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Cancer or pyometra?

Species: Dog
Breed: Lab
Age: 8-11 years
My lab who was quite healthy up and until August started to show a dulling coat and pot belly. I assumed parasites. I took to to a vet for worming which they did, and they also told me they noticed a tight abdominal area, as well as some muscle wasting. The question was raised about possible Cushings disease, but the vet did not pursue it. After the de-worming, I took the dog back in within one week as she seemed to be growing in her discomfort levels. Xrays and a geriatric blood panel were taken.
The blood work showed elevated WBC of 18 (reference range was 4.0 to 15.0); low RBC 3.9 (reference range 5.5-8.0); low hemoglobin 89 (reference range 138-199); low meatocrit .30 (reference range .39-.56); high mean corp volume 77.3 (reference range 63.0 - 77.0); low MCHC 296 (reference range 326 -374); high RDW 19.9 (reference range 10.0 - 19.0); high neutrophils 15.480 (reference range 2.800 - 10.560); low urea 2.2 (ref. range 2.5 - 9.6); high total protein 79 (ref. range 51-78); low albumin 24 (ref. range 25 -36); high globulin 55 (ref.range 20 - 40 g/L); low albumin/globulin 0.4 (ref. Range 0.8 - 2.3); high amylase 1249 (ref. range 328 - 905 IU/L). Hematology comments read "review of glass slides reveals a mild anemia that is non or pre regenerative reticulocytes are borderline. Leukocytosis- suppurative inflammation; anemia could be anemia of chronic disease. Endocrinology came back within normal limits. Urinalysis states monitor crystalluria consider culture"

X rays showed a large mass in the abdomen. The vet simply said the diagnosis is consistent with a cancer diagnosis, take the dog home and let her die in comfort.

I was not comfortable with the Vet's flippant attitude. The dog came home and a week later came into heat. Her heat cycles which are normally silent heats were very different from this one. I put her on a high antioxidant drink (pure acai berry juice which the dog loves) her heat cycle this time included a heavy amount of dripping and sometimes it was a bit of a goopy discharge. I simply assumed she was cleansing toxins from her system due to the antioxidant juice. (It's known to detox a system.) Now I am learning about something called Pyometra and am wondering if this is a possibility to pursue. The xrays of which I have copies, are similar to the canine pyometra xrays I find online.

Her heat cycle has now ended having run the usual number of days. She showed no normal signs of wanting to find a male to mate with when out for walks.

The dog is comfortable; has loss some muscle mass; pants on occasion but not often; has a dry nose; is lethargic; and the last couple of days is showing signs of being weaker in the hind end; she is drinking normally, but I am also giving her juice 70 ml 3x a day by a syringe orally which she readily drinks and looks for more.

Based on all this info. Should I be worried about pyometra or am I simply wishing for a more treatable condition than cancer?

Should I be taking her lab tests and x rays to another vet for another opinion?

I would appreciate your feedback.

Jim


Online vet, Dr. Marie

Dr. Marie replied:

Hi Jim and thanks for your very detailed question. I'm sorry you've had such a difficult experience with vets recently.

From what you have described I, too would be worried about pyometra.

The blood tests are not very specific and could mean a number of things but a few things stick out to me:

-The increase in white blood cells and neutrophils (a type of white blood cell) can be there because of inflammation due to cancer. However, they can also be there because of infection. So, an infection in the uterus is definitely possible.

It wouldn't surprise me if what you thought was a heat cycle was actually her uterus expelling the pus from the infection. Usually this discharge will look somewhat like tomato soup.

If this is pyometra then the infection will come back. Most dogs need to have surgery to be cured.

It can sometimes be hard to differentiate between a tumor and a uterus full of pus on xrays.

If this was my case I would be recommending an ultrasound next. This should be able to tell us if there is a tumor there.

I think at this point you have two options. One would be to go to another vet for a second opinion. Another option would be to call your first vet and ask if there is any possibility that this could be a pyometra. They should be willing to go back and look at the case and re-evaluate.

Pyometra is not always easy to diagnose. I once worked with a vet who missed a case of pyometra and this vet was an incredibly skilled vet with many years of experience.

I hope everything works out ok for Luna!

Dr. Marie.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thank you for your response.

To clarify the consistency of the discharge during Luna's heat or what I thought was a heat cycle (she was due for one) the discharge was not pussy in colour, and did not have a noticeable odour. At times it was normal like a typcial dog in heat and at times it was thick like tomato soup right out of the can--not watered down. I would use a cloth to clean up her hind end as she could not reach it due to her bloated condition. When I'd try to clean her up the discharge would almost be stringy like clinging between her and the cloth--very abnormal for a typical heat cycle discharge. Also, I have noticed that when people pat her heavy high up on her side just forward of the hip area she sometimes slightly yelps as if the area is tender.

By the way, the discharge ended this past week.

Her tests were done a month ago and the vet told me she thought the dog would be dead in two months. This dog doesn't look like she is ready to die.

Not sure if this information adds to your position or not.

-- Jim


Online vet, Dr. Marie

Dr. Marie replied:

I think the fact that there was any tomato soup-like discharge makes pyometra likely.

I can't say 100% for sure but I am really suspicious that this is due to pyometra.

The good news is that pyometra is a curable condition. But the bad news is that it usually requires surgery to be cured and this surgery can cost anywhere from $700 to $2000 depending on the circumstances.

I would urge you to have her seen really soon whether it is by your regular vet or a new one. If a dog has pyometra for long enough, the infection in the uterus can produce toxins that will cause kidney failure and be fatal.

And, just because the discharge is gone it doesn't mean that any infection is gone. Sometimes a pyometra can go from "open" to "closed". When the cervix is open there can be discharge, but if the cervix closes then the pus builds up inside the uterus and the situation becomes even more serious.



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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.