Veterinary advice and information

[hutash]

As many of you know I am a veterinarian and have given advice and tried to inform mags during all the years I have hung around this insane corner of the innerwebs. I recently got a PM asking for advice, part of which was an apology for bothering me, another part was an option to not respond if I didn't want to. I am happy to comment and advise to the best of my ability with the caveat that I am limited within the confines an internet diagnosis.

I rarely read the dog or cat stoke thread, but do tend to check out specific pet related threads, but not consistently. So, what I am getting at, is I am happy to try and help makes as best I can, so if you have specific questions please just PM me. If there is a thread with info that is relevant a link will help. As with any medical condition, the more info we have the better the advise will be. A medical diagnosis is simply just a puzzle. If you only have one or two pieces of it it is extremely difficult to figure out the picture. If you have all but one or two pieces anybody can figure out the picture. The challange is figuring out the picture with as few pieces as possible.

Just a bit of background. I have been a small animal vet for 35 years (involved in vet med for over 40). I spent a few years as a mixed animal vet, and that was my tract in vet school. While I haven't treated large animals in many years, I am still reasonably informed there.
I am recently retired, but still involved, and my wife (also a vet) is always a good source of information for me. It has always been great to have a built in second opinion on my difficult cases.

So, I am happy to help where I can and glad to answer PMs or post in threads where appropriate. As many of you know, I am happy to talk or text if more specifics are needed. I have benefited from the generosity of this board many times, and gladly give back where I can.

Cheers

[uglymoney]

Our mini aussie had/has a medical condition that has receded mostly. He basically stopped eating his food and became extrememly sluggish and tired. He would eat treats and with coaxing eat some food so this kept him going. His red blood cells kept dropping with each visit to the vet and the test indicated he was not regenerating blood cells. He also suffers from muscle loss and severe atrophy on the right side of his face and this has been ongoing for maybe 3 years. Iron pills and a switch to senior food prescribed by our vet who also recommended an internist if we so desired, which we opted not to do since he is 10.5 years old and the money already spent at our excellent fully equipped clinic resulted in no conclusions - options for a fix seemed slim so why spend more money. After three weeks on the iron pills we took him back to vet and his red blood cells had dropped even further. Vet seemed very worried. Vet mentioned it was possible red blood cells had dropped further and were coming back but the chances were slim. This was February into March.

As stated above we have opted to give him the best life we can instead of spending tons of money with a different clinic (that he recommended but he also approved of our palliative plan) trying to figure out what is wrong with our oldish dog, so we kept giving him the iron pills and switched to the senior food formula which he liked better than his old food and even adopted another dog. He slowly regained appetite and strength. Now seems back to normal. He takes no shit from his nutball friend. Crazy strong appetite and can do 10 miles without blinking an eye. He was less worn out than his young adopted friend after 9 miles yesterday in super hot weather and seems none the worse for the wear today. He definitely has less pop than he used to, but dude is getting old so I don't think that is out of line.

I wonder if he had a viral infection or if this is an auto immune condition that is coming and going. The auto immune tests the vet ran and has run in the past because of atrophy were always negative though. Really everything negative except the obvious atrophy and the red blood cell count/lack of regen - which we haven't been back to retest.

Any darts?

[hutash]

Immune mediated red cell destruction would be on the top of my list, even with negative tests, which aren't really negative, they just aren't positive. Most of the other reasons for red cell loss are not likely to turn around, i.e. bone marrow cancer. Immune diseases can be a real bitch to diagnose. Finding the underlying cause is even harder. As big of a believer in vaccines as I am, proceed with caution on this dog, but keep the youngster up to date.

Glad to hear he is doing better. As good as your vet and clinic is, a second opinion is not a bad thing to do, although at this point not necessary. I never take it personally, and am the first to offer one if I am befuddled by a case. It just makes sense.

[skiing-in-jackson]

What great thread this will be. Great and interesting daily reading. Thanks for sharing.

[uglymoney]

Thanks Hutash. I've been wanting to run this past your for a while and I appreciate the dart.

I think if it wasn't for the long term atrophy which has had us worried and on the let nature take its course path for years now, and it seems to be starting to affect the usefulness of the eye on that side of his face, I'd have been more willing to go all in with the internist.

[schindlerpiste]

Always a good man. Thanks!

[Danno]

Many thanks to hutash for providing advice here for many years.

[snowaddict91]

Many thanks to hutash for providing advice here for many years.

+1

[tgapp]

Thanks Hutash. You're a solid dude for putting this thread up. This type of thread is what makes TGR the best online community I've ever found.

Sent from my Pixel 4 using Tapatalk

[DJSapp]

Many thanks to hutash for providing advice here for many years.

+2

Athena is still trucking along and I'm still sane because of the free 2nd opinion

Sent from my Pixel 4 XL using TGR Forums mobile app

[Cruiser]

Hutash, my middle-aged overweight tabby comes into the bedroom too early in the morning and she starts meowing either to be fed or to go out. Wft and I supposed to do about that? The damned birds are already going at 5 and then the cat gets into the act. I need my beauty sleep. Serially...

[bennymac]

Yes many thanks for your generous offer Hutash.

[BFD]

Hope your new house is built and your life is somewhat back to normal.

[ötzi]

Super nice offer Doc, thanks. I bet I take you up on it one of these days. With a puppy, a 10-year-old and a 15-year-old we sort of have the doggie spectrum covered. Something's bound to come up, it always does.

[ötzi]

Hutash, my middle-aged overweight tabby comes into the bedroom too early in the morning and she starts meowing either to be fed or to go out. Wft and I supposed to do about that? The damned birds are already going at 5 and then the cat gets into the act. I need my beauty sleep. Serially...

I'll handle this one, Doc. Cruiser, you need to move. Just let the cat have the place and come back in 20 or 30 years when it's gone.

[hutash]

Hutash, my middle-aged overweight tabby comes into the bedroom too early in the morning and she starts meowing either to be fed or to go out. Wft and I supposed to do about that? The damned birds are already going at 5 and then the cat gets into the act. I need my beauty sleep. Serially...

I didn't realize tour wife's name was Tabitha. Maybe make her sleep outside?

[hutash]

Hope your new house is built and your life is somewhat back to normal.

Thanks for the post...no, not done yet, but getting g close. Constant delays for whiny little excuses like, getting architect getting cancer, engineer getting some weird mobility issue, contractor's assistant son gettin another nasty cancer, paint getting g melanomas cut off (pasty white boy with a lifetime of sun and surf) to name just a few.

Most of this all began before people were on the job site, otherwise I wod be digging to fine Love Canal. I will resurrect my other thread with pictures soon.

[hutash]

Also, I didn't mean this thread to necessarily be an "Ask the Vet", but I am happy to respond when I see it, but more to say for people to feel free to PM me or call if you have my number since many mags have it.

In the mean time we better start a go fund me page for Cruiser once his wife finds out he is calling her middle aged and over weight.

[Tri-Ungulate]

I wonder if he had a viral infection or if this is an auto immune condition that is coming and going. The auto immune tests the vet ran and has run in the past because of atrophy were always negative though. Really everything negative except the obvious atrophy and the red blood cell count/lack of regen - which we haven't been back to retest.

Not a vet but used to work at a VA, and stayed at a Holiday Inn once...

But I think actually both of your hypotheses could be correct, in that some autoimmune conditions that involve premature destruction of red cells can be triggered by a viral trigger, or some other stress. And blood-related autoimmune conditions can run concurrent with other forms of autoimmunity. I'm with hutash that immune-mediated RBC destruction is pretty high on the list of possibilities.

As hutash mentions, negative tests can miss an acute event, depending on when they're drawn. Did your vet reports mention anything about red cell destruction, use terms like "schistocytes, ovalocytes, macrocytosis, elevated MCV, RDW or LDH"? Or did they use the term "low reticulocytes"? Perhaps did they mention "low MCV or microcytic" in surmising that iron deficiency was a potential culprit?

[hutash]

Iron deficiency is extremely rare in dogs. Iron supplements are rarely of any real benefit, but aren't harmful (within reason). If a dog lives long enough with hemolytic anemia often it goes away if the underlying trigger goes away. unfortunately without proper treatment they don't live long enough, but I have seen it.

I vaguely remember a true iron deficiency in vet school due to chronic wipeworms. That was back in the day when some people were still using piprazine (yeah, I'm old.)

[Cruiser]

Doc, this isn't a metaphor. My husky tabby is interrupting my gentle slumber. Short of euthanasia, what are my options?

Pic of plump tabby for reference

[Tri-Ungulate]

Husky Latin Tabby?

[ötzi]

That cat fat

[XXX-er]

Both GF's parents are vets, apparently they met over the autopsy of a dead pig and it was love at first site

[splat]

Yo, hutash. My Pyrenees boy is bumping up on six months and I was wondering 1) Is he old enough to breed before he gets his nuts cut and 2) Can I get a shot that would put him under enough to neuter him myself down at the feed store where I get his vaccination shots? ((and an antibiotic shot, which I imagine might be recommended))