If you feel something is wrong....you should check them out
Discussion
My 9year old Cavalier had been struggling a bit with her biscuits recently and I noticed that she had a little blood on her lips, quick peer at her gnashers and they are typically cavalier and manky so booked her in to be checked out. All sorted, date the following week for a dental and pre-op bloods taken.
She then carried on slightly bleeding from her gums everytime she laid down, just a little. It's ok, vets in a couple of days...
Two days later I notice her tummy is covered in small surface bruises and the alarm bells go off - I think she's got a clotting issue. Back to the vets, they check the pre-op tests on the pc and all looks well until a nurse who knows the dog pops in with the actual full printout. It seems the computerised systems only transfer the most relevent data even though the auto test gives a lot more results. Her platelets should be 400-500 and hers are 19
An hour later and the vet thinks she has immune mediated thrombocytopenia which is where the immune system destroys the platelets...but its ok, her red cell levels are fine and she's not anemic. Big steroid jab, boxes of pills and a whole load of blood taken to go to a specialist. My vet actually hand delivered the bloods to the specialist as she was so concerned.
Next day, the bloodwork is back and I get a phonecall first thing, she is now anemic (score of 18 rather than about 40), lots more bruises and feeling really rough, tries to be normal but just staggers about. The bloods suggest she has Evans Syndrome which is like the immune mediated thrombocytopenia but with knobs on as it does the red cells as well(already down because of all the bleeding)
Booked in to the group hospital to be monitored more closely and to have the steroids injected as she keeps being sick. She can hardly stand, walks 5 paces and falls over - just what she needs as that will cause more bleeding. I pick her up and she empties everything all over herself and me - lovely at 6am and I'm starkers in the garden!
She's in there for the day and I then get a phone call at 21:30 saying her red cell level is now at 10 which is critical and need to take her to a Specialist Vet Centre in Cambs. I've never seen a dog so ill looking, her tongue was practically white and she's got blood in her urine. Speedy drive across Cambs and she's straight in.
She's had a blood transfusion, more steroids, everything. They've been brilliant with explainations, constant updates and as much time as I need. The red cell level is now at 23 and(I type this with fingers crossed) no additional bleeding seen. It takes days for the steroids to suppress the immune system enough to allow the platelet level to start to recover so they are trying to buy time with the top-ups. We just have to wait and see.
She went from a apparently fit healthy dog to critically ill in 4days flat. Thank goodness I noticed the bruises as the dental op would have meant she would probably have bled to death. It has been awful, just dreadful but todays she's standing and has eaten some chicken. There's a very long road ahead, I know that, but I'm clutching at straws of hope.
My Huntingdon Vet group have been great, put so much time and staffing into her and been so supportive.
If you think something is odd, just that little tinkle when you've cleaned her paws again because of a little blood, just take time to think a little broader.
Come on Amber, get yourself better.
She then carried on slightly bleeding from her gums everytime she laid down, just a little. It's ok, vets in a couple of days...
Two days later I notice her tummy is covered in small surface bruises and the alarm bells go off - I think she's got a clotting issue. Back to the vets, they check the pre-op tests on the pc and all looks well until a nurse who knows the dog pops in with the actual full printout. It seems the computerised systems only transfer the most relevent data even though the auto test gives a lot more results. Her platelets should be 400-500 and hers are 19
An hour later and the vet thinks she has immune mediated thrombocytopenia which is where the immune system destroys the platelets...but its ok, her red cell levels are fine and she's not anemic. Big steroid jab, boxes of pills and a whole load of blood taken to go to a specialist. My vet actually hand delivered the bloods to the specialist as she was so concerned.
Next day, the bloodwork is back and I get a phonecall first thing, she is now anemic (score of 18 rather than about 40), lots more bruises and feeling really rough, tries to be normal but just staggers about. The bloods suggest she has Evans Syndrome which is like the immune mediated thrombocytopenia but with knobs on as it does the red cells as well(already down because of all the bleeding)
Booked in to the group hospital to be monitored more closely and to have the steroids injected as she keeps being sick. She can hardly stand, walks 5 paces and falls over - just what she needs as that will cause more bleeding. I pick her up and she empties everything all over herself and me - lovely at 6am and I'm starkers in the garden!
She's in there for the day and I then get a phone call at 21:30 saying her red cell level is now at 10 which is critical and need to take her to a Specialist Vet Centre in Cambs. I've never seen a dog so ill looking, her tongue was practically white and she's got blood in her urine. Speedy drive across Cambs and she's straight in.
She's had a blood transfusion, more steroids, everything. They've been brilliant with explainations, constant updates and as much time as I need. The red cell level is now at 23 and(I type this with fingers crossed) no additional bleeding seen. It takes days for the steroids to suppress the immune system enough to allow the platelet level to start to recover so they are trying to buy time with the top-ups. We just have to wait and see.
She went from a apparently fit healthy dog to critically ill in 4days flat. Thank goodness I noticed the bruises as the dental op would have meant she would probably have bled to death. It has been awful, just dreadful but todays she's standing and has eaten some chicken. There's a very long road ahead, I know that, but I'm clutching at straws of hope.
My Huntingdon Vet group have been great, put so much time and staffing into her and been so supportive.
If you think something is odd, just that little tinkle when you've cleaned her paws again because of a little blood, just take time to think a little broader.
Come on Amber, get yourself better.
Jasandjules said:
Thank you for sharing so that others can benefit.
Hope it all goes well for her - and BTW some raw chicken will help clean her teeth up a treat!
I know the sort of mouth op is describing and believe me raw chicken would not have worked!!Hope it all goes well for her - and BTW some raw chicken will help clean her teeth up a treat!
All the best to Amber what a horrible time for you all
They do get better and I'm sure she will be no exception 
Thanks all, it is indeed a very stressful and worrying time for the poor little hound.
On Saturday her red cell count was back down to 12 so they gave her another transfusion which pushed her back up to 29 on Sunday's test. Platelets were still 19 - looks like the immune system is still roaring away at her at that point
The microscope smear plates do show the red cells aren't being damaged and she has immature cells too which is good news. The continuing severe anemia seems down to general blood loss around her system - ultasound scans don't show anything significant going on in her abdomen(I hate saying stuff like this as it's like tempting fate). They have also given her a drug to stimulate the platelet production, it's some sort of chemo related thing as they have to handle her in gloves for a few days now.
I saw her yesterday morning for 45mins, sat on the floor with her between my thighs and just stroked and comforted her - she perked up a fair bit when she saw me(or was it her duck...) but is a very poorly dog still and must be feeling really rough. They gave me some fresh cooked chicken to try and feed her - the nose wanted it but the rest of her just didn't fancy it so I think they were going to syringe feed her that afternoon. She looked a bit grim with having been shaved from her front legs to her rears for the scans and all her legs have been clipped to take blood from new sites because of previous bruising.
The good news was she had a lovely big pink tongue to lick at my arms
Walking everywhere with my mobile today and waiting for the full blood results of this mornings test - its very stressful but I know she's in the very best hands at the moment and they have been brilliant with both animal and human!
http://www.dickwhitereferrals.com/
On Saturday her red cell count was back down to 12 so they gave her another transfusion which pushed her back up to 29 on Sunday's test. Platelets were still 19 - looks like the immune system is still roaring away at her at that point
The microscope smear plates do show the red cells aren't being damaged and she has immature cells too which is good news. The continuing severe anemia seems down to general blood loss around her system - ultasound scans don't show anything significant going on in her abdomen(I hate saying stuff like this as it's like tempting fate). They have also given her a drug to stimulate the platelet production, it's some sort of chemo related thing as they have to handle her in gloves for a few days now.
I saw her yesterday morning for 45mins, sat on the floor with her between my thighs and just stroked and comforted her - she perked up a fair bit when she saw me(or was it her duck...) but is a very poorly dog still and must be feeling really rough. They gave me some fresh cooked chicken to try and feed her - the nose wanted it but the rest of her just didn't fancy it so I think they were going to syringe feed her that afternoon. She looked a bit grim with having been shaved from her front legs to her rears for the scans and all her legs have been clipped to take blood from new sites because of previous bruising.
The good news was she had a lovely big pink tongue to lick at my arms
Walking everywhere with my mobile today and waiting for the full blood results of this mornings test - its very stressful but I know she's in the very best hands at the moment and they have been brilliant with both animal and human!
http://www.dickwhitereferrals.com/
Thanks everyone, your thoughts do count
Yep, St Neots branch is my prefered one and has been for almost 20years, we then started doing the serious stuff at Huntingdon(who threw everyone and everything at her for a couple of days) and they then referred her to Dick Whites at Newmarket.
Tough day for her yesterday, she's been continually panting hard the last 24hrs and that makes her work hard..which makes her pant...etc. Because the platelets are so low they think her airways are all inflamed and probably getting sore now. They would normally slightly sedate them to break the cycle but Cavs have soft palets, long palets, dumpy noses which carries a risk and they cant intubate her for fear of making the airway bleed - she could drown She still doesn't want to eat much and they couldn't syringe feed her because of the panting - she must be whacked out.
They got a grip on it last night and she finally got to sleep. Full blood tests today as they didn't want to stress her anymore yesterday. It's been a race of criticality the last couple of days. We're still all fighting for her but realise the need to be sensible and do the right thing if, and when, required.
Come on girl.
Yep, St Neots branch is my prefered one and has been for almost 20years, we then started doing the serious stuff at Huntingdon(who threw everyone and everything at her for a couple of days) and they then referred her to Dick Whites at Newmarket.
Tough day for her yesterday, she's been continually panting hard the last 24hrs and that makes her work hard..which makes her pant...etc. Because the platelets are so low they think her airways are all inflamed and probably getting sore now. They would normally slightly sedate them to break the cycle but Cavs have soft palets, long palets, dumpy noses which carries a risk and they cant intubate her for fear of making the airway bleed - she could drown
She still doesn't want to eat much and they couldn't syringe feed her because of the panting - she must be whacked out.They got a grip on it last night and she finally got to sleep. Full blood tests today as they didn't want to stress her anymore yesterday. It's been a race of criticality the last couple of days. We're still all fighting for her but realise the need to be sensible and do the right thing if, and when, required.
Come on girl.
It's time for an update and I'm sorry to say it doesn't have a fairy tale ending...
Wednesday's results were really promising, platelets up to 68 which is in the safe zone for no more bleeding, red cells were still low at around 21 but they could cope with that. Vet was really happy as she was sitting up and eating normally, pottering about in the exercise area They still had concerns about her rattly breathing though, with the raised platelets it, at least, gives then more scope.
Thursday she was a lot quieter, no red bits in her urine anymore but there was raised white cells so they suspected a urine infection(not uncommon as she still had a catheater fitted). Breathing still an issue as she continued to pant and pant and pant...
Friday morning, extremely concerned about her breathing as her lips where slighty blue - they think her larynx(sp?) was not functioning properly and obstructing the airways. In the Afternoon they decide to do an emergency trach operation which is actually fairly routine at the centre because they see so many acute dogs. This didn't really help and its all got a bit life-threatening now. They couldn't do anything earlier because of the risk of bleeding and very high steroid levels to turn off the immune system.
To see what is going on, they pop in an endiscope and find her larynx is really damaged and partly prolapsed, her windpipe is also "floppy" and partly collapsed in places due to days and days of extreme effort to breathe.
They were constantly on the phone over the 2hrs of investigations while she was in theatre. There really was no option but to let her go With the still relatively low platelet count and high steroids any big operation(a very slim option)would've been massivley risky and she had been through enough already.
It's so so hard to give the permission even when you know its almost certainly the best thing. I have pangs of guilt that I left her to much freedom to move around the house and maybe hurt herself more - less falls, less bleeding, less anemia...I could go on and I do in my head but it can't bring her back
We had 8 brillant years with her, she was just about the best thing over the last 5years when we got divorced(J&J may remember me asking about legal stuff a few years ago when the Ex dognapped them for a while - we did, and still do, have them alternate weeks and more extended periods sometimes when hols/work come along). She was full of character and happiness and always straight to the biscuit cupboard, given a chance.
Thank you Amber, RIP my wonderful furry friend.
Lily and Amber
Wednesday's results were really promising, platelets up to 68 which is in the safe zone for no more bleeding, red cells were still low at around 21 but they could cope with that. Vet was really happy as she was sitting up and eating normally, pottering about in the exercise area
They still had concerns about her rattly breathing though, with the raised platelets it, at least, gives then more scope.Thursday she was a lot quieter, no red bits in her urine anymore but there was raised white cells so they suspected a urine infection(not uncommon as she still had a catheater fitted). Breathing still an issue as she continued to pant and pant and pant...
Friday morning, extremely concerned about her breathing as her lips where slighty blue - they think her larynx(sp?) was not functioning properly and obstructing the airways. In the Afternoon they decide to do an emergency trach operation which is actually fairly routine at the centre because they see so many acute dogs. This didn't really help and its all got a bit life-threatening now. They couldn't do anything earlier because of the risk of bleeding and very high steroid levels to turn off the immune system.
To see what is going on, they pop in an endiscope and find her larynx is really damaged and partly prolapsed, her windpipe is also "floppy" and partly collapsed in places due to days and days of extreme effort to breathe.
They were constantly on the phone over the 2hrs of investigations while she was in theatre. There really was no option but to let her go
With the still relatively low platelet count and high steroids any big operation(a very slim option)would've been massivley risky and she had been through enough already.It's so so hard to give the permission even when you know its almost certainly the best thing. I have pangs of guilt that I left her to much freedom to move around the house and maybe hurt herself more - less falls, less bleeding, less anemia...I could go on and I do in my head but it can't bring her back
We had 8 brillant years with her, she was just about the best thing over the last 5years when we got divorced(J&J may remember me asking about legal stuff a few years ago when the Ex dognapped them for a while - we did, and still do, have them alternate weeks and more extended periods sometimes when hols/work come along). She was full of character and happiness and always straight to the biscuit cupboard, given a chance.
Thank you Amber, RIP my wonderful furry friend.
Lily and Amber
, so so sorry for your loss, what a stressful time for you all. Have no doubt though, you made the right decision, there comes a point when that one extra problem is one too many and that was the point you reached with Amber. It makes it no easier. The guilt is natural but completely unjustified. Her illness could not be avoided, it just happened. RIP Amber, taken too early but now at peace.Thanks guys It has been a very difficult two weeks, a whole new world. I know what you're saying Bex, and I have to remember that.
Yep, I/we still have Lily and she's been great this last week - she is a funny dog and always in your face or on your paper...just what I've needed this week and she's also become a lot more affectionate now she's her on her own.
Amber, the World's shortest Cav!
It has been a very difficult two weeks, a whole new world. I know what you're saying Bex, and I have to remember that.Yep, I/we still have Lily and she's been great this last week - she is a funny dog and always in your face or on your paper...just what I've needed this week and she's also become a lot more affectionate now she's her on her own.
Amber, the World's shortest Cav!
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