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Doc Sara
Doc Sara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 952
Experience:  I am a dog and cat veterinarian with a lifetime of experience in our family veterinary hospital.
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My 14 year old dog has been throwing up and now s stool is

Customer Question

My 14 year old dog has been throwing up and now his stool is greasy and black. The latest WBC is greater than 100,000 and lymphocyte also over 100,000. Is there any way to estimate the time he has left?
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Doc Sara replied 1 year ago.

Good evening - I'm Dr. Sara. I'm a licensed veterinarian who works exclusively with dogs and cats. I'm so terribly sorry to hear that Hank hasn't been feeling well. I'm sure the news of his lab work was quite a shock to you. I'm here to help. There will be a delay of 5-10 minutes while I type out an answer for you :)

~Dr. Sara

Expert:  Doc Sara replied 1 year ago.

Thanks for your patience while I typed :) I'm so sorry that Hank has been ill. I know that when we give bad news, even in an older pet, it can be shocking and take awhile to sink in. I'm glad that you're researching his problem and will do my best to help.

With a lymphocyte count like that, unfortunately we are often dealing with cancer. It's a little tough to estimate how much time they've got left from just the CBC, though, because there are multiple different types of cancer that can cause the lymphocyte count to be that high - ranging from ones that are quite mild and actually incidental findings (meaning that the dog is sick from something else and we just so happened to accidentally discover a high lymphocyte count), all the way up to nasty life threatening cancers with very short survival times.

For instance - a chronic lymphocytic leukemia can often be an incidental finding and not cause any issues at all. On the other side, an acute leukemia or stage V lymphoma can carry a very unfavorable prognosis, with many pets being euthanized within days of diagnosis. The way that we sort these out is to send that blood sample off first to a regular reference lab for a pathology consult, and then potentially to CSU for flow cytometry for a test called a PARR - these tests can help differentiate the nasty cancers from the not-so nasty ones. If the pet is severely ill, has other lab signs like low albumin, low platelets, or anemias, or has had recent weight loss, this also makes it more likely a malignant ("bad") cancer.

Another way to differentiate is to wait and see. A dog who has a milder chronic leukemia could potentially just be sick from the stomach flu and recover with symptomatic and supportive care. So if I had a patient with a very high white blood cell count like that and I couldn't send out any other tests, I would prepare the owner for a potentially short survival time, but still treat the pet for their symptoms just in case they rally. On the other hand, a pet with stage V lymphoma or an aggressive leukemia just won't respond well to treatment. In those cases, unfortunately, we need to discuss either referral for more aggressive care (the above mentioned testing, followed by chemo), or hospice care, up to and including humane euthanasia. You are absolutely not wrong to consider euthanasia for Hank in the face of his lab work if he's not responding well to your vet's symptomatic care. I know it's sad, but if you've tried some therapy and it doesn't seem to be helping, it's OK to talk about stopping treatments and saying goodbye.

This is a pretty big topic, so feel free to ask follow up questions - I'd be happy to help.

~Dr. Sara

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