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Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: bianca] #186627
10/08/11 07:14 PM
10/08/11 07:14 PM
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Hollysmom Offline
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They might have to up the steriods, since his HCT is dropping a bit. Have the lowered the Preds at all? Sometimes when the preds are not high enough or have been lowered, then the blood work shows drops in the red blood cells. Sometimes some dogs will have to stay on Pred the rest of their lives.
My thoughts are with you are Kelso...

Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: Hollysmom] #186641
10/08/11 08:56 PM
10/08/11 08:56 PM
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MaxaLisa Offline

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Steph,

I wish I understood this stuff better, the infection versus plain old immune dysregulation. I fought the vets for years on this, so I tend to be biased in one direction, so I'm just not sure about Kelso. I look at the liver involvement, and the systemic inflammation (increased amylase, increased alk phos), and I'm just not sure how this fits in if this is all about an immune system attack. What is the doxy dosage that Kelso is on?

There are so many weird things out there, like babesia, and other rickettsia disease processes. I think this was done, but the spleen was checked on physical exam for enlargement?

I hope that you don't mind, but I put this together: http://tinyurl.com/3dh5lvt You should be able to download it under the "File" option if you'd like. It just helps me look at everything in one place, and I had the "guts" of the spreadsheet already done for Max's values. If you want to keep the spreadsheet there, I can always add you as an "editor", I don't mind inputing the values, it helps me think. (eta: The settings are so that only people with the link can view the spreadsheet. After you download it, I can always make it private.)

I really wish I understood what is happening with the absolute blood counts, including the monocytes and eosinophils.

It does seem, looking at the numbers, that there is only slight regeneration. I'm pretty sure that the specialist will want to get those numbers up. I would want to review Dodds' protocol on this before talking with the specialist so that you can think of some questions, or be able to put any new recommendations in context.

I would consider adding some liver support to the mix - pred is hard on the liver, and the enzymes were already taking a hit frown I would consider that supplement that Hollysmom used (even though it has corn syrup!), or maybe some acetyl-l-carnitine, to help.

This is very scary stuff. I'm glad that clnically Kelso is doing well through the treatment!

Last edited by MaxaLisa; 10/08/11 09:09 PM.

MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
http://www.rabieschallengefund.org/
Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: Hollysmom] #186704
10/09/11 05:26 AM
10/09/11 05:26 AM
Joined: Feb 2010
Posts: 1,490
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kelso Offline OP
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kelso  Offline OP
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Originally Posted By: Hollysmom
They might have to up the steriods, since his HCT is dropping a bit. Have the lowered the Preds at all? Sometimes when the preds are not high enough or have been lowered, then the blood work shows drops in the red blood cells. Sometimes some dogs will have to stay on Pred the rest of their lives.
My thoughts are with you are Kelso...


His prednisone dose has been kept the same since he was started on it. He was given an injection of steroids the first day then started on the 30 mg twice a day orally (60 mg daily) dosing and the vet has not changed it at all since the labs have only minimally improved.

Thank you for the thoughts and the great advice, appreciate this so much. hugging


-Steph

GSD's
Allie, gotcha 7/2007
Riko z Vom Weberhaus, "Fez" 7/29/2012

forever our angels
Meeka, b. 10/31/1994-11/26/2006
Kelso, b. 9/3/2006-2/9/2012

Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: MaxaLisa] #186705
10/09/11 06:09 AM
10/09/11 06:09 AM
Joined: Feb 2010
Posts: 1,490
Kansas
kelso Offline OP
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kelso  Offline OP
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Originally Posted By: MaxaLisa
Steph,

I wish I understood this stuff better, the infection versus plain old immune dysregulation. I fought the vets for years on this, so I tend to be biased in one direction, so I'm just not sure about Kelso. I look at the liver involvement, and the systemic inflammation (increased amylase, increased alk phos), and I'm just not sure how this fits in if this is all about an immune system attack. What is the doxy dosage that Kelso is on?

There are so many weird things out there, like babesia, and other rickettsia disease processes. I think this was done, but the spleen was checked on physical exam for enlargement?

I hope that you don't mind, but I put this together: http://tinyurl.com/3dh5lvt You should be able to download it under the "File" option if you'd like. It just helps me look at everything in one place, and I had the "guts" of the spreadsheet already done for Max's values. If you want to keep the spreadsheet there, I can always add you as an "editor", I don't mind inputing the values, it helps me think. (eta: The settings are so that only people with the link can view the spreadsheet. After you download it, I can always make it private.)

I really wish I understood what is happening with the absolute blood counts, including the monocytes and eosinophils.

It does seem, looking at the numbers, that there is only slight regeneration. I'm pretty sure that the specialist will want to get those numbers up. I would want to review Dodds' protocol on this before talking with the specialist so that you can think of some questions, or be able to put any new recommendations in context.

I would consider adding some liver support to the mix - pred is hard on the liver, and the enzymes were already taking a hit frown I would consider that supplement that Hollysmom used (even though it has corn syrup!), or maybe some acetyl-l-carnitine, to help.

This is very scary stuff. I'm glad that clnically Kelso is doing well through the treatment!


Lisa,

Oh my!! Thank you SO much for the spreadsheet, means alot to me. This is very helpful and something I should have done and cannot thank you enough for doing that. I am one of those strange people that something like this, a spreadsheet, is better than any Christmas present! smile hugging I actually want to print this off to take to the specialist tuesday.

Kelso is on the 60 mg of pred a day and 400 mg of doxy a day (divided in 2 doses). The spleen was checked on palpation as well as the ultrasound. They did the ultrasound of his entire abdomen as well as his heart. Plain film xrays were also done.

Dan printed off the Dodds protocol for vaccine reactions and gave it to our vet, think we will print off another copy for the specialist.

It is very scary. Last week we were "up" a little as we were thinking it was a pure vaccine reaction and he was doing good, labs improving. Now it is almost like we are back to square one of just not knowing....he was a little more tired this week, I commented to Dan thursday night about that, then he labs were not better....my mom came over today and Kelso literally thinks she hung the MOON....and he was a little subdued for Kelso when he was with her today.

And he let me give him a bath in the tub today and did not try to eat the water sprayer...which was a little different for him. But yet he still digs and acts a nut at times, just more short lived than it used to be.

I just don't know. No one does at this point I guess. All I know is that he is not Kelso 3 months ago. We can't tell if it is the steroids or what.

Like I said, he seems happy and does get ornery so that makes us very happy. He is starting to regrow some peach fuzz on his shaved belly and is really looking good coat/eyes ect. His fur is so soft!! So we can only hope that means he really is getting better.

He is eating great (steroids) and it was only a couple of days that he did not eat well (in the very beginning) but yet his weight has been down. He was 80 lbs for when he was neutered more than a year ago and was 78 lbs when he went in for his DHLPP, the next week was 75 lbs and at his vet visit last week was 70 lbs. He is getting tripe, Wellness/Nature's Variety kibble, homemade treats/food and I just made up some satin balls for him as well. It will be interesting to see how much he weighs this next week as I do think he already looks better today.

Something else strange to note.... I threw the ball for him 2 times this week as he seemed antsy .. both times he chased it 4-5 times and then would stop...hunch his back over a bit like he was going to poop and instead of pooping he just plops down. Then starts eating grass. I don't want him too active of course but wanted to see if he wanted to do it and he loves his ball and I really just want him to be happy. I do not think I will do it again until we talk to the specialist. I don't know what that means but after the first time (which I thought was just something strange) it was alarming to see him do that again. Maybe it is because he has lost muscle?

So... it is just so up and down and all over, and I think we are reading into things and then I think he is better ....and on and on.

Like I have said, I just want him to be happy, and I do think he is. Just hoping that we can get some answers soon as well for our puppy cry

I want to take him on our walks, go to the park and enjoy the fall leaves... but am afraid to take him out now if he is having an immune problem?

What is the name of the supp that Hollysmom used... will have to go back and look

Here is the results of the tick testing that was done



-Steph

GSD's
Allie, gotcha 7/2007
Riko z Vom Weberhaus, "Fez" 7/29/2012

forever our angels
Meeka, b. 10/31/1994-11/26/2006
Kelso, b. 9/3/2006-2/9/2012

Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: kelso] #186706
10/09/11 06:13 AM
10/09/11 06:13 AM
Joined: Feb 2010
Posts: 1,490
Kansas
kelso Offline OP
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kelso  Offline OP
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Pic from today! Handsome smile
He loves to mess with his bowl



-Steph

GSD's
Allie, gotcha 7/2007
Riko z Vom Weberhaus, "Fez" 7/29/2012

forever our angels
Meeka, b. 10/31/1994-11/26/2006
Kelso, b. 9/3/2006-2/9/2012

Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: kelso] #186714
10/09/11 08:22 AM
10/09/11 08:22 AM
Joined: May 2010
Posts: 8,875
Queensland. Australia
bianca Offline
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bianca  Offline
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Queensland. Australia
wub


Molly Moo (aka The Piranha, 4 legged mouth) GSD (31/10/09)
Cooper GSD (The Gremlin) 19/10/11
Texas - Tabby cat (Feb 1996-2013) Run free sweet Teppie
Paris - Tabby cat (Feb 1996-2013) Run free my beautiful girl.
Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: kelso] #186758
10/09/11 04:20 PM
10/09/11 04:20 PM
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Posts: 2,488
Central Florida
arycrest Offline
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Originally Posted By: kelso
Pic from today! Handsome smile
He loves to mess with his bowl

Originally Posted By: kelso
...

Something else strange to note.... I threw the ball for him 2 times this week as he seemed antsy .. both times he chased it 4-5 times and then would stop...hunch his back over a bit like he was going to poop and instead of pooping he just plops down. Then starts eating grass. I don't want him too active of course but wanted to see if he wanted to do it and he loves his ball and I really just want him to be happy. I do not think I will do it again until we talk to the specialist. I don't know what that means but after the first time (which I thought was just something strange) it was alarming to see him do that again. Maybe it is because he has lost muscle?...
wub Love that picture, he's such a handsome dude!!!

Are you giving him anything for his stomach like Pepcid A/C or sucralfate/Carafate? From the way you're describing it, it sounds almost like some type of irritation ... maybe stomach or intestinal irritation problem (just saying this because of the pred). Just a thought ... you can ask the vet on Tuesday!!!

hugging hugging hugging hugging hugging hugging


Gayle
Faith, Ledgie & Scooby
My Bridge Kids: Andy, Abbey, Tasha, Tex, Echo, Yukon, JR, Too, Niki, Bo, Ringer, Kelly, Honey, Mac, Slider & Bruiser
Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: arycrest] #186762
10/09/11 04:55 PM
10/09/11 04:55 PM
Joined: Feb 2010
Posts: 5,439
Massachusetts
Braverhund Online partay
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Braverhund  Online Partay
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Kelso wub couldn't get handsomer even if he tried! wow His conquored bowl, his elongated tongue, those gorgeous intelligent eyes. Wishing only good health for Kelso!


Patti
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Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: kelso] #186784
10/09/11 08:00 PM
10/09/11 08:00 PM
Joined: Jan 2010
Posts: 19,513
Northern CA
MaxaLisa Offline

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MaxaLisa  Offline

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Northern CA
I'm glad you like the spreadsheet It looks like it lost just a tiny bit of formatting in the upload, and I don't know if the page break between the chemistry panel and the CBC is there - let me know if you want the original smile

When the platelets get below somewhere about 40,000, that's when you risk internal bleeding, per my vet. Do watch for this on the stomach:

There was an ehrlichia dog on another forum, I showed this picture, and the dog had this petechia - she brought the dog in and the platelets were somewhere around 15,000-20,000, I can't remember. But there was bleeding into the gums and the eyes (retina?) too. When the platelets are really really low, I would be careful of activity. They can do a handcount, but I think you have to ask - I don't know the details on that, only that machine count and hand count of platelets can vary quite a bit.

And yes, with those amounts of pred, his immune system is not competent right now.

Max's gut has taken a hit with the long term doxy. The pred here, at low doses, has already affected his liver. All this stuff is just nasty. But these GSDs have such strong spirit and drive, sometimes it's very difficult to judge what is going on by watching them. IF they show a symptom, then I tend to multiply that a bit, since they tend to not show.

Tick tests....I have seen everyone of them fail, so I don't put complete faith in them. And sometimes we aren't testing for the right things. For example, babesia can cause these same symptoms, often not tested for, and I think might be hard to test for. Just out of curiousity, I would think about running a cbc on Allie, and see if there is any platelet clumping or lowered counts on anything, as a possible clue. One dog could be infected while the other isn't, but if Allie has an issue, it might point more towards infection. If Allie is fine, well, you still know nothing crazy

It is clear that he isn't regenerating as much as he should, and they will want to address that. I've never followed all of the blood counts in a situation like this, so maybe everything that is going on is normal for pure autoimmune. Some of the stuff seems weird to me, but a lot of things in the medical area, as you know, are just weird, and sometimes don't follow the textbook.


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
http://www.rabieschallengefund.org/
Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: MaxaLisa] #186936
10/10/11 03:11 PM
10/10/11 03:11 PM
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Hollysmom Offline
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I was giving Holly LIXITINIC for anemia. It can come under alot of names, my clinic buys in gallon jugs for horses and we just pull up into another jar what we dose for dogs. There are lots of different names out there, but we have always used Lixitinic.

Don't take him anywhere except for the vets or a ride in the car. His immune system is toast right now.If you know someone who has a sick dog or been around a sick dog or puppy, do not let Kelso near them or you until you change clothes. When my girl was sick for the 5 months, and working at the vet, it was important that I changed clothes before I went into my home at night. I always used precautions at work, never worked on a puppy with a contagious illness and changed clothes in the garage at night before I went inside to greet her. On the days she needed blood draws, I usually went home after work and brought her back in or days I wasn't working, was the first appointment in the morning so she had no interaction with other pets at the clinic.
This is a very long slow illness with small ups and major downs. Every blood draw that shows good, you cheer thinking the best is to come, every one that shows loss just devastates you. I would probably not do hard exercise at all, if he feels like playing a bit, go ahead, but no excessive ball chasing or anything. His system is so "soft" right now you don't want to stress them at all.
His pred dosage is on the safe side, my girl was 50 lbs and was getting 100 mg a day(50mg morning and night) for the first two months, which was the maximun dosage then we starting dropping it slowly.Each vet does it the way they feel best, both my vet and I opted for the max dosage first to try to get things going. In her case, it worked.
When I saw the above photo it reminded me of the last dog we had come in with an AIHA. She was a little Pom and the groomer noticed her belly looked like the photo. She brought her in and was diagnosed with AIHA. Started on Pred, Doxy and Famotide for her tummy and that little Pom is now a year out and off all meds and doing great. We have NO clue what started her episode at all, none. They have no clue, like my girl, it just happened.
If something seems off, get him to the vets immediately. We did daily draws, then every other day, then every three days, then weekly then started cutting back on them. I am glad your vet is not reducing the preds yet, some vets who has not dealt with these immune system crashes start reducing too fast and can cause a major setback.
Things can happen so quickly with this disease.
My thoughts and prayers are with you and Kelso. I know how devastating this can be and pray for you all every day.

Last edited by Hollysmom; 10/10/11 03:14 PM.
Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: Hollysmom] #186940
10/10/11 03:41 PM
10/10/11 03:41 PM
Joined: Jan 2010
Posts: 19,513
Northern CA
MaxaLisa Offline

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MaxaLisa  Offline

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Northern CA
Originally Posted By: Hollysmom
... This is a very long slow illness with small ups and major downs. Every blood draw that shows good, you cheer thinking the best is to come, every one that shows loss just devastates you. ...

hugging to both of you!


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
http://www.rabieschallengefund.org/
Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: MaxaLisa] #187120
10/11/11 03:31 AM
10/11/11 03:31 AM
Joined: Feb 2010
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Kansas
kelso Offline OP
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kelso  Offline OP
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thank you to each and everyone of you!

And Hollysmom your advice and support are invaluable to me, appreciate it so much hugging

Hope to update you all more tomorrow after the specialist visit


-Steph

GSD's
Allie, gotcha 7/2007
Riko z Vom Weberhaus, "Fez" 7/29/2012

forever our angels
Meeka, b. 10/31/1994-11/26/2006
Kelso, b. 9/3/2006-2/9/2012

Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: kelso] #187171
10/11/11 12:56 PM
10/11/11 12:56 PM
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Mary Jane Offline
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crossedfingers for the specialist's evaluation and plan going forward.

MJ

Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: Mary Jane] #187198
10/11/11 02:06 PM
10/11/11 02:06 PM
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TMarie Offline
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TMarie  Offline
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I've been following this, and just wanted to let you know we are thinking of you and Kelso.

Re: Kelso is sick :( -anemia/recent DHLPP.. [Re: TMarie] #187375
10/12/11 02:50 AM
10/12/11 02:50 AM
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Kansas
kelso Offline OP
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kelso  Offline OP
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Hello

Nothing much new, which I think is a good thing?!

The internist did an exam, rectal all that good stuff. Looked at all the lab work. Basically said she wouldn't give him anymore vaccines (except for maybe rabies), she is not sure if the vaccine is the only thing or if there was/is something else as well.

She wanted to see another CMP as he had some abnormalities with albumin, alk phos, liver enzymes. So today he had a CMP/CBC and UA/culture done (she wanted to check his urine as we were describing the "hunching" thing).

So not sure there is really anything else...(just like Hollysmom and her pup and others that there was not even a vaccine as the cause) she did say he will be on steroids for a few months. Right now we are keeping the doses of doxy and pred the same until this next batch of bloodwork comes back in the next 24-48 hours.

She did say he had "Pred Head" which I had never heard of, but what I was describing and Lisa was talking about where he kindof looks sunken and you can feel the big bone easily at the top of his head. From muscle wasting from the prednisone. Never knew they called it that....so if anyone was curious!

Ug.

Again, just glad he is doing so good really!

Thanks again. As soon as I know anything more when the labs come back again and get another vet report will update...Kelso says thanks for all the good wishes paw and very helpful advice.



-Steph

GSD's
Allie, gotcha 7/2007
Riko z Vom Weberhaus, "Fez" 7/29/2012

forever our angels
Meeka, b. 10/31/1994-11/26/2006
Kelso, b. 9/3/2006-2/9/2012

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