Foxy - Traci, I need your help
Foxy - Traci, I need your help
Traci, I need your expertise. I took Foxy in to the vet today because I thought she had a UTI - I noticed blood dripping after she went outside. My vet always does a suprapubic aspiration to get a urine sample, and the urine was basically normal - no blood at all. As best he can tell, the blood is coming from either the vagina or the urethra (Foxy was spayed before she was a year old, exactly when, I'm not sure - I got her as an adult). Her blood work is awful. Bun - 125, Creatinine - 3.5, lipase over 2000, but amylase normal. H&H 9.1 and 27%. PO4, Alk phos and AST also elevated. WBC normal. Platelets - slightly elevated - I don't recall the actual values. I left her at the vet for IV fluids and antibiotics and they plan to do an ultrasound to look for a tumor. Foxy isn't a youngster - I think she is 14, but I'll have to look it up to be sure. It looks like cancer is the most likely answer, but do you have any idea what could be causing the obvious blood in the vaginal/vulvar/urethral area?
"A dog is the only thing on earth that loves you more than he loves himself." ~ Josh Billings.
Anything unusual at all in the urine? (i.e., like protein etc), and was the sediment looked at closely? i.e. crystals, or kidney infection)
Did the vet say if she was dehydrated and if so, to what extent?
Don't be quick to assume cancer just yet (if at all), most of the values point to renal or GI or biliary system - (possible kidney infection, stone, renal disease, GI bacteria, inflammation, liver infection) - did the CBC show any indication of inflammation at all?
Lipase and amylase could indicate pancreatic activity but unlikely if the amylase is unaffected - we usually do not put much reliability on either test and opt instead for a specific pancreatic test by outside lab. If she isn't vomiting, painful in the abdomen, feverish, anorexic etc, unlikely pancreas involvement.
The blood in urine could be anything from infection/inflammation, crystals or stone causing inflammation/aggravation, bladder wall thickness, slight injury, mostly involving the urinary tract (or kidney). If the PCV was abnormally low, would definitely want to do ultrasound to see where there might be blood loss somewhere, but you'd generally be observing a ton more symptoms if severely anemic (weakness, lethargy, anorexia, dehydration etc)
A tumor is possible, but unfortunately, imaging is necessary to even try to detect the possibility. I'd certainly start ruling out renal disfunction or GI inflammation first. Just as a precaution, also make sure her heart function is a-ok (did she have hypertension?)
Hang in there and let us know what you're vet is doing/thinking, ok?
Did the vet say if she was dehydrated and if so, to what extent?
Don't be quick to assume cancer just yet (if at all), most of the values point to renal or GI or biliary system - (possible kidney infection, stone, renal disease, GI bacteria, inflammation, liver infection) - did the CBC show any indication of inflammation at all?
Lipase and amylase could indicate pancreatic activity but unlikely if the amylase is unaffected - we usually do not put much reliability on either test and opt instead for a specific pancreatic test by outside lab. If she isn't vomiting, painful in the abdomen, feverish, anorexic etc, unlikely pancreas involvement.
The blood in urine could be anything from infection/inflammation, crystals or stone causing inflammation/aggravation, bladder wall thickness, slight injury, mostly involving the urinary tract (or kidney). If the PCV was abnormally low, would definitely want to do ultrasound to see where there might be blood loss somewhere, but you'd generally be observing a ton more symptoms if severely anemic (weakness, lethargy, anorexia, dehydration etc)
A tumor is possible, but unfortunately, imaging is necessary to even try to detect the possibility. I'd certainly start ruling out renal disfunction or GI inflammation first. Just as a precaution, also make sure her heart function is a-ok (did she have hypertension?)
Hang in there and let us know what you're vet is doing/thinking, ok?
..........Traci
Re: Foxy - Traci, I need your help
No hypertension as far as I know. He did pick up a heart murmur though. WBC was normal - no indication of inflammation. As best I could discern, the vet seemed to be unsure of what was happening. She has obvious red blood in the vaginal/urethral/vulvar area, but the urine, to the best of my knowledge was unremarkable. He thinks whatever is causing the bleeding is in the urethra or vagina, but isn't sure that is related to the kidney problem. He suggested fluids to hopefully intervene in the kidney issue, and antibiotics in case the bleeding was due to an infection. He's hoping the ultrasound will give a clue - he was honest with me and said he wasn't the best at ultrasounds. A vet that is good at them was due on duty at 6pm. The next option would be a CAT scan, but to be honest, I'm not sure I'm willing or able to go to that expense. They will call me if they find anything. The vet practice I use is one of the best in our county, and other vets often refer difficult cases to them, so I'm hoping they will at least be able to come up with a cause. If it is cancer, and I need to just take her home and keep her comfortable, that is what I will do.
"A dog is the only thing on earth that loves you more than he loves himself." ~ Josh Billings.
Re: Foxy - Traci, I need your help
Are they keeping her on IV's overnight?
I too do not fathom a CAT scan, if anything, xrays combined with an ultrasound might be helpful. The vet is doing right by treating renal issues - those values are pretty high right now, the cause remains to be determined.
Have you noticed weight loss? Drinking and urinating excessively? Unusual vocalization, or other unusual behavioral changes?
I too do not fathom a CAT scan, if anything, xrays combined with an ultrasound might be helpful. The vet is doing right by treating renal issues - those values are pretty high right now, the cause remains to be determined.
Have you noticed weight loss? Drinking and urinating excessively? Unusual vocalization, or other unusual behavioral changes?
..........Traci
No significant update until this morning. After IVs her BUN/creatinine came down to 30-something and 2.0. After additional testing they've been able to visualize a mass on the uterine stump and are convinced that's the cause of the bleeding (clotted blood could be seen in the vagina at the mouth of what remains of her cervix). He was unable to completely visualize it due to bone in the way and was uncomfortable performing the surgery himself because he was unsure what he was dealing with. He's recommending I use a board-certified surgeon. (They have one, but he's out on medical leave). I've been referred to a practice in Tampa and have an appointment at noon on Monday. They told me to not feed her because they might be able to do the surgery same day. My vet does not think the kidney issue is related to the mass - that we are dealing with chronic kidney disease, and that will need to be managed. Assuming of course that we aren't dealing with a nasty cancer that will metastasize or already has. No other masses seen on ultrasound is encouraging though.
"A dog is the only thing on earth that loves you more than he loves himself." ~ Josh Billings.
Re: Foxy - Traci, I need your help
Darn, not the news we were hoping for (but glad the renal values improved!)
On that note, surgery would afford the best chance (removal, hopefully benign and not recurring), and if excised with clean margins and no current evidence of metastasis, that would be good news.
I'm assuming the vet said not to feed after Sunday night, correct?
On that note, surgery would afford the best chance (removal, hopefully benign and not recurring), and if excised with clean margins and no current evidence of metastasis, that would be good news.
I'm assuming the vet said not to feed after Sunday night, correct?
..........Traci
Re: Foxy - Traci, I need your help
that's right. They said it was OK for her to have water, just no food.
"A dog is the only thing on earth that loves you more than he loves himself." ~ Josh Billings.
Re: Foxy - Traci, I need your help
Well, I dropped her off at Blue Pearl in Tampa today and she's scheduled for surgery tomorrow. They (of course) repeated all her diagnostic tests, including the ultrasound, and aren't sure it's a mass. They say it appears to be fluid filled, but weren't able to aspirate it. It might be an infection, but her WBC is normal and she doesn't have a fever, so I doubt it. If it is a mass, they think it might be into her pelvis - definitely not good. My DH took the call, and he didn't think to ask what time she was scheduled for. Hoping for good news tomorrow (or at least not horrible news).
"A dog is the only thing on earth that loves you more than he loves himself." ~ Josh Billings.
Re: Foxy - Traci, I need your help
It's possible it could be a cyst, but in any case, it needs to be removed, I'm so hoping for you and Foxy that it isn't more serious. Hang in there and know she's in our thoughts and prayers. Let us know when you know more?
..........Traci