Neutropaenia - should I be concerned?

RE: Neutropaenia - should I be concerned?

Liz Barton — Thu, 28 Mar 2019 12:14:33 GMT

[quote user="Clive Ansell"]it is really impossible to say if it is antibiotic responsive or not. [/quote]

Fair point; I was reading between the lines. Most vets I've worked with would stop the ABs, then restart them if the lump subsequently to increased in size after cessation of treatment. I'm rather hoping it hasn't just been kept on ABs for the 9 months without some sort of justification!

RE: Neutropaenia - should I be concerned?

Clive Ansell — Fri, 22 Mar 2019 16:28:39 GMT

[quote user="Liz Barton"]as it's unilateral and AB responsive it's likely to be foreign body related.[/quote]

it is really impossible to say if it is antibiotic responsive or not.

The mass has reduced over about 9 months, but it is impossible to say if that is because of or in spite of antibiotics. No swabs or biopsies were ever taken, and there is no specific diagnosis of bacterial infection.

Constrained by costs, so going to repeat haematology in about a month. Dog fine and has boundless energy, so not overly worried.

RE: Neutropaenia - should I be concerned?

Liz Barton — Fri, 22 Mar 2019 13:04:35 GMT

[quote user="Clive Ansell"]9 month period. The swelling is now about a quarter of its original size. No biopsies taken[/quote]

As it's significantly reduced in size over that time it's very unlikely to be lymphoma. I'd FNA immediately - nothing to loose - will probably come back as mixed chronic inflammation or salivary gland, but at least you can put O's mind at rest that it's not lymphoma. I agree as it's unilateral and AB responsive it's likely to be foreign body related.

Low cell counts could a chronic leukaemia - a bone marrow aspirate would be ideal. Are all cell lines low? If it's just neutrophils it could be due to sequestration into the mass if it is indeed inflammatory. Although you would expect a rebound at some stage.

RE: Neutropaenia - should I be concerned?

Anthony Dennison — Fri, 22 Mar 2019 11:19:59 GMT

Could also be an atypical Addisonian - may consider checking cortisol.

RE: Neutropaenia - should I be concerned?

Utlendigur — Wed, 20 Mar 2019 20:23:06 GMT

Is it a grey or blue merle collie? They can get a cyclic neutropenia (autosomal recessive inheritance I think).

Young collie with a single submandibular swelling sounds very suspicious for stick injury/FB to me. Might be worth an FNA if it comes up again - hopefully would distinguish between FB/asbcess, lymph node or salivary mucocoele

RE: Neutropaenia - should I be concerned?

Clive Ansell — Wed, 20 Mar 2019 17:13:33 GMT

Thanks for all your thoughts so far.

I'm not overly concerned as the dog is so well, so for now will treat the dog and not the blood results. Will get him off all the meds and re run haematology in the first instance.

RE: Neutropaenia - should I be concerned?

David Mills — Wed, 20 Mar 2019 13:58:48 GMT

Neutropenia may just be normal for the dog. Sounds like whatever it is, it's not really bothering the dog. Lymphoma/leukaemia would be a lot sicker by now.

Really needs biopsy or FNA so can treat effectively. FNA will tell you if it's lymph node or salivary gland quickly.

RE: Neutropaenia - should I be concerned?

Bob Russell — Wed, 20 Mar 2019 13:44:29 GMT

If this is a salivary gland cyst all the antibiotics in the word will not cure it unless there is secondary bacterial infection.

RE: Neutropaenia - should I be concerned?

Clive Ansell — Wed, 20 Mar 2019 12:18:05 GMT

Thanks Michael.

That's pretty much my line of thought. Clients seem reluctant to stop the treatment, and given it is only a few days worth I have suggested to finish it and not give any more antibiotics at all (it's had almost every type of antibiotic off the shelf so far!)

I find in house analysers fine for an overview, but much prefer external labs and a well prepared blood film for all haematological cases.

RE: Neutropaenia - should I be concerned?

Michael Woodhouse — Wed, 20 Mar 2019 12:06:40 GMT

If antibiotics were going to fix it they would have done so by now! I'd stop all Tx and see what happened. Maybe 2 weeks after stopping send blood to an external lab with some nice smears in house to preserve archetecture.

Chuck "clindamycin & neutropeania" into google

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917410/

If money is an issue that's my first step. Beyond that biopsy/remove mass. Bone marrow biopsy if bloods no better off Tx.