5.16.2005
There are a couple of new photo albums in the gallery. Emma Kate's are password-protected, as usual, but the hiking one is available to everyone and expands a bit on the pictures I posted a few days ago.
5.10.2005
We had a really nice weekend, although I'm a little late in posting about it. On Saturday we went to Shoney's for the breakfast bar (YUM) and then went to a local hiking spot. Emma Kate really seemed to enjoy the day and it was nice to get out and do something different for a change. Now that the warm weather is hopefully here to stay, we're going to try to hike more often.
On Sunday we took the pet towels and blankets to the laundromat and then later gave Henry a bath and a good grooming. He looks like a different dog. That night we went out to eat with Mom and Dad and afterwards took Emma Kate to the park. All around, a super Mother's Day weekend. :)
And just to prove exactly how outdoorsy Chris and I are (!), and to reassure certain readers that we are also raising an outdoorsy child, here are some shots from the hike. Please try not to be blinded by my snow white legs.
On Sunday we took the pet towels and blankets to the laundromat and then later gave Henry a bath and a good grooming. He looks like a different dog. That night we went out to eat with Mom and Dad and afterwards took Emma Kate to the park. All around, a super Mother's Day weekend. :)
And just to prove exactly how outdoorsy Chris and I are (!), and to reassure certain readers that we are also raising an outdoorsy child, here are some shots from the hike. Please try not to be blinded by my snow white legs.
5.06.2005
Hannah spent Wednesday night at the vet school. On Wednesday they aspirated the lumps that suddenly popped up on her back legs and they turned out to only be lipomas (benign fatty tumors), thank goodness. They did the bone marrow aspirate and core biopsy yesterday, and we went to pick her up at about 1:45. By that time they had a preliminary idea of what was wrong with her, and today I have a couple of names for it - myelodysplastic syndrome (MDS) with erythroid predominance or primary myelodysplasia with refractory anemia. People can have these too, but they have totally different names, although a common name for it is preleukemia. Basically, what she's got is so rare in dogs that very little is known about it and they can't even agree on a name. The doctor said that they have seen four dogs with this at the vet school.
To explain the process a little more, red blood cells go through about 8 stages on their way to becoming adults, and somewhere about stage 5 she is having a mutation and not as many are making it to adulthood. Some are, but not enough to increase her red blood count by any huge leaps and bounds. So, what they told us yesterday is that it could go one of three ways: 1) She could maintain with the level of anemia she has and live out her life. 2) The anemia could worsen and she would gradually get weaker, and her other organs would be affected. 3) She could develop leukemia, and leukemia is not very reponsive to chemo.
So today the doctor called back once they finished examining the aspirate sample. We talked about treatment, and one option in particular - erythropoietin injections. Erythropoietin is the hormone that stimulates red blood cell production. Unfortunately, only human erythropoietin is available and over time dogs will develop antibodies to it that will in turn attack their own erythropoietin, causing worsened anemia. The other downside to the erythropoietin is that it can cause seizures (great). He said he would not want to do this treatment unless her hematocrit (red blood cell percentage) drops to about 14.
Now, here comes the part that has suddenly turned me into a glass-half-full kind of person. He said there is no explanation for the cause, but that in people, sometimes a deficiency of vitamin B12 or folic acid can cause refractory anemia. Also, in people, phenobarbital can cause a deficiency of folic acid which can then cause the anemia. Because Hannah's hematocrit has been at about 20 consistently and because she has been on phenobarbital since November (until this past Monday when she was finally weaned off it), he wants to do nothing for a few weeks and just monitor her. He is sending out Hannah's blood to check for levels of the nutrients and we will have results on Monday or Tuesday.
I can't help but cling to this notion that maybe the phenobarb caused all of this. She was not anemic before we started it, and I know I noticed pale gums at least as early as February (just didn't know enough to make the connection to anemia, something I'm still kicking myself over). The doctor said that it was overly optimistic to expect that it was a nutritional deficiency, but everything about this is so rare in the first place. If her illness can be rare then why can't the cause also be rare? Even if it is a deficiency, we don't know for certain that increasing the nutrients would solve the problem. Again, there is just not enough history with this - there's nothing to go on. Hannah is forging new territory here. I don't know, in my ideal world, the doc would call on Monday and let us know that she had a deficiency, we would start her on supplements and watch that hematocrit go up, up, up. I just can't help but hope for this. It's hard for me to accept that things happen with no cause.
Anyway, a pathologist is also going to look at the core biopsy - an actual piece of bone marrow - to check some other things. I expect we'll hear about those early next week as well.
Please think good thoughts for Hannah. She is feeling pretty good, especially now that the effects of the morphine have totally worn off. She was chipper this morning. Poor thing has been shaved in so many places that she's not looking too good outwardly, but I think I'm going to take pictures anyway. She's such a good dog, and it's too soon for her to leave us - good thing she's stubborn and has fighting spirit.
To explain the process a little more, red blood cells go through about 8 stages on their way to becoming adults, and somewhere about stage 5 she is having a mutation and not as many are making it to adulthood. Some are, but not enough to increase her red blood count by any huge leaps and bounds. So, what they told us yesterday is that it could go one of three ways: 1) She could maintain with the level of anemia she has and live out her life. 2) The anemia could worsen and she would gradually get weaker, and her other organs would be affected. 3) She could develop leukemia, and leukemia is not very reponsive to chemo.
So today the doctor called back once they finished examining the aspirate sample. We talked about treatment, and one option in particular - erythropoietin injections. Erythropoietin is the hormone that stimulates red blood cell production. Unfortunately, only human erythropoietin is available and over time dogs will develop antibodies to it that will in turn attack their own erythropoietin, causing worsened anemia. The other downside to the erythropoietin is that it can cause seizures (great). He said he would not want to do this treatment unless her hematocrit (red blood cell percentage) drops to about 14.
Now, here comes the part that has suddenly turned me into a glass-half-full kind of person. He said there is no explanation for the cause, but that in people, sometimes a deficiency of vitamin B12 or folic acid can cause refractory anemia. Also, in people, phenobarbital can cause a deficiency of folic acid which can then cause the anemia. Because Hannah's hematocrit has been at about 20 consistently and because she has been on phenobarbital since November (until this past Monday when she was finally weaned off it), he wants to do nothing for a few weeks and just monitor her. He is sending out Hannah's blood to check for levels of the nutrients and we will have results on Monday or Tuesday.
I can't help but cling to this notion that maybe the phenobarb caused all of this. She was not anemic before we started it, and I know I noticed pale gums at least as early as February (just didn't know enough to make the connection to anemia, something I'm still kicking myself over). The doctor said that it was overly optimistic to expect that it was a nutritional deficiency, but everything about this is so rare in the first place. If her illness can be rare then why can't the cause also be rare? Even if it is a deficiency, we don't know for certain that increasing the nutrients would solve the problem. Again, there is just not enough history with this - there's nothing to go on. Hannah is forging new territory here. I don't know, in my ideal world, the doc would call on Monday and let us know that she had a deficiency, we would start her on supplements and watch that hematocrit go up, up, up. I just can't help but hope for this. It's hard for me to accept that things happen with no cause.
Anyway, a pathologist is also going to look at the core biopsy - an actual piece of bone marrow - to check some other things. I expect we'll hear about those early next week as well.
Please think good thoughts for Hannah. She is feeling pretty good, especially now that the effects of the morphine have totally worn off. She was chipper this morning. Poor thing has been shaved in so many places that she's not looking too good outwardly, but I think I'm going to take pictures anyway. She's such a good dog, and it's too soon for her to leave us - good thing she's stubborn and has fighting spirit.
5.03.2005
I don't have a lot of time to go into detail right now, but to make a long story short, Hannah does not have Lyme Disease. It was a false positive from her vaccinations 4+ years ago. Her bloodwork has not changed and she still has nonregenerative anemia. Our vet has referred us to the vet school at Virginia Tech and Chris and I are taking her down tomorrow for a 10:30 appointment. We expect that they will do a bone marrow biopsy, among other things. Please keep your fingers crossed for good news for our girl.
5.02.2005
A few new pictures of Emma Kate, at 19 months and recovering from tonsillitis (you wouldn't know it, would you?). She is modeling the pair of Wondershorts I finished yesterday, in the Westport Island colorway from LTK. I think this is my best pair yet.
Anyway, the last picture is what you get these days when you ask her to smile. :)
Anyway, the last picture is what you get these days when you ask her to smile. :)
