Vetinfoindex
Vetinfo4cats
Catindex
Subscriber Area (members only)
Zoonotic disease
Becoming A Veterinarian
Your Turn
Search vetinfo4dogs
Support Vetinfo and Subscribe toVetinfo Digest
Leukemia in Dogs
Leukemia in Sheltie
also see cancer in dogs
also see Lymphoma
Leukemia in SheltieQuestion: Dear Dr. Richards,
My husband and I just subscribed last evening but have been visiting your
website to learn about possible causes, medications, and effects that have
been referenced in regards to our 10-year old Sheltie spayed female. In
July 2000, she suddenly was stricken by something that caused her to have
facial spasms, frequent shudders and weakness in her hind quarters where she
fell to the floor on her side, straight down on all 4s or just her hind
quarters. At first, the episodes came every 30 minutes and lasted very
briefly but continued day and night and she paced for 24-hours. Then, they
progress to every 15 seconds. Her only rest lasted no more than 90 minutes.
She's been to Auburn University Veterinary School where her neurologist took
an MRI, CSF, CBC and tests for infectious diseases to find the root cause.
All results came back normal. She was placed on phenobarbital, prednisone,
doxycycline, trimethoprim-sulfa, sucralfate for seizure control (she had one
full seizure the morning of her MRI), possible Rocky Mt. Spotted Fever and
inflammation of her brain. She completed the doxycycline and trimethoprim
but remained on phenobarbital (30 mg twice daily), prednisone (10 mg twice
daily for 8 days then down to 10 mg once daily for 1 week then down to 10 mg
once every other day), 1 g sucralfate 3 times daily. The neurologist
offered 2 possible causes: distemper or stroke. Stroke was the less likely
possibility since the onset of her problems progressively worsened over 2
weeks from mid-July to late-July. She's been current on all her
innoculations since she was born in 1990 and only once missed her distemper
vaccination in 1995. But we understand that batches of vaccines can
sometimes be contaminated or be ineffective.Although she wasn't her usual perky self, she was better without the spasms
and shudders. She slept briefly in 2-3 hour stretches at night. Two weeks
later, when she went in for her phenobarbital levels check, they were
minimally within range. Then, she started to lose her toenails, her toe
pads had open sores, a tiny spot appeared on each of her eyes (corneal), she
became slightly anemic and her tongue turned black for a day and again for 5
days. Her prednisone was at 10 mg every other day, so she was adjusted back
to 10 mg once daily. Her regular vet suggested changing her from
phenobarbital to KBr, which I was glad to do with its fewer side-effects. I
covered her feet with socks to prevent her chewing them, gave her baby
aspirin for her tongue and started her on KBr for the next 5 weeks (where we
are today).Then we tried to reduce her prednisone again on September 09, 2000 to 10 mg
once every other day. She became too weak to stand for more than 2
minutes. She was like this for 5 days and her gums became very pale. Of
course, she was too weak to do anything but sleep...ironically, her first
time for a full night's sleep. Since she was due for her KBr levels
measurements in a few days, anyway, I called her regular vet to have her
blood tests done and for her to be seen for the latest problems. Her KBr
levels were barely within range and she was very anemic with an enlarged
abdomen. An abdominal ultrasound was done showing an enlarged liver and
spleen. The liver situation from her phenobarbital. The spleen was more of
a concern (her 1997 radiographs indicated an enlarged spleen then). She
also had a urinary tract infection with traces of blood in her urine. She
was given epogen injection for her anemia and amoxi 250 mg for her
infection. Her regular vet recommended we return to Auburn.This week our dog was admitted back to Auburn where she remains. She's
being examined and watched by Internal Medicine. Tests of her blood showed
low counts of mature white blood cells and low count of red blood cells.
There's a proliferation of immature white blood cells. She was running a
fever, too. Her liver, spleen and bone marrow were aspirated. She
underwent another ultrasound on her abdomen. Her spleen was free of tumors
although there are nodules. Her lungs looked clear. Her heart sounds fine.
The aspirations of her liver and bone marrow showed presence of the immature
white blood cells. The bone marrow showed too many of them that crowded out
mature white and red blood cells. Her spleen aspiration looked fine. She
was given a growth factor for her bone marrow and her red blood cell count
very minimally increased. The internal medicine doctor believes she has
acute leukemia. The only other possibility would be a viral attack on her
bone marrow. He's taking a biopsy of her liver today to confirm the
presence of immature white blood cells.Our dog's case is puzzling Auburn. The neurology, oncology, pathology and
internal medicine departments are all involved in her case this week. She's
receiving growth factor daily, now, to boost her mature white blood cells.
Her red blood cells remains low at 20%, but the internal medicine doctor
hopes that will improve as the mature white blood cells start to increase
and she's able to fight off infections on her own. Along with her
prednisone (5 mg twice daily), phenobarbital, KBr, sucralfate, and
amoxicycline, she's getting another antibiotic and growth factor.Lupus has been ruled out. I've asked for a babesiosis test to be done and
test results won't return from Louisiana University until next week about
the same time pathology results on her liver biopsy will return.It seems that leukemia is rare in dogs. We find no mention of it on your
website. A couple of other veterinary websites we've visited discuss
leukemia. However, since your explanations are more in plain English, could
you explain the condition to us, please? We know that there are 2 types:
acute and chronic. Chronic has better prognosis due to its slower onset and
progression. Could there be any relationship between her early neurological
symptoms and to her present anemic symptoms?Thank you!
N. & S.Answer: N & S -
I think that leukemias are pretty uncommon and that it is probably also
likely that they do not get diagnosed as often as they occur, since the
clinical signs associated with leukemias can be very variable and are easy
to confuse with other disorders.There are several kinds of white blood cells that make up the immune
system. The most common one is the neutrophil, followed by lymphocytes,
eosinophils, monocytes, basophils and some variants of these cells. Each of
these is produced by a group of precursor cells in the bone marrow that are
referred to as stem cells. The stem cells differentiate and produce the
different types of white blood cells but they arise from the same basic
cell line, so there are often mixed types of leukemias.Leukemia is the presence of cancer cells in the bone marrow itself. This is
different from lymphoma, the other common white blood cell cancer, because
lymphoma arises from tissues outside the bone marrow, such as lymph nodes
or the spleen. There are two forms of leukemia, acute and chronic. The
acute form usually has poorly differentiated stem cells, produces anemia,
drops in white blood cell count and a lot of secondary problems associated
with anemia and a severely deficient immune system. When bone marrow is
examined, acute leukemia usually causes the bone marrow to have a large
number of cancer cells, making up at least 30% of the bone marrow cells.
The chronic form of leukemia is different in that it is usually possible to
identify the type of cell that is proliferating, such as granulocytic
(neutrophil) leukemia, lymphobastic leukemia, eosinophilic leukemia or
lymphoid leukemia. White blood cell counts are usually elevated and
sometimes are extraordinarily high, such as 100,000 to 300,000
wbcs/ul. Clinical signs tend to be non-specific for this disorder, too but
enlarged lymph nodes and spleen, weakness, lethargy, lameness, fevers,
increased drinking and urinating, bleeding disorders, liver enlargement and
pale gums have been reported to occur.The prognoses for acute lymphoblastic leukemia and for acute nonlymphoid
leukemia are both very grave, with most affected pets living only a short
time after it is possible to make a diagnosis of these conditions, even
with treatment. There is no consistently successful treatment plan that I
know of but l-asparaginase (Elspar Rx) was supposed to be helpful in some
cases. This medication is not currently available, as far as I know, though.Chronic lymphocytic leukemia and chronic nonlymphoid leukemias have a
better prognosis, although there isn't sure treatment for them, either.
Some dogs are reported to live for months, to years, with these conditions.
I think that the majority of patients probably do well for the shorter time
period, though.It is good that your sheltie is at one of the veterinary schools because
there are resources there for confirming the diagnosis and for obtaining
the most current therapeutic information.I do not know how frequently neurologic signs, such as seizures, are
associated with leukemias, but it they are listed as one possible symptom
in Ettinger and Feldman's "Textbook of Veterinary Internal Medicine". At
the present time, I do not think that initiating factors for leukemia have
been identified in dogs, so there may easily be a link between the
neurologic symptoms and the leukemia, if it is present, but it would be
hard to be sure.I wish that I could help with this situation but you are doing the right
things and have the help of people far more expert than I am in this kind
of care.Mike Richards, DVM
9/28/2000
Last edited 01/30/05
Vetinfo | vetinfo4cats | vetinfo4dogs | Canine Encyclopedia |
Feline Encyclopedia | VetInfo Digest | Links