Simone Update 8/15

Simone is doing much better. Her platelet count was up to 325,000 as of yesterday! Hooray! We're officially out of the woods! She goes back in for another check next week, and then hopefully we can start lowering her steroid dose. They make her thirsty (she now drinks 4-5 bowls of water a day) and thus has to pee a lot (I get up twice a night now to let her out). Her eyes look great though...I've never seen them this white. It's making us wonder if she hasn't had this all along, and for some reason, it's just gotten worse now. Whatever the case, we're glad we caught it and that there's something we can do about it!

Simone Update 8/12

She's doing better. Had a scare on Friday afternoon...She started acting funny, and when I looked her over, I noticed that her gums were paper white. I called the vet and left a message, and she called me back an hour later. By then Simone started acting more normal, and her gums started to pink back up, but she said it could have been internal bleeding, so we went in. They did bloodwork, and by the time the vet saw her, her gums were back to normal. I think Simone was just ticked that we hadn't taken her in that day and wanted to go back (they have good treats!) Her bloodwork came back as improved...the RBC count was down a little, but her platelets were up...to 135,000! A huge improvement over Thursday's 21,000 count. So, everything seems to be going better. We go back in for bloodwork on Tuesday and hopefully her platelets will be normal by then. It's going to be like this for awhile...making sure her platelets stablize, then the vet deciding when to decrease her steroids. It may take months before we get it right, but we're willing. Hopefully she'll get back on track and have another 7 healthy years.

Simone Update 8/10

All of the tick disease tests have come back negative, so her low platelet levels aren't being caused by a bacteria. Darn! That would have been the quickest and easiest fix.

As of yesterday, her platelet count is now at 21,000 (a four-fold increase). We're still ~150,000 shy of being back in the normal zone, but hopefully she'll get there. Her neutrophils are a little elevated (which can indicate a bacterial infection), so the vet has asked us to keep her on the antibiotics for now even though the tick titres came back negative. We go back in for bloodwork on Monday again for the next check.

It's sounding more and more like immune-mediated thrombocytopenia, so it sounds like she will be on steroids for the rest of her life (in addition to her twice daily thyroid and phenylpropanolamine). Soon we're going to need one of those pill cases just to keep it all straight! The vet also had us put her on 2 tablets of maximum strength Pepcid AC to help her stomach cope with the current high doses of steroid.

Simone's current twice-daily medication dose. Yikes!

We're glad her eyes look better...the redness has pretty much disappeared. The weight gain has begun from the steroids though, as she's up 4 pounds in only 2 days. I shudder to think of what it will be on Monday! Poor puppy worked so hard to lose all that weight, and now it's going to pile itself back on. Hopefully it won't be too hard for her to lose again later :)

We'll continue to keep you posted.

Thrombocytopenia

Not a good day. Took Simone to the vet for her red eyes, convinced she had pink eye or something, but the vet said that wasn't it. It appears that she is bleeding behind her eyes and cannot see out of the right one, and only has partial vision out of the left. The vet immediately suspected a rodenticide poisoning, and then listed off an autoimmune disorder in which her white blood cells are attacking her red blood cells, cancer as other possibilities for her symptoms. The vet was hesitant to tell me anything until the tests come back, but told me that she was "very worried".

They took blood out of three of her legs and gave her a giant shot of vitamin K (19 mL...I've never seen a syringe that big) to help her coagulate better, and then sent us home to wait by the phone to hear the results of the blood work.

At 6pm the vet called. Simone's platelet levels are dangerously low (5,000...they should be at 165,000). This means she is not able to clot properly. She has a tentative diagnosis of thrombocytopenia. This might be caused by an autoimmune disorder (then it would be called immune-mediated thrombocytopenia), in which her immune system has suddenly decided to target her platelets, or it might be caused by something else, like canine ehrlichiosis (a bacterial infection transmitted by a tick). As we were in Northern Nevada and California in the last 5 weeks or so, the tick bite might be a possibility. They are running a tick titre on her blood now; we should have the results in 6 days and know for sure. In the meantime, they have started her on a high dose of steroids and an antibiotic (in case it's the ehrlichiosis). She will be getting her blood checked every other day to see if her platelet count starts to rise. We'll know more once the tick titre comes back and after she's had her first few platelet counts.

If it's the autoimmune disease, then she'll be on steroids for the rest of her life. If it's caused by a tick, then the antibiotic should kick it eventually. We've been told it could still be caused by something else entirely (cancer was mentioned as a possibility not to be ruled out just yet), but we won't go there until we have to.

Keep your fingers crossed for us.