Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.
Has your vet told you if her recent blood test showed reticulocytes?
Did they call it a regenerative anemia?
Has your dog had any episodes of bleeding?
Did the vet mention if she is rupturing her red blood cells (or if her serum is yellow)?
Not mentioned reticulocytes,
He thought it maybe her immune system acting the red blood cells and put her on steriods last Friday todate her blood count has not changed.
She has small intermittant bleeding on stools and in urine
no yellow marks
Once more question since you note blood loss in both urine and feces, is there any chance at all, that your dog has been exposed to rat bait?
Possible she may have had the opportunity but not for a least 4-6 weeks, she has nver vomited.
Thank you again,
First, I would note that rat bait will not make dogs vomit. The problem with these poisons is that they block the poisoned animal's ability to clot their blood. And it is worth noting that they do not cause visible effects until weeks after ingestion (since it takes time for the dog to use up all its clotting factors already in circulation before the poison's effects at stopping clotting factor production to become apparent). Therefore, if there is any remote possibility of exposure to rat poison (even weeks ago), then it'd be worth speaking to her vet about checking clotting factors at this point. If the clotting factors are low and she has delayed bleeding times, then they may need to treat her with Vitamin K.
Furthermore, while I do not like to mention it, we do have to consider that we can see anemia and clotting issues related to tumors (this is known as paraneoplastic syndrome). Therefore, if her her anemia worsens (suggesting a tumor bleed), her platelets are low and the clotting factors come back off, then you vet and yourself may have to rule out a lurking tumor behind these signs.
Now the reason for my original questions is because we can see different types of anemia in the dog. The ability to regenerate with these various types will depend heavily on which type of anemia is present. Furthermore, our treatment approach also depends on what kind of anemia is affecting a patient.
In regards ***** ***** question about regeneration, this completely depends on the presence of reticulocytes. (so if the vet didn’t note any, do ask!) It has nothing to do with the hematocrit (20%) of the blood. These are the early stage red blood cells that are pushed into circulation early when the body is trying to quickly get its red blood cell levels back up. So, they are a sign of regeneration. That said, do know that they can be a wee bit slow to appear and may not be visible in the blood until 3-5 days after the event that caused the anemia. So, even if they are not seen today, you do want to keep an eye out for them in her blood smear test.
Further to this, in regards ***** ***** question about blood transfusions. Please know that blood transfusions are not a cure for any anemia. Instead, they just buy time when dogs don’t have enough red blood cells to support themselves. The transfusion blood cells don’t last very long, but we use them as a means of holding patients stable while we try to treat the underlying cause triggering anemia. So, if your dog’s values were to continue to drop, then this would be indicated. But if she is holding steady just now (despite the urinary and fecal blood loss), then we’d want to keep that transfusion on hold for the moment in case we need it at a later point. Because while I appreciate you'd want her to be increasing her blood level, a lack of further decline is just as important.
So, in this case, the first step is to speak to your vet to see if her blood sample had reticulocytes. If they are present, this means that the body is fighting this and the anemia is regenerative. From there, we need to consider why she has blood in her urine and feces. If these are coincidental infections, then they need to be treated. But I would be concerned that these may be a hint of clotting issues. Therefore, it is worth speaking to your vet about potentially checking a clotting profile. If it comes back abnormal and rat bait is a concern, then Vitamin K should be started. If there is any concern about tumors, (based off your dog's age and vet's exam), then this needs to be diagnosed. While doing this, we'd want to keep an eye on that hematocrit and keep an eye out for reticulocytes. And while I appreciate you had hoped for her hematocrit to have increased, remember at this point stability is just as important. So, as long as we are not dropping, then a transfusion isn't necessary but if she does drop then it may be a good treatment option to keep her steady while your vet and yourself pinpoint and address the cause for her anemia.
I hope this information is helpful.
If you need any additional information, do not hesitate to ask!
All the best,
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