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David Corriea
New Member
Username: davidc
Post Number: 1
Registered: 11-2008
| | Posted on Monday, Nov 3, 2008 - 7:07 pm: |   |
Early this year in around march or Feb I noticed one of my mules was losing weight. I took her to the vet. She was tested for parasites and had a complete blood work up. I've been told that its probably a bone marrow problem in which nothing can be done. This mule still looks fairly healthy but has no energy. She was so anemic at the time that my vet couldn't believe she was on her feet. I just wanted to run these tests by someone else to see what they thought. This mule still eats normally and maintains her pecking order in a corral of six. I wonder if i should put her down or not. I wonder if there is any hope of her getting better. I am going to try to upload these blood tests}}}Well it wouldn't let me upload the tests. I guess the files were to big. I just joined this site so I'm not sure how everything works. Is there any way i can e-mail these files or something like that. |
Sara Miller
Member
Username: sdms
Post Number: 232
Registered: 4-2006
| | Posted on Monday, Nov 3, 2008 - 8:01 pm: | |
Hi David. In what format is your test results file? You're welcome to e-mail it to me (my e-mail is in my profile) and I can try to change the size and/or upload it for you.
I guess other than Dr. O's opinion of the test results you should look at your molly's quality of life. It sounds like you've been dealing with this for a while. Does she appear to be suffering? Most animals will let us know when they're ready to say goodbye. We just have to be willing to see it and make that tough decision. Once you know you've done everything you can it makes the decision easier.
~Sara |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 21663
Registered: 1-1997
| | Posted on Tuesday, Nov 4, 2008 - 7:26 am: | |
Welcome David,
Check the file size and if it is bigger than 64k it will not upload. Next double check that you know the files location on your computer. Once you know these two things just hit the Upload Attachment button below and follow the instructions. If the file is bigger than 64k you will need to carefully transcribe the results into a post or take Sara up on her very kind offer. Be sure to include the units and normal ranges.
DrO |
David Corriea
New Member
Username: davidc
Post Number: 2
Registered: 11-2008
| | Posted on Tuesday, Nov 4, 2008 - 11:41 am: | |
Thank you Sara for your reply and offer. Maybe the simplest way is to just type all this out. Maggie does not seem to be suffering in any way. She eats good and gets around fine. Just no energy. If you were to look at her in the corral she you might notice she was a little thin. Other than that she looks and acts fine. Thank you again David |
David Corriea
New Member
Username: davidc
Post Number: 3
Registered: 11-2008
| | Posted on Tuesday, Nov 4, 2008 - 12:32 pm: | |
O K Dr.Oglesby Here is the work up.
ALK Phosphatase 63 (L) (7-3-327)
AST (SGOT) 420 (H) (168-408)
CK 318 (110-700)
GGT 27 (5-35)
Albumin 2.9 (2.6-4.2)
Total Protien 7.0 (5.4-7.6)
Globulin 4.1 (1.8-4.3)
Total Bilirubin 1.4 (1.9-3.7
Direct Bilirubin 1.4 (0.0-1.3)
Bun 10 (10-27)
Creatinine 0.9 (0.8-2.2)
Cholesterol 126 (49-150)
-Glucose 95 (75-115)
Calcium 11.1 (10.5-12.8)
Phosphorus 1.6 (1.4-5.6)_
TC02 (Bicarbonate)16 (25-34
Chloride 96 (96-105)
Potassium 4.1 (3.0-5.3)
sodium 127 (130-140)
A/G ratio 0.7 (0.8-1.9)
B/C ratio 11.1
Indirect Bilirubin 0.0 (0-3.0)
NA/K 31 (
Hemolysts Index N
Index of N,+;++ exhibits no significant effect on chemistry values
lipemia index N
Index of n,+;== exhibits no significant on chemistry values
Page two
Anion Gap 19 (9-16)
CBC comprehensive
WBC 2.3 (4.6-11.4
RBC 0.97 (6.5-12.5)
HGB 3.1 (11-19)
HCT 8.0 (32-52)
MVC 88 (34-58)
MCH 33.6 (12.3-19.7)
MCHC 38.3 (31-37)
Neutdrophil Seg 15 (30-65)
Lymphocytes 83 (25-70)
Monocytes 2 (1-7)
Eosinophil 0 (0-11)
Basophil 0 (0-11)
Auto Platelet 66 (100-350)
Platelet comments Scanning of the blood smear revealed adequate platelet numbers. Due to clumping and or large platelets the automated platelet number cannot be accurately determined.
Platelet count reflects minimum balue
remarks
slide reviewed microscopically.
Blood count verified by repeat analysis.
Absolute neutrophil seg 345 (2260-8580)
Absolute Lymphocyte 1909 (1500-7700)
Absolute Monocyte 46 (0-1000)
Absolute Eosinophil 0 (0-1000)
Absolute Basophil 0 (0-290)
fIBRINOGEN 200 (100-400)
Ehrlichia Equi-Equine No anti body present@ 150
Anaplasma phagocytophilum was formerly called Ehrlichia aqu1. Positive samples are tested in incremental dilutions to 1:3200, tuters beyond 1:3200 are usually of limited clinical value. If you wish and endpoint titer there is an additional charge. A positive titer indicates exposure to E. equ1 or similar antigen but does not comfirm the presence of disease. a CBC is recommended to identify abmormalities consistent with ingedtion. If confirmation of ingection is desired. Ehrilichia (Anaplasma) PCR test. code 1697 can be useful especially in clinically sick animals. |
Vicki Zaneis
Member
Username: vickiann
Post Number: 781
Registered: 3-2005
| | Posted on Tuesday, Nov 4, 2008 - 12:53 pm: | |
David, I have a horse who was extremely anemic and lethargic. He was also very ill. So far no firm diagnosis has been made, however, he seems to have recovered from the anemia and extreme weakness following treatment with Red Cell (used one jug over a period of weeks and have now stopped it) and two different rounds of antibiotics. It can be extremely difficult, from what I understand, to have Ehrlichia show up positive even when it is, and my Veterinarian did treat for that early in the course of treatment in spite of negative tests. It was not expensive to do any of these treatments, and of course, it remains to see be seen if the "cure" will continue long term. My Veterinarian was amazed at how quickly the blood rebounded from being low (and even "thin looking.") We plan to re-check the blood work later this month. Hope that things improve for your boy. |
David Corriea
New Member
Username: davidc
Post Number: 4
Registered: 11-2008
| | Posted on Tuesday, Nov 4, 2008 - 2:20 pm: | |
Vicki Thank you for the input. I forgot to mention that in the beginning I did treat with 1 or 2 ounces of Red cell I think twice a day. Also an injection of I think vitamin K every 3 days. After 3 weeks there was no improvement. Since then there has been no treatment as my vet felt there was nothing that could be done Thanks |
Vicki Zaneis
Member
Username: vickiann
Post Number: 782
Registered: 3-2005
| | Posted on Tuesday, Nov 4, 2008 - 6:30 pm: | |
Sorry to hear that this did not work, David. It is so perplexing when answers are difficult to come by. |
David Corriea
New Member
Username: davidc
Post Number: 5
Registered: 11-2008
| | Posted on Tuesday, Nov 4, 2008 - 8:17 pm: | |
Dr. O I just realized i Left off the units. Iwill give them now in order from the top I hope this is not to cumbersome
U/L
U/L
U/L
U/L
g/dl
g/dl
g/dl
mg/dl we are at total bilirubin
mg/dl
mg/dl
mg/dl
mg/dl
mg/dl
mg/dl
mg/dl
mEq/L
mEq/L
mEq/L
mEq/L we are at sodium
mEq/L
Thous/uL we are at wbc
Million/uL
g/dl we are atHGB
%
fl
pg
g/dl
%
%
%
%
tHOUS./UL WE ARE AT AUTO PLATELET
The last five starting with absolute neutrophil seg are
/ul
I'm sorry about messing this up, I hope you understand what i did now but if not I can type the whole thing out again |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 21667
Registered: 1-1997
| | Posted on Wednesday, Nov 5, 2008 - 7:24 am: | |
David, your horse is anemic to the point of a current RBC level just barely compatible with life but it is also significant that your horse is markedly leukopenic (low WBC count). Together this strongly suggests that your veterinarians assessment of a failing bone marrow is likely, as both cell lines stem from progenitor bone marrow cells. Infection is an unlikely cause of such a problem with, off the top of my head, nutrition, toxins, and neoplasia the most common cause. I will do a bit more research on this because it is unusal to see both anemia and leukopenia and may have diagnostic significance. Has your mule been treated with any medications prior to the onset of anemia or possibly exposed to known toxins? With the lack of information one of the few treatable conditions would be an autoimmune disorder of the attacking the blood cell progenitor lines so large doses of dexamethasone contemplated. However to be given much of a chance of working a transfusion should also be considered quickly.
For more on anemia and further diagnostic and therapeutic steps see Diseases of Horses » Cardiovascular, Blood, and Immune System » The Diagnosis of Anemia.
DrO |
Vicki Zaneis
Member
Username: vickiann
Post Number: 792
Registered: 3-2005
| | Posted on Wednesday, Nov 5, 2008 - 7:14 pm: | |
Sorry, David, that the tests look rather intimidating and will hope that things improve. |
David Corriea
Member
Username: davidc
Post Number: 6
Registered: 11-2008
| | Posted on Thursday, Nov 6, 2008 - 10:07 am: | |
Dr.Oglesby, Maggie wasn't under any treatment prior to the onset of Anemia. I had gotten a little careless about my worming program but her fecal sample didn't show that many parasites and of course we've wormed her since. She was given some kind of blood test for autoimmune disease which came up negative. I can't remember the name of the test but I will try to find out. I'm beginning to think this is some kind of wonder mule because this all started in late Feb. of this year. She has actually put on weight since the beginning and seems content and does not seem to be suffering in any way, just a complete lack of energy. |
David Corriea
Member
Username: davidc
Post Number: 7
Registered: 11-2008
| | Posted on Thursday, Nov 6, 2008 - 12:04 pm: | |
Dr. O the test maggie tested negative for was the Combs test. |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 21682
Registered: 1-1997
| | Posted on Friday, Nov 7, 2008 - 8:22 am: | |
The Coombs is a test for RBC antibodies. It is one of those where if positive strongly suggestive but if negative does not rule out autoimmune disorders of the blood. Since it appears the problem is with cells in the progenitor stage, rather than the mature stage, the Coombs test might NOT have been expected to show positive.
A horse with a HCT of 8 is at risk of dying at any moment. You and your veterinarian should strongly consider immune suppressive doses of dex if infectious disease is unlikely and there are no better thoughts on causes. I think it is a shot in the dark but better than no shot at all.
Is your horse on a iron rich vitamin supplement is case the disease turns around he can respond?
DrO |
Suzanne Moore
Member
Username: suzym
Post Number: 474
Registered: 9-2002
| | Posted on Sunday, Nov 23, 2008 - 8:06 pm: | |
David, this sounds almost exactly like what happened to my 23 year old Morgan gelding in 2000. You remember don't you Dr.O?
DJ had pancytopenia with counts so low the vets at Purdue couldn't believe he was still alive. He showed NO symptoms - he was fat and sassy and one would never guess anything was amiss. My vet found it by accident after running a CBC as a follow up for an infected tooth.
They tried dosing him with dex, but it didn't help. They ran every text in the book including four bone marrow biopsies looking for malignancies, but never found even one cell.
DJ astounded all the docs by living two more years, feeling just great until the last couple of weeks before he collapsed and died before my vet could even get there to do anything.
My advice, for what it's worth, is to take the best care possible of your buddy, get the vet out at the FIRST sign of an infection - immune system all but non existent - and let Maggie tell you what to do from day to day.
We never knew what caused it, but DJ had two more good years after all this was discovered. Perhaps Maggie will too.
I will be thinking about you, believe me. Take care, and keep us posted.
Suzy |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 21829
Registered: 1-1997
| | Posted on Monday, Nov 24, 2008 - 9:12 am: | |
No effect Suzy? He lived two more years. We don't know how long he would have lived without the treatment. But I know what you are saying it did not seem to change the course but realize that pancytopenia is not a disease: there are many different causes. I would hate to see this horse not make it without an attempt to treat one of the causes.
DrO |
Suzanne Moore
Member
Username: suzym
Post Number: 475
Registered: 9-2002
| | Posted on Monday, Nov 24, 2008 - 7:15 pm: | |
Oh, I agree with you completely, DrO. They should try everything. With DJ, the vets at Purdue were hoping the dex would "jump start" his bone marrow which didn't seem to be functioning at all.
The test dose seemed to help, but after a full course, we were back to square one. They didn't try dex again. They did everything they could, but they just didn't have a clue as to what was going on.
A significant difference between DJ and Maggie is the glucose level. DJ's glucose was astronomical and stayed that way. Also, DJ wasn't lethargic. He had as much energy as always.
I still wish I could have had a diagnosis, and my vet does too.
Suzy |
David Corriea
Member
Username: davidc
Post Number: 8
Registered: 11-2008
| | Posted on Monday, Nov 24, 2008 - 8:33 pm: | |
I will be seeing my vet Tuesday and will talk to him about the dex treatment. Is this something I can administer my self? I will keep you posted as to how Maggie is doing. I have got her back on an Iron rich supplement. |
