CKD? Low WBC? Everything else (-:

[Buffy & Trixie's Mom]

I took Buffy (7 year old Collie Mix, N.) for a canine flu shot in late July when it was prevalent in Greater Cincinnati.

That night he became ill and I presented back to the vet. I asked that we do testing to make sure that was all it was --as I was having a road closure the next day which would last days.

Buffy's WBC count -- ordinarily low -- was 1700. The vet asked me to get it retested. I did. I had top present to another vet closer to where I live (same road problem). This vet used IDEXX. IDEXX scored Buffy as a "16" on their new SDMA test.

Spec. gravity of the urine was 1.056 -- normal! No other problems. BUN & Creatinine were within normal limits. Buffy was a little dehydrated when both tests were administered. He had diarrhea for several days.

Vet said that he was convinced Buffy had early CKD. I started a Hils KD diet.

In late September, I had him retested at his regular vet's office. I asked for IDEXX. This time he was normal -- 14. IDEXX still considers 14 problematic, but it is normal.

I had been feeding Buffy a bowl of Hils KD diet in the a.m. and a half can of Purina in the pm. Liberal treats -- IAMS and Alpo Snaps.

But his WBC remain low. The recheck in late July was 3000, but down to 2370 last week. Vet is not concerned. This has been going on for a few years now. So I am not concerned about cancer. Buffy had a normal WBC count (6000) in 2012 . After a rabies shot in 2012, it started going down. Stayed in the 3000s ever since. Except this year -- he had the rabies booster in August and so in September, 2370. Repeating here -- vet is not concerned. But I am his mom and I AM. Vet is smarter them I am (-:

Has anyone ever heard of an up and down low WBC count in an adult Collie, otherwise healthy. He is great!! Happy, active. great appetite. Normal water intake.

Just being on this forum (FluffyBuffy had Cushings and passed away in February 2012 at ten years -- longest living dog I had.) and seeing familiar names gives me comfort.

SmartBuffy's Mom.

[Squirt's Mom]

Hopefully some of our members have some knowledge and experience to share with you! It is odd to this layperson that the WBC go down after rabies shots....I associate those cells with infection, not disease. Interesting.

Based on his behavior you describe - good energy and appetite, active, normal water intake - it doesn't sound as if there is anything critical going on at the moment. But we also know how stoic our babies can be! You are doing a great job in checking things and seeing how his insides are doing so I feel sure if something should crop up, you will catch it quickly. Does the CKD diet seem to be helping that much or are they now thinking that may have been misdiagnosed?

[Buffy & Trixie's Mom]

Because he "passed" the new SDMA test -- with 14 instead of his failing grade of 16, he is off the kidney diet.

I had been feeding him the kidney diet since he failed the initial test in late July. Our regular veterinarian said the test was too new to place so much credence in it. Most vets would recommend a kidney diet with a higher BUN and creatinen than Buffy had -- his were normal. Having said that -- by feeding him the kidney diet (he would get 1/2 cup od dry kidney in the morning and a half can of regular Pedigree in the afternoon -- with liberal Alpo Snaps and IAMS bicuits -- so not a strict kidney diet) I might have skewed the test results in his favor this time just as the diarrhea skewed them against him the first time (-:

It will be wait and see, I guess.

WBC can be altered by vaccines, our vet told me. He stresses he is not worried. I asked official (from the county Bd of Health) to delay the rabies shot or not give it to Buffy at all and was given permission.....but.....(Buffy doesn't bite (-: He doesn't even growl (-: ) but it is better to follow the law, I believe. Police officer's widow here (-:

Do unto others.

Thank you! Buffy's Mommie:

[Harley PoMMom]

Hi and a belated welcome to you and Buffy!

I had a pomeranian, Harley, and he was diagnosed with kidney disease. Usually 50% or more of kidney function is lost before the creatinine shows elevation. Was Albumin or protein found in Buffy's urine (microalbuminuria)? If protein loss was noted in her urine sample was an UPC done? Has an ultrasound ever been done to visualize the kidneys?

Hugs, Lori

[StarDeb55]

Welcome to you & Buffy! I want to let you know up front that I'm a medical lab technologist with 30+ years experience, specifically in hematology. I will say that WBC & RBC are some of my favorite things. i do have a couple of questions for you. It sounds like you have kept choppiest Buffy's lab work. If you have it, I would like to see the results of the last 2, preferably the last 3 CBC,(complete blood count). If you could post the RBC count, hemoglobin, hematocrit, & platelet count, along with the WBC counts that would be very helpful. I would also like for you to include the normal ranges for all these parameters.

I'm looking for trends in all of these values, especially the RBC parameters to see if Buffy has anemia, even if its only mild. I'm not around in the group as much as I used to be, so please bear with me. I will be looking for these results.

Debbie

[Buffy & Trixie's Mom]

Hi and THANK YOU!!!!!

Please let me type these up and post them. Unless.....I think the ones from this year are still in my in-box....so I could try to cut and paste to onto the Everything Else spot or I could e-mail to you and then I would only have to type "what I have" from earlier tests. Those are or were never sent to me electronically. Thank you for reminding me of the ref ranges. Different labs were involved over the last three years. I won't foist all of them on you. The one where he was normal (6000) and the most recent with one or two in-between?

It is important, I think, to look at the normal WBC count from a few years ago, when it started going down from 6000 to what it is today.

So -- I will try a few ways to get this onto the Everything Else spot here.

If I succeed today, you will have it here whenever you come back. If not, I am working on it (-:

I am my dog's only mother (-: and thank you!!!

[Buffy & Trixie's Mom]

To Harley PomMom:

Buffy's last urinalysis was run through IDEXX.

Specific gravity 1.044
glucose: neg
Bilirubin 1+
Keytones: neg
blood: Neg
PH: 6.5
ketones: neg
protein: neg
WBC 30-50 (this was a cystocentesis. Vet thought that was the reason for this. The repeat next week showed the WBC were within limits. I was able to get my first catch of urine (-: that morning.
RBC none shown
Bacteria none seen
epi cell 3+
Mucus present
casts -- none seen
crystals -- none seen
0ther: non-crystalline debris present
Urobilinogen: normal

Buffy "failed" the new idexx SDMA test in late July. Scored a 16, when 14 was high normal.

This was repeated same day as the urinalysis and this time he passed with a 14 (again, high normal.)

In his blood:
BUN: 13
Creatinine: 1.0
BUN/Creatinine ratio: 13.0

Now my question to anyone: Seems the cystocentesis was pretty grueling on my boy? All those WBC? I am not good at collecting....advice? Was this one on the vet? Can this be done more easily on male dogs?

[Buffy & Trixie's Mom]

As requested. Thank you Deb for asking.

Date: July 16, 2012 (Fairly certain that Buffy presented on this date with usual summer diarrhea.)
WBC: 6000 the normal values for this:6.0-17.0
RBC: 6.22 5.50-8.50
HGB: 14.9 12.0 – 18.0
HCT% 39.6 37.0 – 55.0
PLT: 249 180-500
RDW%: 51.2 (a) 12.0-16.0 (note is made: A=35-53

BUN 20 12-25 (consistent w/diarrhea??)
No creatinine given

On this date he also was given corona, Parvo, & distemper.


Date: May 16, 2013 (On this date, Buffy presented for his yearly dental. On January 8, 2013, Buffy was given rabies booster)

WBC 3600 the normal values for this:6.0-17.0
RBC 7.26 5.50-8.50
HGB 17.5 12.0 – 18.0
HCT% 46.2 37.0 – 55.0
PLT 227 180-500
RDW 54.4 (a) 12.0-16.0 (a=35-53)

BUN 12 12-25 (consistent w/healthy dog?)
No creatinine given



Date: September 4, 2014. Buffy presented with usual “summer diarrhea.” He has gotten this ever since we started walking almost daily in the warm weather in our new neighborhood. Moved here in October 2011, after husband died. Prior to that, lived about a mile away. For summer diarrhea he ONLY responds to a combination of Metronidazole and Amoxicillin. Twice, his veterinarian also prescribed Panacur. I guess because the fecal came back negative?

WBC 3300 the normal values:6.0-17.0
RBC 6.67 5.50-8.50
HGB 16.5 12.0 – 18.0
HCT% 45.0 37.0 – 55.0
PLT 232 180-500
RDWa 52.9 35.0-53.0
BUN: 26 12-25
Creat: 1.0 0.5-1.5
Under comments on this date: 3+hemo


Date: May 11, 2015. Buffy presented today for his yearly dental.

WBC: 3850 the normal values: 6.0-17.0
RBC: 5.38 5.50-8.50
HGB:13.8 12.0 – 18.0
HCT% 37.7 37.0 – 55.0
PLT: 160 180-500
RDWa 13.3 35.0-53.0
BUN: 15 12-25
No creatinine given

Date July 24, 2015 (about midnight). Buffy presented after having a reaction (minimal vomiting and mild diarrhea) to the H3N3 about 12 earlier on this day. IT IS ENTIRELY POSSIBLE that the reaction wasn’t to the vaccine at all, but his usual summer diarrhea. On this date he was x-rayed (my request) because they gave him a shot to keep him from vomiting and this was protocol. Showed no problems – also showed two normal-sized kidneys. He was given the above-mentioned meds for summer diarrhea. And the following bloodwork:

WBC: 1810 the normal values: 6.0-17.0
RBC: 5.78 5.50-8.50
HGB: 15.1 12.0 – 18.0
HCT% 39.3 37.0 – 55.0
PLT: 155 180-500
RDWa 18.8 35.0-53.0
BUN: 18 12-25
Creat: 1.3 0.5-1.5

The following lab reports are in chronological order and from different laboratories. Ref ranges will be given.

Date: 5-21-2013. IDEXX.

WBC: 4.0 Normal value: 4.0-15.5
RBC: 7.1 4.8-9.3
HGB: 17.1 12.1-20.3
HCT: 49 36-60%
Platelet Count was 220. Normal: 170-400

NEUTROPHILS: 2000 Normal: 2060-10600
The other bands were normal, with eosinophils the lowest, 120 when normal is 0-1200

On the Superchem report:

BUN: 17 Normal is 6-31
Creat: 1.2 0.5-1.6
BUN-Creat ratio: 14 normal is 4-27

Date: 7-30-2015. Buffy presented for a recheck of his low WBC at Grady after his vaccination. This was a different veterinarian. He sent the report to IDEXX. IDEXX has changed its normal values. Buffy was still having a slight diarrhea at this time.


WBC: 3.5 4.9-17.6
RBC: 7.23 5.39-8.7
HGB: 17.2 13.4-20.7
HCT: 49.9 38.3-56.5%
Platlt: 198 143-448
Neutrophils: 1.82 Normal is 2.94-12.67
Lymphocytes: 0.91 1.06-4.95
Basophils 0 Normal is 0-0.l

Remarks: Slide reviewed microscopically. No parasites seen. Reactive Lymphocytes present.

BUN: 19 Normal: 9-31
Creat: 1.3 0.5--1.5

SDMA 16 0-14 is normal. Indicating early CKD, HOWEVER – he presented again for this test with his regular vet and he earned a high-normal score of 14.


Date: August 13, 2015. Recheck of WBC. NTECH labs. Regular vet. Presented because I was unhappy with failed IDEXX test. Buffy was given a rabies shot the following week BECAUSE WE HAD A DECENT WBC COUNT.

WBC: 3.0 Normal is: 4.0-15.5
RBC: 7.0 Normal is 4.8-9.3
HGB: 16.3 12.1-20.3
HCT: 48 36-60
Platelet count: 188 170-400
NEUTROPHILS 1410 – Normal is 2060-10600

Other bands are indicated as normal.


Date: October 6, 2015. Buffy presented today because I wanted to retest the SDMA and also get a recheck of the WBC. He also had a urinalysis this date. IDEXX.

WBC 2.37 (remember, rabies in mid-August.) Normal is 6.0-17.00
Neu 0.95 low 3.62-12.30
Neu% 40.1% 52.0-81.0
LYM%: 44.7% 12.0-33.0
RBC 5.96 5.10-8.50
HGB 15.1 11.0-19.0
HCT: 41.2 33.0-56.0
PLT: 196 117-490

IF IT MATTERS – THE URINALYSIS WAS DONE FiRST. The vet tech did a cysto. Buffy’s urine had 30-50 WBC and the reference for this is: 0-5 HPF. I was able to get my first catch a week later and there was no evidence of infection, so said the vet. The second urinalysis was done in-house and there was absolutely no comparison to the IDEXX. Very little detail. I was ticked!!!!! Same price!!!!!


Buffy’s spec gravity has been 1.056 in late July. 1.044 IDEXX in October and 1.044 In-House lab.

In House Lab on 10-8-2015.

Under cytology: epith cells 0.1
WBC 0-3

[Buffy & Trixie's Mom]

I approached a local Board of Health supervisor and asked permission from him to exempt Buffy from having to get his rabies booster this year due to his low WBC count. The supervisor was very congenial and explained that I could do so, but gave me tips on keeping Buffy close to home, etc. It is a code in parts of Ohio which says we must get our dogs vaccinated against rabies. Not a law.

I decided to get Buffy vaccinated after his vet said it was OK. The WBC count was low but his vet assured me it would be fine.

Buffy was vaccinated. A few weeks later, retested for WBC and they were 2370!!! Vet was not worried. Normal is around 6000-7000.

The county Board of Health supervisor forwarded me this article: This article explains why Buffy might have a genetic predisposition to low WBC when he receives vaccinations:

"Vaccination Protocols for Dogs Predisposed to Vaccine Reactions."

http://www.dogs4dogs.com/JR_Articles/Breeds%20at%20Vaccine%20Risk.htm

Right before Buffy became ill after receiving the vaccine for the canine flu, I swabbed the inside of his cheek and sent away two DNA samples.

Although he looks very Collie, what we can't see is that little smidgen of him which is Old English Sheepdog -- one of the predisposed breeds.


Also my Cushing's girls were part Brittany, but they were also part Shetland Sheepdog -- another predisposed breed. Both girls had at least one anaphylactic reaction from the Lepto vaccine. And Trixie developed a bump which had to be surgically removed and biopsied from a vaccine...I forget which one. Fortunately she was OK.

So maybe this is an answer to Buffy's mysterious WBC count.

Wish I could get it back up to normal!

[Squirt's Mom]

I wish I understood enough about those test results to offer some input but I am ignorant on all of this. Hopefully someone with knowledge and experience will be along soon tho.

[Buffy & Trixie's Mom]

Hi Deb. Thank you for offering to look at Buffy's WBC count.

I can tell that he is not anemic.

I am happy that I typed it up, because I can show it to his vet the next time we see him.

You did say you didn't get back here often, so I will cut you some slack here, and tell you that I would be fine if you just disregarded. Anemia is not his problem.

Thank you again for offering and it motivated me to compile all of these blood counts -- a useful tool to have. Thank you for that! (-:

Thank you and take care. Buffy

[Buffy & Trixie's Mom]

Buffy presented for a repeat SDMA test, complete blood panel and CBC. He passed the SDMA this time with a 13!!! (14 is normal, below 14 is better!) But his WBC count was 2.5. He never rebounded from the rabies shot in August.

I am going to ask for a bone marrow biopsy. His vet will call me tomorrow. I am not concerned about a blood cancer, but now that we are tittering him for parvo and distemper -- if I don't get him the bordatello he shouldn't go to PetsMart with me, which he loves to do.

When he turns 10 he will be due another rabies. If I get it, it could suppress his WBC even further. If I don't get the rabies vaccine for him, I am not breaking the law in OH, but violating a code. No one will groom him or board him and I don't blame them.

If anyone has any other ideas.....thanks. His mother

Anyone know what a bone marrow biopsy in a 41 lb dog might cost?

His vet's staff did not have it in their data base.

[Harley PoMMom]

So glad to see that Buffy passed the kidney test...YAAA!!! But sorry that his WBC is low, tick-borne diseases were ruled out, right?

Hugs, Lori

[Buffy & Trixie's Mom]

Thank you for your response (-:

Doggone if someone on another blog didn't just suggest he be tested for ehrlichia. She said especially if Buffy came from the south. He did, but not really. He came from Estill County, KY and that is south of Cincinnati, but not what I consider "south" south (-:

I am reading the article about erlichia now. I don't see much which suggests a really low WBC count. Mostly platelet loss. Buffy has had a little of that, too.

My vet didn't even answer my bone marrow biopsy question nor did he acknowledge my list of Buffy's blood tests coordinated with vaccines (abbreviated from the post here, eliminated all of the urine stuff) . Unrequited love with that vet of 25 years. I should cut him slack. Maybe he didn't have a ready response at his fingertips and will get back to me over the weekend. It is better to give benefit of the doubt.

I bet they (vet staff) roll their eyeballs in the back of their heads when I e-mail him something. Or call. Or show up, even.

But I am a Collie-mom.

People on this Cushing's Forum and then today on another dog forum are way out in front with suggestions and information. Let's applaud us. Hooray for us. We rock.

KA & Buffy

[Buffy & Trixie's Mom]

This lady suggests now that I urge a vet to test him for ehrlichia and get a 4Dx test. The vet tech said if he doesn't have a tic, don't test. I think I need to listen to my new friend on the other dog blog. I have a consult with the "vet around the corner" (not the one I have been going to) for Monday, December 14. 9:40.

[Buffy & Trixie's Mom]

Buffy presented to an internist yesterday,. His abdominal U/S and chest x-ray were fine and dandy. Hooray!!!! We are now awaiting the Infectious Disease Testing; Intestinal/Pancreatic Panel and Surface Anti-neutrophil Antibody Test.

All agree Buffy is a most interesting case.

What we all want is a dog with an interesting case (-:

The remedy for a positive Intestinal and Pancreatic test would be a biopsy of his intestines. Maybe just an inflammation, but of course there is always the possibility of cancer. A positive anti-neutrophil test would be to get my guy on prednisone! I might rather just forgo vaccines for a year (he is current on his rabies) and see if the WBC come back on their own.

Titering is a possibility -- I am trying to find a vet who will use the new Vaccicheck or TiterCHEK which checks for life. Who could afford all those titers every year plus the rabies every three plus all the other things which it looks I will do for him.

So far, I can't find such a vet. Keep on looking.

Yesterdays visit was worth every penny. It was over $1500. But what they have to do there is wade thru all the stuff my vets office sent him, do diagnostics so that they can figure out a plan. Write it all up. I wondered the wisdom of the US but in the end said, "sure. fine." I was there, so might as well have it all done instead of coming back.

http://www.dogsnaturallymagazine.com/an-inexpensive-tool-to-reduce-pet-vaccinations/

That is the tittering article.

I need to get back to my writing instead of googling everything and taking IDEXX webinars to keep up with this. But I will probably keep googling and webinar-ing right through Christmas.

Wish us luck!

No dog can go forever with a 2500 WBC count, so I had to do something instead of being Don Quixote!

Thank you all for your support.

Buffy's Mom

[Harley PoMMom]

Wishing you and Buffy the best of luck, please do come back and update us. ;)

Hugs, Lori