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Normal Topic Anemia (Read 2495 times)
Aunty
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Anemia
Feb 9th, 2011 at 12:40pm
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Hi Ethos

sorry to trouble you again but looking for a second opinion prior to making some choices.

I have a bitch that I inherited when she was 2 years old. She was a great dog, at first, but ssemed to slow up earlier than the others during a hunt, and as a new dog i just assumed her fitness still needed raising. She also would put weight on twice as fast as other dogs and lose it much slower. When she came on heat she would get tits down to her ankles. I have since speyed her. Dont get me wrong, she would still work hard, its just the last 2-4 months that shes really slowed up BIgtime

The last few hunts she has been really slow, like the batteries have gone flat completely only 30 minutes from the car. Shes not panting heaps, just absolute no energy.

Last weekend I hunted here again and same thing. This time we noticed very pale gums and ears, so I had blood tests done.

My vet has stated she is very anemic and that he believes its due to blood loss and resultant protein loss ( she has a top balanced diet ). As there has been no major blood loss from hogs we can only 'assume' thats its some sort of internal blood loss.

Accordingly, he is comeing to give a vitamin K injestion tonight and then will retest bloods in 48 hours.

I have asked him what it could be, and as its been over a period of time and no external blood loss, he seems to suggest some sort of pancreatic infection/bleeding. He believes 'if' this is the cause that antibiotics, albeit strong ones over a lengthy course could quite possibly see her right

any suggestions mate?

thanks in advance
  

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chris
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Re: Anemia
Reply #1 - Feb 9th, 2011 at 12:56pm
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any blood in her poo aunty?
  
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Aunty
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Re: Anemia
Reply #2 - Feb 9th, 2011 at 1:06pm
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havent paid much attention bro as I have 6 dogs but will be now. shes actually pretty happy and playful and alert etc etc , but just has really flat batteries
  

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chris
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Re: Anemia
Reply #3 - Feb 9th, 2011 at 1:09pm
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yeagh noticed that, remember when you bought her up north, she was pretty slow ay. seems odd cause she looks fit and healthy and is a happy dog, good luck bro, hope she comes right for ya.
  
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ethos
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Re: Anemia
Reply #4 - Feb 9th, 2011 at 1:31pm
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Aunty thats a good first question from Chris about the blood in the poo -in your part of the county and at this time of year hookworm can cause anaemia and lack of performance if it is present.
I know you worm well and regularly, sometimes hookworm can be hard to shift tho, you could consider getting the vet to look at a stool sample to see if there are hookworm eggs, or worm with drontal at a dose slightly higher than the weight of the dog.
If you can get a copy of the blood test I might be able to interpret the different values for you eg: there can sometimes be clues on the test as to where the bleeding may have taken place, as well as severity.
As you will know the vitamin K is an antidote for rat poison and is sometimes started as a precaution if the cause of bleeding isnt known straight away.
Did the vet send blood away for coagulation testing?

But Id have to say again, both blood and protein loss can be explained by intestinal parasitism by hookworm.
  
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Aunty
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Re: Anemia
Reply #5 - Feb 9th, 2011 at 2:25pm
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thanks mate

i have since had a look through the shit but with 6 dogs it all looks relatively normal and consistent

i drontal as per label, but will try a double dose.

would a hookworm infestation not result in weight loss? she is the opposite

here she is




and here she is on the left showing you the difference in condition between her and my other 3 dogs. Feed/exercise levels are no different., hence my question about worms as i thought it would have been the opposite mate
  

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ethos
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Re: Anemia
Reply #6 - Feb 9th, 2011 at 2:49pm
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True you would normally expect weight loss rather than gain, but similarly if she has low blood protein we would expect her to be thin rather than chubby - moral of the story is the dogs dont all read the textbook.

Ive seen hookworm in fat, medium and thin dogs with or without anaemia, sometimes lethargic sometimes outwardly fine, its still worth treating for even on an off chance.
Hookworm can be a dose limiting worm - in otherwords it is often the worm hardest to get rid off and what determines how much antiworm drug the pill companies put in the tablets. Hence it sometimes sneaks through a worming program.
If treating clinical hookworm in a moderately affected dog I worm now,weekly for 2 weeks then again in 6 weeks.
Another good reason to consider faecal eggcount is whether to go to the expense of treating all other dogs at the same time.
That said, a faecal egg count should show whether or not it is the cause (rough cost estimate $10-25).
If its not the worms, then id really have to see the test results to have an idea.
I wish I lived a bit closer to ya, youve had some interesting cases!
  
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Aunty
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Re: Anemia
Reply #7 - Feb 9th, 2011 at 3:00pm
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cheers again Tom

I'll be with th vet tonight so will post tomorrow when i've got some more info, thanks again mate
  

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ethos
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Re: Anemia
Reply #8 - Feb 9th, 2011 at 3:52pm
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No worries Aunty 
Actually Im off tomorrow for 3 days in fiordland - will flick you a PM when I get back.  Smiley
  
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Aunty
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Re: Anemia
Reply #9 - Feb 9th, 2011 at 9:10pm
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vet came and gave her a vitamin k shot and long acting antibiotic

did a needle check for internal blood but nothing as suspected

he wants to recheck bloods next tuesday.

said initial blood test showed slight raised pancreatic enzymes in addition to raised anemia, sid though that it was a regenerative anemia and that new growth was good

he seems to think its internal bleeding still, i'll be watching her toileting more carefully

one last question sorry mate. i gave her a drontal tab last week as part of regular worming. should i give her 1 again or two, as realise it maybe hard on her system, moreso at the moment

have  a  great trip and thx again

  

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ethos
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Re: Anemia
Reply #10 - Feb 9th, 2011 at 9:21pm
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Ive wormed dogs daily with drontal in severe hookworm cases, you will do no harm by worming again now.
Pancreatic enzmes may sometimes elevate with slight dehydration but it would depend on the amount of elevation and is relative to other things on the test -it sounds good that the vet is covering her for the other possibilities in the meantime.
  
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Aunty
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Re: Anemia
Reply #11 - Feb 18th, 2011 at 5:22pm
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Hiya Ethos

heres a copy n paste of results, first and second

1st HAEM

> @HEADER
> ACCESSION AU1102580
> REPORT HAEM
> REPORTSTATUS FINAL
> OWNER FREEMAN,S
> SUBREF
> SPECIES Canine
> BREED Mixed
> SEX Female speyed
> AGE 3 YEAR(S)
> SENT 7/02/2011 4:12:19 PM
> RECEIVED 8/02/2011 4:12:19 PM
> SIGNEDDATE 8/02/2011 5:23:09 PM
> SUBMITTER Pegman A
> TECHNICIAN CWILLI
> LABORATORY Gribbles Veterinary Pathology Ltd- Auckland
> LABADDR1 37-41 Carbine Road
> LABADDR2 Mt Wellington
> REPORTFEE
> @RESULTS
> MUD RBC 4.21 X 10^12/L L (5.5 - 8.2)
> MUD HB 75 G/L L (120 - 180)
> MUD HCT 0.25 L/L L (0.37 - 0.55)
> MUD MCV 59 FL L (60 - 78)
> MUD MCH 18 PG L (20 - 25)
> MUD MCHC 300 G/L L (310 - 360)
> MUD RETAB 610.45 X 10^9/L H (0 - 60)
> MUD RETPC 14.5 %
> MUD NRC 2 /100LEU H <0
> MUD WBC 15.1 X 10^9/L H (6 - 15)
> MUD NEUT 68 %
> MUD NEUTAB 10.3 X 10^9/L (3.6 - 11.5)
> MUD LYMPH 17 %
> MUD LYMPHAB 2.6 X 10^9/L (1 - 4.8)
> MUD MONO 5 %
> MUD MONOAB 0.8 X 10^9/L (0.2 - 1.5)
> MUD EOSIN 9 %
> MUD EOSINAB 1.4 X 10^9/L (0.1 - 1.5)
> MUD BASO 1 %
> MUD BASOAB 0.2 X 10^9/L <0.4
> MUD WBCRAW 15.4 X 10^9/L (6 - 17)
> @COMMENTS
> RBCs-Anisocytosis 2+
> Microcytes 1+
> Hypochromia 1+
> Polychromatic cells 2+
> Target cells 1+
> NRBCs are metarubricytes
> Leukocyte morphology appears normal.
> Platelets appear normal in number
> Platelets are clumped in the film
> No fresh film received.
>
> krm
>
> VETERINARY INTERPRETATION:
> Moderate anaemia with a good regenerative response - differentials would include haemorrhage or haemolysis. As there is no evidence of agglutination or spherocytosis, haemolysis is unlikely; so blood loss is the top differential. There is also a hypochromia and microcytosis , which indicates iron deficiency. I would recommend you check faecal occult blood .
>
>
> Catherine Williamson
> BVSc ( Hons); MMedVet (Klin.Lab.Diag.)
> HAEMATOLOGY - GENERAL performed at Gribbles Veterinary Pathology Ltd- Auckland
> Reference Ranges and Method Reference will be supplied on request
> Testing Requested
> 1 x Complete Blood Count
> 1 x Complete Blood Count
> @END
>


1st BIOCH


> @HEADER
> ACCESSION AU1102580
> REPORT BIOCH
> REPORTSTATUS FINAL
> OWNER FREEMAN,S
> SUBREF
> SPECIES Canine
> BREED Mixed
> SEX Female speyed
> AGE 3 YEAR(S)
> SENT 7/02/2011 4:12:19 PM
> RECEIVED 8/02/2011 4:12:19 PM
> SIGNEDDATE 8/02/2011 5:36:12 PM
> SUBMITTER Pegman A
> TECHNICIAN CWILLI
> LABORATORY Gribbles Veterinary Pathology Ltd- Auckland
> LABADDR1 37-41 Carbine Road
> LABADDR2 Mt Wellington
> REPORTFEE
> @RESULTS
> MUD NA 145 MMOL/L (141 - 153)
> MUD K 6.4 MMOL/L H (4 - 5.4)
> MUD NAKR 22.7 RATIO (27 - 36)
> MUD CL 108 MMOL/L (106 - 117)
> MUD CRE 98 UMOL/L (48 - 109)
> MUD URE 5.1 MMOL/L (2.5 - 9)
> MUD PO4 1.77 MMOL/L (0.92 - 1.82)
> MUD CHOL 3.9 MMOL/L (3.27 - 9.82)
> MUD TP 53 G/L L (54 - 74)
> MUD ALB 27 G/L L (33 - 44)
> MUD GLO 26 G/L (19 - 35)
> MUD AGR 1.04 RATIO (0.52 - 1.7)
> MUD CA 2.45 MMOL/L (2.08 - 2.82)
> MUD BILI 1.0 UMOL/L (1 - 3)
> MUD ALP 43 IU/L (0 - 87)
> MUD ALT 37 IU/L (0 - 88)
> MUD AST 61 IU/L H (0 - 51)
> MUD CK 745 IU/L H (0 - 385)
> MUD AMY 1668 IU/L H (0 - 1074)
> @COMMENTS
> COMMENT:
> Mildly lipaemic sample which may interfere with some chemistry tests.
> VETERINARY INTERPRETATION:
> The mild hyperkalaemia may be artefactual, due to leaching of K from rbcs whilst in transit.
> Mild hypoproteinemia and hypoalbuminemia - non-selective - consider losses due to haemorrhage, or through GIT or into an effusion. The increase in amylase is mild and may or may not be of pancreatic origin. Other tissues (git, liver) have varying amylase activities. If pancreatitis is suspected clinically consider checking serum lipase
>
> Catherine Williamson
> BVSc ( Hons); MMedVet (Klin.Lab.Diag.)
>
> BIOCHEMISTRY-HITACHI performed at Gribbles Veterinary Pathology Ltd- Auckland
> Reference Ranges and Method Reference will be supplied on request
> Testing Requested
> 1 x Sick Canine Panel
> 1 x Sick Canine Panel
> @END
>
>



then 2nd HAEM

> @HEADER
> ACCESSION AU1103267
> REPORT HAEM
> REPORTSTATUS FINAL
> OWNER FREEMAN,S
> SUBREF
> SPECIES Canine
> BREED Mixed
> SEX Female speyed
> AGE 3 YEAR(S)
> SENT 15/02/2011 4:17:27 PM
> RECEIVED 16/02/2011 4:17:27 PM
> SIGNEDDATE 16/02/2011 5:18:58 PM
> SUBMITTER Pegman A
> TECHNICIAN JMEYER
> LABORATORY Gribbles Veterinary Pathology Ltd- Auckland
> LABADDR1 37-41 Carbine Road
> LABADDR2 Mt Wellington
> REPORTFEE
> @RESULTS
> MUD RBC 5.11 X 10^12/L L (5.5 - 8.2)
> MUD HB 79 G/L L (120 - 180)
> MUD HCT 0.28 L/L L (0.37 - 0.55)
> MUD MCV 55 FL L (60 - 78)
> MUD MCH 15 PG L (20 - 25)
> MUD MCHC 280 G/L L (310 - 360)
> MUD RETAB 792.05 X 10^9/L H (0 - 60)
> MUD RETPC 15.5 %
> MUD NRC 3 /100LEU H <0
> MUD WBC 12.1 X 10^9/L (6 - 15)
> MUD NEUT 66 %
> MUD NEUTAB 8.0 X 10^9/L (3.6 - 11.5)
> MUD BAND 5 %
> MUD BANDAB 0.6 X 10^9/L H (0 - 0.5)
> MUD LYMPH 18 %
> MUD LYMPHAB 2.2 X 10^9/L (1 - 4.8)
> MUD MONO 1 %
> MUD MONOAB 0.1 X 10^9/L L (0.2 - 1.5)
> MUD EOSIN 10 %
> MUD EOSINAB 1.2 X 10^9/L (0.1 - 1.5)
> MUD WBCRAW 12.5 X 10^9/L (6 - 17)
> @COMMENTS
> RBCs-Anisocytosis 2+
> Microcytes 1+
> Hypochromia 2+
> Polychromatic cells 2+
> Poikilocytes 1+
> Target cells 1+
> NRBCs are metarubricytes.
> Leukocyte morphology appears normal.
> Platelets appear normal in number
> Enlarged platelets present
> Platelets are clumped in the film
> No fresh film received.
>
> krm
>
> VETERINARY INTERPRETATION:
>
> Andrew, this has the hallmark of iron deficiency erythropoiesis - mild to moderate microcytic hypochromic anaemia. There is still a good marrow response which suggests that iron is not totally depleted. Has a source of external blood loss be identified (melena, haematuria)? Internal parasitism?
> HAEMATOLOGY - GENERAL performed at Gribbles Veterinary Pathology Ltd- Auckland
> Reference Ranges and Method Reference will be supplied on request
> Testing Requested
> 1 x Complete Blood Count
> 1 x Complete Blood Count
> @END
>
>



interested to hear your thoughts. I see iron levels are noted as low. I will check Hills Active to see what its iron content is but am surprised at this due to varied diet and only 1 dog out of 7 showing slowness

thanks mate
  

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chris
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Re: Anemia
Reply #12 - Feb 18th, 2011 at 5:55pm
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do dogs get ulcers? be very interested to hear ethos response, hows she doing aunty, still a happy chappy?
  
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ethos
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Re: Anemia
Reply #13 - Feb 18th, 2011 at 6:05pm
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Thanks for posting that up Aunty.
I hope this isnt too much of a ramble:

The elevation in the pancreatic enzyme is relatively minor (amylase goes through the roof sometimes) and I wouldnt consider it diagnostic of a problem here necessarily (without having done full physical exam etc etc).

It certainly looks like blood loss from the body - blood loss internally by rupture outside blood vessels leads to icreased bilirubin which you dont have here. Blood loss by rupture inside vessels would give red blood cell fragments which we also dont seem to have.

The most likely loss of blood then without a history of trauma is via the intestine - parasites like hookworm or a bleeding ulcer or growth in the interstine could cause it, the second blood result shows the body is adjusting to previous blood loss.
Less likely in a young dog is the possibility of a bleeding tumour in the abdomen, causing blood loss in to the abdomen.

The "hypochromasia" and microcytosis means that some of the new red cells being made are not as big and full of iron as they should be hence the comment from the pathologist on iron deficency.
I wouldnt jump to iron deficiency as a straight out answer here though due to good diet and the age of the dog.

I would suspect there may be a relative iron deficiency because the blood loss may well be chronic (happening slowly over some time), not acute(suddenly) meaning that normal iron reserves are stretched because the body is trying to make more blood cells.
The other thing which fits with chronic blood loss is the low total protein, something which can happen with chronic paarasitism and/or chronic blood loss.
Id still have snuck a clotting test in there as well just to check for anticoaulant poisoning or haemophilia (rare in dogs).

So: checking for worm eggs would be handy (not if youve already wormed again though!) if the problem continued you could get a test done on a stool sample to check for blood (faecal occult blood). A negative faecal blood could rule out a lot.

If problem continues:
Other diagnostics to consider if faecal blood negative would be abdominal utrasound/exploratory laparotomy (eg: look for a bleeding abdominal lump)
If faecal blood positive but no response to wormer, consider endoscope both ends. (eg: look for source of gastro intestinal bleeding)
« Last Edit: Feb 19th, 2011 at 8:33am by »  
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Aunty
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Re: Anemia
Reply #14 - Feb 18th, 2011 at 6:53pm
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thanks so much!

i think i'll stop farting about and go straight for an ultrasound

in her day she was a 'good' dog, not great, but well worth a good hunting home so it would be great to get her back to where she was

will keep you posted

thanks again, really appreciate it

and yeah chris, shes happy as larry around home
  

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