Anaemic Greyhound

Re: Anaemic Greyhound

Hanna Bennett — Fri, 27 Nov 2009 11:53:39 GMT

Woo hoo - finally on most recent smear we have small numbers of spherocytes (sampel taken before transfusion) - at least now i can stop panicking that i've missed some really obvious haemorrhage! PCV today stable at 24%, dog has eaten well for last 24 hrs and gained a kg back. I knwo this is likely due to the transfusion not the azathioprine kicking in yet, but anything positive is great for now! And confirmation of diagnosis is good!

Re: Anaemic Greyhound

Utlendigur — Wed, 25 Nov 2009 20:54:35 GMT

It does sound like haemolysis - nb Coombs tests can give 10-40% false negatives. The weight loss seems more than you'd expect with IMHA though. Could there be a tumour somewhere triggering a microangiopathic haemolytic anaemia (eg haemangiosarcoma?) - any schistocytes/acanthocytes etc on the smears?

I assume the dog is on immunosuppressive doses of preds in which case could this itself have caused GI bleeding to start/worsen, and cause deterioration, given that the dog has a thrombocytopenia. Maybe gastric protectants if not already on them.

Re: Anaemic Greyhound

Hanna Bennett — Wed, 25 Nov 2009 19:29:50 GMT

slide agglutination still negative - so helpful! and faeces are orange (presumably again a result of the bilirubin) and sloppy. PCV is 23% post transfusion (woo hoo) so he's gone off home with lots of drugs to come back in two days. Had a bloody cat die on me this afternoon so really not having a good day.

Re: Anaemic Greyhound

Hanna Bennett — Wed, 25 Nov 2009 17:09:22 GMT

I've not seen any of these lungworm coagulopathies - as i say, we seem to be lucky so far - can anyone describe them for me? I've assumed the clotting times would be out of whack. And diagnosis - i know you can find it on faecal samples but am i mad thinking there is also a PCR?

Assuming haemolytic but why? no underlying cause presenting itself at this stage. have spoken to the lab about tick diseases, and given the relatively good platelet count today (200) they are inclined to think that erlichia is unlikely and babesia is certainly not high on the list. He's currently sat in a kennel having his blood transfusion. Owner does not want to leave him so he's going home tonight afterwards - very difficult to manage cases in these circumstances! Will send him home with more preds, azathioprine and some panacur i think! And maybe some gastroprotectants...

Re: Anaemic Greyhound

Laurence Webb — Wed, 25 Nov 2009 17:06:41 GMT

Have you checked for slide agglutination? Even if coombes was -ve on a previous sample it may be agglutinating now. I'd agree about Lungworm - baermanns on faecal samples may show something although it's not that sensitive. For that matter it's not got black poo has it (teaching my gandmother to suck eggs I expect!). An endemic tick screen would also be on my list if funds are there.

Bone marrow would be helpful for completeness, although if it's showing a strongly regenerative response then if may not add too much to the diagnosis.

Re: Anaemic Greyhound

Mike Martin — Wed, 25 Nov 2009 16:53:34 GMT

Not my field, although I would also have lungworm on the D'list. But could it be some type of auto-immune haemolytic anaemia? Might be worth checking with your lab or Med Spec in case you need more blood before start azothiaprine or similar drugs.

Re: Anaemic Greyhound

Hanna Bennett — Wed, 25 Nov 2009 16:08:58 GMT

blood biochem all wnl exc alb/glob just below normal. tbil is 15 (top end of our normal range). othewise biochem all wnl. Dog is not clinically jaundiced (unsurprisingly given tbil), definitely regenerative, reticulocyte count was 364 on last sample so moderately regen but smear picture is consistent with regeneration too ie. polychromasia etc. Not keen on a bone marrow bx on this dog til after it's blood transfusion but yep, guess that might need doing yet. has wbc of 53 todayof which neuts are 42, but susp this is partly due to preds. was also going to add some azathioprine in.

Re: Anaemic Greyhound

listhestar — Wed, 25 Nov 2009 16:06:10 GMT

Is the dog still on abs? Have seen some odd sydromes in greyhounds where PM (unfortunately) suggested tick borne problems as the starting point. (and the body just carries on in a merry fashion)

Bone marrow biospy after transfusion would be my next thought I guess but yes not easy.

Good luck, keep us informed how you get on

Lisa

Re: Anaemic Greyhound

Hannah Wynne Richards — Wed, 25 Nov 2009 15:28:21 GMT

No -one really knows how A vasorum stops blood clotting, so I wouldn't rule it out on normal clotting times, and I have seen some very anaemic Anyway best of luck !!!!

Wynne

PS If you send faeces to lab, then only 50% of those with lungworm are positive on any one exam

Re: Anaemic Greyhound

stephen sargent — Wed, 25 Nov 2009 14:28:17 GMT

Sounds like one of those frustrating cases!

Just some thoughts which may or may not help. Is this a genuinely regenerative anaemia? Reticulocyte count may help. Also you didn't mention blood biochemistry. Is the dog jaundiced, with so much bilirubin in the urine?

If there is no response to the preds, a bone marrow biopsy may be the next step.

Re: Anaemic Greyhound

Hanna Bennett — Wed, 25 Nov 2009 14:20:29 GMT

and the rest of it's biochem all wnl

Re: Anaemic Greyhound

Hanna Bennett — Wed, 25 Nov 2009 14:19:53 GMT

no longer a racing greyhound, 7yr ME retired family pet (though does come from a household with other racing dogs). Clotting times are normal - does this rule out angiostrongylus? PCV is now 15% so roll on the blood transfusion.

Re: Anaemic Greyhound

listhestar — Wed, 25 Nov 2009 13:44:31 GMT

On another note- I assume its a dog rather than bitch. Otherwise suppresion of season drugs could be considered although normally only use testerone based products.

Lisa

Re: Anaemic Greyhound

listhestar — Wed, 25 Nov 2009 13:42:28 GMT

Is kindey function ok? had an exertional rhabdomylosis case present- anaemic, sore kindeys. Is a possibility though.

What's the dog racing hx- is it a 630 or 480m runner.

lisa

Re: Anaemic Greyhound

Hanna Bennett — Wed, 25 Nov 2009 12:23:14 GMT

was wondering about that - haven't seen any in this area but the dog has come from outside our usual catchment - everything i've read suggests they are not as anaemic as this. Will panacur him anyway i guess.

Re: Anaemic Greyhound

Kevin Castle — Wed, 25 Nov 2009 12:00:06 GMT

Don't forget to check/treat for Lungworm!