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Grim ER Vet - Sigh -

6K views 59 replies 26 participants last post by  LisaT 
#1 ·
This morning I took Grim (now 8) to the Emergency Vet Clinic because something seemed profoundly wrong (not interested in food or ball and whining) and the vet diagnosed constipation (no signs of an obstruction - as tight as his belly was I feared bloat and it was sudden onset .) --

Tramadol, stool softeners, a drug for motility and getting him to eat pumpkin - he sent us home and the digital exam broke up some of it and he went while we were there......but he said there seemed to be a lot of backed up feces. Strange - he has been going. But he said there would be more evidence if there was a blockage.

However, he also noticed an anomaly with the spleen and they are going to work us in for an ultrasound tomorrow. So my first though straight on is hemangiosarcoma.

He said there are spleenic tumors that are not cancerous and that it was a good sign his blood panel was perfect, (other than slight glucose elevation but he said that was probably from stress of being x-rayed and the pain) ......Well we take it one day at a time.

Right now he seems groggy from the tramadol (he gave him a shot) but he did heat half a can of pumkin and his stool softener and I am just keeping him with me all day.

So I may be struggling with what to do / how to process what I will hear tomorrow. FWIW he also appears to have benign prostate hyperplasia and some spondylosis mid spine but he said it was all in normal range for his age.
 
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#28 ·
I hope the news after the visit is that all is good and we can participate in the study and I can get the sample collected when he goes in for neutering. {if all is good, the nubbins will need to come off to shrink the prostate gland}
 
#29 ·
May you receive good news tomorrow or Wednesday and may your baby have many more healthy years left.
 
#30 ·
Zooming good thoughts for Grimm tomorrow.


Arwen had the enlarged spleen scare, her bloodwork showed nothing. I took her for an ultrasound, and she did not have hemangiosarcoma -- not at that point.

A couple of years later, and with no real warning save a little kibble left in her bowl for two days, she did bleed out.

Hoping your boy doesn't have it.
 
#34 ·
RBC 5.5 range 5.5 - 8.5
Platelets 219 range 175-500
neu 5.7 range 2-12
lym 1.29 range .5 - 4.9
mono .76, range .3-2
eos .35, range .1 to 1.49
baso, .05, range 0-0.1

Does that show anything?
 
#35 ·
Nothing is screaming out.

The RBC's, at the low end, might be because they are being held in the spleen. This can be caused by infection, autoimmune, and perhaps other things. If they don't find anything on the u/s (and that would be good!), I would do a follow-up CBC in 2-3 months, just to make sure that none of those numbers are changing in a bad way.

I don't quite understand what makes basophils appear. They are in the normal range, but in years of blood tests, they've only showed up once on one of my dog's blood test. Just kinda weird, I don't know if anyone here has an answer for that.

If there really is any chance of a tick disease, I would pursue that. Some dogs are pretty good at fighting off the initial infection, but in some dogs, the infection then goes into a subclinical and then chronic phase. The chronic phase is when you get the dogs that crash, or suddenly bleed out, it can take several years for this to happen.

I'm glad that he's feeling better, hope the u/s shows nothing!
 
#36 ·
I don't quite understand what makes basophils appear. They are in the normal range, but in years of blood tests, they've only showed up once on one of my dog's blood test. Just kinda weird, I don't know if anyone here has an answer for that.
From memory basophils appear when there is an allergic reaction OR parasitic infection as with eosinophils and I cannot remember seeing many at all. Eosinophils were more common but still rarrish and very pretty to look at.
I hope Grim is feeling better soon:)
 
#37 ·
I am definitely going to ask about tick diseases; it has been a banner year. I have pulled off several (though almost all deer ticks) even though he gets HW preventives that are supposed to kill fleas (I have found attached but not engorged)
 
#38 ·
So here is the update

Grim does, in fact, have an enlarged and somewhat granular spleen with no sign of any tumor. There are also no signs of tumors anywhere.

His prostate is very enlarged and impairing his ability to defecate so fixing that (neutering him) is NOW. He does not see cancerous changes there.

He did not think there was a tick borne or other issue but is sending (at my request) a sample to the NC lab. Wow $250 but he does not recommend doxycline without known cause.

I liked the guy - we talked about the prostate and the spondylosis and said both could be responsible for slowing him down (of course this summer has been wicked hot too, and a blast of cool air perks him up). He is not into NSAIDS and was supportive of both fish oil and turmeric. So I am working on an anti=inflammatory regime for that.

We are going back in 3 months for a quick re-check on the ultrasound.
 
#39 ·
Thanks sparra!

jocoyn, good news that there is no tumor there, that's a huge relief, since things like hemangiosarcoma have very few options :(

NCSU has one of the top tick labs in the nation, my dogs had one of their specialized tests done there.

Without further weird things in the CBC, and no positive tick tests at this point, I completely understand "no doxy". That's one reason to have several CBC's, each over a couple of month's time, to see if the blood values are going up, down, bouncing around, staying stable, etc. The argument for doxy, when there are no positive tests are either 1) current blood tests consistent with tick disease, or 2) blood tests over time trending towards those same inconsistencies. Right now, that isn't the case.

It does sound sound like there is systemic inflammation.

I'm so confused by what's going on with my dog right now, that I'm not sure I have a lot of clarity right now, but what I have found recently is that low cortisol, contributes to systemic inflammation and a suppressed immune system. This could stem from adrenal issues. If your boy is a dog that does not deal with stress easily, then you might want to try to support the adrenals. That's just in the category of a weird thought.
 
#40 ·
He is pretty unflappable.....in terms of stress. I've had him since 2006 and he has not been sick a day in his life except for knocking out his teeth on a tree.
 
#42 ·
ditto the good news and glad you like the vet he sounds like a "keeper" !
 
#46 ·
Grim made it through his neuter today and now we have the "keep him calm for 10 days" That is a lot of slow walks and down stays and enghghgh!!! (well what I say when I want him to stop licking his incisision)....I guess I will have him at my side until I am sure he won't mess with it. Glad to be a telecommuter.

The vet was kind of perturbed that I had the specialist do the ultrasound so HE looked at it too (no charge but he made enough money on the neuter to cover playing with the ultrasound) and told me he thought neither the prostate or spleen was as big as reported. But mainly he said he saw no signs of tumors either.
 
#49 ·
Grim got back all titers from NC State and is negative for everything.

After some swelling, and more constipation followed by antibiotics and a sugar alcohol based laxative (which I am slowly reducing) he is getting back in shape.

Owwwww the scrotum swelled up so big the vet SQUEEZED it out on the table - no local or anything and you could tell it hurt. It filled back up the next day though but is slowly reducing in size. We did get antibiotics though it did not really appear infected.........and of course now there is a small opening for drainage so I have some antibiotic powder to put in the area but he is leaving it all alone. Neutering is apparently harder on older dogs so I understand.

Decided I won't do a fall cadaver cert with him (fortunately IPWDA is good for 2 years but I like to test annually) and it may take some time to bring him back online but I think he will be able to work again. With the down time I will restart his stats for finds and false indications to make sure we are back in good order.

We will still get a quick ultrasound of the spleen in 3 months just to see if there is more news.
 
#51 ·
I would gather if there was an infection that the bloodwork would show something.

The vet told me that GSDs can be just strange with regards to their spleens...I guess if we find additional abnormalities it will come out.
 
#52 ·
I would gather if there was an infection that the bloodwork would show something.
Not necessarily.

Sometimes the immune system is suppressed and won't mount a normal response. In other cases, the infectious bug can fly under the radar of the immune system. This is what happens with some tick diseases in fact. Titers might not elevate until awhile after antibiotics are begun and kinda "wakes up" the immune system.

There are no real hard and fast rules, which is what is frustrating, since most vets like to follow a flow chart.

My boy, has a nasty systemic infection of some sort. Not one bit of standard evidence in his bloodwork.
 
#53 ·
So what would you see with a supressed immune system? The dog has been healthy as a horse all his life. He has certainly been exposed to his share of bacteria and muck in the woods......wouldn't he have become sick or ill if the system was suppressed? Some of the places he has been I have had to wash him before I could even put him back in my car (swamps and stuff like that)

Now that the constipation is resolved he is back to his normal self again
 
#56 ·
I think that it's more likely that some "things" can evade the immune system. The dogs with suppressed immune systems that I've seen tend to have repeated infections, either determined visually (skin infection), or by response to antibiotics.

I hope that all this is just a temporary blip for your boy.

I hope so too. I see on the your tick link erlichia can go under the radar and may be causative in hemangiosarcoma. Hmmmmmmmmm more research on that one.
 
#57 ·
Blood based infections causing blood based cancers :(

With ehrlichia, when it goes chronic, you typically see low end platelets or RBC's. Sometimes high normal types of white blood cells, sometimes suppressed. Before it gets to that stage, they may all be well within normal. I think on a rare occassion you might see really elevated platelets if there is a lot of blood vessel damage that the blood is trying to repair.

They can mimic so many different things. This is one reason why I like to run annual blood panels, and in sick or senior dogs, about every 4-8 months, depending. Since doxycycline also has anti-cancer properties, when all else fails, I'm also a proponent of a trial of doxy.

It's all a gamble. This could all be a fluke, or something that the body resolves on it's own, but then there is that nagging "what if", so you have to do what makes sense to you.
 
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