Check-up December 11

Pretty much the same- everything good but RBC which is 31, still below normal. No idea why. Rich wants to leave her on the same dose of Pred until about Jan 1 and then lower it and come in when I get back from Christmas to see how she is doing on the lower dose. She is up to 19.8 pounds and acts much better, but she did wear out after about 1 1/2 miles of the Christmas tree lane walk last night.

I forgot to make sure I had enough Azathioprine so now I have to count them and see if we can make it until I get home or if I have to run up to the vet's office again. If I do I'm going to get Candy's nails cut when we go.

I'm grateful..

I'm grateful that Janine is better. How do I know she is still doing well on only 10 mg of Pred? She got into a fight with Teddy and none of her boo-boos ended up bleeding all night or swelling into giant hematomas. (Teddy is limping.)

I'm grateful that the Imuran is working for her and that she can get off Prednisone.

I'm grateful that I can afford to pay for her care.

I'm grateful that she has become a snuggle bunny in the last month. I don't know if it was being sick or being gone for three days or just finding out, when she wasn't feeling well, that cuddling was nice, but she used to be a very independent girl and now she likes to cuddle more.

Good news

After eleven days on half as much Pred, Janine's numbers are good. Platelets are normal, PCV is normal, ALT is normal, WBC is normal. RBC is a bit under normal but that may be the vet's office's machine. So we are going to try cutting to half again, which puts her (19.6 lbs) at 10 mg a day, still a healthy dose of Pred. She'll stay on the same dose of Azothiaprine for now.

Maybe we can make some inroads on that muscle loss and potbelly!

Effects of Prednisone

Janine is still doing well but you can see she is getting the Pred potbelly, poor girl! We will be trying to reduce the dose soon and hopefully that will diminish somewhat. She has always had such a sleek figure.

A new cuddlebug?

I don't know if Janine just doesn't feel so good or has gotten to like it, but she is turning into a cuddle bug. She has never been one to come cuddle so this is new and very nice. She has always liked hugs from anybody but then was very independent and doing her own thing outside or at the door. Now she likes to snuggle up with me.

I noticed the vet's office clipped her nails. I'm glad they are cut but not too happy that they did it before they knew her platelets were up, and that they did it without asking me. But it does save me from Dremeling them this weekend so I guess its a toss-up.

A corgi's dream...

Janine is living every corgi's dream- she gets to eat as much as she wants! Not whatever she wants, but as of yesterday she has her vet's okay to eat whatever she can. Starting today she is getting three meals. We are trying to put some weight back on her. Weight loss could mean cancer, but it also might be a result of the drugs and of not feeling really great. Over the summer, I deliberately kept her weight down since she was limping off and on. So now we will see if three squares a day will get her back up. Luckily she is ravenous due to the Prednisone.

My vet says if it IS cancer, the drugs seem to be working, so for now we'll stay with it. The plan is to go 10 more days and then try to decrease the Prednisone since it seems like the Azathiaprine is what is helping the most.

I really want to get her to Christmas so she can chase bunnies at least one more time, even if it turns out to be leukemia.

Vet visit 10/30

We just got back from the vet. Janine's platelets are back up, but so is her white blood count. Liver is doing okay. Hematocrit is still low but coming up. She's still losing weight, though, despite extra food, so that is a concern. The plan is ten more days on the current regimen, then cut the Pred in half for ten more days, then recheck. If anything is off in the meantime I'll bring her in.

The good news is that platelets normal means I can grind her nails! yay!

Janine is doing very well, by appearances. She seems to feel good and looks good. The muscle loss from Prednisone is showing but otherwise she looks the same. Her nails desperately need grinding but not until I'm sure her platelets are back up.

When your dog is sick...

When your dog is seriously ill, you start worrying about every tiny thing. Low platelets cause bruising, so I'm always checking Janine for bruises. I lift her lip and check her gums for color (red blood cells.) I check her poop (diarrhea from the drugs.) I check her eyes- bleeding would be low platelets, yellow would be liver disease. I worry about her when she's sleeping (she's too quiet!) and when she's running around (she could hurt herself!) I check her when she's sleeping to see if she's still breathing.

Luckily she seems to be doing pretty well. Good color, no bruises, no blood, no yellow, and no diarrhea! And she is sleeping but is still breathing.

Thursday

Janine seems to be feeling better today. She had diarrhea this morning but has been bouncy and barky which is a good sign. She worries me when she doesn't come sleep in the bed with me, though I think it is actually a sign she feels better as she hasn't normally been a cuddler at night. She had a little yard fudge on her walk today and wanted to chase squirrels and a cat.

No big change...

Janine is back on the Imuran, but so far no bad side effects like the diarrhea she had before. I hope it doesn't hurt her liver too much. She is on SAM-e for her liver. Imuran can also reduce the white blood count but that's actually the point here- we want her to stop destroying her own platelets.

She seems to feel pretty good though not as bouncy as she did over the weekend.

Introducing Janine

For those who don't know her, Janine is a six year old Pembroke Welsh Corgi. Janine was a rescue, found in a backyard after the family moved out, at the age of one. She was thin (nearly as thin as she is now) and bleached nearly white.

She came to live with me just over five years ago. (Almost to the day of getting sick.)

She is something of an agility dog although she won't stay on a strange teeter. She loves chasing rabbits. She's a big barker- we call her "The Mouth" and she likes to boss her brother's around. I knew she was better when she started barking again.

The saga to date

This started on the 10th. Here is my post on Cool2BCorgi from that date.

She seemed fine at dinner and an hour later was acting lethargic and unresponsive so I took her in. Xrays showed no obvious blockage; it looked like a dog that had overeaten. (I have no idea how that would have happened as she didn't get into food and no garbage has been gotten into.)
Blood work did show an elevated white count and low red count. The vet wanted to give her a clean-out shot and make her feel better then send her home on antibiotics and something for her tummy.

Well, the clean-out shot didn't make her vomit and she was looking worse, not better, so they wanted to keep her overnight. I'm worried. Janine is never sick; I don't think she'd eat that much if she did get into something. She also had blood in her eyes; the vet said that could happen from a near-choking but I said it was there on Sunday and was clearing up. I suppose over the weekend she could have managed to do something. But the other possibility is she isn't clotting normally.

Anyway, she's there, I'm worried, and we both could use your prayers/good vibes/well-wishes.

Oh, and an hour or two before Janine got sick, Merlin had a seizure. (Not unusual but just one more thing.)

On October 11, they discovered her platelet level had dropped to 12. They wanted to give her platelets, which despite the cost I agreed to. Not sure now this was a good idea... the only source I've found that recommended platelets if bleeding wasn't occurring was a UC Davis one, no doubt our vets trained at UCD, but everyone else says they aren't helpful unless active bleeding is occurring.

Update on October 12:

Her platelet count has gone back down despite the drugs they are giving her. They are going to give her one more unit of platelets and hope that gives the drugs time to kick in. The vet I talked to just now (different one) was talking about doing a bone marrow biopsy after that but I asked if they found out she has what is essentially leukemia what the prognosis was, and as it isn't good, don't see the point of getting a yes or no answer on it. Right now it is a case of either she gets better on this treatment or not- I won't put her through chemo or radiation for a less than one year survival, so I don't see the point in putting her through the biopsy, which requires sedation, especially since they can't even send it out until Tuesday. I'm willing to spend money on a treatable problem, but not to extend life when there isn't any hope of it long term. I'll do some online research and see if I can confirm the poor prognosis but I don't expect to find anything different.

This is horrible. I certainly did not expect Janine, who is the second youngest and (was) by far the healthiest of my dogs to be on the brink of death today. I just keep praying that she turns around and starts to make platelets again.

October 13

Still no great response to the meds, but she is coming home tonight and following up at my vet's for further meds and blood tests (as long as she is with us- either she responds soon or she is not going to make it.) Now that she is off IV's there is no reason to stay there.. basically all she needs now is time to respond if she is going to.

_
October 14

Janine's platelets are up to 77 from 18 yesterday, red blood cells up to 3.9 from 3.0, packed cell volume up, too.

Liver values are also up, not good, but we are assuming that's the Pred and the azathioprene and those are responsible for the improved blood count. White blood cells are still high and not yet going down, also not good.

This is the first increase in platelets without a transfusion, so it's a really good sign, although she is still far from normal.

October 16

Janine's platelets are back to normal, that's the good news. Liver enzymes came down a little but are still elevated. The bad news is that red blood cells are still low and white blood cells are going up, which indicates infection, but she is on two antibiotics already. Could be viral, or she could have lymphoma or leukemia. The plan is to slowly take her off the nasty drug, see how she does next Tuesday, then hopefully reduce the Prednisone if we can. If white blood count stays high then maybe a bone marrow biopsy, which he thinks he can do without anesthetizing her (just a local plus morphine.) I'm not sure if I'll let him do that or not, it just depends.

So good news and not so good news, but its hard to say yet what the white blood count means; it could be trivial and it could be terrible.

October 19

Janine is definitely feeling better and her color looks better and one of the two lymph nodes is down. A good sign, although I realized that with the dose of Prednisone she is on, anything would appear to be better. Still, it is nice to see her looking and acting more like herself, whatever comes after. I'm hoping her liver is also doing better; at least, so far she isn't turning yellow.

October 21 (today): I noticed bruising on her inner thigh and suspected her platelets were down again. See today's entry (the first entry) to read about the fact that I was correct.

October 21 Update

I'll just post today's update and then come back later and fill in the blanks.

The good: Janine's white blood count (WBC) and all related values are back to normal and her RBC, while still low, is up to 4.03 (5.5 is normal-low.) Her ALT is also coming back towards normal.

The bad: Janine's platelet count is back down to 80 after going back to normal last Thursday (normal is 200+.) Also her weight is down to 18.2 lbs and she is bruising again.

We are hoping the drop in platelets is related to decreasing the Azathioprine (Imuran) so she is back up to the full dose there as of tonight. That's the nasty drug that has all kinds of side effects, but none of them are as bad as bleeding to death because she has no platelets, so she'll be back on it.