AFGHANS ARE US -HEALTH

HYPOTHYROIDISM AND ADENOCARCINOMA

TILLY’S STORY

Tilly's story is produced here with permission of her breeder/owner Hazel Cranham

Tilly was born a very happy beautiful puppy. She had a very mild case of Juvenile Pyoderma, I recognised the small spot and it was treated right away, it didn’t develop further and gave her no problems as a baby.

For around the first five years of her life she was exceptionally healthy but had a few behavioural problems, one of which was excessive foot sucking when she was worried. I had no cause to be concerned about her though, she was lively and very happy.

As she got older, around five years, she started to have increasingly bad phantoms, she had had none as a youngster. Eventually after lots of health problems from my other girls and dogs I had bred I had Tilly tested for Hypothyroidism on the 25th Jan 2005 as a precaution. I thought she wasn’t HT as she showed no obvious symptoms but wanted to be absolutely sure. Tilly’s test results came back the following day as her being very hypothyroid and she started being medicated with Soloxine. On the 31st January I took Tilly and my other girls to Tim Hoskins at the Windsor Vet Hospital to have bloods taken and spun and sent to Jean Dodds in the USA for a full panel to be done. She confirmed Tilly, like Yummy had Immune Mediated Hypothyroidism and would be on soloxine for life.

Tilly stopped foot sucking and had no more really bad phantoms once the medication had settled in and I wasn’t at all worried about her until suddenly on the 7th of Jan 06, I found one of her nipples had slightly changed shape. I had it checked out by and it was decided as there was no inflammation and no discharge to monitor it for a while, we had lost her mother to mammary cancer. We also decided to see a very reputable holistic vet Tim Couzens at the Holistic Vet Medic Centre where Tim put her on ctuberculinum daily for 3 days and then once weekly. She was also on homeopathic iodum + conium + thuja once daily and appeared to be doing fine.

Nothing else changed and we were not too concerned but later in the year, around the mid end of October, Tilly suddenly had a very bad phantom with a rapid weight loss although eating very well, lumps were appearing over her mammary glands and down her back leg, biopsies were taken and the histology came back as mixed tumours. Tilly was put on Medrone while we waited for the phantom to come to an end before surgery for a mammary strip took place. But by the 16th of November it was decided by both her holistic and usual vets it couldn’t be left any longer and a mammary strip of the side worst affected was done and Tilly also had to be spayed at the same time. A huge amount of surgery but necessary unfortunately as we weren't prepared to lose her without a fight.

Tilly came home after the surgery as she was wouldn't settle at the clinic. She bled profusely and the vets and I started a battle to keep the bleeding under control and more pressure bandages were applied daily to the wounds.

Immediately after surgery

Day one and pressure bandages being applied

Perking up by day 3

Day 14 and out and gently about again - what a very brave and special girl

Eventually the seepage stopped but Tilly was having blood removed from anterior swellings. Bloods were taken and sent for coagulation profile. Her white count was on the low side, possibly it was thought due to the mastitis, she was on antibiotics and we hoped it would correct the platelet count. We waited for the histology from the tumours to come back, when they did there was one dangerous tumour, the others were a mammary complex adenoma with abscess formation and focal mastitis with secretory and ductal hyperplasia.

Tilly's wound showing a blood filled swelling behind her elbow

Tilly was a perfect patient bless her, she started to heal well with and despite everything we breathed a tentative sigh of relief , her Platelet count was now 100 out of a range of a 100-500 which was now on the low side of normal and RBC was 4.08 out of a range of 5.5 - 8.8.5 so both were better. She had something called a 'buffy coat test' done by the haematologist to confirm results (because her red cells didn't separate cleanly from granuloyctes? and grans are high along with WBC) and it said her blood should be able to clot but was still breaking down so she was back on a clotting agent, large amounts of antibiotics and steroids with a stomach protectant for inflamation because scepticemia was a risk among other things. They took 170mm of blood out of just one of  the under skin bleeds which was quite a lot 16 days after surgery, even with the other bleeds her colour was still pretty good though and she was eating and drinking but just wanted to sleep mostly still which was probably the best thing for her.

(Sylvia - Buffy Coat - If the blood is "thick" there may well be difficulties in separation as you have described and from what I have read the buffy coat is the fraction of spun blood sample that, after spinning, contains most of the white cells and then a layer of clear fluid (plasma): a layer of the red blood cells and this layer in between termed buffy (because of the colouring) which will contain most of the white cells and also the PLATELETS which of course is the concern for TILLY, I think they use this type of testing to subtract DNA as RED blood cells in mammals does NOT contain any DNA)

At Sylvia’s suggestion I sent Jean all Tilly's info, she thought Tilly's platelets were disfunctional  and the use of drugs like Rimadyl to combat pain post-operatively would aggravate any bleeding potential from her disfunctional platlets as they are all antiplatelet drugs. Two days after surgery Tilly did have Rimadyl for two or three days.

By the 1st of Dec she was very unwell again, bleeding at the smallest scratch and the wound looking swollen and slightly angry. Tilly was put on Clavaseptin and injected with Metacam. She seemed unconcerned about her wounds.

On the 18th of Dec bloods were again taken for a platelet count and sent to Cambridge university to be tested for platelets breed specific. By now her platelets were very low… and it was recommended she was tested for Von Wilebrands factor. Tests were also done for other things as Cambridge could not find the cause for the low count on the first testing.

By January Tilly was having mystery blistering along the site of the scar, it appeared and vanished equally as fast as it came, while she had the blistering she felt very unwell but perked up when it went. An appointment was made at Cambridge to take Tilly to see Mr Mike Hertage MA, BVSc, DVR, DSAM, MRVCS, DECVIM, DECDVI.  We had to take her family history veterinary reports with us for him to study. Tilly was x-rayed and scanned for more possible tumours but nothing was found apart from one benign one on the back mammary from the un-stripped side which of course we already knew about.

More bloods were taken and the WB count had dropped again, Thyroid bloods were also taken and her thyroid was holding up on her soloxine. She did a few days later have a nasty reaction on her neck where the bloods were taken from.

Mike spoke very highly about Jean Dodds and was pleased she had done the earlier immune mediated hypothyroid diagnosis which confirmed his own and also Carmel Mooney’s. Both initially thought the low platelets were caused by dysfunctional platelets but by now he said it was her own compromised immune system causing bacterial infections. A very long course of  Clavaseptin was prescribed and after a month on them you would have thought nothing had happened. It was decided it was far too risky to do a second side strip so she was just to be monitored unless something else happened. I was told that if Tilly's thyroid wasn't already being supported she probably wouldn't have survived up to this point.

For 22 wonderful happy months Tilly was back to her old self and really enjoying life again, oddly enough the benign tumour shrunk and vanished and we were elated……but sleeping dragons raise their heads!

On the 26th August during all their bedtime checkups I found what looked like a few tiny blisters under her armpit, next morning she was at the vet, I think in my heart I knew her remission was over, biopsies were taken.

Tilly's armpit only days after the first little blisters showed

One blister like tumour - Looks harmless doesn't it.

On the 1st of September the histology came back, it was Adenocarcinoma and with a very poor outcome for her. I was told she had about 7/8 weeks at most and was going to make the most of it as she still seemed very well in herself although the tumours were spreading rapidly.

I was horrified when exactly a week later and just a day after the following photo's were taken Tilly was attacked and bitten on the affected side by a Staffordshire Bull Terrier, my lovely vet John did all he could but my beautiful brave Tilly died just 3 short weeks later to the day, the 29th Sept 2008.

Footnote: before all this happened Tilly had just had one previous bleed. It was after bloods had been taken and there was no apparent reason for it as it didn’t happen immediately as you would expect if it was going to.

My grateful thanks go especially to Sylvia, Theresea and the many friends who supported us throughout our Tilly's heart breaking problems to the end