH your hands (doxy tastes awful) and then tightly wrap the bread around the fish. Offer it during the meal. Liver values can also rise, esp with this high a dose. Ask your vet about monitoring these carefully. good luck patrice

Patrice NYS

Thank you so much Patrice. I looked at his meds and it's only 300mg every 12 hrs. He's taken his 5th dose tonight. I have beef flavored pill pockets I hide them in so he takes them along with his meals with ease!! As soon as I get his results back Monday morning I will def let you know the results. Thank you so much for your interest.

Shan florida

Patrice, I followed up on the information you gave me. I researched it all weekend. I posted Mag's test results on the L-Tick forum without much luck... I haven't received his tick test results back yet so I decided to hold of on the Auburn trip until tomorrow. A lot of websites stated that this type of tick disease is hard to test for...that it will only show the dog has been infected not what stage the dog is in. Do you think I should go back to my vet and get the SNAP test done today? Are you a vet by chance? I do have questions about his blood test results... Thanks again Patrice! You have been my biggest help this weekend!!!

Shannon Florida

Shannon, I saw your post late last night. You are probably not going to hear much because most of those folks were probably in bed by the time the post went out on the digest. You will hear from folks. Keep updating them about the information you get from the vets. I was reading more about e. canis and there is a period of time in the early exposure where testing may not even show anything. It might just be too early to get any test results. However, if this were me, and I know a number of folks on Tick-L would agree, I would treat with doxy under the suspicion that this might very well be a tick disease. And I would treat at the highest dose. But this is just me. If you need some kind of proof that you need to use a much higher dose, Gil has a page of information with the references your vet would want to see confirming this high dose. You can go out to her website and print those pages. I am under a time pressure today, I need to get to the vets with Chance. I am sure you will hear from Tick-l later tonight. my vest Patrice

Patrice NYS

Shannon, I have been doing a little more reading to educate myself on what is happening and using your blood test results that you posted to tick-l to figure out what you are looking at. There are only a few things that can cause this cluster of symptoms that have currently shown up. I say cluster, but there are only 4 things that your cbc, chem tests and clinical tests show that are not normal. 1. enlarged spleen 2. high lymphocytes 92,026/116,560 range: 690-4500 3. high basophils 979 range: 0-150 4. monoclonal gammopathy (elevated gamma globulin level due to very high levels of one particular type of antibody) Test result for globulin show 4.3g/3.6g with a normal range of 1.6-3.6. So it is either slightly above normal or just at the upper range of normal. Your one vet believes that they are seeing signs of Lymphocytic Leukemia. Your other vet is thinking Erlichia canis. Two other causes would be lymphoma and multiple myeloma. Three of these involve some sort of cancer of the the bone marrow and white blood cells. (Thus that very high number of lymphocytes) One cause has nothing to do with cancer and is a tick borne disease. The spleen is very enlarged. Its job has a lot to do with the body's immunity. This is a clue that it is working very hard fighting something. It may very well be fighting a tick disease. But it can also be large due to lymphocytic leukemia LL. The high basophil count may have something to do with an allergic reaction or a viral infection. Basophil functions are not well understood. Some sources I read said that high numbers are related to fighting a parasitic infection. This would certainly point to a tick disease. You indicated that while the platelet count seemed low, they said it was fine. There can be platelet clumping when a blood test is done that could account for this off number. Low platelets would be another sign of a tick disease or could be a part of LL. So where do you go from here? Well, if you treat as though it is a tick disease and the repeated blood tests begin to show improvement, even if the tick tests don't currently show e. canis, then your vet might agree that was the cause of these symptoms. What I don't know and a vet would know, is there is a contraindication to use doxycycline if there is a form of lymphoma or leukemia? If this were me I probably wouldn't ignore the testing for lymphocytic leukemia. Having a bone marrow biopsy might be a good way to rule this out. That is something you have to decide with your vet. This requires anesthesia and a small puncture to a bone, usually the shoulder, but sometimes the hip. It will be a bit painful, but not debilitating. A dog with acute lymphocytic leukemia will show signs of being very sick and very quickly. A dog with chronic lymphocytic leukemia may take a long time to show signs of being sick. There are chemotherapy treatments. Otherwise, all your other blood work and chem screen show a relatively healthy dog. There doesn't seem to be signs of anemia or autoimmune disease. If this were me I would work quickly with my vet to determine what exactly is happening. I would do another repeat blood and chem test soon to find out if the numbers remain the same or change. Make a note of any signs or symptoms that seem unusual. Anything out of the ordinary may point to another clue. my best patrice

Patrice NYS

Hey Patrice.... As I prayed for Mag to have E. canis, he was diagnosed with Chronic Lymphacytic Leukemia. I just got home from Auburn today. The oncologist did a bone marrow biopsy, another abdominal ultra-sound, another blood panel, and aspirated his spleen and lymphnodes. "Cancerous cells" were found in all three organs. His TBD tests all came back negative. My vet explained to me that any WBC over 100,000 is always leukemua. E. canis can not get them lymphocytic count to reach anywhere near this number. We start his first chemo and prednisone dose tonight and will continue for 2 weeks until we have his WBC count rechecked for any response. Thank you so much for all of your help. Mag is still feeling great at this point so I now pray for a lengthy happy treatment! There is no cure for Leukemia so as long as my Mag is feeling good I will be happy. She told me there is no way of telling what "stage" he is in at this point, but since he is feeling normal maybe he only towards the beginninh and may have two or more healthy years with us.... Hope all is well with you! Thank you again for your support during this whirlwind of an experience. You really have been a huge support to me! Thanks again (I can not say it enough) ~Shannon

Shannon Florida

This thread was discussed between 16/05/2009 and 22/05/2009

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

This thread is from the Vetnet archive. The live Vetnet forum is active now.