Low Platelet Count and Surgery????

[Skeeter0757]

Does anyone have any knowledge of it being safe to have bladder and castration surgery at the same time on a 4.5 year old, 128 lb, intact male Irish Wolfhound with a low platelet count of 88?? His Lymphocytes were also low 636, and Lipase low 67 and Na/K ratio was High. His BUN was 9 and Creatinine was 1.0 which are in normal range.
My vet is saying the low platelet count is an artifact, (?????) from what I am finding on the internet an artifact means possible lab error?? or doesn't have anything to do with what we are looking at??? I would think being able to clot is important???? They are looking for a possible bladder tumor, or possible stones, this Friday starting with tests, with possible surgery.
My Augie has had wellness check-ups every year with complete blood panels and urinalysis. And with these wellness checks comes information you would not usually be exposed to unless they become really sick. But I like staying on top of his health. Augie has had blood in his urine for the past three years, (and you wouldn't know it to look at him, watch him play, or eat) and was treated with antibiotics without any change to his urine samples. In the past my vet has told me this is just my Augie, but I am getting more concerned as he had a drop of urine pass the other day with visible blood in it the day after two falls on the ice, three weeks ago. No drops of noticeable blood in the urine since.....and with his platelet count now coming back low I want to make sure with these tests it isn't anything more.
This last blood count was done 8 days into a round antibiotics, Sulfatrimeth 480, and from what I can find on the internet Sulfa drugs lower platelet counts. Does anyone know if this is correct? Because when I try to read the veterinary jargon it is really hard to comprehend.
Does anyone have any experience, or knowledge with multiple surgeries at one time on a giant breed dog??? They are wanting to castrate him at the same time, and I am terrified. These big guys are super sensitive to anesthesia, and I am afraid it might be to much for his system, especially with the low platelet count.
I know of a perfectly healthy Wolfhound who went for x-rays of his hips for certification for breeding, and never came out of the anesthesia.
Does anyone have a vet who allows them to stay for tests being done on your pet while they are awake? Or have you had your pet catheterized while awake?

Thank-you to anyone out there that may have any knowledge on this.
Sincerely
Skeeter

[dragondawg]

If the Vet believes the platelet count is an artifact, then a retest might be a logical step. Although in this case it may not matter as the platelet level you gave would still give ample clotting ability to the blood. But the question still remains as to why it's low? The question might automatically be answered with the additional tests.

The Sulfa drug could be the cause, and withdrawal in favor of another antibiotic would reverse the low platelets if the antibiotic is at fault.

Sulfa vs platelets

Note the possibility of kidney inflamation which in itself could cause blood in the urine. Although with good Bun and Creatinine levels that makes for happier kidneys.

The other possibility is that there is internal bleeding inside depleting the platelets.

Presumably your Vet is going to run an ultrasound on the dog as part of the tests. There are various scenarios where castration in addition to major surgery (e.g. removal of a damaged spleen) would probably not cause that much more discomfort to the dog. Or an ultrasound may indicate a congenital structure problem where infections are going to be frequent. In which case castration becomes the only operation to perform. On the other hand if it's a tumor then castration is a secondary issue and possibly no longer important.

You probably need to sit down with your Vet and discuss the scenarios where castration in addition to any other surgery makes sense, and when it might not. A test like an ultrasound may take about 30 minutes, and depending on how mellow your dog is they usually don't have to sedate the puppy. Thus you could wait at the office as they complete the tests, or be called in after they are complete to discuss the results.

Getting a pre-op blood panel will increase the safety per anesthesia. My Vets are very partial to pre-op blood testing. Optional, but I always go along with it. Usually non-geriatric dogs have little problem with anesthesia.

Over all it sounds like you need to get more feed back and discussion from your Vet to address your concerns.

[Catlady711]

Does anyone have any experience, or knowledge with multiple surgeries at one time on a giant breed dog??? They are wanting to castrate him at the same time, and I am terrified. These big guys are super sensitive to anesthesia, and I am afraid it might be to much for his system, especially with the low platelet count.

My personal opinon would be to wait on the neuter until the surgery for the bladder is done. I guess that one would depend entirely on your own vet and his experience with that.

I know of a perfectly healthy Wolfhound who went for x-rays of his hips for certification for breeding, and never came out of the anesthesia.

Today's anesthetics are much safer than they were years ago, as well as having the option of using isoflorane (gas) which are not as long lasting and are more easily reversable. Anesthetics always carry a certain amount of risk and pre-op blood work helps reduce some of that risk by letting the vets know ahead of time if they need to use or avoid a specific anesthetic. I'm sorry to hear about your friends dog dying from a simple procedure. While very unfortunate for your friend and her dog, it is fortunately a rare incident.

Does anyone have a vet who allows them to stay for tests being done on your pet while they are awake? Or have you had your pet catheterized while awake?

Some vets will allow you to stay while they do tests, it rather depends on the particular vet and their policy, as well as any insurance requirements.

Some pets can have a catheter placed while awake, but it's fairly uncomfortable and most vets would rather tranquilize the pet first.

As dragondawg said, you do need to set up an appointment with your vet and express your concerns and options available. Also a second opinon is never a bad idea and any professional vet will never have a difficulty if you want another opinon concerning the health of your pet.

Good luck

[Skeeter0757]

Thank-you to everyone who took the time to write in regards to my Augie having a possible double surgery with a low platelet count. I really appreciate all of your time and effort to answer my e-mail. I called my vet and rescheduled for Monday to just have tests done.

DragonDawg thank-you I will take your advise and ask for an x-ray and then an ultrasound instead of the cath. I was also going to bring in urine specimens from both of my dogs to rule out something they are eating. And request a new blood work up, if he needs to have the surgeries.

I told my vet I wanted to do whatever was the least invasive for Augie. But somehow I was talked into these procedures he could do right there, x-ray, cath/with dye instillation. And then right into surgery with castration, and follow with the bladder surgery if needed. Whew!!! My head was spinning.

I do have some good news in my research I read where one type of bladder stone is dissolved with a drug, so you don't have to have surgery. I haven't gotten far enough to find out is this is safe yet, but a bit of hope to avoid the bladder surgery. In humans I have heard of some kind of ultrasound waves they direct at the stone and it breaks it apart, so you can pass the little pieces. But I haven't found anything like this for our fuzzy faced friends yet.

Thank-you to Catlady711 I feel more confidant to ask for just the tests and then move forward from there. Most of the time I feel like I have just been in a tornado, after visiting the vets office. This last trip took me to the hoop, my mind was running 1000 miles per hour, and I was on overload. But I have had some time to digest it all, do some research, and I feel better equipped to move forward from here.

Thanks again to everyone who even took the time to read this, even if you didn't have anything to ad.
Sincerely
Skeeter, Augie (aka: Snarf Baby), & Mr. Pe-Do-McGee. (aka: Skip-pe-de-do)