Here's where I need some thoughts. Since we don't have the biopsy results yet, the Vet isn't sure if it is cancer or Hemolytic Anemia. The confusion is that Tilly's RBC is very low and not staying up with the transfusions. But she also has a very low protein count. Yet she is not losing blood anywhere so where is it all going? The spleen is very enlarged. Clear weight loss (boney on face, hips, back).
Could it be that the cancer is in the spleen and liver hence the RBC and protein. Or is it not cancer and the spleen is enlarged from trying to produce RBCs?
Pam,
This is very similar to what happened with my Bianca in January - if possible - you need to get a bone marrow biopsy done asap! The fact she is not holding on to the RBC, and apparently not making them, her marrow is a prime suspect. Has your vet done any blood smear slides and looked at the shape of her cells and the percentages of various cells? Bianca was around 20% when we first counted her hematocrit but no organs were affected at that time. She dropped to 18% then we did a bone marrow biopsy for the diagnosis. Her marrow is definitely affected here as she is not making RBC. Can your vet or is there one nearby able to do a biopsy? Depending on what her platelets are, she may need a specialist to do the procedure. The cancer may be anywhere, including the bone marrow, and the spleen and liver are being affected because of what they do to process the dying RBC - without new ones being made, they are being taxed. They seem to be the primary organs affected when the blood becomes so poor.
With Bianca the diagnosis was not good - her marrow was primarily histiocytes and she was not producing any normal cells. Her blood smears showed star shaped RBC and these "mottled" areas which later were identified as histiocyte cells in the blood. The critical care center who did the biopsy gave her the diagnosis of malignant histiocytosis. I took her home, gave her prednisone, drew blood for the cancer study at the Fred Hutchinson Research Center in Seattle, and helped her to Rainbow Bridge 4 days later. Her system completely shut down and there was nothing I could do for her. She was fine Dec. 15 when I returned home from 4 months treating my own cancer in Seattle, slowly stopped eating between Christmas and New Years, was sickly looking by 1/8/03, we did the biopsy 1/10/03, and she passed 1/14/03. It happened very fast.
I hope this is not the case with Tilly but I do encourage you to seek a bone marrow biopsy if possible as soon as possible. I have had 10 of my own and although uncomfortable, they are not overly painful.
Good luck. Molly and the gang Charlottesville, VA
