I wonder why they moved this thread to senior dogs since younger dogs can be afflicted with the same condition???
Sorry to keep you waiting. I just got the results back yesterday. Not sure why they took so long but maybe because we were right upon the weekend.
The results aren't too bad but her platelets have dropped from 287 (Dec 14) to 191. Her red blood cells are normal (5.74) and her white count has dropped from 6 to 5.4 so that is good.
As you know she is on the doxy treatment again (started Jan 1). I did contact the fellow who was co-author of the journals in which anaplasmosis was studied in Minnesota and in the 3 cases in Saskatoon. He use to work at North Carolina State U but now teaches. He gave me some really great advice and he told me that in their studies, anaplasmosis does not become chronic so once you treat it it should be cleared from the body. That being said, because Timber's immune system was suppressed an additional treatment in her case is needed because the antibiotic kills the multiplying bacteria but it is the dogs immune system that takes care of the rest. So we can't be sure she was able to get rid of the entire infection. He also said that The only tick-borne diseases that can be in a sub-clinical phase ("hidden") and come back after stress or other immunosuppression episodes are Lyme disease, Ehrlichia, and Bartonella.
After getting these results my vet suggested putting Timber back on low dose steroids. I certainly felt worried about doing that but I guess she just wasn't sure if we weaned her off too quickly or not and wondered if that was why her platelets had dropped. Again, I contacted this fellow for advice and his suggestion was not to introduce the steroid again --- in his words:
At this point the big question is: did your dog develop immunomediated thrombocytopenia (ITP)? And if yes, did he develop before, during, or after Anaplasma infection? It is not an easy question, because both diseases cause decrease in platelets. There is no specific test to diagnose ITP, and we normally need to rule out other diseases first (especially tick-transmitted diseases). Therefore, I would not reintroduce dexamethasone at this point, so you can be sure that doxycycline would be efficient and infection is not part of your problem anymore.
You should not be so worried about the platelet numbers, because it naturally varies a little bit within the normal range. For some labs, >180,000 is normal, for others >200,000. If it takes too long for the sample to arrive in the lab, platelets clump together, and the machine artificially reads less platelets in the sample. Always ask for a blood slide review, so the pathologist will tell you if there is an adequate number of platelets or if there are clumps. Platelets also adhere to glass surfaces (including blood tubes!) if they are not analyzed within few hours after the collection.Your dog should not experience any bleeding disorder if platelets are >50,000.
Finally, corticoid therapy increases platelet production even in healthy dogs. Dogs with abnormally high values of endogenous corticoid (due to an adrenal tumor for example) normally have very high platelet numbers. So I would expect a slight decrease in platelet number after you stop dexamethazone.
If you had stopped dexamethazone too fast, your dog would be really really sick by now (vomiting, diarrhea, etc). I donít believe this is the case.
I would repeat a blood cell count by the end of the doxycycline treatment, or if the dog gets sick before it. Letís hope that everything goes well this time.
So, it is always good to ask questions and I think after all that has gone on, I seem to be questioning everything now.
As for the patient, she is doing great. I think she is almost back to her old self, gaining more weight and howling all the time. She has gained back 10 pounds so looks much better! We have a second appointment for acupuncture and some chiropractic adjustments. I'm not sure if I noticed a difference but we only had one visit to date so we will wait and see what happens. Her spine and pelvis area are very stiff and her legs are still weak. She still limps but I believe this might be an injury from so much muscle wasting and weakness. She had a burst of energy and was digging a hole in the snow but right after that caused her to limp again so that's why I think she may have some kind of chronic injury.
Good news overall!