Enlarged Platelets and Anemia - Important!

I just got a voice mail from my vet advising me that Kosmo needs to be seen to get more bloodwork done *asap??.* She said it's because his last blood work (before his neuter) had showed her that he was anemic. it's been 6 months now exactly since he's been neutered.

I remember when his first blood work came back she said it was "abnormal" because of the platelet counts but as I've read here, that's very common with cavaliers, right? Can "abnormally" large platelets cause an unaware vet to suspect anemia?

She said it was OK to do the neutering because it wasn't abnormal enough to cause problems, but now that it's been 6 months apparently she wants to get it tested again.

This whole thing is confusing to me.. I could take him in to get checked out but I know there are lots of vets out there with no first hand knowledge of Cavaliers and I'm not about to subject him to more testing if it's not necessary.

h*lp

If you go to the health Library you can print out an article on this issue from one of the cavalier club sites. Yes he could appear anemic because of large platelets. Your vet needs to know this is normal in the breed and is rarely the problem it seems to be. Print out the article and give it to them for their files. If she really wants to do further bloodwork have them *hand count* the white cells. But I don't think Kosmo needs more tests.

Article to print out:

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

Thanks so much for your quick response Karlin. I don't want to put him through a bunch of unnecessary testing, especially when it seems as it could be congenital. I read that article right before you posted it, it just didn't say anything about a misdiagnosis of anemia, so I needed to confirm that before faxing that information sheet to the vets. If she seems adament to test him then I can bring him in, but it seems as if it will be a waste of time right now. :yikes Maybe i'll call her and speak to her about it - ask her if I can fax a copy of that over.. *maybe I'll "slip" an infosheet on SM in there too.. :lol: * I'm planning on bringing the SM thing in when he gets his annual rabies though - I just wanted to definitively find the distinction between large platelet counts and "anemia."

Thanks!

That's true, on second thought if anemia is the only issue she is thinking of with abnormal bloods, you may want to have him tested and explore what is causing this. If he is anemic something as simple as worms can cause the problem. Given his background though it is fairly possible he could have had anemia caused by poor diet/worms etc. Blood tests aren't too much of a bother for most dogs.

Sara, Karlin gave you lots of valuable info. All the members on this board and Cav Connection gave me such valuable advice when our Murphy had blood tests and his blood test also showed low platelets. One of our vets wanted to start him right away on steroids. Thanks to the people here we did not give him steroids and met with our favorite vet (a different one) in the practice. Here's what happened from my prior post:

"She 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.

Here's some more info:
http://www.cavaliertalk.com/phpBB2/...latelets&sid=64d17039ffcc2fb38116f43feaf707e9

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

Please let us know what happens!

Anemia (?) and Spleen Issues

Hello- first time poster, here.

Our 8 year-old TriColor Cavalier, Sadie recently lost her appetite and seemed very tired. We brought her to a trusted vet and after a physical exam, X-rays and a scan, it was his impression that she had an enlarged spleen and possibly a mass pressing on the spleen. He did not see signs of cancer elsewhere. He also said that she was slightly anemic (her "count" was 37 and it should have been above 40). He put her on antibiotics and predinizone and luckily, her appetite and energy levels now seem normal.

However, we brought her back after 10 days for a blood test and her "count" is now 33 (I don't really know what this means). Our vet is concerned that this could be a sign of something more serious. Unfortunately, because of Sadie's slight heart murmur, she isn't a surgery candidate and they don't even want to do a biopsy. We are returning in another week for additional tests. I'm not sure that the vet is aware of the platelet issues specific to CKCS (which would require a hand count of the cells), but I plan to bring him some articles (the links on this forum didn't work, but I found other articles on the subject).

Here are my questions:

1. Is it possible that there is a correlation between the CKCS platelet issues and the fact that Sadie is showing signs of anemia?

2. Has anybody seen similar spleen issues or an interplay between an anemia diagnosis and spleen issues?

We love Sadie so so much. She is the sweetest most loyal dog that has ever been a part of our family and we want to do what's best for her. Until now, she has been in near-perfect health. Right now, it's a waiting game. However, I still hold hope that the vet isn't familiar with the CKCS platelet issues and that her spleen will shrink as a result of the meds.

Hmmmm.....I never saw this original thread or I would have commented. This is a big topic, but I'll try to make it simple here.

There is no relationship between enlarged platelets and anemia. I'll paste some links below for further reading.

Basically, platelets have to do with the clotting ability of blood. Low platelets (not the CKCS kind which is a benign anomaly) cause thrombocytopenia - a decreased ability for the blood to clot. This can result in a dog bleeding out so it is dangerous. Often true thrombocytopenia is an immune disorder but it can also be caused by things like rat poison or tick borne diseases.

Red blood cells are related to anemia - too few red blood cells cause anemia and symptoms are weakness, poor appetite, etc. Anemia can also be autoimmune (IMHA - immune mediated hemolytic anemia) or can be caused by a diseased spleen or loss of blood and is also a complication of kidney failure (the body stops producing red blood cells). Anemia can be caused by not enough red cells being produced or by too many red blood cells being destroyed. You can read all about it in the links. There aren't good treatments for IMHA (I lost a dog to that a couple of years ago). Transfusions only "last" for a few days. Giving EPO can help reverse anemia but there are usually complications - very long topic. Steroids (prednisone) are given for suspected IMHA or immunosuppressants like cyclosporin. These drugs can help stop the body from destroying its own red blood cells.

The blood test that measures these components is a CBC - complete blood count. This test shows hematocrit (HCT) or packed cell volume (PCV) which is what tells you if a dog is anemic. 33 is not terribly problematic. My girl that died had an HCT of 15, and it was acute anemia. Under 20 is dangerous - even more so if it is acute (sudden in nature) rather than chronic (slowly progressing, as happens with kidney failure). My Cavalier with kidney failure lived for two years and did quite well with an HCT that stayed in the low 20's (his was chronic), and he died at 16 for reasons other than kidney failure. CBC also measures hemoglobin, red cells, white cells (they fight infection) and platelets.

http://www.cloudnet.com/~jdickson/imhaitphandout.htm

I usually don't like to use links relating to humans, but this is a good explanation of red cells, white cells and platelets:

http://www.lef.org/protocols/heart_circulatory/blood_disorders_01.htm

Now - relative to Sadie:

Are you in the U.S.? Where do you live?

I would consult a board certified internal medicine vet specialist for optimum diagnosis and treatment planning. This is beyond a GP vet.

Can you get a copy of her CBC so you can see all of the values? Another test can be done to show if the anemia is regenerative or not.

The spleen and red blood cells are linked (read the links). If she has cancer just in the spleen or a benign tumor, a splenectomy could be done as that organ is not necessary for life. Good link:

http://www.marvistavet.com/html/body_splenic_masses.html

An 8 year old with a slight murmur can perfectly well undergo surgery, but you need a specialist. (I've had a 14 year old with more advanced heart disease have a successful cancer surgery and he was fully recovered within days - but a specialist handled his care. I've had several older Cavaliers with heart disease do quite well with various surgeries - spays, mastectomy, removal of eyes, etc.) This of course is a personal choice and there is not a right or wrong answer with a decision about surgery, but you should know that this absolutely is an option and you've been given incorrect advice if you've been told that Sadie is not a candidate for surgery.

Pat

Copied and pasted from a good website:

A simple measurement of red blood cell count is called the “packed cell volume” or “PCV.” The packed cell volume is an expression of the percentage of the blood’s volume which is taken up by red blood cells. It can be measured using only a drop or two of blood and can be done “while you wait” in any veterinary office. The sample is spun in a machine called a “centrifuge” to separate the red cells, white cells, and serum. The blood tube is then read against a chart to get the packed cell volume. “Hematocrit” or “HCT” also measures the volume of blood present as red blood cells but uses a measure of hemoglobin to determine it. Practically speaking, PCV and Hematocrit measure the same thing.

sadiesdad said:

... Our 8 year-old TriColor Cavalier, Sadie recently lost her appetite and seemed very tired. We brought her to a trusted vet and after a physical exam, X-rays and a scan, it was his impression that she had an enlarged spleen and possibly a mass pressing on the spleen. He did not see signs of cancer elsewhere. He also said that she was slightly anemic (her "count" was 37 and it should have been above 40). He put her on antibiotics and predinizone and luckily, her appetite and energy levels now seem normal.

... Here are my questions:

1. Is it possible that there is a correlation between the CKCS platelet issues and the fact that Sadie is showing signs of anemia?

2. Has anybody seen similar spleen issues or an interplay between an anemia diagnosis and spleen issues?

We love Sadie so so much. She is the sweetest most loyal dog that has ever been a part of our family and we want to do what's best for her. Until now, she has been in near-perfect health. Right now, it's a waiting game. However, I still hold hope that the vet isn't familiar with the CKCS platelet issues and that her spleen will shrink as a result of the meds.

Click to expand...

What do you feed Sadie? That could be a factor in the anemia diagnosis. Dogs eating raw diets typically are slightly anemic, but that is not a problem.

I don't think the CKCS platelet syndrome would be involved here.

I would not cut out the spleen unless as a last resort. The spleen is important to a well-functioning immune system. I don't know whether there is a correlation between the anemia and the spleen.

Antibiotics and steroids (like prednisone) are two/thirds of what most mentally lazy vets seem to have in their bag of tricks. The third item is Science Diet dog food. Whether the antibiotics and/or pred will work depends upon what is causing the spleen problem. It sounds like the vet does not know and is guessing. I recommend going to a specialist, like Pat recommends.

If Sadie was my dog, I would take her to a well-qualified holistic vet, but that's just me, plus the fact that here in Central Florida, we have such a vet, who specializes in successfully treating cancer. Ironically, he often has said that he wishes the owners had brought their dogs to him before their spleens were removed.