August 19th, 2008

tinydevon

The Continuing Saga of Devon's Platelets

Well, time for an update on Devon's condition.

A week ago last Monday I took Devon back to my vet for another blood draw to see if there was some way we could get a non-clumped sample. I actually helped her draw the blood this time and we did all the things I'd read about that were recommended to get a clump-free sample. But, it didn't work and the results were the same, 10,00 with clumping present. But this time my vet requested that the slide be looked at by a pathologist and her comment was that the clumping could be caused by ITP (idiopathic thrombocytopenia). That convinced me that he really did have low platelets and so I requested that she refer us to the vet school. I also asked if she thought I should go ahead with the trip I had planned on taking and she said she thought it was too dangerous for Devon to travel.

So I cancelled the trip but not my time off from work. I thought I could at least use the time off to catch up with things around the house and spend some quality time with my dogs and with friends. But it didn't really work out that way. I mostly just worried about Devon and spent a lot of time trying to distract myself. I had made an appointment at the vet school for today and as the time got nearer I got more and more nervous about what they would find.

It was a relief to finally get there this morning and know that at least we were--possibly--going to find out what we could do about this condition. I was also relieved to find out that their approach was going to be more conservative than I'd been led to believe from the account of the consult with the internist  I'd been given.  And I was impressed with how well the resident explained everything and answered our questions. 

The short version of what he told us was this:  The most likely reason that Devon's platelets were low was that his immune system is recognizing them as foreign and killing them but to rule out tumors they would need to take chest x-rays and do an ultrasound of his abdomen. If that was clear then they would draw blood for a tick panel that tests for some of the more rare and hard to isolate diseases. But since those tests can take a couple of weeks to run, they didn't want to wait to start treatment if the body imaging was clear. So we left Devon there for a few hours so that they could do the x-rays and ultrasound and draw some more blood.   

Continued from 8/19:

When I picked a sleepy Devon up later they told me the x-rays and ultrasound were clear, the blood work was normal (other than having only 25,000 platelets--no clumping in this sample, hmmmm--and some changes that are usually seen with patients taking prednison),)and that they wanted me to start giving him another medicine along with the pred called Azathioprine (Immuran). It's another immunosuppresive drug and if it's going to work it should bump his platelets up pretty high. If not, well, I prefer not to think about that scenario right now.

Yep, I'm just thinking short term right now. There'll be plenty of time to worry about long term later. Right now I just want to make sure that he's as happy as he can be and keep him away from the other dogs so he doesn't get bumped. Whenever it's not a bazillion degrees out I take him for hikes in Duke forest and let him splash in the creek.  Agility is out as an activity in case he falls or hits a jump or gets bumped by another dog and because pednisone causes muscles weakness and trembling. It may be that he can't ever go back to it but as long as he can have a good quality of life for as long as possible, that's all that really matters.