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There may be a slight delay after I receive your answers since I have to type up a response to you. Thanks for your patience. Deb
Yes, he wants to do a biometric analysis and blood work, he wants to give her B-complex vitamins and give her antibiotics and such.She has been weak since she had her convulsion 2 days ago, she was laying down next to me when she started convulsing, hey eyes went white and she started shaking, then drooling a lot, and her gums went completely white, after it was over her gums regained a little color but they are still pale.But she's been tired and weak for about 3 weeks now.
She isn't on any drugs.Thank you very much Dr. Deb I REALLY appreciate your help
Ximena: Thanks so much for the answers to my questions, but I'm afraid my response to you isn't going to be very encouraging and I'm very sorry for that. When dogs present with pale gums and weakness, then I worry about anemia. If you'll bear with me, I'll discuss the most common causes of anemia in a dog this age:
1. Increased destruction as would be seen with an auto immune disease (Autoimmune Hemolytic Anemia) which means the body is destroying red blood cells because they are recognized as "foreign". For a dog this age who might develop this condition, I am cautiously optimistic that they can successfully be treated but high doses of steroids are the required treatment before improvement might be seen. 2. Increased sequestration which means that the red blood cells might be collecting in the spleen. This is often secondary to a cancerous process, I am sad to say. An ultrasound would be useful in determining if the spleen is enlarged and an aspirate or cells or biopsy could confirm if this is cancer.
Sometimes the spleen can rupture and cause an abdominal bleed. If the bleed is slight enough, then the body can resorb the blood until the next event. But if the bleed is significant, it may take longer for the blood to be resorbed...days instead of hours or minutes. And t sudden death can also occur. 3. Decreased production such as a primary problem with the bone marrow. This is often associated with cancer, as well, I am sad to say. It would take a bone marrow biopsy to confirm. 4. Many tick diseases can cause anemia.
We do have tests for many of these diseases, but we are testing for antibodies, not the organism itself, in most cases. If antibodies are not being produced (for whatever reason) then the tests could be negative and yet this is still the underlying problem. I've also come to believe that there are tick diseases that we haven't even been able to identify yet and thus would not have tests for all of them.
Doxycycline is the drug of choice for most tick diseases that we see. 5. Depending on the level of anemia, chronic disease can also cause levels to be low. This is often seen with kidney disease but any chronic disease process can cause it.
Other possible explanations for weakness, pale gums and weak pulses would be cardiac disease. Without an ultrasound, then a definitive diagnosis can't be made although an x-ray may be suggestive of this condition. This could be either a primary problem or secondary.....unfortuantely, cancer of the spleen (usually hemangiosarcoma) can also spread to the heart and cause issues there as well as in the abdomen.
Given that she had a seizure two days ago (and I'm assuming that this was a first time event), in combination with her other symptoms, then the likelihood that Mika has a very bad condition is pretty high, it saddens me to say.
As far as diagnostic testing is concerned, bloodwork, x-rays and an ultrasound are not invasive procedures. She wouldn't have to be sedated for them and they shouldn't weak her further. Obviously something like a biopsy would be more invasive.
The only antibiotic that I might consider in a situation like this would be Doxycycline on the off chance that this is a tick disease. Vitamin B might help her feel a little better but is not addressing the underlying problem.
Without additional diagnostic testing, then the cause of her current symptoms is impossible to know for sure. But I would be doing a disservice to both you and Mika if I were overly optimistic about her situation at this point. I know this is not what you want to hear and I'm terribly sorry about that, but I hope you understand.
I also hope this helps you to understand the various possible causes of her signs.
Ok, Thank you. I just have one last question.If she is just anemic and doesn't have cancer, you recommend steroids? or what treatment? can she be cured then?Should I tell my vet to do ultrasound as well or just wait for the blood work results to come back. Thank you
I hope you'll keep me posted about her.
Even after you've rated (if you do, of course), we can still continue to communicate, especially after you get her test results back.
I can also send you a follow up email next week to which you can respond when you have the time to do so.
Good luck. Regards, Deb
I just wanted to thank you for the rating and bonus; it's greatly appreciated. I also wanted to wish you the best with Mika.
I'll look forward to chatting with you after you get the test results back.
Kindly ignore the request for additional information. Regards, Deb
Hi Dr. Deb!
Just wanted to let you know how Mika is doing.
They did her blood work and an ultrasound. My vet prescribed two medicines; Omeprazole which is an antibiotic and then an antibacterial and antiprotozoal called Flagysin.
We changed her diet as well; she's eating k/d prescription diet food and I'm giving her vitamin B. In the ultrasound her spleen appears just fine, her kidneys, on the other hand, appear swollen, but there was no sign of cancer. My vet told me she has renal insufficiency and regenerative anemia.
I forgot to tell you that her feces was black, (I now know that means she's bleeding). And her feces has now brownish color to it.Her gums are more pink and her appetite is back.Does that mean she`ll get better or what can I expect?
Thank you so much
Dr Deb:Ok I understand, she does have a chronic kidney disease and I have to prevent further damage and stabilize her. So I`ll ask my vet to give me the antibiotics you recommend. Other than that what would you recommend I do? Is there a special treatment for Chronic kidney disease?
I can't thank you enough for everything!
3. Fluids under the skin (which can be done at home) can significantly benefit many of these dogs, especially if they start showing disinterest in food. Even though she may still be drinking water, dogs with kidney disease often can easily become dehydrated; in addition the electrolytes in the fluids can help them feel better.4. Phosphate binders which contain aluminum hydroxide such as Amphogel if the phosphorus levels are elevated. Once (or if) the phosphorus levels are < 6 mg/dL, then consider Calcitrol (which is a Vitamin D analog). However, if calcium levels are high, you wouldn't want to use it.
5. Secondary hypertension is often seen in dogs with kidney disease. Blood pressure measurements are relatively easy to do and appropriate drugs can be started if high. 6. Low dose aspirin can be beneficial in some cases but I would discuss first with your vet before starting.
7. Use of appetite stimulants such as Mirtazapine if the appetite starts to diminish.