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#183371 - 09/23/11 06:25 PM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: arycrest]
middleofnowhere Offline
Carpal Tunnel

Registered: 02/22/10
Posts: 2675
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I don't think we'll get any updates until Monday.

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#183654 - 09/25/11 12:40 AM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: middleofnowhere]
kelso Offline
Veteran

Registered: 02/15/10
Posts: 1490
Loc: Kansas
Likes: 38
Hello

Thanks for thinking of Kelso smile I tried to get here soon!

Some good and some...eh

The good is that he is really acting himself. wub Last time I posted on tuesday he was about 70% now probably 90%, but not sure how much that is the steroids giving him the extra zip. I also have not seen how tired he gets with activity as we have not really let him do much except hang out in the house, but he definately is SO much better than a week ago.

He de-faced, de-stuffed that cute snugga wubba I posted him snuggling with last week....so I knew he was feeling a bit more like himself smile No fever, eating good, just overall would not notice that much is wrong except for he pees ALL THE TIME!!!!! wink because of the steroids.

The eh....His labs are not improved, in fact just a hair worse frown Still "pancytopenic" White blood cells (were actually normal last time), hemoglobin, and platlets are all low.
White blood cells 4.0 normal range (5.7-16.3), last week 5.7
Red Blood Cells 3.85 (5.5-8.5), last week 4.15
Hemoglobin 9.2 (12-18), last week 9.5
Hematocrit 29.4 (37-55), last week 29.7
Platlets 66 (164-510), last week it just said about 50-120


The report still commented that "neutrophils appear slightly toxic" but the neutrophils were in the normal range, absolute lymphocytes were low this week 840 (1000-4800) and last week they were high (4845).

The reticulocyte count was normal this time (1.0) so that may be good, hopefully means his bone marrow is responding. Last time it was 0.2


I talked with our vet and he had seen Kelso all day on Thursday as he stayed there throughout the day as we were at work. He was happy that he was acting so great and was very encouraged then! He was a different dog at the vet for sure, they definately noticed that he felt better vs last week. But after getting the labs back and before contacting us he spoke with the internist to ask what they thought and if Kelso needed to go to them since the labs were not better.

The internist said we should hang tight as he is improved clinically and continue the meds as is, recheck a CBC (labs) next week again, if his counts have not improved and/or worsened at that time he will go see the internist for further workup ect. Maybe the labs are lagging behind the treatment?

The working diagnosis at this point is Immune Mediated Hemolytic Anemia (IMHA, Immune Mediated Thrombocytopenia (ITP), but my vet did say today that other things such as infection, cancer have not been totally ruled out as we do not know the underlying cause, or if it is a primary process and there is not any underlying disease. Or if it was the vaccine... I need to ask him more about this, I talked to the on call vet that day about it and she did not think so, but have not talked to our personal vet about it.

So, that's all for now I guess. I am just so happy Kelso is happy right now smile
_________________________
-Steph

GSD's
Allie, gotcha 7/2007
Riko z Vom Weberhaus, "Fez" 7/29/2012

forever our angels
Meeka, b. 10/31/1994-11/26/2006
Kelso, b. 9/3/2006-2/9/2012


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#183669 - 09/25/11 01:26 AM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: kelso]
BowWowMeow Offline
Carpal Tunnel

Registered: 02/11/10
Posts: 4747
Loc: Buffalo
Likes: 127
Thanks for the update! So glad that Kelso is feeling like himself again and destuffing his stuffies. groovy

That is worrisome about the labs though. Since the pred is an immuno suppressant it can hold things in check but, of course, doesn't treat the underlying problem. I still wish you had a more definitive diagnosis.
_________________________
Ruth

Rafi, the german malaroo, age 9.5ish
http://www.dogster.com/dogs/693238

Varda & Gio (the crazy cattens)
...............
Warming my heart:
Queen Cleopatra
Chama
Kai
Basu
Massie

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#183677 - 09/25/11 07:12 AM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: BowWowMeow]
Mary Jane Offline
Carpal Tunnel

Registered: 02/16/10
Posts: 2696
Likes: 125
Surely, Kelso's behavior reflects the whole dog, so killing toys must be good.

I'm a the edge of my knowledge here, but reticulocytes ought to reflect new production from bone marrow-and the more mature cells may the increase later. Well, no need for me to guess, you'll know more next week.

Can you return the stuffie for a free replacement?

MJ


Edited by Mary Jane (09/25/11 07:13 AM)
Edit Reason: clarity

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#183678 - 09/25/11 07:25 AM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: kelso]
arycrest Offline
Pooh-Bah

Registered: 02/11/10
Posts: 2488
Loc: Central Florida
Likes: 86
Originally Posted By: kelso
...

The good is that he is really acting himself. wub Last time I posted on tuesday he was about 70% now probably 90%, but not sure how much that is the steroids giving him the extra zip. I also have not seen how tired he gets with activity as we have not really let him do much except hang out in the house, but he definately is SO much better than a week ago.

He de-faced, de-stuffed that cute snugga wubba I posted him snuggling with last week....so I knew he was feeling a bit more like himself smile No fever, eating good, just overall would not notice that much is wrong except for he pees ALL THE TIME!!!!! wink because of the steroids.

...
I talked with our vet and he had seen Kelso all day on Thursday as he stayed there throughout the day as we were at work. He was happy that he was acting so great and was very encouraged then! He was a different dog at the vet for sure, they definately noticed that he felt better vs last week. But after getting the labs back and before contacting us he spoke with the internist to ask what they thought and if Kelso needed to go to them since the labs were not better.

The internist said we should hang tight as he is improved clinically and continue the meds as is, recheck a CBC (labs) next week again, if his counts have not improved and/or worsened at that time he will go see the internist for further workup ect. Maybe the labs are lagging behind the treatment?

The working diagnosis at this point is Immune Mediated Hemolytic Anemia (IMHA, Immune Mediated Thrombocytopenia (ITP), but my vet did say today that other things such as infection, cancer have not been totally ruled out as we do not know the underlying cause, or if it is a primary process and there is not any underlying disease. Or if it was the vaccine... I need to ask him more about this, I talked to the on call vet that day about it and she did not think so, but have not talked to our personal vet about it.

So, that's all for now I guess. I am just so happy Kelso is happy right now smile
happyboogie While all of this is still extremely frightening, I'm so thrilled to hear that there's improvement in the way Kelso's wub feeling and acting!!!

And what good news that the internist is satisfied enough that he doesn't want to see him pending his next blood work.

I'm pleased to hear they at least have progressed to the point of having the working diagnosis.

hugging hugging hugging Kelso, Steph & Dan hugging hugging hugging
_________________________
Gayle
Faith, Ledgie & Scooby
My Bridge Kids: Andy, Abbey, Tasha, Tex, Echo, Yukon, JR, Too, Niki, Bo, Ringer, Kelly, Honey, Mac, Slider & Bruiser

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#183699 - 09/25/11 10:17 AM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: arycrest]
Furonthefloor Offline
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Registered: 02/23/10
Posts: 602
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huggingto you Kelso! I hope you continue to feel like your beautiful self. We'l be thinking of you.

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#183732 - 09/25/11 12:06 PM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: Furonthefloor]
AgilePaws Offline
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Registered: 02/14/10
Posts: 2140
Loc: Woodstock, IL
Likes: 40
Continuing to send good thoughts to Kelso! hug
_________________________
Sandy

RATCHX SG Wisp v Schneiden Fels BH RA NAP OJP CAA CGCA TKN TC HIC
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SG Flame v Nummer-Eins TKN HIC


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#183763 - 09/25/11 03:22 PM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: AgilePaws]
MaxaLisa Offline

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Registered: 01/26/10
Posts: 19473
Loc: Northern CA
Likes: 255
Thanks for not making us wait until Monday for an update!


Go back to your first post in this thread and try to convince yourself that this is not vaccine-induced. The vaccine triggered *something*. If this is ultimatley AIHA/ITP, then this is a vaccine reaction, pure and simple. If this is infection (not even gonna mention the C word), then it was aggravated and brought into crisis by the vaccine. Some vets don't believe this stuff is possible, but you watched it and are living it frown


AIHA is precisely one of the driving forces for the official revised vaccination protocols, though many vets still insist on annual vaccines


I am very happy that your vet is still keeping an open mind. It's easy to leap to AIHA, but if it's infection, that leap can be fatal, since AIHA therapy doesn't include abx.

IF it's infection, keep in mind that the high steroids, and non-aggressive dose of doxy will not allow the body to make progress against the infection. The protocol really addresses the bone marrow problem, and the doxy "kinda" keeps the infection in check from progressing. I'm dinking around with this now, and Max's pred doses are miniscule compared with Kelso's.

I don't know exactly what the labs are doing, pred is doing some weird dance between suppressing the immune system and prompting it to make blood, etc. Seems to me that reticulocyte count being so much better is great thumbup

It's going to be tricky playing with the pred and doxy too. I'd be inclined to stick with your vet, if he is comfortable doing this, only because it sounds like the specialist isn't keeping all the options open yet. If infection isn't on his radar, then I wouldn't switch to him unless you are pretty darn sure it's not infection, if that makes sense. At some point, whether you wean off pred first or wean off doxy first, it will be a leap of faith, making the choice to believe one theory over another, and that gets scary!

I hope that the labs catch up next week. The next step would be the addition of some scarier drugs, and closer to the protocol of Jean Dodds' that I posted way back. I'm REALLY hoping that next week things really start turning around, ASAP!


I'm really encouraged that he's feeling so much better, that is HUGE and has to mean something smile

Hang in there you guys, hard to be patient though
hugging hugging hugging
_________________________
MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

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#183767 - 09/25/11 03:33 PM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: MaxaLisa]
BowWowMeow Offline
Carpal Tunnel

Registered: 02/11/10
Posts: 4747
Loc: Buffalo
Likes: 127
^^^^ I agree with this. I was probably incoherent in my late-night comments but the high doses of steroids always make me nervous for what will happen when they begin tapering off...especially when their isn't a definitive diagnosis and there is a potential infection.
_________________________
Ruth

Rafi, the german malaroo, age 9.5ish
http://www.dogster.com/dogs/693238

Varda & Gio (the crazy cattens)
...............
Warming my heart:
Queen Cleopatra
Chama
Kai
Basu
Massie

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#183893 - 09/26/11 12:12 AM Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: BowWowMeow]
kelso Offline
Veteran

Registered: 02/15/10
Posts: 1490
Loc: Kansas
Likes: 38
I am thinking that the diagnosis is IMHA/ITP, it is just a matter of what the underlying cause is/or if there is one besides the vaccine (which I have no doubt played a part in this). And that is tricky, like Lisa is saying...the way I am thinking about it is that a bone marrow biopsy would rule out cancer, but cancer is not the highest thing on the list so know one wants to go there at this point, cancer would be preceded by idiopathic/vaccine induced/infection as a cause. Seems there is no way to definately say which witch is which right now? And we are covering those bases for now (except the lower dose of doxy which is something I will discuss with our vet). I also need to ask him if we should add something to protect his belly with the high doses of steroids.

I spoke with another member here that had a pup with this (no known cause) and they weaned the steroids with the antibiotics as an adjunct, probably what we will have to do as we might not find the "cause" (besides the vaccine as a cause/insult contributing)

Was reading the forum about IMHA and it seems sometimes the steroids get tapered..things go bad again, so then they go back on the steroids. I do not think they will begin to taper until he is within normal ranges again though? And it seems most failures were when the taper was not long enough?

I feel like I have a puppy again laugh hammer No more sleeping through the night, we have to get up at least 1-2 times a night to let him pee. The peeing is crazy! Poor guy has not peed in the house since he was a puppy and has had a couple accidents this week frown

Like I said, he is acting pretty much like himself. He wants to play and go about and things which makes me very happy! He has always been a bit of an anxious/ants in his pants type of dog and the steroids are definately enhancing that a little so I want to be careful he dosen't over- do it and he does seem a little anxious.....

I emailed Jean Dodds tonight as well.

Picture of Kelso and his nekid belly today, enjoying the sun (but not to much, don't want him to get a sunburn!)



thanks again, you guys are the best

_________________________
-Steph

GSD's
Allie, gotcha 7/2007
Riko z Vom Weberhaus, "Fez" 7/29/2012

forever our angels
Meeka, b. 10/31/1994-11/26/2006
Kelso, b. 9/3/2006-2/9/2012


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