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Sick and listless 2 year old


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Hi everyone. A while ago, I posted about my border collie, Gloria, who had an unusual array of symptoms including migrating lameness, lethargy, wasting and an intermittent fever. I got lots of feedback from people and we looked at every possibility-but she was negative for all tick borne illnesses and fungal infections. Her blood work was always normal except for a very slight elevation in neutrophils. When I last posted, it had been decided her symptoms were consistent with polyarthritis and she went on a course of immunosuppressants (azathioprine and prednisone). She seemed to improve, then the symptoms returned and with a vengeance. At the suggestion of a third vet, we took her off the drugs and she she was mildly anemic and had low WBCs from the immunosuppressants. After a few weeks, she seemed to improve then relapsed again with a 105.8 degree fever and severely swollen tonsils and lymph nodes. Biopsies were performed, all seemed to indicate an infection but nothing cancerous. Then the cycle repeated and she had a bone marrow biopsy. Just prior to the biopsy, her hematocrit dropped dangerously low and to save her life, she had a transfusion. The biopsy showed very low RBC and platelet precursors and a lot of granulocyte precursors and neutrophils. The thought was that this was an unusual presentation of azathioprine induced bone marrow suppression or that she had an auto-immune disease that was attacking her myeloid precursors specifically in the erythrocyte and megakaryocyte lineage. She did well after the transfusion until about 4 weeks out, when her hematocrit dropped again. WBCs were fully recovered by this point. She received another transfusion and the hope was that her bone marrow was going to recover. All analyses thus far had not been consistent with leukemia. No elevated WBCs, except a slight elevation in neutrophils again. Then, Friday, a second bone marrow biopsy showed that her RBCs were making no recovery and she now has unusual cells present that appear to be cancerous myeloid stem cells with neutrophilic characteristics. It is still not a typical presentation of leukemia but the diagnosis this time is very ominous. She is transfusion dependent and there is no treatment for this type of aggressive leukemia. This is a sad story. I hope that anyone who has a sick dog and goes to many vets with none of them able to find an answer reads this. Her symptoms were consistent with what people with leukemia often complain about before anything is evident in their blood work...bone pain and fatigue. I don't know that anything could have been done had the diagnosis been made last year when the symptoms started, but her bone marrow is now too far gone. We are keeping her comfortable.

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  • 2 weeks later...

Gloria passed away last night. She had an opportunistic infection as a result of the leukemia. Antibiotics weren't enough. Her bone marrow never recovered and she had not enough red blood cells to give her strength or white blood cells to fight it off. Thanks to all for your thoughts. I guess I am fortunate to have lived this long and never before seen cancer take an animal-human or canine.

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I was out of town when you updated on Gloria and missed it. I am sorry now to read of her passing. I hope you will cherish your memories of her and know you did the best you could to help her right up to the end. Godspeed Gloria.

 

J.

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