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Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 10372
Experience:  I have owned, bred and shown dogs for over 40 years.
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Hi, My 12 year old golden retriever has a weak pulse and her

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Hi, My 12 year old golden retriever has a weak pulse and her gums are pale, she just had a convulsion 2 days ago, my vet says they have to puts her through a couple of tests to see what is wrong with her; but Im afraid that will make her weaker. What should I do?
Hi, I'm Dr. Deb. I will do my best to assist you today.

I'm so sorry to hear about this problem with Mika; I know you must be quite upset about her situation.
I do have a few questions to ask about her first, if you don't mind:

1. Do you know what specific tests your vet wants to run? Blood work, x-rays or ultrasound?
2. How long has she had these symptoms?
3. Is she currently on any drugs?

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

Customer: replied 4 years ago.

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

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.




Customer: replied 4 years ago.

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

You're welcome; I'm glad that I can help you and Mika, of course.

I'd do the blood work first. Then depending on the results, I'd go from there.

Anemia is usually secondary to some underlying disease. If she has Auto Immune Hemolytic Anemia, the prognosis is still somewhat guarded in a dog this age. I don't want to give you the impression that steroids will "cure" her. Auto immune diseases can be tricky; some dogs respond really well to steroids but others not so much an d it's impossible to predict which ones will or won't.

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

Dr. Deb and 4 other Dog Specialists are ready to help you

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

Customer: replied 4 years ago.

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

I'm glad you're updating me on Mika since it sounds like cautiously optimistic good news. And, I'm so delighted that there doesn't appear to be any cancer that could be detected and that she's eating with a more normal gum color.

Regenerative anemia is good since it usually means there's a healthy bone marrow producing red cells and trying to make up for the loss.

Omeprazole is actually an antacid, not an antibiotic, and I'll use it for nausea or when I suspect gastric ulcers or when kidney issues have been diagnosed or suspected.

As to her prognosis, much depends on how elevated her kidney values...mild, moderate or severe is how I usually categorize it...or if this was an acute insult or a more chronic one. Usually we'll see regenerative anemia with chronic kidney disease so this is more likely. If this is the case, it takes at least 75% of kidney tissue to be irreversibly damaged before you see changes in the blood work. The goal is to prevent more damage and stabilize the process. It's often very difficult to predict which dogs will deteriorate rapidly and which ones will do well for long periods of time.

An acute injury might be associated with an infection in her kidneys. Neither one of the drugs she's on would be a particularly effective drug, in my opinion, if I suspect an infection. I'd rather see her on Clavamox or Cephalexin or Baytril. I would also want to have done a culture and sensitivity to find out if bacteria are growing in her urine (with the assumption that the source might be the kidneys) and what drugs it might be sensitive to.

So, at this point, I honestly don't know if she'll recover from this or if it will progress and ultimately be fatal for her.

But the fact that she's doing so well right now is extremely encouraging. Deb
Customer: replied 4 years ago.

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!

It's my pleasure to be able to help you.

Treatment options for chronic kidney disease include the following:

1. Fish oil such as Welactin or 3V Capsules can help some of these dogs since it has anti-inflammatory properties.
2. Low protein diets such as K/D to prevent further damage to the kidneys.

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.