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Primary Immune-Mediated Neutropenia In Dog

  1. #1

    Primary Immune-Mediated Neutropenia In Dog


    After 6 months of eliminating many other causes, my 10 year-old Shih Tzu (Mushu) was diagnosed with Primary Immune-Mediated Neutropenia, which basically means he had a very low white blood cell count, specifically low neutrophils. This is a somewhat rare immune disease, and there is no single test that identifies it, so it's about eliminating other things. However, he did have a blood test sent to U of Tennessee that finally confirmed it after knowing it was not due to secondary causes like infection, drug reaction, tick-borne, etc.

    I would love to connect with others who have a dog with this disease - Mushu is currently on Prednisone (Corticosteroid), Clavamox (antibiotic), and Gabapentin (for pain) and is seeing great improvement after only 3 days on the Prednisone. The studies show it is curable, so we are excited to have finally identified the issue and have him on the road to full recovery...see article here: https://www.ncbi.nlm.nih.gov/pubmed/15088959

    The disease masks a lot of other conditions and symptoms varied over time, so that's an area I would really like to hear from others who may have had the same challenges. It started with a minor nose bleed and sneezing over a couple days, went away...then he got severe conjunctivitis in both eyes and became more & more lethargic over a couple weeks, and we took him to vet when he wasn't eating normally. Sent to a vet specialist where multiple tests were performed for several thousand dollars, and we were told it was "80% sure it was lymphoma." Did some research online, and made an appointment at the U of Florida Vet School. Oncology confirmed the test results DID NOT indicate cancer, so we decided to keep him with UF and our primary (who we love).

    He was up and down over several weeks, sometimes himself and sometimes very lethargic - also exhibited a front paw limp that would come and go, and severe paw licking at times. Follow up visit with Oncology confirmed again he did not have cancer, and he also consulted with opthamology for his recurring eye issues.

    Prescribed cyclosporine drops for his eyes which are not uncommon for breed, first time we heard the term "immuo-related." Set up follow up visit with Opthomology to recheck eyes and internal medicine, lethargy returned. Internal medicine did additional tests and all was normal except low neutrophils, then sent blood to U of Tennessee for a special test which finally confirmed it. Now on the meds mentioned above, will return for CBC Friday (5 days on prednisone). Right before we started the meds, he was crying and wincing when touched, had a more severe limp and could not jump or roll over without severe pain. Took him back to primary, they did not find damage but suspected immune related joint issues, prescribed gabapentin at that time.

    And that's the short story!

  2. #2
    Join Date
    Mar 2014
    Location
    New Hampshire
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    6,784
    if you are working with a vet school he's in the best hands. I know Pred is a routine "catch all" but its a steroid and will kill the immune system leaving him open to other infections and with no working immune system he won't be able to fight it off. I hope it all works out for you and the dog gets well.
    he is your friend and protector, he will love you unconditionally, you owe it to him to be worthy of such devotion

  3. #3
    Join Date
    Apr 2017
    Location
    North Carolina, USA
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    I'm so sorry to hear about your Mushu. I hope things continue to go well for him on his road to recovery.

  4. #4
    Join Date
    Mar 2015
    Location
    PA USA
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    Sorry to hear about Mushu and I hope for the best for your both. I've never had that experience but maybe someone else has and can offer advice.
    “Save a life and save a stray”

  5. #5
    Thank you to everyone who sent positive wishes to Mushu, the world is a little short on compassion these days.

    I know reaction to prednisone is mixed, but I honestly believe it’s a miracle drug that saved my dog’s life. I cannot and do not speak for everyone’s experience, only my own in dealing wirh a serious immune disease that had him in pain and barely moving. 5 days in, and turn-around is nothing short of miraculous. He is not 100% back and is still on other meds for now, but he’s significantly better every day since we started.

    Yes there are side effects and we await his neutrophil count from a CBC test this morning, but in this situation the benefits far outweigh the alternatives.

    He is on Clavamox because as was pointed out pred does impact the immune system, so it’s a preventitive to help him fight off infection while on it - noting in this case, the whole point is to stop his immune system from damaging his white blood cells to the point of destroying the host.

    Even the UF vet school has called it a rare and interesting case, so I will continue to update as things evolve for others who may benefit from our journey in the future.

    For now, I wish everyone wet noses and wagging tales....
    Last edited by Mushurox; 02-16-2018 at 10:53 PM. Reason: Typos

  6. #6
    Join Date
    Mar 2014
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    New Hampshire
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    good to hear he's getting better. I know when we have a sick animal we learn to take things one day at a time. But it looks like things are looking good for you and him. Wishing you the best and hope it continues and you have many good days and years ahead.
    he is your friend and protector, he will love you unconditionally, you owe it to him to be worthy of such devotion

  7. #7
    Join Date
    Apr 2017
    Location
    North Carolina, USA
    Posts
    196
    I'm so glad it's working for Mushu, that's what matters the most! Keep us updated, as it's a learning experience for us all.

  8. #8
    Join Date
    Mar 2012
    Location
    USA
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    11,959
    I'm sorry to hear about Mushi, but I'm glad he's doing a little better. My last dog developed a similar type of blood auto-immune disease in his old age, and Prednisone was just one of the medications they gave him and it helped a lot. His condition got better after awhile which was good because the doctor said he was too old and sickly to get a full blood transfusion which was really what he needed. But one day he had a relapse, and the blood cells were very bad, worse than before, and we had to say goodbye to him. A little bit about it starting with post #17 of this thread. http://www.petforums.com/showthread....highlight=Hans

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