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Getbig Misc Discussion Boards => Pet Board => Topic started by: ~flower~ on September 20, 2007, 03:24:16 PM
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Addie was spayed yesterday. When I called this morning to check on her and find out if she could come home today I was told their was some concerns. Her incision site was still bleeding. They put a pressure bandage on it and were watching it. We thought she possibly had von Willebrand’s, a blood clotting disease, and that was the reason for her bleeding. Her vitals were pretty good, but we discussed a possible need for a transfusion.
I got called back with an update around 4 and she was still the same. So we decided that he would open her up and re-suture and glue the incision. I got a call back after that and he doesn't believe that she has von Willebrand’s, the problem was her body was already breaking down the sutures!! He said it could be because of scar tissue from her obstruction surgery, but he didn't really think their was that much scar tissue, or maybe it was a reaction to the sutures. So he used permanent sutures in her now. That will hopefully solve the problem. He said in very very rare cases healing doesn't happen and some mesh may need to be used.(?)
She will probably have to stay through the weekend. Keeping her calm and inactive is crucial to her healing. I will be going to visit her, hopefully tomorrow if she has improved.
She has refused all food and while I know they haven't offered her raw ::) Addie does like food so she would eat whatever they offered!! I will probably grind up some chicken for her and take it to her when I go see her.
I feel like shit, I should of just left her intact. :-\ She never was a problem in heat, she's about 4 years old, I don't have any intact males in the house, so maybe I should of just left her whole. I've been responsible with her and would of continued to be. Now she is going through all this and probably wondering WTF?
This is part of the reason I prefer male animals to females!! Their "bits" removal is usually much smoother and less of a risk!!
:-[
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ps- I have to give credit to the vet and the vet techs. He (the vet) went and checked on her 3 times last night and I know they will be doing that again over her stay. I'm sure getting up every couple hours is not fun and he was working out a schedule with his techs.
I know all vets have someone check the overnighters, but sometimes they go above and beyond.
I was also very impressed and appreciative of the way they handled it when I had Simon put to sleep. I told them that too a number of times because I think that compassion and caring should be acknowledged.
I know Hedgie wouldn't approve, but this vet calls you "mom" when he's talking to you and explaining options. He knows that to a lot of people pets are valued family members. Sometimes it's the little things like that that can make something a little bit easier.
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Flower as you told me don't beat your self up.. You made a descision. It wasn't to hurt addie. So don't feel it is your fault. Your a great owner and there is no need for you to beat yourself up or take the blame. Right now Addie just needs you to be there for her.. She will pull through.. If Chaos and Chucka are still breathing (which they are as of this morning. ;D) Then Addie will pull through this.. Don't stress the small stuff....... (Hint) It's all small stuff... Keep us updated please...
Addie will be in my prayers.
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Thanks Sin, :). I know, it just sucks (as you know!!) and not seeing her and wondering if she thinks I abandoned her and her going through all this is crappy.
I appreciate your words and prayers. :)
I checked out your recent pics and it's good to see them 2 rascals up and around. :D Adorable shots, and love the bandanna!! ;D
I haven't been around much with school and now this will be on my mind, but will post updates and try and post. Sometimes this place (getbig in general) can be a headache, but other times it is a great distraction!! ;D
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Thanks Sin, :). I know, it just sucks (as you know!!) and not seeing her and wondering if she thinks I abandoned her and her going through all this is crappy.
I appreciate your words and prayers. :)
I checked out your recent pics and it's good to see them 2 rascals up and around. :D Adorable shots, and love the bandanna!! ;D
I haven't been around much with school and now this will be on my mind, but will post updates and try and post. Sometimes this place (getbig in general) can be a headache, but other times it is a great distraction!! ;D
Agreed, I hate this shit hole place half the time I usually only post here and the MMA board, but Blutoe has really screwed up the MMA thing.. But yeah it does suck thinking about them, but you just have to realize it's better for her to be there then at home.. As hard as it is to stomach...
Just visit when you can and call and check up.. I called about every 3 hours the first few days.. I even called the cleaning people and had them check on my boys.. It was kind of funny, the cleanin guy was like I am glad those cages stay locked. I dont like pits.. But by the end of the stay he was petting Chaos at night I guess....
Just take care of yourself and keep updated. Other then that if you trust your vet then you should be okay. It sounds like he has it under control.
I am glad my boys are doing better to... ;D Addie will be back home and giving you kisses in no time.. I got faith, DO YOU????? of course you do, so dont worry yourself to death. It won't help anything TRUST ME.... Your girl will be back home soon. Please keep us updated now that you got me concerned as well. We are all here for you...
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Will do Sin!! They have instructions to call me at any time, I can be there pretty quick, so if she takes a turn I want to be there. He's pretty confident that she ill be fine, it's just rougher than expected. But of course he has to tell you every possibility and about other complications.
I'd like to give a BIG shout out to STELLA!!! She has been very supportive to me and for Addie today and yesterday when I was just being a worrier and didn't even have anything to worry about yet, and even had me laughing today - so thanks STella!! :-*
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Really nice posts Sin. And I had to laugh about the cleaning guy!
FLowey, we are all praying over here!
I was just posting about you!! ;D
Those dogs of yours, they are so special too! :D
I'm gonna go grind that chicken for Addie now.I have to make Tino some ground chicken too this weekend so might as well do it and have it ready.
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Gosh thanks Flowey :-* and she's going to be fine :)
even had me laughing today - so thanks STella!! [/color] :-*
It was my Aunt and the weiner wasn't it ;D
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Gosh thanks Flowey :-* and she's going to be fine :)
It was my Aunt and the weiner wasn't it ;D
lol @ weiners!!
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Addie was spayed yesterday. When I called this morning to check on her and find out if she could come home today I was told their was some concerns. Her incision site was still bleeding. They put a pressure bandage on it and were watching it. We thought she possibly had von Willebrand’s, a blood clotting disease, and that was the reason for her bleeding. Her vitals were pretty good, but we discussed a possible need for a transfusion.
I got called back with an update around 4 and she was still the same. So we decided that he would open her up and re-suture and glue the incision. I got a call back after that and he doesn't believe that she has von Willebrand’s, the problem was her body was already breaking down the sutures!! He said it could be because of scar tissue from her obstruction surgery, but he didn't really think their was that much scar tissue, or maybe it was a reaction to the sutures. So he used permanent sutures in her now. That will hopefully solve the problem. He said in very very rare cases healing doesn't happen and some mesh may need to be used.(?)
She will probably have to stay through the weekend. Keeping her calm and inactive is crucial to her healing. I will be going to visit her, hopefully tomorrow if she has improved.
She has refused all food and while I know they haven't offered her raw ::) Addie does like food so she would eat whatever they offered!! I will probably grind up some chicken for her and take it to her when I go see her.
I feel like shit, I should of just left her intact. :-\ She never was a problem in heat, she's about 4 years old, I don't have any intact males in the house, so maybe I should of just left her whole. I've been responsible with her and would of continued to be. Now she is going through all this and probably wondering WTF?
This is part of the reason I prefer male animals to females!! Their "bits" removal is usually much smoother and less of a risk!!
:-[
Its best she's kept over the weekend. Did they say anything about bleeding from the ovarian pedicle? In a large dog like Addie, its sometimes difficult to get good ligation of the ovarian vessels---because you are reaching so deep within the body cavity. If there is any bleeding post operatively, then rechecking everything the next day is the best way to go--even if this includes reanesthetizing the dog and reopening the incision. The alternative is the dog going home and its guts falling out from a bad incision line. Its just simply better to be safe than sorry.
Remember all "absorbable" sutures are essentially broken down via immune reactions/enzyme reactions within the body. So its possible if shes sensitive to a certain type of suture, she's showing an immune reaction causing the reaction that was seen--which is more likely if she's had previous surgeries with the same type of suture. No suture would have broken down in 24 hours, not unless it was something excessively weird, but I have seen dogs with some fairly substantial swelling and when the suture was changed to a different type, that reaction appeared to dissappear. Mesh is something that is excessively rare---I've never had to do that with a spay, and my old boss in Ohio only had one out of nearly 25 years in practice. Thsi dog seemed to react to every type of suture used except stainless steel. It was very strange. It even reacted to silk skin sutures.
Don't beat yourself up. This doesn't sound like an uncommon complications seen with an older dog spay---especially one of a large breed. From a health standpoint, spaying her will probably benefit her longterm health vs not spaying her---especially if there were no plans for breeding. It also sounds like your vet has things under control. It's two short weeks and the incision will be healed. ;)
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Really nice posts Sin. And I had to laugh about the cleaning guy!
FLowey, we are all praying over here!
I love those pictures. :D
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Addie was spayed yesterday. When I called this morning to check on her and find out if she could come home today I was told their was some concerns. Her incision site was still bleeding. They put a pressure bandage on it and were watching it. We thought she possibly had von Willebrand’s, a blood clotting disease, and that was the reason for her bleeding. Her vitals were pretty good, but we discussed a possible need for a transfusion.
I got called back with an update around 4 and she was still the same. So we decided that he would open her up and re-suture and glue the incision. I got a call back after that and he doesn't believe that she has von Willebrand’s, the problem was her body was already breaking down the sutures!! He said it could be because of scar tissue from her obstruction surgery, but he didn't really think their was that much scar tissue, or maybe it was a reaction to the sutures. So he used permanent sutures in her now. That will hopefully solve the problem. He said in very very rare cases healing doesn't happen and some mesh may need to be used.(?)
She will probably have to stay through the weekend. Keeping her calm and inactive is crucial to her healing. I will be going to visit her, hopefully tomorrow if she has improved.
She has refused all food and while I know they haven't offered her raw ::) Addie does like food so she would eat whatever they offered!! I will probably grind up some chicken for her and take it to her when I go see her.
I feel like shit, I should of just left her intact. :-\ She never was a problem in heat, she's about 4 years old, I don't have any intact males in the house, so maybe I should of just left her whole. I've been responsible with her and would of continued to be. Now she is going through all this and probably wondering WTF?
This is part of the reason I prefer male animals to females!! Their "bits" removal is usually much smoother and less of a risk!!
:-[
I hope she comes back healthy and soon
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That sucks flower. Just try to relax, before Plato was neutered I tried to have him done two weeks before and there was a complication where he vomited an extremely large amount of fluid as he was sedated. We still have no idea why and obviously hes been neutered since then, but when I got that call I know how it feels, you are just like oh my god he is so miserable. But then you go and get them and they are happy to see you and just happy to get out of the Vets office and they just want to go home and sleep =P
Addie will be just fine, just try not to think about it. Dogs don't worry, we worry for them =P
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Its best she's kept over the weekend. Did they say anything about bleeding from the ovarian pedicle? In a large dog like Addie, its sometimes difficult to get good ligation of the ovarian vessels---because you are reaching so deep within the body cavity. If there is any bleeding post operatively, then rechecking everything the next day is the best way to go--even if this includes reanesthetizing the dog and reopening the incision. The alternative is the dog going home and its guts falling out from a bad incision line. Its just simply better to be safe than sorry.
Remember all "absorbable" sutures are essentially broken down via immune reactions/enzyme reactions within the body. So its possible if shes sensitive to a certain type of suture, she's showing an immune reaction causing the reaction that was seen--which is more likely if she's had previous surgeries with the same type of suture. No suture would have broken down in 24 hours, not unless it was something excessively weird, but I have seen dogs with some fairly substantial swelling and when the suture was changed to a different type, that reaction appeared to dissappear. Mesh is something that is excessively rare---I've never had to do that with a spay, and my old boss in Ohio only had one out of nearly 25 years in practice. Thsi dog seemed to react to every type of suture used except stainless steel. It was very strange. It even reacted to silk skin sutures.
Don't beat yourself up. This doesn't sound like an uncommon complications seen with an older dog spay---especially one of a large breed. From a health standpoint, spaying her will probably benefit her longterm health vs not spaying her---especially if there were no plans for breeding. It also sounds like your vet has things under control. It's two short weeks and the incision will be healed. ;)
Internal she looked fine, the bleeding was coming from the body wall, the sutures were starting to break down. Temperature normal, vitals normal. Her crit started at 52% before surgery and went down to 40%, which is still normal (he said normal was 35-45% so she was actually high before surgery).
She did good overnight, no more bleeding, but he was thinking about it last night at he would like to have a blood coagulation test (DIC? I don't remember if that was the test or a condition?) done. I guess the test for von Willebrand's can take a week to get back, and while he doesn't think she does have that, if there is a possibility she does then better to know instead of waiting for her to take a turn. She's on antibiotics as a precaution since she was opened up twice.
I will be dropping off some food for her and hopefully get to see her later on. They will be offering her something bland this morning, I hope she feels better and eats, she hasn't had anything since Tuesday night. I should bring her some tripe ;D, but I will not subject the techs to the smell since they are devoting so much time to her!
I think health wise it was a good decision, I wouldn't want to spay her much older, but if I had known she would go through all this before I had it done, I might not have done it!!
Thanks everyone for all the good thoughts, much appreciated!! :)
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Glad to hear that she is doing better.. It sounds like the vet is taking care of her... Addie is still in our prayers.. Me the wife and the two bulls are pulling for her... LEt us know if you need anything.. Hope all gets better.
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Flower, I am sending Addie good vibes all day long too!!
:)
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Internal she looked fine, the bleeding was coming from the body wall, the sutures were starting to break down. Temperature normal, vitals normal. Her crit started at 52% before surgery and went down to 40%, which is still normal (he said normal was 35-45% so she was actually high before surgery).
Yeah, 52% is on the high end of normal. You dont start thinking about blood transfusion until the crit is 20% or less and typically even then may wait until its 12-15%. While the numbers sound really bad at first, she wasn't in any sort of danger. Had she ever had puppies? Did they say was the incision right on the linea or did it get off center a bit? If she's had puppies, there is risk for enlarged blood vessels in the bodywall secondary to mammary gland development. If the surgeon got "off center" meaning the incision was more muscular than linea, then there is increased risk for bleeding post op. I've spayed a couple of older dogs with similar post op problems and the surgery was textbook. They simply bled post op. I've gone back in and tried to identify, fix any leaky vessels and still had some minor bleeding. In these cases a pressure bandage goes a long, long way.
She did good overnight, no more bleeding, but he was thinking about it last night at he would like to have a blood coagulation test (DIC? I don't remember if that was the test or a condition?) done. I guess the test for von Willebrand's can take a week to get back, and while he doesn't think she does have that, if there is a possibility she does then better to know instead of waiting for her to take a turn. She's on antibiotics as a precaution since she was opened up twice.
DIC is bad---very, very bad. it occurs when the blood begins clotting throughout the capillaries for some major disease reason. Some criticalists call it "Death Is Coming" because te prognosis is so bad. I imagine the vet is just running a coagulation panel. Von willebrands is a specific type of coagulopathy (a deficiency in von Willebrands factor, which affects Factor VIII in the clotting process) , but there are others that dogs can have that will prevent their blood from clotting correctly. Its important to identify these sort of things for future medical treatment---say she gets hurt or something. If she ends up having von Willebrands, make sure they check her thyroid function. There is a correlation between hypothyroidism and von Willebrands in non doberman breeds.
I will be dropping off some food for her and hopefully get to see her later on. They will be offering her something bland this morning, I hope she feels better and eats, she hasn't had anything since Tuesday night. I should bring her some tripe ;D, but I will not subject the techs to the smell since they are devoting so much time to her!
I think health wise it was a good decision, I wouldn't want to spay her much older, but if I had known she would go through all this before I had it done, I might not have done it!!
Thanks everyone for all the good thoughts, much appreciated!! :)
You know, the bottom line is she's doing better. Its been a bit of a rough trip, but she'll go home. Like I said before, in two weeks, the sutures will be healed and she'll be back to her old self. The bottom line is its sounds like she's going to be OK.
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Yeah, 52% is on the high end of normal. You dont start thinking about blood transfusion until the crit is 20% or less and typically even then may wait until its 12-15%. While the numbers sound really bad at first, she wasn't in any sort of danger. Had she ever had puppies? Did they say was the incision right on the linea or did it get off center a bit? If she's had puppies, there is risk for enlarged blood vessels in the bodywall secondary to mammary gland development. If the surgeon got "off center" meaning the incision was more muscular than linea, then there is increased risk for bleeding post op. I've spayed a couple of older dogs with similar post op problems and the surgery was textbook. They simply bled post op. I've gone back in and tried to identify, fix any leaky vessels and still had some minor bleeding. In these cases a pressure bandage goes a long, long way.
I just remembered I had heard about a study done with raw fed versus kibble dogs and blood values being slightly different. I did a quick google:
http://www.mountaindogfood.com/RawHelp/Raw_Food_Study.pdf (http://www.mountaindogfood.com/RawHelp/Raw_Food_Study.pdf)
So her 52 is normal for raw fed dogs according to that study. Would that be HCT on the lab report? Her blood work done the week before surgery had HCT at 55.0. He said what you said, that 20 would be a concern, but 12 or 15 would be a major concern. I guess it's good that she started out high! ;D
DIC is bad---very, very bad. it occurs when the blood begins clotting throughout the capillaries for some major disease reason. Some criticalists call it "Death Is Coming" because te prognosis is so bad. I imagine the vet is just running a coagulation panel. Von willebrands is a specific type of coagulopathy (a deficiency in von Willebrands factor, which affects Factor VIII in the clotting process) , but there are others that dogs can have that will prevent their blood from clotting correctly. Its important to identify these sort of things for future medical treatment---say she gets hurt or something. If she ends up having von Willebrands, make sure they check her thyroid function. There is a correlation between hypothyroidism and von Willebrands in non doberman breeds.
I think he mentioned DIC when I was asking what else could make her body break down the sutures so fast. He didn't think it was a concern. He wanted to do the blood coagulation test since an actual von Willebrand's would take too long to get the results back and this would hopefully alert us to any problem. If it comes back off I will have an actual von Willebrand's test done to confirm so that we know.
You know, the bottom line is she's doing better. Its been a bit of a rough trip, but she'll go home. Like I said before, in two weeks, the sutures will be healed and she'll be back to her old self. The bottom line is its sounds like she's going to be OK.
Thanks. :) She bounced back so quick after her obstruction surgery (she was running around like nothing happened the next day) that I was expecting the same after this.
It's odd not having her around. No whining in the morning, no whining for dinner at night. No big oaf trying to sit on my lap. Tad seems like he knows something is missing but he hasn't put it together. He will wait on the back porch and look at the door like he does when he is waiting for Addie, but I don't think he knows what he is waiting for!! He slept curled up with Briona last night, he will sleep with or ON any of them, but Addie is his preferred buddy. I guess his little walnut brain isn't advanced enough to put it all together!! ;D
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I just remembered I had heard about a study done with raw fed versus kibble dogs and blood values being slightly different. I did a quick google:
http://www.mountaindogfood.com/RawHelp/Raw_Food_Study.pdf (http://www.mountaindogfood.com/RawHelp/Raw_Food_Study.pdf)
So her 52 is normal for raw fed dogs according to that study. Would that be HCT on the lab report? Her blood work done the week before surgery had HCT at 55.0. He said what you said, that 20 would be a concern, but 12 or 15 would be a major concern. I guess it's good that she started out high! ;D
[/color] ;D
You will see minor changes---elevation in BUN, creatinine, it shouldn't be anything that is statistically significant.
The hematocrit fluctuates so much based on hydration status, I have to wonder about it vs the reasons given in that link you posted. You can see a dog in the AM have a Crit of 55%, give it access to water, and its 48% a couple of hours later because of hemodilution--hematocrit is a fairly dynamic value that doesn't have excellent diagnostic specificity. The way to evaluate red blood cell numbers accurately is with a complete red count, not a HCT. Rather than the dogs having "more" red cells if the dogs fed a dry kibble drink more water, thus resulting in the slightly lower hematocrit.
Anyway, those are moot points..... the bottom line is Addie is doing better. ;)
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So wonderful to hear Addie is doing so much better!!! :D
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So wonderful to hear Addie is doing so much better!!! :D
:-[
I went and saw her and took her some ground chicken. The Doctor had an emergency and he could only stick his head in while I was sitting with her. The blood test was not good, she does have a problem with her blood but I couldn't get the specifics then. He will call later or I will talk to him tomorrow.
She looked like hell. Bandage around her tummy, some big bloody scrape on her knee and just, well crappy. She didn't try and get up until I left, probably wanted to go with me so she made the effort to stand. I did get her to eat some chicken, she didn't eat it with as much gusto as I had hoped, but at least she ate. She hadn't really touched the food they had offered her so it was good I brought what she is used to. I think she ate some of it to please me or because I was there with her, I hope she will eat for them later on.
I won't tell people not to spay or neuter, but I would be lying if I said that this has not changed my personal feelings on it. I know this is an odd, rare case, but it's hard to sit here and know I had a happy, healthy dog a few days ago, and now she is going through this... all for an elective surgery that we were doing fine without having. It was very hard to look at her and know it was MY decision that put her in this spot. I have no ill feelings towards the vet, I know this is not his fault and I have no complaints with the care she is receiving, I blame myself.
And I know I didn't give her the blood problem, whatever it is (I will post when I have the specifics), but that really doesn't matter, she is where she is because I made a decision, and right now she is the one having to deal with the results of that decision.
:-[
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:-[
I went and saw her and took her some ground chicken. The Doctor had an emergency and he could only stick his head in while I was sitting with her. The blood test was not good, she does have a problem with her blood but I couldn't get the specifics then. He will call later or I will talk to him tomorrow.
She looked like hell. Bandage around her tummy, some big bloody scrape on her knee and just, well crappy. She didn't try and get up until I left, probably wanted to go with me so she made the effort to stand. I did get her to eat some chicken, she didn't eat it with as much gusto as I had hoped, but at least she ate. She hadn't really touched the food they had offered her so it was good I brought what she is used to. I think she ate some of it to please me or because I was there with her, I hope she will eat for them later on.
I won't tell people not to spay or neuter, but I would be lying if I said that this has not changed my personal feelings on it. I know this is an odd, rare case, but it's hard to sit here and know I had a happy, healthy dog a few days ago, and now she is going through this... all for an elective surgery that we were doing fine without having. It was very hard to look at her and know it was MY decision that put her in this spot. I have no ill feelings towards the vet, I know this is not his fault and I have no complaints with the care she is receiving, I blame myself.
And I know I didn't give her the blood problem, whatever it is (I will post when I have the specifics), but that really doesn't matter, she is where she is because I made a decision, and right now she is the one having to deal with the results of that decision.
:-[
Flower, stop beating yourself up.
If she has some sort of a bleeding dyscrasia, its far better to have identified it now than at a later date when it might possibly be too late to treat/deal with the problem. It seems like everything is caving in, but its not. If you handn't elected for surgery, then who knows when you may have discovered her problem. It may have been too late. Right now, she's made it through the surgery, she's eating now post op. Those are good signs. Talk with your vet, figure out a treatment plan for whats going on with her and then go from there.
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Flower, stop beating yourself up.
If she has some sort of a bleeding dyscrasia, its far better to have identified it now than at a later date when it might possibly be too late to treat/deal with the problem. It seems like everything is caving in, but its not. If you handn't elected for surgery, then who knows when you may have discovered her problem. It may have been too late. Right now, she's made it through the surgery, she's eating now post op. Those are good signs. Talk with your vet, figure out a treatment plan for whats going on with her and then go from there.
i agree
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:(
Right now, she's made it through the surgery, she's eating now post op. Those are good signs.
:)
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Flower, stop beating yourself up.
If she has some sort of a bleeding dyscrasia, its far better to have identified it now than at a later date when it might possibly be too late to treat/deal with the problem. It seems like everything is caving in, but its not. If you handn't elected for surgery, then who knows when you may have discovered her problem. It may have been too late. Right now, she's made it through the surgery, she's eating now post op. Those are good signs. Talk with your vet, figure out a treatment plan for whats going on with her and then go from there.
I'll second this.. Everything happens for a reason and if you had not done this, things could have just complicated.. Have faith we are all pulling for Addie.. Just be strong and trust in whatever you trust in.. She will pull through. Chaos hadn't eatin in over a week. So it's not that bad....
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~flower~
I am so sorry you are going through this difficult time. :'(
Please PM me if you need to talk and we'll exchange numbers.
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Flower, you need a couple shots of some cheap rum and some phone sex to cheer you up.
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I think you are right Jedi!!! :D
Ok, brief update:
Results from the clot panel: ACT(activated clotting time measures whole blood clotting time) was 10.3 (normal 5-9secs) PT (Prothrombin time measures how long it takes blood to clot) was 26.5 (normal is 10-12secs)
They are checking her crit now and depending on what it says she will be started on steroids. The current thinking is idiopathic thrombocytopenia. Her body basically is attacking it's red blood cells, so the steroids will "shut it down" from doing that.
The scrape on her knee he believes is a pressure sore, she didn't run into anything or get bumped, but it has gotten bigger. It is like 4" around and constantly bleeding. Not dripping or gushing, but it is steadily wet.
She has none of these problems for her obstruction surgery. She got over that like it never happened. The next day she was running and jumping around and no bleeding problems.
They did get her to eat some more of what I brought for her last night.
I call back in about an hour and see what the latest crit says and what that will tell us.
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Platelets are down, she will be started on steriods and will possibly need a blood transfusion.
I told them I am not waiting until Monday to see her again, so they are going to get back to me to see if that can get arranged. There is the possibility that she won't make it, and I will be damned if I just leave her there and not visit her.
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Hope every thing is ok Flower were all pullin for Addie over here
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. There is the possibility that she won't make it,
What!! Please check your email and PMs
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???
Whats weird is Addie used to bang into everything & it's now after 4 years...this comes out.
Do they have an explanation for this....or was it something she always had & you never knew about?
There wasn't somethig they could have given to her before surgery that gave her this blood problem?
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???
Whats weird is Addie used to bang into everything & it's now after 4 years...this comes out.
Do they have an explanation for this....or was it something she always had & you never knew about?
There wasn't somethig they could have given to her before surgery that gave her this blood problem?
The ruleout list for thrombocytopenia is a mile long..... literally, I can list 10-12 different causes off the top of my head ranging from use of platelets post surgery to bone marrow suppression to bone marrow dyscrai to drug reactions to genetic predispositions (Cavalier King Charles Spaniels) to autoimmune disease. It makes thrombocytopenia a sometimes difficult disease to deal with---and unfortunately, considering Flowers opinions against vaccinations (I really don't want to start a fight here, but it needs to be said) there has been a correlation between recently administered modified live vaccinations and the development of immune mediated thrombocytopenia. I'm only aware of cases where this was diagnosed 2-6 weeks post vaccination, not years as in Addies case, but there was a correlation.
Unfortunately, unless a full CBC was done prior to surgery, there may have been no indication of what was going on within Addies body until her platelet count dropped so low as to cause a problem. Even with preoperative blood work, if her platelet count was on the low side of "Normal" it might not have been an indication of a problem.
The important thing now is to get her platelet count up.
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The ruleout list for thrombocytopenia is a mile long..... literally, I can list 10-12 different causes off the top of my head ranging from use of platelets post surgery to bone marrow suppression to bone marrow dyscrai to drug reactions to genetic predispositions (Cavalier King Charles Spaniels) to autoimmune disease. It makes thrombocytopenia a sometimes difficult disease to deal with---and unfortunately, considering Flowers opinions against vaccinations (I really don't want to start a fight here, but it needs to be said) there has been a correlation between recently administered modified live vaccinations and the development of immune mediated thrombocytopenia. I'm only aware of cases where this was diagnosed 2-6 weeks post vaccination, not years as in Addies case, but there was a correlation.
Unfortunately, unless a full CBC was done prior to surgery, there may have been no indication of what was going on within Addies body until her platelet count dropped so low as to cause a problem. Even with preoperative blood work, if her platelet count was on the low side of "Normal" it might not have been an indication of a problem.
The important thing now is to get her platelet count up.
so in knny's terms (laymen)
There is a strong possibility something they gave her could have started this
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The ruleout list for thrombocytopenia is a mile long..... literally, I can list 10-12 different causes off the top of my head ranging from use of platelets post surgery to bone marrow suppression to bone marrow dyscrai to drug reactions to genetic predispositions (Cavalier King Charles Spaniels) to autoimmune disease. It makes thrombocytopenia a sometimes difficult disease to deal with---and unfortunately, considering Flowers opinions against vaccinations (I really don't want to start a fight here, but it needs to be said) there has been a correlation between recently administered modified live vaccinations and the development of immune mediated thrombocytopenia. I'm only aware of cases where this was diagnosed 2-6 weeks post vaccination, not years as in Addies case, but there was a correlation. The Doctor said their could be many reasons for her platelet problem.
I haven't mentioned vaccines having anything to do with this because she hasn't been vaccinated since she has been with me, so I won't correlate this to them. She's had a major surgery in the past with no problems so that also makes me think a connection to any vacs she had years ago a thin one. (See, I DON'T think every problem is vaccine related ;)) I would of thought she would of showed some signs when she had her obstruction surgery of a problem, or could something like this be "brewing" and just waiting for the body to be stressed enough to show up?
Unfortunately, unless a full CBC was done prior to surgery, there may have been no indication of what was going on within Addies body until her platelet count dropped so low as to cause a problem. Even with preoperative blood work, if her platelet count was on the low side of "Normal" it might not have been an indication of a problem.
The important thing now is to get her platelet count up.
I have her pre-op Hematology Report:
WBC 7.2
RBC 8.01
HGB 18.5
HCT 55.0
MCV 69
MCH 23.1
MCHC 33.7
Lymph 31
Mono 4
EOS 8
Platelet Count 210
then ALKP 82 U/L ALT 30 U/L BUN 15 mg/dl CREA 87 mg/dl
TP 6.5 g/dl
Looking that the reference ranges for canine it says PLATELET COUNT is 200-900 thous/CMM so she was on the really low end for that????
The tech I spoke to didn't actually say she might not make it, but when they ask you how far to what extent they should do treatments, that doesn't sound good. The transfusion will run around $200 and I told them if the felt it was a medical necessity then by all means do it.
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I haven't mentioned vaccines having anything to do with this because she hasn't been vaccinated since she has been with me, so I won't correlate this to them. She's had a major surgery in the past with no problems so that also makes me think a connection to any vacs she had years ago a thin one. (See, I DON'T think every problem is vaccine related ;)) I would of thought she would of showed some signs when she had her obstruction surgery of a problem, or could something like this be "brewing" and just waiting for the body to be stressed enough to show up?
Yeah, I know, I just didn't want to start somekind of a fight by bringing it up. You've got enough on your plate right now.
Yes, because of the many causes of thrombocytopenia, it could have developed/been brewing for some time. I kind of look at it this way. I was diagnosed with Type I insulin dependant diabetes when I was 12 years old (my father was diabetic). The Halloween before I was diagnosed I gorged on candy with my friends. Did that halloween cause me to be diabetic? No. Was I diabetic during that Halloween? no. The predisposition for the disease was there and it developed AFTER Halloween. Does that make sense?
I have her pre-op Hematology Report:
WBC 7.2
RBC 8.01
HGB 18.5
HCT 55.0
MCV 69
MCH 23.1
MCHC 33.7
Lymph 31
Mono 4
EOS 8
Platelet Count 210
then ALKP 82 U/L ALT 30 U/L BUN 15 mg/dl CREA 87 mg/dl
TP 6.5 g/dl
Looking that the reference ranges for canine it says PLATELET COUNT is 200-900 thous/CMM so she was on the really low end for that????
Its impossible to say without knowing the cytologists notes for platelet clumping and morphology. If the platelets were clumped than everything could have been normal. Its also impossible to say without knowing platelet morphology. Idenitfying things like "Giant" platelets in the face of a normal platelet count can be an indicator of a brewing problem. Depending on how the blood work was run---manual count vs automated cytometer vs laboratory its possible that the count was given and these notes weren't done.
In all honesty, in a dog her age, with no other outward signs of clinical problems and a normal physical exam, I would have spayed her. There isn't enough of an indication of a predisposing problem.
The tech I spoke to didn't actually say she might not make it, but when they ask you how far to what extent they should do treatments, that doesn't sound good. The transfusion will run around $200 and I told them if the felt it was a medical necessity then by all means do it.
Its impossible for me to give you any indication of prognosis without seeing her. I'm sorry. I will say that this is something very serious. I will also say I've seen several dogs survive thrombocytopenic events and go on to lead normal lives. She's been through alot, but she's still not out for the fight. There are some "ifs" involved.... the biggest being why she's thrombocytopenic in the first place. Idiopathic means the exact cause isn't known. So treatment is general, based on clinical signs AND based on evaluation of physical parameters including what her platelet count is doing.
I'm going to be on and off the computer all afternoon today and tomorrow (damned phenobarb paper I'm trying to write. >:( >:( ) Feel free to PM or e-mail me if her status changes. I'll do what I can to answer your questions.
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so in knny's terms (laymen)
There is a strong possibility something they gave her could have started this
No. There are many causes of thrombocytopenia.
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Yeah, I know, I just didn't want to start somekind of a fight by bringing it up. You've got enough on your plate right now.
Yes, because of the many causes of thrombocytopenia, it could have developed/been brewing for some time. I kind of look at it this way. I was diagnosed with Type I insulin dependant diabetes when I was 12 years old (my father was diabetic). The Halloween before I was diagnosed I gorged on candy with my friends. Did that halloween cause me to be diabetic? No. Was I diabetic during that Halloween? no. The predisposition for the disease was there and it developed AFTER Halloween. Does that make sense?
Yup, that makes sense.
Its impossible to say without knowing the cytologists notes for platelet clumping and morphology. If the platelets were clumped than everything could have been normal. Its also impossible to say without knowing platelet morphology. Idenitfying things like "Giant" platelets in the face of a normal platelet count can be an indicator of a brewing problem. Depending on how the blood work was run---manual count vs automated cytometer vs laboratory its possible that the count was given and these notes weren't done.
In all honesty, in a dog her age, with no other outward signs of clinical problems and a normal physical exam, I would have spayed her. There isn't enough of an indication of a predisposing problem.
Its impossible for me to give you any indication of prognosis without seeing her. I'm sorry. I will say that this is something very serious. I will also say I've seen several dogs survive thrombocytopenic events and go on to lead normal lives. She's been through alot, but she's still not out for the fight. There are some "ifs" involved.... the biggest being why she's thrombocytopenic in the first place. Idiopathic means the exact cause isn't known. So treatment is general, based on clinical signs AND based on evaluation of physical parameters including what her platelet count is doing.
I'm going to be on and off the computer all afternoon today and tomorrow (damned phenobarb paper I'm trying to write. >:( >:( ) Feel free to PM or e-mail me if her status changes. I'll do what I can to answer your questions.
The Doctor just called back, her platelets are being destroyed. She is down to 33,000 (per whatever??). He has started her on Dexamethasone (sp) and has contacted the Emergency Vet (also the Ortho, Cancer and Eye specialist Center) to make sure they have the packed cells on hand if she does need them. He wants to see what the Dexamethasone does before going that route.
I believe he said her crit is at 32, so she is okay in that area, it's the platelets.
He is going home now to eat and relax a bit but will be back there to check on her at 5:15 so I will be meeting him there and get to see her for a few minutes. He said that sore bloody spot on her knee doesn't actively bleed unless she moves around. What could cause that? He said a pressure sore? But it is on the inside of her knee? I guess depending on how she is sitting it could rub. Is her skin that fragile because of the platelets low count?
I will update later after I see her.
Thanks for your replies vet, I appreciate your knowledge. :)
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Yup, that makes sense.
The Doctor just called back, her platelets are being destroyed. She is down to 33,000 (per whatever??). He has started her on Dexamethasone (sp) and has contacted the Emergency Vet (also the Ortho, Cancer and Eye specialist Center) to make sure they have the packed cells on hand if she does need them. He wants to see what the Dexamethasone does before going that route.
I believe he said her crit is at 32, so she is okay in that area, it's the platelets.
He is going home now to eat and relax a bit but will be back there to check on her at 5:15 so I will be meeting him there and get to see her for a few minutes. He said that sore bloody spot on her knee doesn't actively bleed unless she moves around. What could cause that? He said a pressure sore? But it is on the inside of her knee? I guess depending on how she is sitting it could rub. Is her skin that fragile because of the platelets low count?
I will update later after I see her.
Thanks for your replies vet, I appreciate your knowledge. :)
Dang Flowey.
Could she be licking/biting that area to cause the spot? Or would the sore be different than what it is? Does she ever lick/bite her legs when she is stressed?
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since I am the google copy and paste queen ::):
http://www.veterinarypartner.com/Content.plx?P=A&A=1412 (http://www.veterinarypartner.com/Content.plx?P=A&A=1412)
Immune-Mediated Platelet Destruction
For reasons unknown, platelets can be mistaken by the immune system as invaders. When this happens, antibodies coat the platelets and the spleen's phagocytes remove them in numbers up to 10 times greater than the normal platelet removal rate. The megakaryocytes in the bone marrow respond by getting larger and growing in numbers so that they may increase their production of platelets. The platelets produced under these circumstances tend to be larger and more effective than normal platelets and are called stress platelets. The bone marrow attempts to overcome the accelerated platelet destruction rate; unfortunately, with immune-mediated destruction occurring, a human platelet can expect to survive only one day in the circulation instead of its normal 6 to 8 days. If antibody levels are very high, a platelet may survive only minutes or hours after its release from the bone marrow and, making matters worse, antibody coated platelets still circulating do not function normally. This is balanced by the especially effective stress platelets entering the scene so that overall it is hard to predict how the balance will work out in a given patient.
What Would Cause the Immune System to Get so Confused?
In many cases, a cause is never found; however, in some cases a primary reaction in the immune system precedes the platelet destruction. For example, immune destruction of some other stimulus could be occurring. A blood parasite, tumor, drug, or other cell type (as in lupus or immune-mediated red cell destruction) might all generate an antibody response. As antibodies are produced in response to the surface shapes of the enemy cell, some of the surface shapes may unfortunately resemble "self" shapes, such as shapes on the surface of platelets.
What Happens to the Patient?
The usual patient is a middle-aged dog. Poodles appear to be predisposed, though Cocker Spaniels and Old English Sheepdogs also seem to have a higher than average incidence of this condition. Cats are rarely affected and it is usually associated with feline leukemia.
Spontaneous bruising is the major clinical sign. The gums and oral surfaces or the whites of the eyes are obvious areas to check, as is the hairless area of the belly. Small spots of bruising in large conglomerations called petechiae (pet-TEEK-ee-a) are the hallmark signs. A large, purple expansive bruise might also be seen. This is called ecchymosis. Large internal bleeds are not typical of platelet dysfunction, though bleeding small amounts in urine, from the nose, or rectally may also indicate a platelet problem.
When these sorts of signs are seen, a platelet count is drawn, along with usually an array of clotting parameters; red blood cell counts to assess blood loss, and other general metabolic blood tests. Since testing to detect actual anti-platelet antibodies is not available, the veterinarian must determine if any other possible causes of low platelet count make sense.
Other Causes of Platelet Dysfunction
Dramatic reduction in platelet numbers is almost always caused by immune-mediated destruction, though certain tick-borne blood parasites could also be responsible:
* Ehrlichiosis (especially infection with Ehrlichia platys)
* Rickettsia rickettsii (Rocky Mountain spotted fever)
Very low platelet counts can also occur in response to the suppression of megakaryocytes within the bone marrow. This might be caused by:
* Artificial estrogens
* Sulfonamide antibiotics
* Chloramphenicol(an antibiotic)
* Chemotherapy drugs
* Bone marrow cancers
Disseminated intravascular coagulation is a life-threatening disastrous uncoupling of normal blood clotting and clot dissolving functions in the body. One of its hallmark signs is a drop in platelet count (along with a constellation of other signs).
If platelet numbers are normal but it is obvious that platelet function is not, some other causes to look into might include:
* Von Willebrand's disease (a hereditary clotting disorder)
* Metabolic toxins (liver or kidney failure)
* Overuse of aspirinor similar NSAID
* Pancreatitis
* methimazole(for the treatment of hyperthyroid cats)
* Bone marrow cancers
Therapy for Immune Mediated Platelet Destruction
Once a tentative diagnosis of immune-mediated platelet destruction has been made, the goal in therapy is to stop the phagocytes of the spleen from removing the antibody-coated platelets and cutting off antibody production. This, of course, means suppressing the immune system using whatever combination of medication seems to work best for the individual patient.
Prednisone or Dexamethasone
These steroid hormones are the first line of defense and often are all that is necessary to bring platelet counts back up. Unfortunately, long-term use should be expected and this means steroid side effects are eventually inevitable*: excessive thirst, possible urinary tract infection, panting, poor hair coat etc. The good news is that these effects should resolve once medication is discontinued; further, if side effects are especially problematic, other medications can be brought in to reduce the dose of steroid needed.
** THIS COULD NOW BE A LIFE LONG CONDITION FOR HER??
Vincristine
This injectable medication is mildly immune suppressive but also seems to stimulate a sudden burst of platelet release from the marrow megakaryocytes. The platelets released in response to vincristine contain a phagocyte toxin so that when spleen phagocytes ultimately eat them, the phagocytes will die. While repeated injections of vincristine ultimately do not yield the same effect, at least a one-time dose may be extremely helpful. One should note that vincristine is extremely irritating if delivered outside of the vein. It must be given IV cleanly or the overlying tissue will slough.
Androgens
Male hormones may have some masculinizing side effects but they do seem to cut production of anti-platelet antibodies. It also seems to synergize with the corticosteroid hormones like prednisone and dexamethasone. Danazol has been the androgen typically recommended in the treatment of immune-mediated platelet destruction with weight gain being the most common side effect.
Azathioprineor Cyclophosphamide
These are stronger immune suppressive agents typically used in cancer chemotherapy. If steroid side effects are unacceptable or if the patient does not respond to steroids alone, one of these medications may be indicated. Cyclosporine, a newer medication made popular in organ transplantation, also may be used, but expense has been problematic.
Transfusion
One might think that a transfusion of blood or at least platelet-rich plasma might be helpful in the treatment of a platelet dysfunction. The problem is that platelets do not survive well after removal from a blood donor. One has about 12 hours to deliver the freshly withdrawn blood to the recipient before the platelets become inactive. After the platelets are delivered they are likely to live only hours. In general, most efforts are spent on establishing immune suppression.
Gamma Globulin Transfusion
Gamma globulins are blood proteins including antibodies. Human gamma globulin appears to occupy the phagocyte antibody-binding site so that coated platelets cannot be grabbed out of the circulation. This has been a promising therapy for both humans and dogs, but is generally prohibitively expensive.
Splenectomy
If medication simply does not work or the condition keeps recurring once medications are discontinued, the solution may be to simply remove the spleen. After all, this is where the phagocytes removing the platelets are primarily located. In humans, immune-mediated platelet destruction is generally treated with splenectomy first. Response in dogs has not been as predictably good, thus in veterinary medicine it is generally one of the last therapies invoked.
Could the anesthesia or some drug used to sedate cause this?
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Dang Flowey.
Could she be licking/biting that area to cause the spot? Or would the sore be different than what it is? Does she ever lick/bite her legs when she is stressed?
"Spontaneous bruising is the major clinical sign."
I am thinking that this is actually a "bruise", and maybe because of her size and the area it is (the knee where the skin is stretched as she sits) maybe it opened? Maybe Vet will have a thought? I will be asking my vet when I see her later, he did say that it wasn't done in transport or when she was up and moving. That was my first thought. Moving big dogs can be dangerous to the dog and to the staff. When they are knocked out they aren't as easy to move as a person. Some vets won't do some surgeries on giant dogs because of the strength needed and the chance of harm to everyone. At least I have had one vet tell me that. The woman who did Emmett's neuter wouldn't do Addie's spay even though Addie is 40pounds lighter. She said it was just too much to move them and dangerous. She did also have some arthritis in her wrists which also made working on a giant dog harder on her.
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Can she have a toy in her cage? Or can you take her a shirt of yours or blanket you haven't laundered yet? It may be of some comfort?
Damn :'(
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probably no toys because it is best for her just to lie their calmly. Not that I think she would play anyways. :(
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probably no toys because it is best for her just to lie their calmly. Not that I think she would play anyways. :(
After I posted that I thought she could end up eating your shirt or something....so forget that :(
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Yes, that would be great, another obstruction. :P
I noticed on the Hematology report that Anisocytosis is checked (looks like a tv or tr ?)
Would unequal red blood cells have any input on what is going on with her or point to a possible cause?
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:'(
Ok.....
explain this to someone that can't comprend this stuff....
Is Addie in trouble? What's the seriousness?
I know it's not great....but just to what degree.
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I don't know if I can answer that right now. After we see what the dexamethasone does and a transfusion if she does end up having that, a better prognosis could be given. I am going to ask the vet just that question later, is she in danger and how real is that. He has called her condition "fair" this whole time. I guess that means she hasn't entered into an actual crisis yet, but the results on her platelets show that she is heading that way.
I don't know what this means long term for her either? Will she be on meds? Is this a "crisis" of a disease and maybe she will never have another "crisis" present itself?
She was healthy before she went in, so that is on her side.
I don't think DIC has been ruled out conclusively at this point:
DIAGNOSIS OF DIC
DIC can be difficult to diagnose because it can be triggered by many unrelated diseases, the clinical manifestations are variable, and there is quasi-consensus about what constitutes a definitive diagnosis. Diagnosis is based on the following criteria:
• Presence of an underlying disease known to be associated with DIC.
• Multiple abnormalities of the coagulation profile. Not all variables will be abnormal in every case. Some clinicians consider abnormalities in 3 of the following commonly available tests to be sufficient for a diagnosis: Platelet count; ACT, PT and APTT; fibrinogen concentration; AT-III concentration; FDP concentration; presence of schistocytes on a peripheral blood smear.
:-\ http://www.vetcentric.com/magazine/magazineArticle.cfm?ARTICLE=Thrombocytopenia%3A%20When%20Your%20Dog%20Suddenly%20Starts%20Bleeding (http://www.vetcentric.com/magazine/magazineArticle.cfm?ARTICLE=Thrombocytopenia%3A%20When%20Your%20Dog%20Suddenly%20Starts%20Bleeding)
Severe thrombocytopenia is much more common in canine patients than in feline patients. The disease has diverse causes, ranging from active bleeding during surgery to cancers to Rocky Mountain spotted fever. However, in dogs, the most common cause is the disease immune-mediated thrombocytopenia, or IMT. Unfortunately, mortality rates of patients with IMT approach 50 percent: death is caused by severe blood loss, especially bleeding into the gastrointestinal tract, or bleeding into the brain.
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I always have Dr's or Vets tell me on a scale value (scale 1-10 - 10 being bad)
It's the only way I can understand things
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Flower, if you need any donations to help with the doctor's bill,,let me know. ;)
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Good luck.
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"Spontaneous bruising is the major clinical sign."
I am thinking that this is actually a "bruise", and maybe because of her size and the area it is (the knee where the skin is stretched as she sits) maybe it opened? Maybe Vet will have a thought? I will be asking my vet when I see her later, he did say that it wasn't done in transport or when she was up and moving. That was my first thought. Moving big dogs can be dangerous to the dog and to the staff. When they are knocked out they aren't as easy to move as a person. Some vets won't do some surgeries on giant dogs because of the strength needed and the chance of harm to everyone. At least I have had one vet tell me that. The woman who did Emmett's neuter wouldn't do Addie's spay even though Addie is 40pounds lighter. She said it was just too much to move them and dangerous. She did also have some arthritis in her wrists which also made working on a giant dog harder on her.
Yeah,its most likely a bruise----its hard to say without seeing it, but consider the cage is probably metal (or coated wood) and even with a pad in it, if she rolls across the bone just the right way, considering her current condition, she's in a condition to develop these type of "cage sores". Typically they start as a bad bruise, then the dog starts licking them, making them appear worse.
To answer your other questions.... I doubt it if its anesthesia drug related. I have no way of knowing for sure without knowing exactly what drug protocol they used (there are several considered "standard" for large breed dogs). Thrombocytopenia is more associated with antibiotics and similar pharmaceuticals, not anesthesia drugs.
Yes, this may be a lifelong condition. Right now she's going through a bad spell. She's got to get through this. Events at a later time could trigger a reoccurance.
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Yes, that would be great, another obstruction. :P
I noticed on the Hematology report that Anisocytosis is checked (looks like a tv or tr ?)
Would unequal red blood cells have any input on what is going on with her or point to a possible cause?
No, Anisocytosis just means red blood cells of different sizes. I don't consider it an indicator of any specific cause, however it might help you figure out the exact cause of the problem----for example a dog with severe bone marrow suppression with thrombocytopenia may also show anisocytosis as a result of the bone marrow not producing redblood cells correctly either.
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:'(
Ok.....
explain this to someone that can't comprend this stuff....
Is Addie in trouble? What's the seriousness?
I know it's not great....but just to what degree.
I know flower's vet may not have come right out and said this, but I will. This is serious, very serious. How she does depends on her response to the steroids and her degree of platelet destruction. Does she have a resonable chance at survival? Yes, but she's going to have some intensive medical treatment the next few days.
Could things get much worse? Yes.
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I know flower's vet may not have come right out and said this, but I will. This is serious, very serious. How she does depends on her response to the steroids and her degree of platelet destruction. Does she have a resonable chance at survival? Yes, but she's going to have some intensive medical treatment the next few days.
Could things get much worse? Yes.
:-\
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I don't know if I can answer that right now. After we see what the dexamethasone does and a transfusion if she does end up having that, a better prognosis could be given. I am going to ask the vet just that question later, is she in danger and how real is that. He has called her condition "fair" this whole time. I guess that means she hasn't entered into an actual crisis yet, but the results on her platelets show that she is heading that way.
I don't know what this means long term for her either? Will she be on meds? Is this a "crisis" of a disease and maybe she will never have another "crisis" present itself?
She was healthy before she went in, so that is on her side.
I don't think DIC has been ruled out conclusively at this point:
DIAGNOSIS OF DIC
DIC can be difficult to diagnose because it can be triggered by many unrelated diseases, the clinical manifestations are variable, and there is quasi-consensus about what constitutes a definitive diagnosis. Diagnosis is based on the following criteria:
• Presence of an underlying disease known to be associated with DIC.
• Multiple abnormalities of the coagulation profile. Not all variables will be abnormal in every case. Some clinicians consider abnormalities in 3 of the following commonly available tests to be sufficient for a diagnosis: Platelet count; ACT, PT and APTT; fibrinogen concentration; AT-III concentration; FDP concentration; presence of schistocytes on a peripheral blood smear.
:-\ http://www.vetcentric.com/magazine/magazineArticle.cfm?ARTICLE=Thrombocytopenia%3A%20When%20Your%20Dog%20Suddenly%20Starts%20Bleeding (http://www.vetcentric.com/magazine/magazineArticle.cfm?ARTICLE=Thrombocytopenia%3A%20When%20Your%20Dog%20Suddenly%20Starts%20Bleeding)
Severe thrombocytopenia is much more common in canine patients than in feline patients. The disease has diverse causes, ranging from active bleeding during surgery to cancers to Rocky Mountain spotted fever. However, in dogs, the most common cause is the disease immune-mediated thrombocytopenia, or IMT. Unfortunately, mortality rates of patients with IMT approach 50 percent: death is caused by severe blood loss, especially bleeding into the gastrointestinal tract, or bleeding into the brain.
From what you've described, it sounds to me like she's going through an IMT crisis. She may or may not be on medication long term. SHe will require followup blood work to make sure her platelets are not getting destroyed. There is a risk of another crisis at a later date. Thats all part of IMT.
I really don't know about DIC. Thats getting into a realm of emergency and critical care and internal medicine I'm not up to date with. Most of my patients won't get DIC--or its never been identified in these species positively. They die first. With dogs and cats there is such controversy about DIC, its a question I'd have to ask my wife (even though she's an equine surgeon, she's getting ready to sit for Emergency and Critical Care boards---she's way more up to date on DIC literature than I am). Traditionally, I'd think if Addie was in DIC, she'd have not made it this long. DIC is very, very bad. Not something a dog lives for days with.
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:-\
Now lets not go and get all discouraged. This is a condition that Addie stands a reasonable chance of getting through. Its not a time to get depressed and focus on the negative. When you consider the big picture of her condition, there are several positives----from her being alive this far post surgery, to a HCT in the 30's to her trying to eat a little. She's sick right now, but she's still got a chance. Its a matter of seeing how she responds to medication and how she does over the next couple of days.
FLower, I don't know where you live exactly and I don't know your veterinarian, but now is a time that if that veterinarian suggests referral to a specialist or a 24 hour referral hospital, I'd strongly consider it. The main reason being is the larger hospitals will have ready access to items like blood for a transfusion, inhouse laboratories for monitoring her clotting profile and platelets, and other things that may not be as readily available in a smaller hospital.
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allrighty....... Addie did seem to be a little better today for some reason. They had taken her outside and let her walk around a few minutes before I got there and the pressure bandage was off.
She at first was not that interested in eating, but after some time with me sitting there she suddenly cleaned the whole bowl!! :D If anyone is considering cropping ears for looks consider this.... at one point I could tell Addie was getting over excited, she was starting to breathe more rapidly. I put her head in my lap and started rubbing her ears and I could see and feel her calm down. She relaxed, her breathing leveled out. I think if given enough time she would of went to sleep. When I had to leave she tried to hold me down with her head. :( The ears are very sensitive for dogs so consider that before you crop ;).
I asked the scale of 1-10 question and he said 7-8, so I think those are pretty good odds. :) He is going to check her platelets again tomorrow and make sure they haven't dropped further and hopefully they will be higher. If she continues to improve and her platelets go up hopefully she will be able to come home on Monday.
He thinks right now that this is an acute crisis brought on by the stress of the spay, not a chronic condition. It is too soon to tell.
With Addie everything seems to be complicated and/or expensive. :P
Thanks again everyone for your good thoughts, experience (appreciated Vet), and offer of money - lol.
Will get another update tomorrow morning after the platelet check, and be seeing her in the afternoon most likely. I just hope it does take another turn, it seems like every time I get better news and feel positive, something else turns up.
It's really weird with her not around. :-\
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FLower, I don't know where you live exactly and I don't know your veterinarian, but now is a time that if that veterinarian suggests referral to a specialist or a 24 hour referral hospital, I'd strongly consider it. The main reason being is the larger hospitals will have ready access to items like blood for a transfusion, inhouse laboratories for monitoring her clotting profile and platelets, and other things that may not be as readily available in a smaller hospital.
The emergency vet office did the clotting panel and have already been checked with for having blood, but thanks for the heads up on that. He can do her platelets and crit in house, so that is good.
I think if she wasn't eating at all, or if she overall was worse (vitals,etc) then he would suggest transferring her there or I would. If she takes a turn or something else presents it self then that definitely would be considered.
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Flower, if you need any donations to help with the doctor's bill,,let me know. ;)
Thanks Jedi!! :-*
So far we should be good with the current plans and expenditures. Obviously this is more than I was in the spay budget which for a dog her size isn't cheap!
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I asked the scale of 1-10 question and he said 7-8, so I think those are pretty good odds. :) He is going to check her platelets again tomorrow and make sure they haven't dropped further and hopefully they will be higher. If she continues to improve and her platelets go up hopefully she will be able to come home on Monday.
:-\
is it
1 being bad & 10 being good
or
1 being good & 10 being bad
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I asked the scale of 1-10 question and he said 7-8, so I think those are pretty good odds. :)
is it
1 being bad & 10 being good
or
1 being good & 10 being bad
From the smiley-face I think it' 10 being good.
Flower, thank you for the update and I'm so thankful it was a positive one!
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WOW flower...sorry you and Addie have to go through this. :(
I hope that things continue to improve!!
:)
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Im glad things are turning up buddy! Please keep us posted!
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nice one
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Today's Update:
Platelets were up to 80,000 this morning- YEAH!!! White cells are down so the antibiotics are doing their job, her crit is down from 32 yesterday to 30 today, but that isn't a cause for alarm at the moment. No active bleeding from her incision or her knee (pic below). Temp normal, other vitals normal.
She ate with gusto and was standing when I got there. Much more "peppy" today. Was very content just to try and sit on me and then making do with her head in my lap. She will be in a small run over night and not the big cage to give her more room for movement.
If her platelets have improved more tomorrow and everything else looks good she should be able to come home tomorrow night!! :D She will be restricted on her activity of course. Her platelets and other stuff will be checked when she gets her sutures removed.
So it looks like the Dexamethasone yesterday and the pred this morning are working, her immune system is not destroying her platelets, and her body is producing them, so that is good.
We won't know whether this was an acute crisis or if it is a chronic condition. It will be something to plan and look for if she ever needs another surgery or is injured in the future.
Thanks for all the support, encouraging words and information, it does mean a lot. :D
Pics of her knee :( (taken with cell phone) :
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Thanks for the update Flower! Wonderful news :D
Will you put anything on Addie's knee or leave it to heal on it's own?
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good news
:D
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addie is october's dog of the month.
period :)
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I agree with WOOO!
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Awww that's really cute. :)
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Hope everything works out Flower.
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LOL @ Woooo & JediKnight ;D
It looks like Addie will be coming home today!! :D No recheck of her platelets was done because she is acting sooooo much better. I guess they had her out and she had to go around greeting everyone in the office. :)
She'll get a warm bath this afternoon to clean her up after her ordeal (that will make it TWO baths this year for her!!!) and I should be getting her around 4:45, I have to call back around 2 and make sure she is still cleared to leave.
STella - I will probably just leave her knee alone. I could put raw honey on it to help healing and scarring, but considering the size of it and where it is I think that would just encourage licking by both her and the other dogs, in particular Tad!! Since she is on antibiotics infection shouldn't be a concern, so I'll just keep an eye on it.
It will be interesting to see the welcoming Addie gets. I'm sure their will be lots of sniffing and checking her out. Tad has been a snuggle whore in Addie's absence and has been shacking up with Bri most of the time. :o I even took a few pics but will have to make sure Addie doesn't see Tad's betrayal!!!
She will be happy to get some "solid" food, but I had ground up some extra chicken that will make up the majority of her meals for the next few days. Missing a dog has really messed up my feeding system for meal times!! I have had to think instead of doing it pretty much on autopilot.
Keeping her calm and inactive shouldn't be a problem because she is a couch potato, but if she is feeling better she may have some pent up energy and just being happy to not be confined, so sparring with Briona will be out of the question.
It seems the worst is over (paws crossed) and will have to see what future tests show about this incident, is it an isolated one brought on by the stress of the spay, or is there an underlying problem?
Thanks again and again for the support and positive words.
Will post "back home" pics in the next few days. :D
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Awesome news! Back home pictures are a MUST! :D
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Oh Flower, I just found this thread. I went through a roller-coaster of emotions reading it too. I am so very happy Addie is feeling better and on her way home today.
Give all your babies a big hug from all of us here, and from Rocky too :-*
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Glad to hear things are going better...
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Thanks Laura and Tu! :)
My baby girl is home!! She was so excited!! Dragged me out the door, said let's go home!!!
She's on antibiotics for a few more days, gets her sutures/staples out in 10. Will decide then if a recheck of any blood work is necessary. She is not on any pred since it can interfere with or slow down healing, and isn't on any pain meds because they can affect blood clotting sometimes and we really don't want to mess with her blood!! She doesn't seem to be in "much" pain, but is quiet. She is resting on the couch now, I bet being in a strange place and strange animals making noise doesn't make for restful sleep, so I think being home is some of the best medicine she can have. :)
Tad was pretty defensive when he saw her. The fur on his back by his butt was all standing up (I guess looking like your ass is huge is a defensive strategy ;D I wish I had gotten a pic of that he looked like a badger or something) and was barking at her and ticked when she came near me, he has since settled down and I think realizing who she is. Briona and Emmett were all sniffy and a bit skittish too, like they recognize her smell but it is different so they are wary. I expect by the end of the night or tomorrow morning they will all be fine. You'd think she was gone a lot longer than 6 days!!!! She had no problem with any of them, in fact she tried to play with Briona a little and it was kind of funny to watch Briona running away like "Mom!! She's touching me!!" ;D I told Tad to remember that she was the only one who liked him when he first came here and to stop being a lil shit! >:(
If she continues on fine then she will just be red flagged for any future surgeries and will be given blood products after surgery to prevent this from happening again. She could be be borderline von Williebrand's or something and surgery brings it on.
A few quick pics:
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Addie snoozy face, and one taking of Tad and Briona. Maybe Tad is upset that she is back because he was making time with Bri? ::)
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Tad has been a snuggle whore in Addie's absence and has been shacking up with Bri most of the time. :o I even took a few pics but will have to make sure Addie doesn't see Tad's betrayal!!!
(http://www.getbig.com/boards/index.php?action=dlattach;topic=169308.0;attach=197697;image)
MONSTER CUDDLES!!! ;D
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MONSTER CUDDLES!!! ;D
I am making sure Addie doesn't see that, but I think she would understand. Tad is a lil baby and likes to sleep with one of them, his preference is usually Addie.
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She lose weight?
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Tad was pretty defensive when he saw her. The fur on his back by his butt was all standing up
Maybe he thinks Addie is the low-woman on the totem pole now since being gone and he's edged above her? He may want to check himself ;D
LOL @ the pics and stories thank yo so much.....such great updates thank God. Addie looks beautiful :)
(Bri and Tad look cute too :))
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Maybe Tad smelled the other animals scent on Addie from the vet
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AWWWW great pics flower! I'm glad to see her home, and I am sure you and the other pups are too!
:)
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I am glad to see she is doing better and she is home. She is probably so happy to be back. I wish you all the best.
Yeah, she is pretty happy! :D She's very, uhm.... stoic? She was panting a lot last night even though it wasn't hot, I think maybe that is because she is in some discomfort? I put a warm compress on her incision and that area and it seemed to help. I will be mentioning that to the vet along with that she seems to be drinking more water than usual. Not gulping it down like she's dying from thirst, just more than normal it seems. I folded up a comforter for her on the floor because sometimes finding space on the couch is not possible and I don't think curling up in the chair would be comfortable for her. Getting up and down which is easy for a big dog like her, may bring some discomfort too. She has some bruised and bloody (but not like her back leg!) sores on her elbows from the kennel probably from her condition making her bruise like that. She looks pretty beat up!!! Her coat still looks great though!! Thanks for your kind words. :)
knny- she had lost over 15 pounds before surgery, I think she lost a few more from this ordeal. She's actually at a good weight for her now. She looks sleek and healthy (besides all the bruises and incisions!). So I will be attempting to keep her looking like she does now and not let her sow back up. ;D
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They were all fine a few hours later. This morning Tad was bouncing off Addie as they were waiting to be fed. No butt hairs sticking up. ;D
When Tad comes to work and I bring him home all 3 are on him sniffing him up. He scrunches down until they are satisfied that it is him and have checked out any interesting smells he brought with him. ;D
I was snuffled pretty good after my visits with Addie. Emmett almost sucked my shirt up his nose!! lol
I think they recognized her but their was some uncertainty. She was gone, she has some different smells on her, she's still not feeling great, they picked up on all that. Briona and Emmett didn't act like they would if she was a totally strange dog, they were just cautious around her at first.
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Glad to hear Addie is home.. I hate to say it BUT I TOLD YOU SHE WOULD BE FINE.. To many prayers going out for her not to be.. Glad you got your girl home...
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Glad to hear Addie is home.. I hate to say it BUT I TOLD YOU SHE WOULD BE FINE.. To many prayers going out for her not to be.. Glad you got your girl home...
Thanks Sin!! Can't wait to get home and see her. I feel a little apprehensive, I am not 100% at ease that this crisis has passed.
Thanks for your support and prayers. :)
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Keep topic of Addie's recovery & well being on course.....
or it will be deleted!
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I'm so glad Addy is home and feeling better Flower!!! :D
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I'm so glad Addy is home and feeling better Flower!!! :D
Thanks Laura!! The house is full again!! :D
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Thanks Laura!! The house is full again!! :D
I'm gonna send Rocky over to play! :)
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I'm gonna send Rocky over to play! :)
Tad might get jealous if he makes a move on Addie, they are an "item" again ;D
(You can kinda see Addie's catheter tape mark and her boo boo elbow :()
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Tad might get jealous if he makes a move on Addie, they are an "item" again ;D
hahaha . . . classic. wonder if tad will always think of himself as a puppy b/c of the constant size differential b/w himself and his girls
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hahaha . . . classic. wonder if tad will always think of himself as a puppy b/c of the constant size differential b/w himself and his girls
I don't think he thinks of himself as a puppy actually. I have wondered if Addie took to him so quickly because she was intact and she felt maternal towards him though? She was fascinated by him, and Great Dane pups are big so he was the right size for a newborn Dane pup! She is the more outgoing, readily accepting of other dogs, dog. I watched a friend's American Bulldog for a week once and she immediately was playing with him. Now THAT was a rambunctious week!! He was 6months old and all big puppy! I was really glad when he left!! lol!!
Just like I don't think the Danes are always aware of their size, I don't think Tad is either.
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Here's a Great Dane (8mos) with the Zoomies!! ;D
http://www.youtube.com/watch?v=UGRryKOfH1o&NR=1 (http://www.youtube.com/watch?v=UGRryKOfH1o&NR=1)
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hey look its the flower family . . raw food and all.
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That's a good one too! ;D
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Those pics are really cute.
And that video with the 4 great danes is a great vid. Great looking, well behaved dogs. That is exactly how I feed Plato too, with him waiting until I say. GREAT video, I respect those people. Jesus they are big dogs too.
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Awww, they look so cute Flower. Makes me wanna get Rocky a friend.
Looks like they both are really glad Addies home. :)
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I don't think he thinks of himself as a puppy actually. I have wondered if Addie took to him so quickly because she was intact and she felt maternal towards him though? She was fascinated by him, and Great Dane pups are big so he was the right size for a newborn Dane pup! She is the more outgoing, readily accepting of other dogs, dog. I watched a friend's American Bulldog for a week once and she immediately was playing with him. Now THAT was a rambunctious week!! He was 6months old and all big puppy! I was really glad when he left!! lol!!
Just like I don't think the Danes are always aware of their size, I don't think Tad is either.
Correct.
Dogs don't have the same kind of "size awareness" as we humans do.
They progress in life, and become adult dogs, no matter what size they are.
Other dogs sense this as well, they don't treat a small dog as juvenile dog. Once the dog has grown balls (literally speaking ;D) other dogs will treat the dog different.
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now i want a great dane!!!!
fucking horses...
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now i want a great dane!!!!
fucking horses...
Great danes are the BEST breed of dogs in the entire world! 8)
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Is it Great Danes that have hearts too small for their size bodies?
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Is it Great Danes that have hearts too small for their size bodies?
yup... adding to this most small dog breeds have hearts that are too BIG for their bodies
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yup... adding to this most small dog breeds have hearts that are too BIG for their bodies
thats internet bullshit that comes from misinterpretation of heart diseases in dogs. Their hearts aren't "too little" or "too big" if they were, they'd die.
Don't believe it.
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thats internet bullshit that comes from misinterpretation of heart diseases in dogs. Their hearts aren't "too little" or "too big" if they were, they'd die.
Don't believe it.
Actually I heard that when I was in my young teens...and believe me...there was no internet then, lol. ;)
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Actually I heard that when I was in my young teens...and believe me...there was no internet then, lol. ;)
LOL. Then the internet is perpetuating the bullshit. ;)
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thats internet bullshit that comes from misinterpretation of heart diseases in dogs. Their hearts aren't "too little" or "too big" if they were, they'd die.
Don't believe it.
hmmm... little dogs live 16 years... ginormous dogs live 8 years.....
maybe it's not "bullshit"
vet
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How's Miss Addie doing?
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hmmm... little dogs live 16 years... ginormous dogs live 8 years.....
maybe it's not "bullshit"
vet
Every dog doesn't die from heart issues.
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Looks like Addie is going to have a nice scar from that "bruise" on her leg. It doesn't seem infected, but the middle part is "stiff" and stays flat even when she bends it, like it's a piece of cardboard. :( She has a smaller one on her side, and a beat up elbow. For a spay she really looks beat up!! :(
Is that gonna be like a big scab I will find on the floor one morning (unless someone eats it)? :P
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doesn't look good.
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doesn't look good.
I don't think so either but it smells fine and I don't see any signs of infection. :-\
No oozing or anything. I just think it is going to take some time to heal because of the size.
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Looks like Addie is going to have a nice scar from that "bruise" on her leg. It doesn't seem infected, but the middle part is "stiff" and stays flat even when she bends it, like it's a piece of cardboard. :( She has a smaller one on her side, and a beat up elbow. For a spay she really looks beat up!! :(
Is that gonna be like a big scab I will find on the floor one morning (unless someone eats it)? :P
Poor baby. :(
Yes, I'm going to guess that you'll probably find it on the floor if she doesn't end up eating it (gross). But keep an eye on it ;)
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Poor baby. :(
Yes, I'm going to guess that you'll probably find it on the floor if she doesn't end up eating it (gross). But keep an eye on it ;)
If I find that on my floor I will really really wig!!! More so than when those yellow fungi penises grew in my lil mini fruit orchard!!!
Where's STella? She likes scabs! :-X
Vet suggested aloe vera - I'm such a duh, I have an aloe vera plant and I never even thought of it. ::) Thanks again Vet!! :)
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If I find that on my floor I will really really wig!!!
I can see you screaming when you walk across that thing and it sticks to the bottom of your foot
Where's STella? She likes scabs! :-X
lol no that was Slippy. He said: "they're teh chewy." :)
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I can see you screaming when you walk across that thing and it sticks to the bottom of your foot
lol no that was Slippy. He said: "they're teh chewy." :)