July 23rd, 2008

Devcolor

Poor Boy

Poor little Dev-dev has been dealing with a troubling health issue over the past week or so.

I took him in for his annual physical and had a Chem 10 and a CBC drawn in addition to all the regular stuff they do (heartworm, Erlichia, fecal, etc.) The platelets came back as "too clumped to count" which isn't that unusual a result but the lab also did a manual review of the slide and added the comment that his platelets were estimated as "low". I remembered that the last time he'd had a CBC his platelets were "TCTC" but at that time they were estimated as "adequate".

Since testing error is always a possibility, his blood was re-drawn and the vet tech prepared a slide of his blood to review in-house. Again, there was a lot of clumping but they were able to estimate the number as 14,000.
Keep in mind that Devon has seemed completely normal; no lethargy, no lameness, no vomiting or diarrhea. He has been playing hard with his "little" sister with no sign that it tires him out. He also doesn't have any of the clinical signs of thrombocytopenia (low platelet count), no bruising, for example.

My vet suggested starting him on Prednisone right away and also on Doxycycline in case it was some kind of tick-borne illness other than Erlichiosis. The Prednisone is supposed to suppress his immune system in case his own body is destroying his platelets.

Today they drew his blood again but this time instead of using a syringe and then putting the blood into the tube that contains the anti-coagulant (EDTA in this case), they used a large bore needle and drew the blood from his jugular vein right into the tube so there would be very little chance that the clumping resulted from the blood not getting into the anticoagulated tube.

This time the result was 75,000 platelets which looks like the Prednisone is having the desired effect.

If this is caused by his own immune system, we may never know why. Or, it might be because he has some other underlying problem. He might (and this is what I'm hoping for) need only one treatment with Prednisone for his platelets to recover and never need Prednisone again. Or he might have to take Prednisone for the rest of his life at some dose that keeps his body from destroying his platelets (but at what cost to his health?).

He's on a pretty high dose of Prednisone right now, 10 mg twice a day. He'll be on this dose for one more week and then he'll be slowly tapered to a smaller and smaller dose with us checking his platelets every week at first.

He's acting so unlike himself right now that I feel awful for him. He's so quiet and low key and he's normally so happy and full of energy. The only time he's like his old self is when I fill his pool for him and let him splash in it.

So, does anyone out there have any experience with thrombocytopenia-- especially ideopathic thrombocytopenia? All his other blood values are normal (except an increase in monocytes). My vet mentioned doing a bone marrow biopsy down the road but I really don't want to subject him to that if I can avoid it.

It really helps to have this forum to share my concerns with. I know most of you have dealt with difficult health problems with at least one of your animals and must know how heavy my heart is right now.