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View Full Version : HELP!! Thrombocytopenia (low platelet issue)



molly
16th July 2006, 12:41 AM
Hi. I requested our vet do a thyroid function test along with a CBC and urinalysis on our 2 yr. old Murphy. He has alot of issues with Jekyl and Hyde behavior, some limited SM type symptoms (yelping and spinning to look at his hind quarters)/air licking, has really excessive hair shedding and is generally very listless with no appetite.

They questioned why I would even want to do testing (they think it is all behavioral). I just feel there is something wrong medically without boring you with all the boring detail. So I wanted to start with thyroid testing and move along from there. If it is not medical, great. They were also not happy because I asked that the test results be faxed to Tufts (a Dr. Dodd study).

So today, the vet calls, says his thyroid is fine and says Murphy has a low platelet count and has immune thrombocytopenia and he wants to start him on steroids right away and proceeds to tell me all the weird side effects that the medication will cause.

I said that I had read the breed has a history of a decreased number of blood platelets and could go along with no adverse effects and asked could this be the cause.

Well, he was very abrupt and said NO DOG has this condition genetically. Just put him on the meds because he could bleed out. Said to watch for bleeding/bruising, etc. Said his count was 2.8 (??). Basically, he took the doctor is GOD approach and don't question me. He was in a hurry.

Ok, it is Saturday and he was closing soon and we were on the phone. So I decided to go in and see him Monday to discuss this all further. I have printed off alot of info from the various health sites to take with me.

Have any of you had blood results that show up low platelets and has your vet been aware of the condition in cavaliers? Have they been receptive to reading the info and learning or checking it further?

The only other time I brought up the platelet health issue for cavaliers that our breeder told us about, I got a lecture on how breeders never went to medical school. This was a year ago when Murphy had zinc poisoning from pennies and they have him blood transfusions and chelation therapy because his platelet count was very low.

Anyway, I like my vets and usually trust them. BUt I am very leary of putting Murphy on steroids. Any help you could give on this, I would really appreciate. Thanks for taking the time to read all this!

Charleen
16th July 2006, 12:54 AM
How difficult for you & Murphy. I am sorry to hear of Murphy's condition. I am surprised after reading your details, you are still happy with your Vet. It seems like he doesn't want to be bothered with people that ask questions. Are there more sympathetic vets at the same clinic that you can communicate with better? Do you know of other Cavalier owners near you that can recommend a vet that is more in-tune to cavalier ailments?

Please let us know how your meeting goes on Monday. That'll be a tough one. You stand your ground girl! Don't let that Dr. intimidate you.

molly
16th July 2006, 01:39 AM
Charleen, thanks for your encouraging words. The male vet is usually less likely to listen but generally I trust him with most things. Like alot of males (ahhhem!), he just doesn't like being questioned. I am going to see the female vet that I really like on Monday (she was just voted vet of the year in NJ). She graduated high school with my daughter and she is much more open! Wish me luck with poor Murphy's issues.

Charleen
16th July 2006, 01:51 AM
Good luck Molly & Murphy! I'll be thinking about you both on Monday.

Luke goes to the vet for the day on Monday. He has ear wax stuck in his ear canals and the vet has tried different treatments for the last month, to no avail. So Luke will be put under to have the wax surgically removed.

So - I will definitely remember to pray for you & Murphy and a diagnosis.

Take care

molly
16th July 2006, 01:56 AM
Charleen, we'll be sure to say a prayer for Luke too! Please let us know how he does. Hugs to him!

RodRussell
16th July 2006, 02:06 AM
Molly, please have the vet take a look at this webpage: http://www.cavalierhealth.org/platelets.htm Print it out for him. It lists several recent research articles which have concluded that low platelet counts in Cavaliers are a special case. Low platelet counts in CKCSs without any other symptoms do not indlicate any disorder and should not be treated with anything.

Rod Russell
Orlando, Florida USA

RodRussell
16th July 2006, 03:24 AM
Molly, you might suggest to this vet that if he really knew all there is to know about low platelet counts in dogs, he would know that the Cavalier is an exception to the rule. (The fact is, the Cavalier is an exception to a lot of rules, and vets need to know about all of them: MVD, SM, glue ear, episodic falling, curly coat syndrome, fly catcher's syndrome, enlarged platelets, and low platelet counts.)

When we were looking for a new vet a few years ago, we met with one and explained to him that Cavaliers suffer from early-onset mitral valve disease and are 20 times more likely to have it than the average breed. We handed to him copies of MVD research articles copied from veterinary journals, telling him he could have them and keep them in our dogs' file. He abruptly slid the papers back toward us, indicating that he did not need to receive any information about veterinary matters from a dog's owner. This kind of attitude is not worth tolerating. A Cavalier's life is too short to try to spend time to educate vets who are not openly willing to learn more about a particular breed's problems.

Rod Russell
Orlando, Florida USA

Cathy Moon
16th July 2006, 04:27 AM
Molly,
I would absolutely get a second opinion before having Murphy undergo any treatment.

Geordie has the same platelet condition. When the vet ran Geordie's blood through a cell counter, it looked like very low platelets and extra white cells, causing some alarm. Then they did a manual cell count and found the large platelets. Here is what I copied from the ACKSC website and gave to my vet:

http://www.ackcsc.org/health/cavalierplateletissues.pdf

The vets have a permanent copy in Geordie's file.

Now Geordie is going to Ohio State University for the PSOM study, and I have already notified his vets that he has this condition, and they want a copy of this for their files, too.

Maybe your vet is right, and maybe he is wrong. But to treat Murphy for this condition if the vet is wrong could be life threatening, so I would absolutely go outside that practice to get a fresh second opinion!!

Cathy Moon
16th July 2006, 04:43 AM
One more thing, have they checked Murphy's knees and hips? Or done urinalysis?

When India injured her knee a long time ago, she would yelp and look towards her butt quickly. She also seemed lethargic from that because walking was uncomfortable. She had to have surgery for luxating patella.

India also yelps and looks toward her butt quickly when she has a UTI. UTIs make a dog lethargic, too.

Nicki
16th July 2006, 09:32 AM
Molly, I'm so sorry to read of your concerns for Murphy. I am very upset by your vet's attitude, I hate it when they treat you as a stupid pet owner :x and think you don't know anything.

We have the time to research the conditions that affect our beloved breed, they can't possibly know everything about every breed - and species - so I believe we are partners in the care of our doglets and that we can learn together.

I hope the lady vet is more receptive...please dont start the steroids yet. I don't know how many Cavaliers you have in your area, if it's not very many, they might not have come across this before.

I hope it's not SM, you need to rule out everything else first. Like Cathy's India, my Peaches had luxating patellas - and hip dysplasia, amongst other things :( - it could accout for some of Murphy's symptoms.


Cathy, I hope India is ok now


Charleen - good luck to Luke for Monday, will be thinking of you

Karlin
16th July 2006, 11:50 AM
More on platelets, a VERY welkl recognised condition with cavaliers and noted by ALL the breed clubs on their websites:

http://www.cavaliertalk.com/phpBB2/viewtopic.php?t=471

I would immediately change vets (individually or collectively); honestly, what an attitude! And also give them these links so they can see you are right. As Nicki says you shpould have a partnership with your vets and sometimes we do need to help them understand the specialised breed health issues in our dogs. But to be told we are wrong without them even considering your points is very unfortunate. I would not start the steroids either unless there's other reasons to consider them.

On the wider issue, I am sorry you are seeing these health problems. If other possibilities are ruled out, you might consider trying him on frusemide -- the first step of SM treatment -- to see if it helps. This could be the problem and medication might really help.

PS there will be a VERY low cost MRI facility available to your area in the next 45 days or so -- stay tuned for news. So don't go to MRI him yet unless absolutely necessary.

RodRussell
16th July 2006, 03:22 PM
It is ironic that even the ACKCSC has on its so-called "Health" webpage a link to an article about the platelet issue (albeit 5 years old and out-of-date due to four major platelet studies written since then). That webpage totally ignores the disease affecting and killing the most Cavaliers, which is mitral valve disease, and yet it pays great attention to the platelet disorder, which really is not a health problem for the breed.

I do not mean to downplay the importance of knowing about the platelet issue, but the bottom line of that issue is that a low platelet count, by itself, is not a health problem for Cavaliers, while MVD, which the ACKCSC's "Health" webpage refuses to acknowledge the existence of, is the most serious health problem for the breed.

Rod Russell
Orlando, Florida USA

Karlin
16th July 2006, 05:38 PM
Rod, I'd never noticed that, but you are right -- how bizarre. Their 'current breeding advice on syringomyelia' is also the advice initially offered by Dr Rusbridge 3 or 4 years ago. For more than a year, there's been a suggested programme involving MRIs that is quite detailed.

The CKCSC website finally put up information on SM a few months ago -- and their explanatory document is a very thinly disguised amalgam of Dr Rusbridge's information sheet and my symptoms document with no credit given to either of us. You'd get an 'F' in fifth grade for such blatant plagiarism. But at least the information is out there.

http://www.ckcsc.org/ckcsc/ckcsc_inc.nsf/founded-1954/syringomyelia2.html

RodRussell
16th July 2006, 06:42 PM
Karlin, the reason the CKCSC,USA has any information at all about MVD is because of the change in presidential adminstrations at that club. The past president downplayed MVD, stopped publishing the MVD breeding protocol which the club's prior administration (under president Anne Eckersley-Robins) endorsed, and eviscerated the club's health registry (really a healthy heart registry). The current president appointed Anne Eckersley-Robins as the chairman of the CKCSC,USA's health and education committee, and she is responsible for the club re-acknowledging the existence of the MVD breeding protocol by including it on the club's website, and re-invigorating the health registry.

Rod Russell
Orlando, Florida USA

molly
16th July 2006, 07:52 PM
I want to thank you all for your help and encouraging words. I have printed all the data I could find on this condition and will ask the vet Monday to have a hand count done along with the clotting factor test. And I also thank you for the good thoughts for him.

I will be sure and let you all know what happens as we go down this testing path. Murphy has been our problem child for the year we have had him. I am hoping that he does not have an under lying severe medical condition that is causing all his issues. Thanks again.

judy
16th July 2006, 08:53 PM
Molly, sorry to hear about your boy's symptoms.
Good for you, to have the thyroid sent to the Tufts study, and for at least trying to help your vet help your dog.

You haven't included in your posts anything positive about your vets, and lots of negatives, so like others, i want to encourage you to shop around as Rob did and find someone more intelligent than your current one. This is not just about being male, I've met female vets who have narrow limited perspectives and presumptions too--not that they aren't nice, some have nice personalities, and as you describe the other vet, are "more open," but more open is not enough. If possible one should have a vet who is seeking to learn, who is interested in things that are new to them that they don't already know about, and who encourage patients/owners to express their concerns and to enlighten them when such things come up.

The fact that you said "they" were not happy with you for wanting the thyroid panel faxed to the Tufts study sums up the whole problem right there. "They" (the practice in general? the office staff? under the leadership of the chief vet?) are opposed to participating in such an important study? What you have decribed is rigid prejudiced thinking that opposes learning. They are hostile to being told things they don't know, and they are hostile to others, such as the Tufts researchers, for trying to learn new things, or bothered by patients wanting to participate in such attempts to advance learning.

Even though no one at your vet's office may have stated these unfortunate biases to you, you have gotten that message. I am just responding to what you have said. I would not trust that office or that practice to give my dog the best possible care. A vet that would rush to give the highly toxic prednisone without checking into the possibility the dog may not need it, is careless and arrogant. He is using scare tactics with you to pressure you to follow his advice--he probably believes in his statements to you, he probably expects your dog to bleed out at any minute. However, until the blood panel, "they" (you said) were dismissing his symptoms, "just behavioral." This can't be good medicine. First, they dont' know the cause of his symptoms so they dismiss them rather than trying to investigate thoroughly. Then, they get a blood test result and they swing the other way, hysteria and ominous threats of eminent death requiring damaging medications. This is not intelligent. If the female vet was fundamentally different, i doubt she'd remain in that practice with the other guy.

How about asking Dr Dodds for a referral? I live in the same town where her home office is and when my zack was sick when i first got him and 4 vets were just throwing medicines at him without success and without know what was going on, i was going to take him to see her, and i talked to her office. I was told that i could email her about zack and that she would definitely write back to me, though it might take a while because she was out of the country at the time.

WoodHaven
16th July 2006, 09:58 PM
Cavaliers aren't the only breed that has large platelets that clump and get computers confused. 5 years ago we did a blood test at UW Madison-- they freaked out when they saw his platelet count--- I pulled from memory something I'd learned on a cavalier list. The vet said he didn't know that cavaliers had that too. He mentioned two other breeds that have the same thing. The wanted to put him on steroids-- of course my vet and I now laugh a bit-- IF his count was truly that low-- he'd be bleeding from every oriface and bleeding internally. (NOT running around playing like a maniac). Sandy

Cathy Moon
16th July 2006, 10:31 PM
Molly,
Just to let you know, Geordie has been having Jekyll and Hyde issues since he reached maturity. It seems to be partly temperament, partly lack of proper socialization during the key window of time for puppies, and, I'm guessing here, partly PSOM, probably pain/discomfort and hearing problems, which could affect his self confidence.

I have been working with a trainer since Geordie was 7 months old and he is now 3 years old (on July 30!), and he has come a long, long way. I will not give up on him, but I realize he does have certain limitations, like he will never be a therapy dog like India and Chocolate.

That said, we love Geordie all the more because he really needs us to understand and help him.

If you find out what is causing Murphy's problems, please share with me, I keep thinking maybe I'm overlooking something!

Give Murphy extra kisses and snuggles from us! :flwr:

Karlin
16th July 2006, 11:28 PM
The current president appointed Anne Eckersley-Robins as the chairman of the CKCSC,USA's health and education committee, and she is responsible for the club re-acknowledging the existence of the MVD breeding protocol by including it on the club's website, and re-invigorating the health registry.

I know she has really worked hard on a number of fronts.

All the same I've emailed them to state they need to accord the same respect to copyright material they use from others that they demand from people using their own site, where people are required to gain permission to use any material and credit them. I've asked them also to link directly to the downloadable versions of the symptoms and information sheets as they are restricting distribution on their site but Dr Rusbridge and I freely allow those two documents to be downloaded and circulated (obviously in a form where they include the authorship and copyright information). And suggested it would make sense to link directly or get permission to post all of Dr Rusbridge's current breeding recommendations, as they surely are of interest to breeders.

So now I will see what they say. :)

Charleen
17th July 2006, 06:54 PM
Molly,

How did things go today with Murphy at the vet's office.

Been thinking about you both.

molly
17th July 2006, 08:30 PM
Thanks, Charleen. I spoke to the female vet this morning on the phone. She was very receptive and said she had not heard of this condition in cavaliers before. She wanted to do some research through the vet schools on the cavalier platelet issue. I emailed her a bunch of links and we are going to see her tomorrow. Murphy of course is full of pep and energy this morning so she agreed we should not give him prednisolone or anything yet. I'll let you know how we make out tomorrow. Thanks!

Did Luke have his surgery today and how did it go? He is in my prayers. Please let me know.

judy
17th July 2006, 09:06 PM
glad to hear you have a good working relationship and communication with your other vet, and that she is reasonable and acting competent. that sounded like a sucky experience with that other guy. i sure hope murphy doesn't have anything serious. you are a great advocate for him! good luck!

molly
18th July 2006, 11:47 PM
Well, to everyone who helped Murphy and I so much, here's the update. First I want to THANK YOU ALL for such immediate and terrific advice and information. Thanks to you, I did not start him on the prednisolone and for that and all your emotional support, I am grateful!!! :lol: :lol:

We met with my favorite vet. She was right on the money. Gave Murphy a very thorough exam, told us that his lab work was hand counted and he has very large platelets (macrothrombocytes) and they checked his clotting factor (was fine) and so were the counts. He has no symptoms and is relatively active. She was familiar with the disease but not in cavaliers. Glad for the information you all provided too.

Therefore, after a really thorough exam, she strongly believes that he has idiopathic thrombocytopenia coupled with macrothrombocytes. She also concurred that he needs no treatment for it at this time. Also, said there is not yet a genetic marker for the condition. Gave me lots of good information including a discussion on some suspects links with MVD and/or immunizations.
.
His thyroid testings were in the normal range. She spent a good 30 mintues examining/going over all his symptoms. She offered some speculations as to some neurological conditions he may have (including SM) that are in line with his strange symptoms and behavior. She also discussed lymes disease and another tick born illness. Any way, we will see a neurologist in the coming weeks for a consult. I am going to check with Karlin because she mentioned an MRI cost opportunity in the next few weeks in our area.

Thanks again! You are the BEST! Murphy thanks you too because the side effects of the meds would not have been fun. Sorry this is so long.

Karlin
18th July 2006, 11:51 PM
Glad this experience was so much better and that you have some places to start from now. It must be a relief.

There will be a very low cost clinic in your vicinity probably starting around September. Unless things are very worrying I'd wait til then as it will be a fourth or so of the current price of an MRI and will include several other tests.

molly
18th July 2006, 11:59 PM
Karlin, boy that was quick!!! Thanks, I will watch for it! Take care and thanks again for all your help.