If you didn’t know Oliver was sick, you’d never be able to tell. He’s bouncy, goofy, silly, wonderful Oliver, but a little quieter, with a little less stamina and every once in awhile he gets this far away look in his eye and you know he’s not feeling 100%.
We had a good follow up visit yesterday. Here’s the status report: BUN and creatinine (measures of kidney function) are back to normal! Hooray! His blood pressure was 150, so still high, but lower than it was and being maintained by the medicine. Great! Pretty much all of his “numbers” were in really good shape.
Except for one. We got a really good education on how blood is produced yesterday. You ready?
OK, reticulocytes are immature blood cells that have shed their nucleus and been released by the bone marrow. The presence of reticulocytes in the blood indicates that the marrow is producing new red blood cells and responding to a hormone released by the kidneys called Erythropoietin.
So, we know that Oliver is still anemic because his Packed Red Blood cell count yesterday was 24. That’s steady from the last time it was tested on September 23, but it should be around 40 so it’s still low.
Oliver’s bone marrow is not producing reticulocytes and it appears his kidneys are not releasing erythropoietin.
We’re now in entering into the “Land of Could Be” – a place where we’re just going to go ahead and buy a permanent vacation home. This issue with the kidneys COULD BE kidney fatigue, basically. Oliver’s system has been through so much in the last month that it’s just packed up its toys and is pouting in the corner, not wanting to do any more.
Today Oliver is going BACK to the ER Vet and will get a shot of Vitamin B12, a shot of Iron and a shot of erythropoietin. The erythropoietin will have to be repeated twice more over the next week and the whole goal here is to kick-start that hormone production, get the kidneys in gear and kick the whole system back online.
If that doesn’t work, Oliver will have to have a bone marrow test to see if there’s another reason why they’re not producing new red blood cells and we DO NOT want to do that.
Oliver played it up pretty hard during a visit to Barking Dogs yesterday.
In the meantime, we were able to reduce his number of meds, cut back on the prednisone even more and we’re just gonna keep bouncy, goofy, silly going while all of this is going on.
‘Cause that’s what Oliver’s all about — if you’re going to do something, do it ALL OUT. If you’re going to eat, eat with gusto and enjoy every bite – even the ones you dropped on the floor. If you’re going to sleep, sleep hard – throw your legs up in the air, kick your head back and snore your little head off. If you’re going to play, play until you collapse on the cool tile, worn out, panting and smiling.
And if you’re going to get sick, well, you may as well have something very rare, very odd, very confusing — and very expensive. That’s our Oliver.