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Rebecca
Rebecca, Dog Veterinarian
Category: Dog
Satisfied Customers: 8254
Experience:  29 years of companion animal practice.
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My dog has a low platelet count (38000). She has been treated

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My dog has a low platelet count (38000). She has been treated for tick borne infections. Her spleen is enlarged. In the last few days she has lost energy. So far she is eating and drinking normally. Her BM is normal. She is seeing a vet. I'm concerned because things are deteriorating rapidly. Any suggestions will be appreciated.
Submitted: 5 years ago.
Category: Dog
Expert:  Rebecca replied 5 years ago.
Hi Chet,
This is an information request, so I can better answer your question.

What tests have been done; has she been tested for specific tick borne diseases? Are her blood counts all normal, besides the low platelets? Have blood chemistries been done (liver, kidney, electrolyte numbers)?

There is no charge to respond to an info request. Rebecca
Customer: replied 5 years ago.
GHP/CBC/Lytes, Tested for Ehrlichia(spelling?), Most everything in the CBC is normal with the exception of Platelets. Her count has been going down for about two years. Sometimes it is up then down. It was 58,000 Sat 21 Mar, 38000 yesterday. She has lost interest in her normal routine. She seems to run out of energy quickly though she is not panting. She is still eating and drinking normally. So far her stool is normal. No bleeding, gums normal.
Expert:  Rebecca replied 5 years ago.
Do you know what the Ehrlichia test results were? Were the GHP and Lytes normal? Is she at all anemic (low red count)? Have any X-rays been done? When was the last CBC? Rebecca
Customer: replied 5 years ago.
She has had positive and negative results from the Ehrlichia tests which have been run at UNC, and other Universities.Her last CBC was done yesterday. Red count is normal. I'm going to assume that the GHP and Lytes were normal as the only abnormal indicator is the low Platelate count. In the past she has had clumping which made machine counts impossible. In the last two CBC's there was no indication of clumping. I think I mentioned that her spleen is enlarged. An ultra-sound yesterday shows a nodule that was not there during her previous U-S, which took place last year. I'm taking her in Friday for an aspiration of the spleen if her platelate count is in a safe range. The blood draw yesterday was from the jugular, bleeding was not a problem.
Expert:  Rebecca replied 5 years ago.
Hi Chet,
   It is hard to say what could be the problem, without access to your records and without being able to examine your dog. In the cases of Ehrlichia I have treated, however, the platelet count rebounds quickly once treatment has begun, and doxycycline is the appropriate treatment. Usually with Ehrlichia, all the blood counts are down, not just the platelets.

   The spleen can take up or break up platelets, so if the spleen looks abnormal, that is the next place I would look. If the spleen nodule aspirate turns out to be normal, I would next consider doing a bone marrow biopsy. I would also be checking for other infectious diseases, besides the Ehrlichia. I assume heartworm has been tested for at this point.

This is a tough case, as I am sure you are aware, and it sounds to me like your doctors are proceeding in the best way to find out what is wrong with your dog. I hope the test on Friday gives you an answer, and a good one. Hope this helps, Rebecca

I am going to be offline for a few hours now, but will be back later today if you have more questions. Rebecca
Customer: replied 5 years ago.
I think she has been tested for everything known. If her Platelet count is out of the danger zone they are going to aspirate the spleen Friday. We have talked about a bone- marrow biopsy. One of her Doctors has said that if she had a problem with the bone-marrow she would have been symptomatic or worse by now. This has been going on for almost two years. Heartworm test is negative, she is on Sentinal once a month. She has had mutiple treatments for tick-borne pathogens. Do you have any outside the box ideas as to what the problem might be?
Expert:  Rebecca replied 5 years ago.
Outside the box would be things like:

Normal platelet count for this individual. Some dogs (greyhounds, for example), will have platelet counts in the 40,000 to 60,000 range and be perfectly fine.

Unusual infectious diseases, such as Bartonella, Borrelia, and other tiny intracellular parasites, but this should cause some signs of disease, and not just a low count.

Autoimmune diseases, such as lupus, or immune mediated thrombocytopenia, although usually the platelet count is much lower than your dog's numbers, and you would see some clinial signs.

If your dog is asymptomatic, I would have the spleen aspirate done (if there is any chance of spleen cancer, you want to catch it early), and if that is normal, and her clotting times are normal, I would just monitor it for now. As they told us in vet school, treat the patient, not the numbers on a piece of paper. Normal ranges are like a bell curve, and some normal individuals will fall outside the "normal" ranges. Hope this helps, Rebecca






Customer: replied 5 years ago.

She has had X-rays, U-S, probably every blood test known to the canine and human world. She goes to Texas A&M Teaching Hospital so I believe she is in good hands.

 

She was feral when I first met her. Took me a week to trap her (tranquilizers didn't work on her) eight years ago. I estimated she was two when she came home with me June 2001. She started facial graying in 05 which sort of confirms my age estimate for her.

 

She is marked like a black and white Border Collie, which I originally thought she was mixed with though I had no idea what the other parts are. I have since decided she may be part Siberian Husky due to her coat. She has a medium length slick top coat and a fine undercoat which is shed several times each year here in Texas. She will also howl like the huskies I had many years ago. She is a good hunter, tracker, fighter and has no interest in herding. She lives in the house with a Border Collie, two cats and two birds. The cats are indoors only, the birds are in their own room.

 

She is allowed to run loose in the pasture (when I am with her) where there are Coyotes, Bob Cats, Rabbits, Skunks, Raccoons, Opossums, Armadillos, Horses, Cows, Turtles (which she loves for some reason), Squirrels (loves them too), Beaver, snakes, rats (rarely), Moles and various other wildlife. I have seen her make direct physical contact with Armadillo, Beaver, Squirrel, Turtles, Moles, and rats.

 

I did have a problem of Raccoons getting into my attic where they took up residence unbeknownst to me several years ago. They made a mess up there and I did see some fleas from them that got into the house. Could this be a source of her problem?

 

About a year after she arrived here she developed open pyometra, which was initially treated with AB's. It returned so I had her spayed. I was lucky it was the open type. Is it possible she could have stump pyometra? I believe this is difficult to diagnose and is often overlooked.

 

I've had the Border Collie tested and she is fine. She has also been spayed.

 

Expert:  Rebecca replied 5 years ago.
Hi Chet,
A dog with an stump pyometra would have a high white blood cell count, and it would be unusual to have a low platelet count alone. Stump pyometras usually only occur if one or part of an ovary was missed when she was spayed, since pyometras are connected with a heat cycle.

Fleas in the desert Southwest are associated with plague, but dogs are fairly resistant to this disease. Again, you would have blood cell counts be high, not just a low platelet count. Any infectious disease acquired from wildlife ought to cause an elevated white blood cell count ( except Ehrlichia, which causes low white cell and platelet counts, but that has been ruled out).

I am sure the specialists at TAMU would be familiar with the local flea and tick borne diseases, and be looking for these diseases. I still think the spleen is the most likely suspect, and spleen disease should be ruled out next. The spleen clears cells from circulation, and could be the source of the loss of platelets. If it is normal, I would be looking at the bone marrow, to be sure platelets are being produced normally, but your vet has ruled out bone marrow diesase.

I would go with the spleen aspiriate, and go on to a bone marrow next, especially since you say so many dieseases have been ruled. out. Hope this helps, Rebecca
Rebecca, Dog Veterinarian
Category: Dog
Satisfied Customers: 8254
Experience: 29 years of companion animal practice.
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Customer: replied 5 years ago.

Thanks for the rapid and informative responses.

 

Chet

 

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