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Hi there, this is Dr. Elaine. May I ask a few questions please?
How old is your dog?
He or she (you mentioned both)? Spayed/neutered?
Any drug treatment so far?
What test(s) are you waiting on? Bone marrow biopsy? Blood antibody tests?
When did treatment start?
Any response at all?
My dog is a girl, minature schnouzer. 7 years old. She in neutered. She has had x-ray, ultra sound and a coomb's test. her spleen was swollon but everthing has come back normal. She is on meds. day 3 for immune deficiency-just in case. It is noted that her production of red cells is not working from her bone marrow. There is no internal bleeding, and she is eating, peeing and bm. movement. She is on anti vomit meds because that is why I brough her in. Where they noticed white gums. She is alert but somewhat lazy. She will be tested for thyroid.Her paxcell has dropped from 17-15-14. But still acting OK. Treatment started 3 days ago.
Ok, thanks for that good info.
Autoimmune hemolytic anemia (or simply immune mediated anemia)= IMA is the most likely disease process in a female schnauzer her age.
Some of these patients become yellow (on top of pale) because of the hemoglobin released in such huge amounts from the actual breakdown of cells. The cause is thought to be something that overstimulates the immune system--this something can actually be cancer somewhere in the body, not necessarily in the bone marrow, possibly an infection, a drug reaction. Most of the time the cause is unidentified
These dogs usually have what is called a "responsive anemia"--their bone marrow is working hard to replace cells that are literally being "dissolved" within the circulation or "plucked out" by organs like the spleen. This is often why the spleen is big.
In other cases, the spleen enlarges because IT is working hard to itself pump out more red cells into circulation from where they get stored.
Dogs with an "aplastic anemia" (aplastic==not producing any new cells, but not necessarily destroying cells already in circulation) are "running out" of red blood cells as the cells age and then die off as would happen naturally after 100 days)--but they aren't replaced. Estrogen and other drugs can cause this.
Bone cancer itself (osteosarcoma) is indeed very painful. One of the most debilitating in those terms.
Bone MARROW cancer (usually leukemias which affect white cell production--overproduction-- NOT red blood cell cancers) is not painful per se.
It can take longer than 3 days for a response. She may yet require a transfusion, as many do (or another blood product).
They may advise that a bone marrow sample be collected to see just what cells are/aren't being made in there--i.e. if they are being released and being destroyed just as they are made, being made and NOT released, or not being made at all.
Most all bone marrow cancers involve the overproduction of white blood cells (leuk=white; -emia= blood) of one type of another (lymphocytes, moncytes usually).
Aplastic (bone marrow NOT making blood cells) anemia (an=without, -emia= blood) is equally if not more serious, depending on its cause. It often involves more than just the red blood cells, but white cells and clotting cells (platelets) as well.
There is no particular number that tells us when to transfuse. It depends on her clinical appearance, and whether she is "holding" at a certain place or suddenly drops down. As long as she is hanging in there, and "fairly perky", not in pain, then I think waiting at least until day 5 is prudent. This will be evaluated daily.
Avoiding transfusions is preferrable in cases of autoimmunity, because the tranfusion itself elicits yet at least some more immuno reaction, and often the transfusion is destroyed quickly, adding to the hemoglobin burden.
Oxyglobin, however, is a synthetic "blood product" which supplies oxygen carying capacity without the immongenicity of organic blood components. This is often given when needed in cases of IMHA.