Canine Blood Clots Ahoy

Another day. Another run to the veterinary ER. As one of three veterinary emergency and critical care specialists on Team Lilly likes to say, “Lilly doesn’t read textbooks.” The news we got yesterday (Tuesday, October 29) wasn’t good, but it also wasn’t the worst thing they could have told us. It all started Monday night, when Lilly somewhat suddenly lost the use of her right rear leg.

Canine Blood Clots – Symptoms

At its worst, Lilly:

• Dragged the leg
• Carried it — more like she couldn’t put it down versus holding it up on purpose
• Walked on her knuckles, with her right foot turned under
• Limped and wobbled along.

But it was intermittent. The more she walked — or tried to — the better things got. The more we massaged her, the better things got. I suppose that should have tipped me off, but I didn’t realize something like this was possible. And, after all we’ve been through, it’s obvious why I assumed the issue was neurological in root cause.

I alerted our veterinary neurologist by email late Monday night, telling him I would holler if things didn’t improve by morning. Tuesday morning, I shot 15-second video of Lilly trying to walk and emailed that to him as well. It turns out it was his day off.

I was prepared, nonetheless, to watch and wait this out because Lilly had no other symptoms.

Unexpected Help & Emergency Warning

THEN, somewhat out of the blue, our primary care veterinarian — who has been out of town for a few days — called to check on us. I told her what was going on, and she told me to call the neurologist immediately. She feared a blood clot … which stumped me because Lilly had some clotting tests on Monday that came back fine.

Lesson learned? Those tests ONLY tell you if a dog is at risk for bleeding NOT clotting.

I hung up and called our neurology team. The on-duty technician had me check for a temperature difference between Lilly’s left and right legs. Lilly had been curled up under a blanket in front of the fire all morning. Her left leg was warm. Her right leg was ice cold. They told me to bring her to the ER pronto. The neurologist working yesterday was headed into surgery.

So, off we went AGAIN.

Canine Blood Clot Diagnosis

The ER veterinarian could feel a pulse inside Lilly’s upper thigh / groin area, so that was GOOD news, meaning the clot likely wasn’t in her aorta.

A technician came in and tried to find a pulse lower down in Lilly’s leg using a doppler machine to listen for a pulse. Nothing! Just static.

So, the radiologist squeezed Lilly in and performed an ultrasound of her entire leg. The team found the clot in Lilly’s femoral artery, just below where we were feeling a pulse.

Canine Blood Clot Context and Causes

Not the best news. Not the worst news. Other clot locations would have been much, much worse.

This clot is likely a side-effect of both long-term steroid use and Lilly’s ongoing protein loss. Both can make her blood stickier than it should be. Neither of those things is going to change, so this is where we are now.

After confabbing, our neurologist (by phone on his day off), our ER veterinarian, and the internal medicine specialist who we’ll see on Friday and who’ll take over management of the non-neurological parts of Lilly’s case, chose to put Lilly on Plavix to thin her blood, prevent more clots, and, we hope, break up the clot that’s already there.

Worse case scenarios are all game-enders:

• Loss of blood flow causing the leg to “die”
• Clot grows, cutting off blood to both legs
• Clot grows, cutting off blood to the kidneys

Right now, on the imaginary 1 to 10 scary scale, our ER veterinarian says the clot is a 2-3.

What’s Next?

We’re watching for:

• Signs of bleeding
• Signs of poor blood flow, coldness in the leg, for example
• Return of lameness
• Pain (blood clots can really hurt)

Lilly did have a small nosebleed overnight, but it wasn’t any worse than the ones we’ve seen off and on. To avoid any exertion, I carried her up the stairs this morning. She needed help standing up, but once on her feet, Lilly raced down the hall to kiss Tom, then raced back to the kitchen for breakfast.

I didn’t sleep much last night, but I’m glad to see Lilly looking better today.

Other Oddities

While we were in the ER yesterday, Lilly developed a knot on her head, right between her eyes. We have no idea what that is about, so we’re just watching it.

We’re also waiting on results from both a culture and a needle aspirate biopsy of the swelling inside Lilly’s lower lip. It might be a yeast infection (from all the antibiotics she has been on for her bladder infections), but it was much more solid than expected when they stuck a needle in it, so we’ll see.