Neutropenia in dogs – Our saga with Clover’s weird white blood cell counts continues, so we saw a board-certified veterinary internal medicine specialist (the same one who helped us with Clover’s non-stop UTIs as a puppy). The headline is that, right now, the neutropenia itself isn’t posing much of a danger (unless her values continue to drop), but the possible causes for the neutropenia fall into scarier territory.
Neutropenia (noo-troe-PEE-nee-uh) is a low neutrophil count as determined by a CBC (complete blood count). The body uses neutrophils, which are a common and important type of white blood cell, to fight infections.
Neutropenia in Dogs – A Clover Mystery
Basically, there are 2 possible reasons that Clover’s blood work shows such low levels of neutrophils:
- She is not producing enough of them in her bone marrow for some reason.
- She is producing plenty of them, but they are getting used up by infection or inflammation in the body.
Because Clover has no other symptoms other than sustained low neutrophil counts (for 3 months now) and because we’ve already ruled out a few possible infections, we’re focusing our current diagnostic efforts on figuring out *if* she is producing enough neutrophils.
Honestly, look at her! She seems completely fine.
We ran another blood test yesterday, looking for a possible endocrine problem that can prevent the body from making enough neutrophils, even if challenged by infection. We should have those results next week.
I fully expect we’ll rule out that possible cause, but it was an easy test to run, so we did before making any additional decisions. It requires 2 blood draws exactly an hour apart, so we missed agility class. I ran and got some lunch, while Clover stayed with our veterinary internal medicine team for a while. I thought it would be good practice for her to hang out in a new clinical setting (since the ER / specialty hospital we use just moved into an amazing new building).
The next big decision probably revolves around doing a bone marrow biopsy, which requires full anesthesia and is essentially like a little surgery. We’re talking core biopsy, not just a needle aspirate.
Yes, we’ll be looking to rule out cancer, but it will also give us information about how the bone marrow is functioning. There are 8 stages of neutrophil maturity, so if we:
- See all 8 stages, we’ll know the marrow is doing its job
- Don’t see all 8 stages, we’ll know something is killing the neutrophils before they get released into the blood
Neutropenia in Dogs – Every Case is Different
In another dog and in another situation, the tests a veterinarian or veterinary specialist would suggest would likely be different. For example:
- If a dog did seem to feel poorly or had symptoms such as a fever, then it would make sense to go looking for an infection.
- If a dog had traveled out of the state or out of the country, then other possible tests might be necessary.
- If the dog was an Australian Shepherd (or mix), they might look into a genetic mutation that creates oddly shaped neutrophils that lab tests often overlook when counting neutrophils.
- If there were substances in the home (such as hormone replacement products), possible / accidental access to those would be resolved and the dog retested to check for improvement.
So, just because this is the path we’re taking for Clover, that does not mean it’s exactly what your veterinary team might suggest, if you face something like this with your dog.
Neutropenia in Dogs – Might be Nothing
There is a chance that we’ll run a bunch of tests and find out that nothing seems to be causing Clover’s neutropenia. In that case, we’ll assume this is “normal” for her and simply monitor her blood work regularly to ensure nothing is getting worse or changing.
But, there are a bunch of worry-inducing hurdles to cross before we get there.
The one that’s looming the largest for me (emotionally) right now is an immune-mediated neutropenia that would require potentially life-long immune suppression. And, that FREAKS me out because of the toll immune suppression took on our late canine heroine’s body over the 23 months we fought to save her from a severe adverse rabies vaccine reaction that triggered a major auto-immune brain crisis.
I’m having a bit of PTSD about it, in fact.
For now, though, I’m trying NOT to worry until we really KNOW something.
Tell Me What You Know …
If you’ve had a dog with long-term neutropenia or if your dog has had a bone marrow biopsy, share your input in the comments. I’d like to know more about your experience with neutropenia in dogs.
Thanks! Have a great weekend!