Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Tiggs Platelets Update- Something Going On

Hello friends, Well, unfortunately, there was no lab glitch. His platelets are officially low. They tested at 74 this time (74,000), normal is around 160. So, my vet after scouring the state, found a Snap 4 test and she's going to that clinic tomorrow on her day off no less, to drop off his blood. She will also send out a Babesia test (another tick borne disease) that the Snap test doesn't cover. We cannot start him on any meds yet because it will throw the result. Her feeling, along with the Internist she consulted with is that if this were Immune Mediated Thrombocytopenia, he'd be more down in the 20's. But, his platelets appear enlarged. She thinks there could be an underlying infection. So, first we need to rule out all TBD, then decide what meds to put him on (probably Doxy for sure), then possibly have to go back on Pred/Aza :(((((( His PCV is still holding high. So, perhaps we simply have an infection that could be addressed w/o immunosuppressives, but we have to look a little deeper before we decide the best course of action. He still has no bruising, I've been checking his gums, belly, ears, etc. I'll let you all know when I find out about the Snap/Babesia results- probably a long shot, but I agree, we have to check. We'll know more Sat probably. Thanks for all the well wishes...we are officially worried. Melissa and tiggs

melissa slc

Mellisa, I have been waiting for your update. I found it quite surprising what Patrice posted about the TBD being so high in AZ and nothing in Utah, that does not make sense. When Wylie was first diagnosed they ran the snap 4 test and also sent out for a full tick panel because we do have a lot of ticks here, but the interesting outcome was she tested positive for Rocky MTN spotted fever. My vet was very perplexed as we dont have it in CA and wandered if we had traveled to neighboring states that do. We had not. Patrice had said see these TBD are migrating and the vets don't know it. SO I WOULD HIGHLY SUGGEST A FULL TICK PANEL DONE if you can, and not just test for Babiosa,its about $250. The main reason we had Wylies full done, was it inlcluded the Babesia which is around here, but again the total surprise/shock of the Rocky Mtn disease. Keeping my fingers crossed Tiggs just has a minor infection causing the low platelets that can be cleared up easily Laurie and Wylie

Laurie CA

Melissa, You and Tiggs are in our prayers. It's scary but perhaps it is just an infection. It sounds like your vet is really on top of things so that is a big plus. Stay strong and give Tiggs a big hug from us :) Chris & Alex

Chris Pa

Melissa, Our thoughts are with you and Tiggs. We cross our fingers, toes and paws that it will all be something harmless and easy to treat. Best wishes and a big Canadian bear hug from Brigitte & Kahlu

Brigitte BC Canada

I wish you all the best with Tiggs. My dog, Mitch, was first diagnosed (in July) with immune mediated anaemia and thrombocytopenia when his platelets were 77 and his pcv 21. We have not had to much trouble maintaining his pcv (once initial intestional bleeding was under control and a blood transfusion) but his platelet count is a different matter. He is currently living with a platelet count of 24 and he does not show signs of bruising if just kept at home and in the garden but if we take him out for walks then he does get small bruises that look like midge bites. We do not really have tick disease that causes thrombocytopenia in the UK although he was tested all the same - 3 times just to make sure, it seemed so typical. I do believe in hindsight that all his problems really started after last years vaccines but he didn't hit a crisis point till July. I was paranoid about having him home from the vets unless his platelets got above 50 but they never have - his lowest being 2. I have found that he is more robust than I thought. I know it is very worrying but just don't rough and tumble him and try not to let him jump about too much and I'm sure he will be ok and you can focus on getting him better. If it is tick bourne that is probably the best outcome in that it can be treated. Hang in there and the support here is fantastic, everyone will help you on your roller coaster journey.

kath scotland

Oh my, I'm so sorry you're dealing with this now. I'm hoping and praying it's something easily treated. I'm curious as to why they see them as large but consider it not to be ITP. Doesn't this mean the marrow is sending out more newer ones? Have you done an ultrasound to check the spleen for enlargement? How's his temp? Did you get a chem panel done? I'll have my fingers crossed for our little bud. Prayers and best wishes for Tiggs. Johnny & Tessy

Johnny

Melissa, Anyone who has fought AIHA will always live on the edge, whether real or imaginary of possible evils lurking. I am sure it is terrible to know something is wrong but not knowing what. Try to hang onto the idea that you have faced bigger challenges and met them head on, coming away a winner. Hopefully Saturday's results will give you answers. Penny

Penny Lytle Creek Calif

Golly gosh Melissa, Im wishing you all the best as well for a good outcome - it is indeed an odd one. Now I have everything double-crossed for you guys. Stay in touch

Silka Melbourne Australia

Melissa, I was just reading about low platelets, one causes of rat poision, could Tiggs have any way gotten into something like this? Laurie

Laurie CA

Hi friends, Tiggs' Snap 4 test was all negative (this was very, very difficult to find here). We're still going to run a Babesia test just to be certain (again, another long shot, but I think we have to look). We'll get that tomorrow- it went out of state. So, we've ruled out ticks just about... There is no chance he could have gotten into rat poison, or anything else like that. Temp was low normal, everything else on the full blood panel was normal, except for the neutrophils (granulocytes) which were high. Physical exam didn't reveal anything unusual. The other vet already did the full physical exam (abdomen, butt, prostate, etc). I would assume (I will double check tomorrow if we bring him again) that they checked the spleen when they palpated his belly. Weight is unchanged...appetite good, poops/pees normal. No signs of bruising yet...but he is low energy for sure...very tired, but pink gums, tongue, etc, and PCV still very good. I am guessing we have some sort of infection here, but we could still be looking at Immune mediated...my vet is off today, but I have spoken with the office manager who is in contact with her. I would think we need to at the very least be adding an antibiotic here pretty soon and discuss the possibility of going back on Pred... So, I think they want to wait until tomorrow when Babesia test comes back...then probably make a decision as to meds, next course of action...Part of me is definitely wondering about the possibility of Lupus. I've read a lot in the last few days, I think there is always a chance of this, but I think it would also be treated the same way since it is also auto immune in nature. That's all I know for now! Thanks so much for the continued thoughts, ideas, and support. I guess more waiting until tomorrow. melissa and tiggs

melissa slc

I have never of Lupus in a dog, intersting I think I would get him on antibiotics asap since you have run all of your tests. If you do this, I would think you would start seeing a rapid response if its infectous and could be unkown infection not popping up in anything else Hugs to Tiggs Laurie

Laurie CA

Hugs to Tiggs and you too, Melissa. I hope it is just a passing infection which is easily cleared. Thinking of you. Silka

Silka Melbourne Australia

Melissa, I am glad to see that the tick panel was all negative! So scratch that off the list. It's more of a stretch to see babesiosis where you are. I'll expect that to be negative too. I'd also say that the chances of this being true canine lupus are narrow. The chances, then, of this being related to an infection or marrow abnormality are now a bit greater. That higher level of granulocytes can indicate an underlying bacterial infection. These are neutrophils whose job is like pacman, they go around ferociously attacking bacteria like this. Then they eventually form the pus that you associate with an infection. The normal low level of platelets is around 140, depending on your lab. You said that Tiggs was showing around 70? I believe that it is not considered to be truly dangerous until that number reaches something like 10-20. So you do have some time to sort this out. Most dogs that have been on prednisone for extended periods of time are prone to infections and those of the urinary tract are high on the list. It's can be hard to notice when a dog has a UTI, bladder or kidney infection. But it certainly is simple enough to find out whether this is the case. See if your vet agrees that this might be a good test to run. my best patrice

Patrice NYS

Good news on the tick panel Melissa. I thought the same thing when you mentioned increased granulocytes. I always have extra antibiotics on hand in case I ever need them for cases like these. Until you can get Tiggs on antibiotics (if you do decide on that route) I'ld get a urinalysis done and even put him on a cranberry pill/powder supplement. Can't hurt right. Maybe you have some left over from before. I'll keep him in my thoughts and prayers. Johnny & Tessy

Johnny

I know when Riley started with the low platelets, he was only 9 and they wanted to get him up past 50 before they released him from emergency. We would all be fun at a party Im sure, talking about thrombocytes, granulocytes, neutrophils and reticulocytes! Hoping for more good news for Tiggs.

Silka Melbourne Australia

Thank you all again...still waiting on Babesia- actually the tick borne version of this would be rare here, however in the rescued pittie population it's not that uncommon for some dogs to be babesia carriers (Tiggs would not be, but he does on occasion play with dogs that I suppose could be, but again, highly, highly unlikely and a long shot for sure, but leave no stone unturned I guess). I was very frustrated today, my vet waited until the last minute to call us before the clinic closed for the day, leaving us in the lurch until Monday...super infuriated about that. She said to bring him in Monday for Doxy...I could have done that yesterday or today, they'd already taken the blood they needed for the test!! She also said in her message that they would probably start him on Pred again...but I would rather wait and see if the Doxy can do it, would you all agree? I also asked for a urinalysis on Friday, but she put that off until the blood came back. I'm getting frustrated, I love my vet, but I keep bringing him back in and saying, "what about this, what about that, lets test this, lets test that" and here we are one week into this low platelet count with NO answers and NO medications. I am really contemplating taking him to another vet for a second opinion...that's painful to even consider, because I have been very happy with her, and her ability to get us through IMHA, but in my mind, we are going on 8 days with low counts and not one bit of resolution or medication administered. At this point, if anything happens to him, I hold her personally responsible. It is not for a lack of trying on my part. Ugh. Sorry, I'm so frustrated right now. More waiting. Promise to update. melissa and tiggs

melissa slc

Melissa, I so feel for you. I am as frustrated as you that there is nothing I can bite my teeth in. That's why I decided to go in on Monday and have them send a blood sample to Dr. Dodds for a complete analysis. While we are there do a urine sample and send it in to be cultured. We just need some answers. With the holidays coming up I don't want to miss valuable time. How is Tiggs clinically? I think i start to see things with Kahlu! Is he walking slower, does he seem tired, are his gums paler and so on. It is maddening. The waiting is the worst, don't we all know about that? Take care and keep thinking positive! Brigitte & Kahlu

Brigitte BC Canada

thank you Brigitte, i'm thinking of you and kahlu too and hoping for answers. thanks for everyone crossing everything (i love that silka), thanks to everyone here. once again, you all are our rock. clinically he's good, but there is a marked difference in his energy since last weekend, which is what brought us in (along with not eating and shaky legs). but, he went on a short walk and was pretty happy. he's eating, etc. but, he's sleeping more than usual, that's the biggest red flag for me.

melissa slc

Hi Melissa and Brigitte - well Im frustrated too for both of you. I know just how that feels in regard to the vet that you care about, but you know something is missing; possibly because you know too much now! I hope someone with knowledge of the Doxy posts for you. Is there any value telling your vet your concerns, that you are considering another opinion? She may just realise that she has been too dismissive. I wish I had a magic wand to get rid of all these problems. :

Silka Melbourne Australia

How's Tiggs feeling today Melissa? Getting lots of rest? Just wanted you to know he's in my thoughts and prayers and that I'm sending him some healing vibes (all the way from Canada too.....the good ones EH!) Hugs, Johnny & Tessy

Johnny

Melissa - I've been following your posts the past couple of weeks and am sorry Tiggs may have more going on than overdoing it on his hike. I just wanted to say I completely understand how you are feeling about your vet and how frustrating that is. I am in the same place with Murray for a different issue but I know it's tough to balance getting another opinion in the midst of a problem and yearning for a doctor with the intellectual curiousity to uncover every stone to try to understand what is going on with Tiggs. I'm interested to know where you net out - I'm struggling with it myself. I hope you get some answers soon - let us know how you are doing and, in the meantime, know many people are thinking of you and Tiggs and hoping for the best. Bonnie

Bonnie Chicago

I am putting out positive strength and energy for you and Tiggs. Hang in there. Things will turn around.

Mardi Northern Calif

Hi friends, I spoke at lenght with my vet today, I feel much better at least about our relationship. I raised my concerns about possibilities (lupus, cancer, immune mediated thrombo, etc). At first, her suggestion was to put him on doxy and Pred... After processing it all through, we both agreed to start Doxy today (no Pred), and retest him on Friday- clinically he is doing well, so I hate to ramp him up on Pred if we don't have too. If by Friday, he's still not climbing with Platelets, we go further, more testing, and add Pred ASAP (or if he changes clinically for the worse). I'm still hopeful that he's battling an infection somewhere, so I'm hoping that the antibiotic will do what we need it to do. If not, then we'll deal with whatever we are facing. He's acting pretty good, no trouble eating, nice and pink, no bruising, pulling on leash, chewing his favorite blue nubbly ball, etc). I hope I don't kick myself for not starting Pred, but I just don't want to go there unless absolutely necessary. The only downside is my vet doesn't have a great way to easily test platelets (like we do with the PCV), so we'll be doing a lot of CBC's. That's ok I guess. Thank you all so much, I will update when I have any more info or news. melissa and tiggs

melissa slc

Thinking of you Melissa - I guess what you have to go on is that Tiggs is behaving like a normal dog - I miss Riley doing all that kind of stuff. Hope your worries are put to rest very soon and that the treatment is the right one. Silka

Silka Melbourne Australia

I'ld do the exact same as you. Hold off on the pred if you can. Did you do a recent CBC just to see if they dropped any? I'ld be curious to see if they dropped and if they did by how much. Hang in there Tiggs, Mum ganna do what's best for you. Johnny & Tessy

Johnny

Melissa, I am glad you are trying the antibiotic route first, I think if its an infection you will show some immediate improvement. I posted on my thread abut Wylie, they gave her in injectable antibiotic yesterday morning, she had a pill last night and this morning her temp went from 104 to 100 which is normal. So if you dont see any improvement, then its probably best to start the pred, but praying its an infection of some sort that the doxy will help. Laurie

Laurie CA

Melissa, how is Tiggs doing? Laurie

Laurie CA

Hi Laurie, He went in for another draw today. He started Doxy about 3 days ago, and I have to say, he's back to himself. But, the inhouse still showed him low (50's), but again, this machine is highly inaccurate (it's 20 years old! and not very high tech) compared to the out of house, which we'll get back tomorrow. My guess is that his count is coming up a little, but I wouldn't be surprised if it's still a tad low, I just hope it's up a little bit. His PCV was 51, so no concern there. Clinically, he's a rock star. So, I'm just going to wait and see what the out of house says, and we really don't want him back on Pred unless it's absolutely necessary. Thanks for the thoughts, I'll post more tomorrow! melissa and tiggs

melissa slc

This thread was discussed between 10/12/2009 and 18/12/2009

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