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My dog Rosie has been ill since last Saturday she has been…

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Hi my dog Rosie has...
Hi my dog Rosie has been ill since last Saturday she has been admitted to vets since Sunday and she doesn’t seem to be getting any better. It started with her Saturday morning very lethargic and no interest at all in anything I took her to vets they said she had temperature and she was tender round her tummy. They give her injection to ease her tummy anti sickness and pain killers. She slept all day wasn’t herself at all wouldn’t eat or drink by Sunday I took her to out hours they admitted her as she had higher temperature 41. Later that night they said her white blood cells where low. Monday white blood cells lower again temperature still high but coming down a bit white bloods cells where 1.1 then went to 0.9 then started to rise back to 1 then 2 temperature had came down. She was allowed home last ngt she was still very poorly I had to take her back this morning for her bloods checked again. She wasn’t right at all she was still very lethargic and not interested in anything drank a bit water wouldn’t have anything to eat at all. When I picked her up she was wimping. Also through the night she was shaking but felt hot. I took her back this morning as planned for blood check. They did her temperature first it had gone up and said they would have to take her back in, then took her bloods then came back and said her white bloods where fine back to normal but red cells are really low and they would repeat them later the day they again came back really low. She has had a scan X-ray heart echo and they said everything looked ok apart from 1 kidneys a tube was bit clear so could be infection they sent urine away for culture growth still awaiting that back. They don’t seem to know what’s wrong and I thought she be on the mend by now have you any ideas what could be going on I feel like she fading a way in front of me she was 5.6 on Saturday and she is now 5.
Submitted: 7 months ago.Category: Dog Veterinary
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Customer reply replied 7 months ago
I thought you would answer within 30mins
Answered in 1 hour by:
12/1/2017
Dog Veterinarian: Dr. Gary, Dog Veterinarian replied 7 months ago
Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 20,006
Experience: DVM, Emergency Veterinarian, BS (Physiology)
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Hello, I'm Dr Gary. I've been practicing veterinary medicine since 2007. I look forward to helping with your questions/ concerns.

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Dog Veterinarian: Dr. Gary, Dog Veterinarian replied 7 months ago

Sorry about the wait. I just logged on and saw this. I'm reviewing the question now. I'll be back with you shortly.

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Dog Veterinarian: Dr. Gary, Dog Veterinarian replied 7 months ago

This is a little strange how her white cell numbers are coming up but her red cell count is now dropping. This points to something going on in the bone marrow. I would really want to get a bone marrow biopsy done. This will give you an answer as to the cause. It could be an infection, auto-immune disease, cancer (leukemia, multiple myeloma) or a toxin (estrogens). Without the bone marrow results, we're just treating the treatable things and giving it time.

Whether or not you do a bone marrow biopsy, I usually have these dogs on full quadrant antibiotic coverage- Clavamox + Baytril. I'll also consider Doxycycline in case I'm thinking about tick borne disease.

For now, I think the anemia may need to be addressed if it's < 20%, especially if < 15%. If so, then a blood transfusion may buy you some time to get a diagnosis and figure out if something else is needed. If this ends up being auto-immune, then steroids (Prednisone) will be needed. If it ends up being cancer, then chemotherapy can be started.

I hope this helps give you some ideas, let me know if you have any other questions.

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Customer reply replied 7 months ago
They have mentioned a bone marrow biopsy. I think they are going do a cct scan first would that show anything up ? What is a toxin (estrogens) and what is multiple myeloma? Could these suddenly just come on without her being unwell first she was fit running round last week. How would they know if it was a tick bourne disease? The tablets she is on are rilexine 75mg twice a day, metronidazole 50mg twice a day, pardale v half a tablet twice a day, portion 4mg twice a day
Customer reply replied 7 months ago
No don’t want to talk over the phone
Dog Veterinarian: Dr. Gary, Dog Veterinarian replied 7 months ago

I think a CT could be helpful, but a bone marrow biopsy will be more helpful.

The toxin that can cause bone marrow suppression is estrogen creams. They are used by women going through menopause. They can get absorbed by dogs and then cause bone marrow suppression. If that's not something in the house, then it can be ruled out.

Multiple myeloma is a type of cancer similar to lymphoma or leukemia. It's just a different cell line. It's diagnosed on the bone marrow biopsy if present.

A tick borne disease is usually ruled out with tick titers.

Rilexine is Cephalexin, a broad spectrum antibiotic. Metronidazole is an antibiotic that covers anaerobes. Pardale is like Tylenol, it's for the fever. I think I would ask about adding a Fluoroquinolone like Enrofloxacin (brand name Baytril).

I can't talk on the phone either now. That's just an offer that always pops up from the site.

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Customer reply replied 7 months ago
There are no kind creams like that in the house. Could any other creams cause anything she sleeps in my room but haven’t noticed if she managed to get any don’t think she has as she never done anything like that. What are Tick ticklers ? I am just going out my mind with worry. When I said red cells they said about not clotting and platelets been low is this the same thing?
Dog Veterinarian: Dr. Gary, Dog Veterinarian replied 7 months ago

The only creams would be those containing estrogen.

Tick titers are blood tests to check for tick borne diseases like ehrlichia, lyme, anaplasma.

There are 3 cells lines that are made in the bone marrow- white cells, red cells and platelets. The platelets have the shortest survival time in circulation, then the white cells then the red cells. When we have bone marrow disease, we usually see the platelets and white cell lines drop first and then the red cells. They come back in the reverse order as the disease is being controlled.

If you're able to get copies of the bloodwork, I'd be happy to look at things for you and give you another opinion on it.

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Customer reply replied 7 months ago
Ok i will ask for them and get back to you. Do you think it’s more pointing to bone marrow problems ? Should I still say about a Fluoroquinolone like Enrofloxacin (brand name Baytril) tablet ? Also with her not eating for so long will she be ok ? they give her an anti sickness injection tonight as they said she was slavering.
Dog Veterinarian: Dr. Gary, Dog Veterinarian replied 7 months ago

I would definitely ask for Enrofloxacin if the fever is still present.

I would also lean toward a bone marrow biopsy sooner rather than later to get an answer.

When it comes to nutrition, I tend to put a naso-gastric feeding tube in and trickle feed a liquid diet. I do this when I have a dog that goes more than 2-3 days without eating.

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Customer reply replied 7 months ago
Hi Dr Gary Rosie had her bone biopsy 2ngt she is just sleeping. Her temperature been normal all day but she hasn’t been herself very lethargic, she looks so little and sad. Her platelets continued to drop and her white cells are now above normal ? They are starting her on a steroid when she wakes up from the Surgrey. Any more thoughts on what it could be ?
Dog Veterinarian: Dr. Gary, Dog Veterinarian replied 7 months ago

I'm glad she got the bone marrow biopsy done- that should give you some answers in the next few days.

The steroid is a good idea. I think auto-immune disease is definitely possible here. If it shows something else, then the steroids can be stopped. I'm glad they waited for the bone marrow before starting the steroids. The differential list is still the same- infection vs auto-immune vs cancer. Soon we'll know.

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