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Low Platelet Counts - Can my dog die from it?
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An_220781 posted:
I have a Cavalier King Charles Spaniel whose platelet count was tested at 249 K/ul in February and March of 2010. In April of 2010 he was running a fever of 104.3 and WBC count was a little high at 19920 ul and not eating or drinking and began vomitting, so he was put on an antibiotic and given IV fluids for several days. His platelet count was 15 K/ul on April 30, 2010, was manually counted and was 20 K/ul and then retested on 5/3/10 where it was again manually counted at 15 to 20 K/ul and WBC was back to normal. I had 1 vet wanting to try herbs and watch closely and I got scared, so I went to another vet whom sent me emergently to the Internist whom evaluated and saw a small amount of signs on his gum of bleeding so he was placed on Prednisone and Cyclosporine.

Due to an issue with CKCS and his disappearance of symptoms on gum line and research done, we sent a blood sample to Univ. of Auburn to test for Macrothrombocytopenia which I guess is common in this breed.

My dog was tested again at vet on 5/7/10 and was at 36 K/ul to 100 K/ul and again on 5/13/10 and was at 57 K/ul to 80 K/ul after meds being lowered for 2 days on Pred. and Cyclosporine.

On 5/14/10 Genetic test returned and my dog is a Carrier of beta1tubulin mutation for macrothrombocytopenia.

How do I know what is the right thing to do about meds?
Is he in danger of bleeding out even if he has this?
Where can I go to get more information on this issue since not very many vets are aware of it?
How does the platelet counts change and why?
Is this a life threatening issue?
How do I know who to trust?

i am a big researcher and like to know as much information as possible, so I can make an informed decision but I don't know where to get information on pets, that is why i am her on this website. i searched the diagnosis and did not find any information. Can you point me in the right direction?

Thank you.
Worried Owner of Fabulous CKCS who is 4 Years Old
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An_220782 responded:
One more thing .. would you use the same lab to do testing or does it matter?
 
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AMERICAN VETERINARY MEDICAL ASSOCIATION
Bonnie Beaver, BS, DVM, MS responded:
We don't know a lot about macrothrombocytopenia because it is not a common problem and pretty much limited to the Cavalier King Charles Spaniel breed. In fact the people at Auburn are really the leaders in this problem. From what I have been able to learn, the problem is confused with all the typical causes of low platelet numbers but does not respond to typical therapies for those conditions. Platelet numbers typically range fro 50,000 to 100,000 and no medication changes that. These dogs just have larger than normal platelets but the platelets function normally and so they are in no more in danger of bleeding out than any other dog. The medication that your dog received is typically used in dogs with immunemediated thrombocytopenia, which is not related to what your dog has. As I understand itn, no medications are needed, the biggest problem is that low platelet counts are confusion to veterinarians and not actually causing something of significance to your dog.
 
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Schirm8090 replied to Bonnie Beaver, BS, DVM, MS's response:
Is it possible to have platelets at 219,000 in February and March and then drop to 15,000 after a fever and vomitting episode and it still be macrothrombocytopenia? I found out he is a Carrier for the mutation and it be a genetic issue for CKCS? How is DIC ruled out? What else can I do? I have him on Prednisone and Cyclosporine per an internist and he is getting bloated and is very tired. He is very hungry but not himself. He seems very sad and tired. Sometimes, he shows his fun side, but it is very short lived. I am very worried about him and don't know how to help him the best. I don't want to miss anything and risk losing him. I would be devastated. I also don't want to make my vet mad because I am questioning everything either. Do you have any advice on how to proceed?
 
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AMERICAN VETERINARY MEDICAL ASSOCIATION
Sandy Willis, DVM, DACVIM replied to Schirm8090's response:
Dear Schirm,

As Dr. Beaver mentioned, platelets can be large and counts, particularly machine counts, low due to these large platelets, in your CKCS. But there are no clinical signs associated with this such as fever and vomiting. And depending on how the platelets are counted, you could potentially get a count of 219,000/ul one time and 15,000/ul another time but I am worried about the fact that your dog is not feeling well.

You mentioned mediations that an internist has your dog on. Have you been to see the internist yourself? Internists are specialists in diseases such as this and working with your veterinarian and yourself, should be able to short through what is going on. There are side effects of prednisone and that is why we use other medications such as cyclosporine for immune-mediated thrombocytopenia. DIC also causes a low platelet count and is ruled-out by blood tests for coagulation. These are excellent questions that I would ask your veterinarian and you shouldn't make them mad because understanding what is going on is very important for an owner like yourself. It sounds like your dog might be suffering from some of the side effects of prednisone, so please relay these to your veterinarian.
I would talk to your veterinarian further. If a specialist has seen your dog, that is great. Some veterinarians consult with specialist's on the phone which is also a good step but the best way to get specialty care sometimes is actually to see the specialist.

Dr. Sandy
 
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Schirm8090 replied to Sandy Willis, DVM, DACVIM's response:
We have seen the specialist and have sent blood to University of Auburn and found out he is a Carrier for Macrothrombocytomenia. He is on the Prednisone and Cyclosporine as his counts were 249 in Feb and March and on April 30th went down to 15 and on 5/3 were 14 - 20 via manual count on both. He is being retested every week to see if they are going up and he is currently at 50 to 80 on manual count. I am just worried as he is still very tired and sad, although very hungry (due to Pred, I think). I am just worried and want to make sure I am doing everything I can to help him recover and make sure that we are not missing anything. Thank you for your response.
 
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Schirm8090 replied to Schirm8090's response:
Do you have any recommendations for vets in your area of WA or Labs that you recommend for CKCS that might specialize in this type of breed?
 
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BTKoby responded:
Hello...I know it has been several years but how is your dog? My dog have just been diagnosed with the same thing as he had just went thru a blood transfusion and is waiting to see if his body will reject it before he continues with medication to correct the issue. I am searching the web desperately to better understand this.


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