Disease and Medical Resources: Dr. Peter Rice

Lola the Dog … and Patient

The spots we noticed last weekend on Lola’s belly are called petechiae (pet-ee-kee-aye) and are a sign of a bleeding abnormality. Not good. Pharmacists watch for these in patients taking anticoagulants.

It all started about a month ago. First, I heard that my son Daniel was serving as a “foster parent” for two dogs from the animal shelter. I had never heard of human foster parents for dogs, but it all made sense when Daniel decided to keep one of the dogs.

Lola is a now about a four month old puppy, with all the charming attributes of a young dog.

  • She is playful, fascinated with everything, and gangly; she frequently falls or rolls over as she is learning what her dog-body can do.
  • Lola is a mix breed dog with some attributes of a Labrador and a face that can sometimes pass as a pit bull.
  • She is ultra-friendly.
  • As a “only-child” dog, Lola has been subjected to helicopter parenting, and they’ve worked hard to see that she is socialized (they count the number of people she’s met) and educated.

So, as proud “grandparents” to this dog, my wife and I had her over to play last weekend in the backyard with our doxy Rooster. My wife noticed the spots; Daniel later sent me a photo of them, which I identified as petechiae.

After some brief discussion, Daniel went first to the internet and then to an emergency veterinary clinic. Bleeding under the skin can precede or signal more severe bleeding elsewhere. Lola also had a nosebleed.

The most likely disease possibilities included infection, immune destruction (possibly an adverse effect of a vaccine), and ingestion of rat poison. A blood test showed that Lola had thrombocytopenia; she was really short on platelets. This ruled out rat poison as a cause. Lola remained at the vet hospital for observation and treatment with antibiotics (for infection) and steroids (targeting the immune system).

Lola had some other tests which came back to show that she had Lyme disease and Anaplasmosis which supported an infectious cause to Lola’s problems. She has continued on antibiotics and steroids, and is doing very well.

But in the meantime, here was Daniel looking for information on a mysterious disease affecting a loved one. Daniel is smart – he’s an engineer – but has minimal training in the medical sciences.

Medical Resources and Disease

Medical Resources and Disease

The internet can be a great source of information, but as Shakespeare said, “you just can’t always trust what you find on the internet.”

Daniel found lots of information – much of it accurate – but was left trying to interpret it. So many different disease causes (including genetic abnormalities and cancer) and a reported mortality of up to 1 in 3 dogs with thrombocytopenia. Why were they doing these tests and giving these drugs to his dog??? Why were the drugs not working?

When we finally spoke, it actually did make some sense. There were many causes for the disease; the veterinarian was treating the most likely causes that could be affected by drug therapy. The drugs in this patient work right away, but it takes time for the body to make new platelets. It helped him to talk and ask questions he had not thought of, or which would have been awkward to ask the vet.

And we are all like that. We assume that others know the basic information that we know, and so we’ll do things without explaining. Health professionals try hard, but between the higher stakes and working efficiently, often patients or family don’t understand or don’t feel secure about their treatment.

Pharmacists are always available to talk with you about your medicines – or even your dog’s medicines.

We know about many diseases, and lab tests, and pretty much all drugs. We love to hear interesting stories. Often we can help patients who are concerned about something dealing with their medications or treatments, usually be reassuring that drugs or tests are appropriate, but sometimes by identifying when they might not be.

If there is anything that concerns you about medicines or your health, stop by and ask your community pharmacist. Take care of yourself.


DVM360: An Update on Anaplasmosis in Dogs

PetMD: Low Platelet Count in Dogs

Dr. Peter J. Rice

About Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. --------------------------------------------------------------------------He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association. --------------------------He welcomes interesting medication questions and suggestions for future columns.
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