Dog

Get Your Dog Care Questions Answered by Experts

Ask an Expert,
Get an Answer ASAP!

Dog
This answer was rated:

I recently lost my baby, Tacitus - 5 yr old cocker spaniel,

I recently lost my baby...

I recently lost my baby, Tacitus - 5 yr old cocker spaniel, due to ITP this past Friday, 07/26/2013. He was bleeding into his organs. However, he did not show any of the signs that the internet describes as symptoms of a sick doggy. Even up to the point that we took him to the vet, he was totally alert and happy to be going with us. He seemed to act like as if we were going on a trip, he looked out the window. he wanted to get in front of the car. No sign he was sick except for the bleeding. He was NOT lethargic, nor was he bleeding from his eyes or nose or mouth, he would eat properly, he run and played around, he did EVERYTHING he normally did. Late Wednesday, he started to have blood stains in his pee, by Thursday morning, he was peeing blood and had blood in his poo. We took him to the vet the same day Thursday, where they told us he had ITP. Unaware that he had previously had treatment for ehrlicia, a tick born virus usually in dogs from texas (we live in CA but we brought him from texas). The vet started to give him blood transfusions and many other treatments (at the end costing a total of 9,500$). once we found out he had been treated for ehrlicia, we begged the vet to give him vitamin K, to stop the bleeding because the transfusions weren't doing anything and the bleeding spread to his lugs and other organs. they did x-ray and showed he did not have cancer or any obstructions in his intestines. he was completely healthy except for the ITP and enlarged spleen. other than that, he was COMPLETELY healthy. he did not get into rat poison most definitely, that's what they first vet tried to accuse us of. I was wondering what is the proper treatment for ITP with history of ehrlicia. We begged the vet to use vitamin k, but she blatantly refused, and was so angered b our suggestion she huffed and puffed and stomred out the room. then the director told would not let us explain ouir reasonining, cutting us off mid-sentence saying, "vitamin k is not going to work" or "nope, not gonna work." we even had the previous vet that cared for him from texas call from texas to the vet here in SF, CA but she still refused to administer the Vitamin K. she kept pumping him with blood transfusions, filling our dog with blood with no where for it to go besides the rest of his organs. I want to know the proper procedures for such cases.

Show More
Show Less
Ask Your Own Dog Question
Answered in 1 hour by:
7/30/2013
Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 10,708
Experience: I have owned, bred and shown dogs for over 40 years.
Verified

Hi Walter, I'm Dr. Deb.
I recently came online and see that your question hasn't been answered. I'm so sorry that you've had to wait for a response, especially given the nature of your question.

Please accept my sincere condolences on your loss; I know this must have been heartbreaking for you and your family.

The diagnosis of ITP is not necessarily an easy one to make and while I'm not disputing this diagnosis, the causes of a low platelets are varied. If you'll indulge me for a moment, I'll cover the possible causes which then might dictate possible treatment options.
1. Increased destruction as might be seen in Rickettesial or tick diseases. In a case like this or any case where a tick disease might be a factor, I'd start these patients on Doxycycline immediately.
Unfortunately, Vitamin K is not the standard treatment for a tick disease although it would be if a rodenticide was suspected (see below).
Auto-immune diseases such as ITP can also cause increased destruction as you know. High doses of steroids are the initial treatment of choice.
If ITP is suspected and steroids are not effective after 7-14 days, then other immunosuppressive drugs should be considered:

a) Azathioprine (Imuran®). Combination therapy with prednisone and azathioprine has been reported to have longest survival times.

b) Cyclosporine (Neoral®): Neoral® is preferred over Sandimmune® because of more consistent absorption. However it has used on a limited basis because it is costly and requires therapeutic drug monitoring within the first 24-48 hrs then every few weeks

c) Leflunomide: 4mg/kg every 24h. Leflunomide has been reported in a few studies to be effective in treating immune-mediated and inflammatory diseases. Very expensive.

2. Decreased production in the bone marrow. Some sort of underlying cancerous problem would be suspected. It would take a bone marrow biopsy to detect such a problem and obviously the prognosis is poor.

3. Sequestration such as in the spleen. Unfortunately, this is usually associated with a cancerous process, too, such as lymphoma. An ultrasound with a needle aspirate can be helpful in making this diagnosis.

4. Rodenticide poisoning. Even if there's not a high suspicion that this is the problem, treating with Vitamin K can be started since there is no downside to doing so.

5. Cancer elsewhere in the boy.

So, my approach to thrombocytopenia would be to start Doxycycline, start steroids, (usually I give an injection of Vincristine once if ITP is suspected), consider other immunosuppressive drugs if indicated, give transfusion if the platelets are low enough, start Melatonin (since it has been shown to increase platelet production), and give the owners a guarded prognosis.

If a rodenticide is suspected or is even a long-shot possibility, then I'll start Vitamin K at the same time.

Although the vet may not have felt that Vitamin K was indicated if they were certain that no rat poison had been ingested, it wouldn't have been harmful. I have to confess I don't understand the attitude that was shown to you either. It has no place in communication with owners as far as I'm concerned.

I know that you are absolutely devastated by Tacitus' death since everything happened so incredibly quickly. I also have to wonder whether or not he might have gone into DIC (LINK) given his rapid decline. This is a complicated cascade of events but ultimately is fatal.

Even though I know this isn't what you necessarily will want to hear, I would be doing a disservice to both you and him if I were less than truthful and honest. I hope you understand.

I also hope this helps you to understand what treatment options are usually considered in these cases.

Again, my condolences to you and your family. Deb

Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 10,708
Experience: I have owned, bred and shown dogs for over 40 years.
Verified
Dr. Deb and 87 other Dog Specialists are ready to help you
Ask your own question now
Walter:
I just wanted to thank you for the rating and the bonus; they are greatly appreciated.

My heart goes out to you and your family at this incredibly sad time. Regards, Deb

Kindly ignore the information request.
Ask Your Own Dog Question
Customer reply replied 4 years ago


thank you for your information. the thing that gets to me is that he did not have any symptoms described. no lethargy. no red spots. gums a little light in color but still pink. no noticeable bruising. no discharge from his mouth or nose or eyes or ears. no bleeding from his skin. not weak. he ate normally. he slept normally. he ran without signs of pain or discomfort. he jumped on the couch. he played with our other baby. he was panting but not for long periods of time. usually, 10mins at most until we opened a window/door. he liked to sit outside. we took his temperature and it was at 100. I'm just trying to understand why it happened so quick. he was lively, alert, fully functional. but when tested, we were told he was anemic, he had no platelets, or were so low that they could not be detected by the machine. by the time we left him at the vet, the other thing I noticed that his hind legs shaking. I figured because he was scared by then. they did x-rays and ultrasounds and nothing else was wrong besides ITP and enlarged spleen. maybe he could have had other ailments but the first results mostly indicated ITP. the vet did say that his platelets were gone and vitamin K was not something that would help. they wanted him to attain more platelets by immunoglobulin transfusions, frozen plasma, match-donor blood and a list of other things. they also used doxycycline along with other meds. sadly, nothing worked and he basically died in 24hrs.

Walter:
You're more than welcome.
I sensed that you were struggling with the fact that he had no prior symptoms but this is often the case with very acute cases of thrombocytompenia and in cases where the platelets have basically bottomed out.

If there is a more gradual reduction of platelets, then you're more likely to see the signs you mentioned. In most cases, signs don't develop until the platelets are <40,000 but in some cases, they won't show up until they are 5,000.

I'm quite familiar with Ehrlichia and Anaplasmosis since I live in New England where tick diseases are endemic. I've also seen my fair share of ITP cases although the tick diseases certainly outnumber them.
I obviously don't know what his blood work showed but if he was non-responsive to Doxycycline, then this is not likely to have been a tick disease, even though he might have been anemic as well.

The enlarged spleen can also be seen with tick diseases but it can be seen with lymphoma or other cancers as well. I wouldn't expect it to be enlarged with a rodenticide poisoning.
Given how rapidly he passed and failed to respond to any treatments, then I have to suspect cancer as a possible underlying problem with DIC as a possible sequela. I know he seems awfully young for cancer but, unfortunately, it happens to even young and middle-aged dogs.

ITP can be primary or can be secondary to a large number of conditions including infection, cancer, drugs and vaccines. I suspect that this was not a primary condition but rather secondary.

Deb
Ask Your Own Dog Question
Customer reply replied 4 years ago

We got the blood results of our baby, Tacitus. out of all the list of diseases on there, he was negative for all EXCEPT Ehrlichia. the one disease the vet refused to accept was what was his actual condition. she said it was not ehrlichia. i saw what treatment is for this disease and she only did the doxycycline.


we took him to our regular vet and she suspected rodentcide. which we told her was not it as we are very sure he didnt get to any. she did say that vitamin k would be given to a rodentcide toxicity but did not do so because she was afraid to give it to him without knowing why he was bleeding. they are the ones who refurred us to the emergency vet. we also got a summary report and half the stuff stated on there were never told to us. and it seems one report to the next, information changes.


 


this just feels like its worse the more we find out.

Walter,
I find this additional information somewhat distressing although probably not as much as you do.
There would have been no harm in starting Vitamin K even without a rodenticide being confirmed. While it doesn't look as if this was a real possibility in Tacitus' case, it would have been prudent to cover all bases by administering it to him.
I don't typically see tick diseases present with platelets as low as you initially described to me; this is more consistent with ITP. But I always start pred and doxy together if there's any question about what might be going on; I may or may not start Vitamin K. If the numbers don't start increasing within 7-10 days with Doxy, then this is not likely to be a tick disease and more likely ITP.
Obviously Tactitus's condition deteriorated quite rapidly which is one more reason why I'm not certain that a tick disease was primarily responsible for his non-response to treatment....this is not at all typical for the tick diseases (including Ehrlichia) that I see.

Doxy is the mainstay of treatment for Ehrlichia. Occasionally Chloramphenicol or imidocarb might be used but I've not personally had to resort to these other drugs in treating it.

I can understand how upsetting this must be, even after the fact. I suspect you strongly believe in your heart and mind that if Vitamin K had been administered to him that he would be alive today. Sadly, we'll never know whether this would have been the case or not.

I know you're still struggling with understanding what happened with him and I'm truly sorry that you're not able to find the answers which will help you move on.

Deb

Ask Your Own Dog Question
Customer reply replied 4 years ago


it's not that i believe vitamin k would have made saved him but if there was a chance that it would have, i wish she would have taken it.


 


if he was going to die, then so be it but she didnt want to try. she said she wouldnt give him an injection because he would die frmo anaphalactic shock. we asked to give it to him orally but she said no because he would choke on the pill due to him not breathing well.


 


after reviewing the summary, she gave him other pills and many other shots. seems she could have given it to him, if he was going to die anyway, it would not have hurt.


 


we called various times to ask how he was and every time they said he was doing well. the report, however, says otherwise. maybe they didnt want to alarm us. Everytime we called them, it seems we were always given different information.


 


i guess what i'm struggling with more is that i really dont know what they did to him and it seems they didnt treat him well. and i just wish i knew what the treatment would be for Ehrlichia which may have caused the ITP. we asked for a detailed list but they only gave us the summary after we begged them to send it to us but they gave the run around.


 


if i knew the proper procedure then i guess i would be more at peace that they did try everything to save him. and i would be more at peace. but like you said, now we can never know if it would have worked. and as soon as he died, i didnt know we had the option to hold the body until we could get a necropsy or give us time to decide what to do with th remains, they just said, "would you like a private or group cremation" they didnt ask if that was an option, they made it seem that was our only choice. i dont know the process after they die since this is my first dog to die. now i feel they rushed to cremate him to get rid of evidence.


 


what i'm struggling i guess is that i just feel they are being not right about this.


 

Walter:
I can definitely understand your feelings. It sounds to me like there was a definite breakdown in communication from their end of things which is contributing to your sense of unease and disquiet about how he was treated. This breakdown happened during his hospitalization and would appear to be continuing after the fact, unfortuantely.

From the sounds of it, he was given the standard treatments for Ehrlichia and ITP which would be Doxy and steroids....and transfusions.

As far as what options you had after he had passed, offering an autopsy is something that many vets feel uncomfortable with because of owner reactions. They are often quite horrified at the prospect so some vets will avoid adding more unpleasantness by mentioning the possibility.
This obviously doesn't make it right but might help you to understand why it wasn't mentioned at the time.

Deb
Ask Your Own Dog Question
Ask Dr. Deb Your Own Question
Dr. Deb
Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 10,708
10,708 Satisfied Customers
Experience: I have owned, bred and shown dogs for over 40 years.

Dr. Deb is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

You are a light at the end of scary tunnel when $ are tight, but people need professional help to turn to for help with their dear pets!

LinhCharleston, WV

$1,000 spent at his vet, and I finally get the correct diagnosis from Nancy Holmes for $15

CarolCedar Hill, MO

I think this is the greatest web site in the world. Thanks to all!

JudyNew Haven, CT

I have referred several friends to your web site. I'm impressed with how easy it is to use your site, the Experts available and the quickness of answers.

NinaUSA

I am completely pleased with the quick response that I received in our time of need for our dog, Jasmine. I couldn't believe how quick the response was and I thank you. It's good to know you're there!!

Jasmine's MomUSA

Please let everyone involved with your site know that your Expert, Dr. Lucy, has saved my dog's life. I will recommend your site to all my pet loving friends. Thank you again for simply being there!

Sonya GEasley, SC

Last night my Expert spent close to 3 hours working with me on my dog's illness. Thank you so much for this opportunity to share in her care and knowledge!

Cathie MPompano Beach, FL

< Previous | Next >

Meet the Experts:

Dr. Gary

Dr. Gary

Dog Veterinarian

3,033 satisfied customers

DVM, Emergency Veterinarian; BS (Physiology) Michigan State Univ

Joan

Joan

Vet Tech

5,320 satisfied customers

Vet Tech for over 35+ years working w/Dogs/Rescues

Candy

Candy

Veterinary Technician

7,973 satisfied customers

Practicing Veterinary Technician for 26 years.Former Veterinary Practice Owner, Technician Trainer

Dr Scott Nimmo

Dr Scott Nimmo

Small Animal Veterinarian.

5,120 satisfied customers

BVMS, MRCVS. { Glasgow UK }

Dr. Andy

Dr. Andy

Medical Director

4,898 satisfied customers

UC Davis Graduate, Interests: Dermatology, Internal Medicine, Pain Management

Theresa

Theresa

A Voice for Your Pet

4,705 satisfied customers

19+ years experience in small animal medicine

Dr. Drew

Dr. Drew

Veterinarian

3,292 satisfied customers

Small Animal Medicine and Surgery

< Previous | Next >

Related Dog Questions
My pregnant dame went to the vet today because we planned
My pregnant dame went to the vet today because we planned her mating with our stud. I noticed a bulge growing by her inner thigh so we wanted to check it out and have an xray to confirm the pregnancy.… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
He is shaking panting and has a warm nose. Sparkles little
He not himself he always love to play and he slept al day and now he is sitting up almost in my face… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
Clinging, panting, shivering and licking my skin. Oliver, 14
I am currently looking after 2 small dogs for a friend . These dogs are regular companions of Oliver. He also has a brother. All are small dogs. Oliver weighs 16 lbs… read more
Dr. Christina
Dr. Christina
Small Animal Veterinary Internist
399 satisfied customers
My dog keeps stretching...definitely not normal. Stretches
My dog keeps stretching...definitely not normal. Stretches his front legs out and hikes his rear, like he just got up from a nap....but this is like every 5 mins or so. He will get up from laying down… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
My dog threw up and it smells really bad. It's with a mucus
My dog threw up and it smells really bad. It's brown with a white mucus like substance … read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
My Toy Maltese just got into a chicken burrito with red
My Toy Maltese just got into a chicken burrito with red sauce. He has a super sensitive stomach and can not handle any people food at all. Always stars vomiting and gets diarrhea. He's only 5 lbs and … read more
Scott Perry
Scott Perry
Veterinarian
Doctor of Veterinary Medicine
1,527 satisfied customers
My teacup 13 week old Yorkie is sick. He's been throwing up
My teacup 13 week old Yorkie is sick. He's been throwing up I recently changed his food i don't know if it's that, but he threw up twice tonight and has been really inactive and still. He hasn't moved… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
My morky is not acting his perky self. Hubby has been
My morky is not acting his perky self. Hubby has been carrying him up the steps the last dayor two. We thought maybe he was hurting due to our extreme cold temps and he is 7 years old. We gave him a b… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
My 30 lb dog ate a small amount of my 20mg lexapro
My 30 lb dog ate a small amount of my 20mg lexapro pill...not even 1/4. She is taking metronidazole for colitis and pills look similar. Thankfully she spit it out. … read more
Rebecca
Rebecca
Veterinarian
Doctoral Degree
445 satisfied customers
My dog vomited up his food this afternoon and now tonight he
My dog vomited up his food this afternoon and now tonight he has vomited blood … read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
He was whimpering out of no where. his tail is tucked and
he was whimpering out of no where. his tail is tucked and gives out a little yelp if we try to really inspect. excessive panting in spurts and he trembling on and off. its the middle of the night.. sh… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
My Italian Greyhound ate about half of a CET Enzymatic chew
My Italian Greyhound ate about half of a CET Enzymatic chew without chewing it. Will it cause any issues? … read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
My 7 month old pup ate bunch of leaves in her day care's
My 7 month old pup ate bunch of leaves in her day care's back yard. Friday night she started having little diarrhea and threw up leaves twice. We gave her one dose pepto bismol. Saturday diarrhea stop… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
My 8 pound dog ate part or all of a single piece of a dove
My 8 pound dog ate part or all of a single piece of a dove truffle, I'm not sure it was a whole piece but I'm assuming it was . That was a hour ago and is not acting unusual and is sleeping on the sof… read more
Dr. Michael Salkin
Dr. Michael Salkin
Veterinarian
DVM
3 satisfied customers
My dog ate a latex glove I️ tried peroxide but she hasn't
My dog ate a latex glove I️ tried peroxide but she hasn't thrown up at all … read more
Dr. Christina
Dr. Christina
Small Animal Veterinary Internist
399 satisfied customers
My 4 year old chihuahua terrier mix recently started
Hi, my 4 year old chihuahua terrier mix recently started dripping 3-4 small drops of bright red blood after peeing today. She has gone pee about 4 times, all attempts have been normal enough with a no… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
He may possibly ate one women's one a day 50+ multivitamin.
He may possibly ate one women's one a day 50+ multivitamin. He weighs 14-15lbs … read more
Dr. Michael Salkin
Dr. Michael Salkin
Veterinarian
DVM
3 satisfied customers
My dog got some sort of reaction to the plastic bowl I was
My dog got some sort of reaction to the plastic bowl I was using and she began itching at it and the lumps on her chin opened up, she has since been switched to metal bowls and I've been cleaning her … read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,186 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x