stella pred reduction

Angela · July 16, 2012, 08:11:31 AM

Hi Elizabeth,

The drops of blood could be her season or she may have a bad UTI, the neutrophils indicate an infection. Stella's hct looks good at 41% but I can't shed any light on what is meant by normocytic normochromic anaemia.

Hugs

Jo CIMDA · July 16, 2012, 11:29:38 AM

Hi Elisabeth

The reference ranges are not there, but on the face of it the platelets look ok and although her HCT is on the low side I would be pretty happy about the results. If Stella is having a season or bleeding due to a UTI then that may be the reason for the comment normocytic normochromic anaemia. 41% is ok and she should improve on this number as she gets over this infection. UTI (if that is the problem) often need several courses of antibiotics before the infection has totally gone. Leaving Stella on EOD preds (as opposed to daily preds) will assist her recovery. Trust your instinct Elisabeth. I'm sure you husband will give you a lot of medical support.

Quote:
Normocytic-Normochromic anemia: Megalocytic-Normochromic is a blood disorder characterized by normal amounts of haemoglobin within normal-sized red blood cells. However, the number of red blood cells is low.

Jo

shawkyelisabeth · July 17, 2012, 01:27:47 PM

This morning I found Stella with a lot of fresh blood drops around her that could not possibly have come from a season so I got her up on her feet to find that blood was coming from her nose, it dripped down quite a lot with a big blood clot. Then she put her nose into cold water and the blooding stopped somewhat with only an occasional drop coming out of her nose. At first I thought that she might have hurt herself with some sharp object but I could not find anything that could have caused such an injury. So I packed her into the car off to the vet, he found she had a fever of 40.5 C and related the bleeding to the strong heat mainly and in part also to the longterm pred treatment. He gave her an injection to stop the bleeding and another to control the fever and prescribed two tablets daily for the same purpose. She got a vitamin injection which I am supposed to give her at home for a couple of days,, but I cannot do because she gets very agressive at anybody -even me- when it comes to injections. So i give her multivitamins and vit b tablets, iron and liver protectant, antibiotics and a gastroprotctant as well as 5mg pred eod. It seams we are heading back to that intense medication that i am not really happy about but we have to deal with.
Do you have any clue about what the cause of the nose bleeding could be, is it the extreme heat we have? I am trying to not dramatize events. Stella was comparatively well in the morning barking, running around , bringing her favourite toys for me to throw to her, but not eating. She ate a little bit of meat yesterday leaving the noodles behind.
hugs elisabeth

gschellinger · July 17, 2012, 04:45:23 PM

I think there are various reasons for nose bleeds. I have looked into all sorts of reasons why Lola is so congested in her sinus. One reason is nasal cancer. A symptom of nasal cancer is nose bleeds. Don't mean to alarm you but it is ONE reason. Lola has not had a nose bleed so we are not thinking cancer anymore. I believe ususally there is also nasal congestion in addition to nose bleeds with cancer. So don't worry. Just be aware, I guess.
Poor Stella has sure had her share. Hang in there...

gail.

shawkyelisabeth · July 17, 2012, 05:17:19 PM

Yes I have already looked into the causes for nose bleeds clinging to the extreme heat here in Egypt as the most comforting explanation. I keep her in cool rooms hoping that it is the heat and she will improve. Overall she is ok but does not eat! Elisabeth

Shannon · July 17, 2012, 05:59:54 PM

Hi there. Poor Stella. Her fever was pretty high,is her nose bleed not connected with the cause of the fever? Did the vet do a blood smear to see if there were any parasites in her blood cells? I'm sure the heat is a possibility though. Hope she's on the mend soon.

Jo CIMDA · July 17, 2012, 07:12:07 PM

Hi Elisabeth
I'm so sorry you are having these problems with Stella. Do you know the reference range for the blood results, especially the platelets? I don't think it could be a platelet destruction because her platelet number seems fine and a spontaneous bleed wouldn't occur until the platelets were down to 40. It may be the heat but would that send her core temperature up? You would know that more than me. She may have a bacteria or a fungus. Was the nose bleed from both nostrils or just the one? Does she have any mucus coming down her nose? Could she have knocked it and it bled due to trauma? Should you check for babesia?

Jo

gschellinger · July 18, 2012, 02:00:28 AM

Maybe not eating because of the heat? It does affect some people like that too. Have you tried some yummy sorts of foods she doesn't usually get to have? I hope she is better soon.
gail.

shawkyelisabeth · July 18, 2012, 03:26:35 AM

The platelet reference range is 150 - 450.Could it be a secondary disease ITP, IMT, Evans syndrome? Thats what I quickly found connected with nose bleeding and IMHA, but have no idea what it could mean. Still clinging to the heat and infection with fever explanation. The thought of renewed babesia is frightening but a possibility that I cannnot investigate. I cannot get Stella through this blood test again, heat, traffic chaos in Cairo, she refusing and very agressive at anybody touching her legs for bloods....lets still think positive and assume that it is nothing serious that cannot be dealt with within reasonable limits. I will keep my eyes on her fever that should disappear with effective antibiotic treatment. Other then that back to nursing with ice packs on her nose for vasoconstriction! I hope she will eat a little in the morning, at least her favourite joghurts. your input is very much appreciated...hugs to everyone Elisabeth and Stella

shawkyelisabeth · July 18, 2012, 03:33:23 AM

I think the bleeeding is from one nostril and there was very little mucuous as far as I have seen but I will have a closer eye on that. During the night there were also some blood drops on the bathroom floor with some clots.

shawkyelisabeth · July 18, 2012, 03:48:53 AM

I dont think it could be bleeding due to trauma.
The ref range for 12.9 haemoglobin is 13-17
4,95 rbcs ref range 4,50 - 5,50
41.0 haematocrit ref range 38.0-50.0
82,7 MCV ref range 80.0 - 101.0
27.0 MCH ref range 27.0-32.0
31.5 MCHC ref range 31.0 - 35.0
220 platelets ref range 150-450
8,25 WBCs ref range 4.00 - 11.00
would you also need the Differential leucocytic count?
These are human reference ranges since we do the test in a human lab, no vet lab in Egypt!

Angela · July 18, 2012, 05:39:35 AM

Hi Elizabeth,

Stella's platelets are within range so it is unlikely to be Evans Syndrome; other than that, the nose bleeds are quite odd but I have no experience with them in dogs.

Fingers crossed here that the antibiotics fix whatever it is & soon

Hugs

Shannon · July 18, 2012, 07:04:19 AM

Hi Elisabeth,

I hope Stella is feeling much better today. The WBC differential may be helpful as it can give an indication of what kind of challenge the body is dealing with. What antibiotics is she on? Really hope she's on the mend.

shawkyelisabeth · July 18, 2012, 02:59:30 PM

Differential leucocytic count
Basophils 0% relative 0.00% absolute up to 0.10 ref range
Eosinophils 0% 0.00 0.02-0.50
Neutrophils 68% 5.62 2.00 - 3.00
Staff 14% 1.16
Seg 54% 4.46
Lymphocytes 26% 2.15 1.00 - 4.00
Monocytes 6% 0.50 0.20 - 1.00

Shannon · July 18, 2012, 06:19:46 PM

Hi there,

So its just the neuts that are high... High neuts generally indicate a bacterial infection. Hope the antibiotics are kicking in and she's feeling better and eating now?

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stella pred reduction