High white blood count

[Jen]

Hi, hope everyone had a nice holiday season! Maggie’s been holding steady at 38 hematocrit. We’ve only reduced cyclosporine to 100 mg every other day from every day since her diagnosis on 9/5/14. She’s still on 20 mg pred & aziathioprine as well as stomach protector & 1/2 baby aspirin daily Sam e, milk thistle, & melatonin. Her last CBC showed elevated white cells, but vet thought maybe bc she had a parasitic infection. Have any of you experienced elevated WBC while taking all these immune suppressing drugs? Think it could be the infection? She goes for recheck tmrw. Also, I’m nervous that we haven’t seemed to reduce meds much even though she’s holding at 38 ( I know low end but it’s stable). Thank you for any advice or comments.
Love,
Jen & Maggie

[Patrice]

Hi Jen,
I am glad to hear that Maggie’s hematocrit is at 38! That is a good healthy value. How long has she been at this? If it’s been stable for a month or so like this, then it may be time to begin reducing the prednisone gradually. This dose is not extremely high, but it is still high enough to cause some unwelcome side effects.

Do you have a copy of the CBC you could provide to me? There are several types of white blood cells, each one doing their own job. A lot can be interpreted from which type of blood cell is high. When your vet says Maggie may have a parasitic infection, she is thinking about a type of blood cell that is normally not seen in any significant numbers in the blood. But it can also be an indication of an allergic reaction.

If you do have the CBC, scan it, save it as a pdf and upload it on the Urgent Advice page. I will have a look at it.
my best
patrice

[Jen]

Patrice, thank you for responding so quick. I will get a copy of last CBC & upload ASAP. She has had two instances of diarrhea & based on stool sample both times vet confirmed a parasite. I can’t recall the name ( begins w letter c) but fairly common & was given a powder that cleared it up in few days. Her CBC was conducted while she had the parasite so hopefully they were elevated because of this. She has been stable at 38 for couple months now & only lowered cyclo dose do far. If CBC looks good tmrw I will discuss lowering pred. She is starting to show effects of med – weight gain, panting, hind legs weaker . Thanks again !!!

[admin]

Hi Jen
Just a quick note to say 38 is great news & that the diarrhea has got better. Hopefully, that was the reason for the raised WBC. I know Patrice will be looking out for the blood test results to see which particular WBCs are high & I totally agree that a reduction in pred would be a good idea now Maggie is stable – all in all good news – well done Maggie for fighting this damn disease! The pred side effects are awful & Worzel suffered badly from wobbly back end & muscle wasting, so I know you will be glad to reduce it (nice & steady through!).
Love & hugs
Sheena, Worzel & Ollie xxx

[Jen]

She had another CBC yesterday (posted on urgent advice) and appears her WBC levels have come down to normal range which is good. Her hematocrit is actually 35 now & previously was 36- not sure where I came up with 38 . I did notice her RBC, hemoglobin & hematocrit decreased from lower end of normal range to a low range from her dec to jan CBC. Maybe I’m just over analyzing everything. Her vet suggested stopping cyclo – currently taking 100 mg every other day & reducing pred in half to 10 mg daily. I questioned such a large pred reduction asking if 25% Woolf be safer. He said they typically reduce by half. I know you all think 25% is better.

[admin]

Hi Jen

I didn’t get the blood test results for some reason – would you mind re-posting them? Or could someone else forward them? I looked in my spam folder, but not there!

Very happy to hear the WBC has dropped into normal – a PCV “drop” of 36 to 35 is absolutely nothing to worry about & it’s only just under bottom of normal – we love normal! Personally, I would go with the 25-30% drop in the pred & leave the cyclo as it is – that is more typical & much safer for this particular disease. With other diseases, such as skin problems etc, a 50% is usual – but it’s not usual for IMHA – 25% -30% is better – caution is the key word. The only exception would be for a clinical reason such has heart muscle atrophy or something serious like that. I can assure you lots of people including Linda & Sadie would tell you the same – relapses are frightening & not wanted – take it slowly, please, especially as Maggie is only just on the edge of normal. Maggie can handle a bit of muscle weakness – it will come back gradually, so don’t worry about that.

Sending loads of hugs & best wishes
Sheena xxx

[Jen]

Hi Sheena ,
I appreciate the advise on med reductions . I too feel a 50% reduction is too much. I tried to resend the CBC so pleAse let me know if you do not receive it.
Many thanks:)

[Vally]

Jen, ditto what Sheena said. I think the reduction of 50% is normal for OTHER conditions, but so many of us, Bingo included, has relapsed when doing 50% reductions, so unless there’s a reason, such as severe side effects, I would do it slower. 25% – 30% is much safer. I would also leave the cyclo where it is for now.

My vet’s advice was that generally, the prednisone is the one that causes the most side effects, so it’s better to get that down before the cyclosporine. Now that’s not always the case, as with Sadie, but is more usual. Secondly we never do two drug reductions at once.

The blood tests came through this time – I think the first test showing is the later one though and the second attachment “Image.1” is the first test.

Also a drop from 36 to 35 is nothing. That can be effected by how hydrated they are. The more hydrated, the lower the reading.

Love Vally & Bingo