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

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allergies so I got her...
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: 1 year ago.Category: Dog Veterinary
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Answered in 15 minutes by:
11/13/2016
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 31,705
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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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.

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Customer reply replied 1 year ago
Thank you. I've talked with u before. Just added more details.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year 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.

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Customer reply replied 1 year ago
A pathologist did look. Said immature reactive.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year 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.

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Customer reply replied 1 year ago
In your experience, what chances do you believe this could be early leukemia? Can this be a response to her allergies?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year 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.

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Customer reply replied 1 year ago
Can this lead to leukemia?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year ago

Please continue on in our conversation if you wish.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year ago

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

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year 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.

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Customer reply replied 1 year 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?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year 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.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year ago
Hi,
I'm just following up on our conversation about Rosi. How is everything going?
Dr. Michael Salkin
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Customer reply replied 1 year 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
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 year 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.

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Dr. Michael Salkin
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 31,705
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Experience: University of California at Davis graduate veterinarian with 45 years of experience

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