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Thanks Michelle! Something told me you'd straighten me out!
Everything you said makes sense. I really do need to see a specialist.
I'll look for an intern tomorrow.
You know, I knew I should have asked for a hemobart test. We never had one
in the first place. Brissle was on Baytril, then Dox for the first two weeks,
but that's it. I stopped before starting the VO. So it's been about three weeks.
Since she was making good progress and wasn't on antibiotics for three weeks, it
didn't dawn on me that hemobart could still be a problem. It might make sense to
go back on dox and have a blood test later.
L/M stands for Lymph/Mono or Lymphocytes. That's what my vet was most
concerned about. Here's a description: "These smooth, round white blood cells
increase in number with chronic infection, recovery from acute infection or
underactive glands and decrease with stress, or treatment with steroids and
chemotherapy drug." So these would go up with WBC I assume. I also noticed
the comment on the lab results: "Buffy Coat (3) Lymph/Mono layer has not
separated distinctly from the other cell layers, possibly due to inadequate
staining. Confirm differential results with a blood smear." So maybe there was a
test error or maybe her number is so bad it threw off the software?
Just a silly question on finding an intern. Do interns actually take
clients themselves? Or would I need to go through the hospital? I'm just not
sure how that works.
Thanks again Michelle. You're awesome! I appreciate your insight.
-Kyle
----- Original Message -----
Sent: Thursday, April 07, 2005 8:37
PM
Subject: Re: Brissle Update - Good News
and Bad News
Kyle,
I am at a loss to understand why your vet thinks it's
cancer in the bone marrow. First, if she has cancer (it would be
lymphoma) in the bone marrow, that would have been causing the anemia and it
would NOT have gone away from Immuno-regulin and VO. A transfusion might have
helped a little, but it would not have made her hematocrit improve that amount
for that many weeks. When lymphoma in the bone marrow causes anemia, it
is because it takes up space in the bone marrow that is usually used to make
red blood cells. Without killing off the lymphoma, you can not increase
production of red blood cells. Transfusions increase red blood cells
artificially by adding them in, but red blood cells do not live that
long and so a transfusion can not increase HCT that much or for very long in a
cat whose bone marrow is so compromised that red blood cell production is down
to the point that HCT is 9.7. I am not a doctor, but after going through
what I went through with Simon, who had lymphoma in his bone marrow, I am
pretty positive I am right on this. Second, when lymphoma takes over
bone marrow, it also compromises white blood cell production, and so causes
WBC count to go down, not up. For these two reasons, I really doubt she
has lymphoma. By all means, though, I would take her to a specialist, an
internist or an oncologist. I would probably go to an internist, because
that person would be more likely to tell what else is going on if it is not
cancer.
I have no idea what L/M stands for. But to
me, it sounds like she could have hemobartonella-- was she screened for that?
It can sometimes be hard to detect. That can be combatted with dox,
which I think you had Brissle on?, and I would think also the immune
stimulants you gave her (I-R and VO), and because it behaves like an
infection if it is not entirely gone it would make WBC go up (infections do
that) while suppressing HCT (because it kills red blood cells).
Again, I would take her to an internist. They are
usually at hospitals and places called veterinary referral centers. I could be
talking out my ear, but I have learned a lot about lymphoma and anemia,
through unfortunate means, over the last few years, and what you wrote your
vet said makes no sense to me.
Michelle
In a message dated 4/7/05 6:50:46 PM Eastern Daylight Time,
[EMAIL PROTECTED] writes:
I just
spoke with my vet after Brissle's blood tests from today. The good
news:
Her HCT is now 21.3%, up from 9.7% five weeks ago. The bad news: Her
WBC
is now 36.8, up from 17.3 (normal is 5.0 to 18.9). And her L/M is now
24.4
(normal is 1.5 to 7.8), up from 9.0. Both of these numbers are off
the chart.
My vet said that all signs point to cancer and
he's strongly recommending
sending Brissle to a specialist for chemo. He
said that her glands felt
normal. He believes that the cancer is in the
bone marrow. Everything else
seems normal at this point. She's eating
fine, energy is good.
I will probably go ahead with the
chemo. Just wanted to hear what the peanut
gallery thought. I'm also
wondering how much it costs and how often you have
to
go.
Thanks!
-Kyle
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