How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 26291
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
55012488
Type Your Dog Veterinary Question Here...
Dr. Michael Salkin is online now
A new question is answered every 9 seconds

I rescued a golden retriever She is now 14 months. She has

Customer Question

I rescued a golden retriever She is now 14 months. She has allergies so I got her a one-year check up with a specialist. At 4 months, her lymphocytes were 4900 at 14 months, her lymphocytes are 6900. I am very concerned as the vets checked her for tick borne diseases that came back negative. They stated that leukemia is a possibility. Last week I got her checked with her regular vet and lymphocytes were 6300. However, this was not at the same lab. He said his test run close. Any help?
Submitted: 4 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 4 months ago.

You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Customer: replied 4 months ago.
Thank you. I've talked with u before. Just added more details.
Expert:  Dr. Michael Salkin replied 4 months ago.

I understand your concern but a leukemia isn't very likely. Acute lymphoblastic leukemia is exibited by lymphoblasts (immature lymphocytes) and occurs mostly in middle-aged dogs. Chronic lymphocytic leukemia occurs mostly in middle-aged to elderly dogs and the magnitude of the lymphocytosis may exceed 40,000 to 100,000 lymphocytes/uL. A clinical pathologist needs to take a look at these lymphocytes - are they immature? are they exhibiting characteristics of malignancy?

Persistent non-neoplastic lymphocytosis usually signifies strong immune stimulation from chronic infection, viremia, immune-mediated disease, or recent immunization. Supportive laboratory evidence of chronic infection (in addition to history and physical findings) may include hyperproteinemia with polyclonal gammopathy; presence of "reactive" lymphocytes; CBC evidence of inflammation; or cytologic or histologic documentation of inflammation, lymph node hyperplasia, or both. Finally, physiologic lymphocytosis - a stress-related increase in lymphocytes is seen in both dogs and cats.

Please respond with further questions or concerns if you wish.

Customer: replied 4 months ago.
A pathologist did look. Said immature reactive.
Expert:  Dr. Michael Salkin replied 4 months ago.

Immature reactive isn't the same as immature neoplastic. Sequential monitoring of Rosi's CBC is indicated. Lymph node aspirates should be considered if counts continue to rise and if more atypical lymphocytes begin to be seen. Please continue on in our conversation if you wish.

Customer: replied 4 months ago.
In your experience, what chances do you believe this could be early leukemia? Can this be a response to her allergies?
Expert:  Dr. Michael Salkin replied 4 months ago.

I don't believe it's likely but I would stay vigilent if only because Rosi is a golden retriever - the #1 breed for malignancies. Yes, allergies cause the persistent immune stimulation that leads to lymphocytosis.

Customer: replied 4 months ago.
Can this lead to leukemia?
Expert:  Dr. Michael Salkin replied 4 months ago.

Please continue on in our conversation if you wish.

Expert:  Dr. Michael Salkin replied 4 months ago.

No, persistent immune stimulation isn't a neoplastic process.

Expert:  Dr. Michael Salkin replied 4 months ago.

I regret that my state board of veterinary examiners doesn't allow my speaking to customers by phone in this venue. Please stay in this conversation if you wish.

Customer: replied 4 months ago.
Even though different labs, is this a significant decrease from 6900 to 6300 and is it a good sign that it is not leukemia? My vet said he really believed it may be ehrlichosis. Even though a test came back negative. Said the tests are not a guarantee. Put her on doxycycline for two weeks. I go back next week. If the count goes down, does that mean it is NOT leukemia?
Expert:  Dr. Michael Salkin replied 4 months ago.

A decrease from 6900 to 6300 could occur in 30 minutes if a physiologic lymphocytosis had occurred. I wouldn't expect a leukemia to ever decrease in numbers. Yes, if the lymphocyte count normalized in 2 weeks, leukemia isn't present.

Expert:  Dr. Michael Salkin replied 4 months ago.
Hi,
I'm just following up on our conversation about Rosi. How is everything going?
Dr. Michael Salkin
Customer: replied 4 months ago.
Not good. They sent it to a pathologist. Said intermediate sized immature reactive. Consistent with leukemia lymphoma but benign causes can't be ruled out. She doesn't not have tick borne disease. Vet still thinks it's a Benign cause. She has bad allergies but the only think on her blood work is lymphocytes. Nsteady around the 6 range. Please help
Expert:  Dr. Michael Salkin replied 4 months ago.

We're still in the dark. "Consistent with (acute lymphoblastic leukemia) but benign causes can't be ruled out" tells us we need to do more to clarify what's going on. The next diagnostic of choice is a bone marrow aspiration for cytologic evaluation. A blast cell count greater than or equal to 20% of nucleated cells in the bone marrow is diagnostic for acute leukemia.

Thank you for the update. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.