Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Tiggs Update- low platelets

Hi everyone, Thanks so much for the support. Tigg's bloodwork went to Idexx, and he's still showing a low platelet count. The results noted platelet clumping, so that could also affect the real number, but the result was between 50,000-120,000 (low normal should be around 160,000). The last time we did a full Idexx panel w/ platelets looks like it was in March, and it was between 240,000 and 350,000) but he was still on meds at that point. My regular vet didn't do this weekends bloodwork, she is out til tomorrow, so I'm trying not to panic until we have a chance to review. We'll also redo this by the end of the week- it sounds like it's hard to get an accurate platelet count due to the natural clotting that can occur, which is why the substitute vet did the slide stain as well on Saturday, which showed platelets. So, we'll repeat it all and see what happens. I'm not amping to go back on 120mgs of Pred until I know for SURE that he's thrombocytopenic. His HCT looks good, as did the rest of the blood, so I'm hoping this could be a lab fluke. I don't see any bruising on him, but he's brindled, so his gums are very pigmented, as is his skin, and his belly is quite furry, maybe I'll shave some to take a better look if he'll let me. If anyone has any ideas or insight, let me know. We're trying not to worry yet, just get proper testing and then figure out what to do. Still hoping it's just flukey. Thanks again! melissa and tiggs

melissa slc

Melissa, Is there ANY chance at all that Tiggs was exposed to ticks in the last month or so? What are the results for the hematocrit/pcv, hemoglobin (HGB), red blood cell numbers (RBC), white blood cells (WBC), reticulocytes and bilirubin? Yes, platelet clumping can occur with improper handling of the blood sample. You might see a note like "clumping on feather edge." If you are able to, request the best tech on staff take the next sample (with a smile and a thank you...). To get an idea of how the pcv is I use either the lower eye (pull the lid downwards to get a look) or sometimes I can tell by looking at the color of the ear. The tongue is also a good place to look for color. If you are looking for petechiae, yes shaving a small area of the belly or crotch would be the best place. Overall, how is he behaving? my best patrice

Patrice NYS

Hi Patrice, I was hoping to hear from you. Tiggs' HCT was 49 (pretty much where we have been for about 6 months). Very low probability of ticks. We don't have many to begin with in Northern Ut, and he hasn't been anywhere wooded or anything. He's only gone on one off leash walk in the last month. The hike he went on Friday is a desert-y, grassy type of trail, just some junipers and scrubby stuff. Mostly just dirt and sand. I don't have the bloodwork in front of me now, but the vet said everything was in normal range, except the platelets. His color is good, pink everywhere, and I checked his eyes for any red spots and don't see anything unusual there or in his ears, or tummy. Poop and pee is normal. He is tired, but it's so hard to say...I have three snoring dogs laying around the house, so they all look exhausted! He ate his breakfast no problem, but I do think he seems a little "low" and I can't put my finger on it. The vet said that being 'tired' isn't really a symptom of thrombocytopenia though anyways, is that your understanding to? The one thing I always panic about is my exposure to shelter dogs- I take a lot of precautions however, I leave my shoes outside and disinfect them, wash and sanitize my hands before touching him, and strip and immediately put my clothes in the washer before going near him...but, it's always a slight risk I suppose. When they did the in house, the platelets were very clumpy, so he did the slide stain, then the rest of the sample was sent to Idexx. I'm hoping all of this is just a glitch...I want to get him in by Friday at the latest for a recheck, unless you think it's imperative I do it ASAP. My regular vet returns tomorrow, and I'm anxious to process all of this with her! thanks so much! melissa and tiggs

melissa slc

Melissa, Here are my thoughts. Have the test done again, with the understanding that you must have an accurate platelet number. If this highly accurate test still shows a low platelet count, ask for an immediate SNAP 4DX in house test for tick disease. It shouldn't be very expensive. (This is also testing for heartworm so it's good to have it done anyway, as this should be a yearly test.) This test is highly accurate for canine ehrlichiosis or e. canis. This disease's most significant early finding is thrombocytopenia, or low platelets. This would be the quickest way to find out if he was exposed and that this is what is happening. If it is early, then treatment is very successful. Exposure to ticks can happen in one day, in one second of time. Please keep me up to date. my best patrice

Patrice NYS

Sorry to hear Tiggs' platelet count is low. I'ld be pulling my hair out waiting to get him tested. If this were me I'ld go in as soon as possible....just so I'ld know. I'm awefull at playing the waiting game. A whole week of wondering would make me a wreck! Tessy is sending you some strong Canadian healing vibes to you Tiggs and she says to get better for your mum. Prayers and best wishes, Johnny & Tessy

Johnny

I almost forgot to mention this but when was the last time you had his thyroid levels checked. Maybe I'm wrong but can't this cause lower than normal platelet numbers? Johnny & Tessy

Johnny

Thank you Patrice and Johnny, They pulled a thyroid panel, and dog gone it, i forgot to ask, I was so fixated on the platelet thing, but I was the one who requested it...d'oh! I will find out all the details tomorrow from my vet, and she will fax me the complete bloodwork. I refuse to panic...yet... Interestingly, the Snap 4 is VERY hard to find in Northern Utah...my vet doesn't have it, and most don't. The last time I checked, I probably called about 10 clinics before I found one who had it...that's how rare TBD is here, not to say it doesn't happen, but they look at you like you have four heads when you mention that test. thanks guys! melissa and tiggs

melissa slc

Argh, once again, cannot find a single vet in Salt Lake City that has the Snap 4, so I'm looking at a 200 dollar tbd panel if we opt to pursue that. I would have to say though, again, I think that liklihood is slim to none. Just spent an hour calling every clinic and vet in the whole city... Will wait to see what further blood testing shows then make a decision about whether to run an expensive tick panel :( melissa and tiggs

melissa slc

Melissa, I am not surprised by what you are saying. Tick diseases have been previously very rare in many parts of the country. For instance in NY state, they were mostly located in the southeastern part of the state. However they have been rapidly making their way north and west very recently from Massachusetts and Pennsylvania. Our much warmer winters are partially responsible for that. In the past few years my vet's office has been seeing more tick diseases of different kinds here in Western NYS. If you have time go to this link http://www.dogsandticks.com/US-map-lyme-disease-dogs/index.html that shows the numbers of reported tick diseases in each state (and county) of the United States. Click on the tab that says ehrlichia. You can hover over each state for a state average of the particular diseases or you can click on your state and then county for a closer look. I know that the first thing you will do is hover over Utah and think "phew I am safe, there are hardly any incidences of tick disease in the whole state." But I want you to also hover over the adjacent state Arizona. You will be shocked to see reported cases of ehrlichia at 12,423. How could Utah, at that border, show only 4 cases state wide and the next state show 12,432? Do ticks know where the border is and avoid Utah? Remember I said *reported cases.* I am going to bet that ticks that carry tick diseases are not honoring that border but are migrating on deer and mice northward into Utah as well. Longer seasons of warm weather are going to encourage this migration as well. There is a huge learning curve going on in the veterinary world right now. You will see that there are reported cases of heart-worm in Utah. So for that reason alone your vet should be offering SNAP 4DX testing once a year. I had a dog die from heart-worm in 1977 in New York State. It had not even been heard of at that time. What a sad loss. In any case, your vet is the one that must decide the risk of contracting ehrlichia. If they seem stumped by the low platelets, run the idea by them and see what they think. my best patrice

Patrice NYS

Hi Melissa Any news on how Tiggs is going? Good news I hope! Silka

Silka Melbourne Australia

Oops, sorry, I see Im a bit anxious, looking at the dates, and here I am nagging. Wish I knew what causes this, Riley started off with low platelets and a large bleed tipped him into the anaemia situation - they say he has Evans Syndrome, even if the platelets are ok now. Riley wasnt tired at all, I would not have known anything was amiss until I took him for a walk and he passed blood. Lets know how Tiggs goes - his PCV is great. Silka

Silka Melbourne Australia

Don't worry Silka, I was wondering the same thing. That's what makes this site so great....everyone cares. Sending more positive vibes for ya Tiggs. Tessy wagging her tail for you. Johnny & Tessy

Johnny

Melissa, I have been thinking of Tiggs and you too! let's hope this is just a bump in the road. You know so much about this disease and with all the information you got from Patrice you are well armed for when your vet comes back. If she does not know what to do, maybe you could contact Dr. Dodds? Keep us posted. Best wishes, Brigitte

Brigitte BC Canada

Love you guys, I would rather be nagged than forgotten :)! We are going back in today at 3:30 for a retest. I have all of his last bloodwork now, they faxed it to me, and everything is normal except the platelets (including thyroid, which was normal). So, we are really hoping and praying that the sample blood was simply clotting and causing a wierd result. I will keep everyone posted, I probably won't have too much info today, it will get sent out, she'll probably call me tomorrow, but maybe after examining him she might have more insight. Thank you all so much for thinking of us! melissa and tiggs

melissa slc

Melissa, Well as Tom Petty said "The waiting is the hardest part" Hopefully when you get the results you will find an answer and it will be easily addressed. Keeping you both in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Sending hugs and prayers your way. Cheryl & Ginger

Cheryl & Ginger Pineville PA

I have everything crossed for a great result for Tiggs.

Silka Melbourne Australia

This thread was discussed between 07/12/2009 and 10/12/2009

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