Foxy - Traci, I need your help

[Traci]

Karen, how's Foxy? Any news?

[k9Karen]

Very good, but confusing, news. No mass. The surgeon says she looked for and felt for one, and even cut into the cervix looking for it, but nothing. She's unsure what was showing on the ultrasound (they found the same thing there that the original vet found). She says it could have been a 'shadow'. She is convinced the bleeding is vaginal - possibly a varicose vein, but was unable to find it. So, we still don't know the exact cause of her bleeding. She also had a mammary tumor they were concerned about and it turned out to be an inflamed lipoma. She said they often get infected. so she removed it during the surgery. She said it 'smelled real bad', so I guess it was on it's way to being or already was infected. Her PCV was down to 17 after surgery and they thought they might have to transfuse her, but it was up to 20 today, and they decided a transfusion wasn't needed. That seems awfully low to me though. Her bleeding is down to 'a couple of drops', so hopefully it's on the mend.

She is recovering with no problems. If all continues to go well, they think I should be able to bring her home tomorrow. At that point, I will need to manage her kidney issue and she also has a heart murmur - they did an echocardiogram and the left side of her heart is slightly enlarged and the valve is 'leaking' slightly. I guess that means she shouldn't take up jogging!

[k9Karen]

By the way is there a difference in PCV (packed cell volume) and hematocrit? I thought they were the same thing, but a coworker of mine thinks there is a difference - either in what they are exactly, or in they way they are calculated. In human medicine, the hematocrit is often calculated, which is different from a spun hematocrit, or PCV, but maybe the instruments used in veterinary medicine aren't the same as those to which I'm familiar.

[Traci]

You are right, hematocrit and PCV are the same. Your co-worker might be thinking of the "method" being different: centrifuging vs calculating (the latter with an auto instrument, then calculated). It depends on the preference which method to use, but the vet should try to only use one with a critical patient so it remains accurate and consistent. There are different reasons for using the two methods and depending on how soon, how often, minimal margin of error etc it is needed to test.

Foxy's PCV is low, but your vet might be thinking as long as it is elevating on it's own, and taking a rather invasive surgery into account, he may want to see if the PCV will normalize in another 24 or so hours. Transfusions are not fun, they can be complicated, so if they can be avoided providing the patient is recovering and labs look good on a consistent basis, and there is constant monitoring in place, they aren't always necessary.

I sure wish there was an explanation for the bleeding, but it's also possible that it was stress-caused. The good news is no mass or other abnormalities there!!

When you've had a chance to de-stress and Foxy recovers and has her surgery recheck appt, ask your vet how often he wants to check her heart function. (I'm assuming the surgeon and your vet will have some communication) - You'll want to be careful treating the renal issues when there is a heart issue as well (fluid therapy for example), you'll want to go over all this with your vet, ok?

Hang in there, it would be great to get her home tomorrow, but play it by ear because you want that PCV to be rather normal before bringing her home.

[k9Karen]

Sorry I'm late letting you know - I brought her home Thursday evening and so far she is doing well. Moving a bit slowly, but I don't blame her! Her incision looks wonderful - it's not even pink. She appears to be healing without any issues. No issues with urination or defecation. They gave me several days of clavimox to give her. The entire uterine stump was removed, and I really think the cause of her bleeding must have been there - not a drop of blood since I brought her home and they told me it pretty much stopped after the surgery. I don't think they sent it off for pathology since no cancer was suspected. In a human it would have been, but not necessarily in animals. I have to take her back next week for a recheck and we'll see where we need to go from there.

[Traci]

Thanks for the update, I'm glad to hear she is recovering nicely.

Normally, anything suspicious-looking at all is always sent for pathology, but if no mass were present, it may not have been necessary.

[k9Karen]

I apologize for not posting earlier. I posted on Face Book and just realized I never entered anything here. Foxy's surgery found nothing at all. What remained of her cevix was removed. No mass. That's the good news. The surgeon thinks she might have the equivalent of a varicose vein the her vagina that was causing the bleeding. She's been home for several weeks now, and all is OK - no bleeding at all, so I'm hoping the problem was in the cervix, not the vagina, and was removed with the surgery. She is doing very well, and I'm working to try to put some weight back on her - she was so skinny when she came home, it was downright scary. She's back to her old self and is barking at nothing (which is what shelties do so well). She has a spring to her walk and she's asking for lots of love. Hoping for the best and a few more years with my girl!

[Traci]

What a relief to hear such great news!

I'm wondering if the bleeding was some sort of fluke, in that it may have only been a minimal thing but in fact, alerted you to her renal values and checking more closely in the reproductive tract (what's left of). The good news is that it disappeared, nothing was found in surgery (that's always good news) and she is recovering nicely.

Do, however, talk to your vet about monitoring her heart health.