Dear All, this is my first time posting after losing my boy Cassius (8 years old) 3 days ago...
I'm trying to find some answers on what could have happened as he died of a rare disease the vets havent been able to identify.
I'll share the chronological events of his case, and hopefully some of you might have some answers to help me understand what might have happened:
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4 weeks ago, i noticed that Cassius had struggle eating, his mouth was hurting and he would only eat soft food he didnt need to chew. My first thought was that he had some teeth pain so I took him to the vet. The vet said his teeth were fine, but he noticed his gums were pretty pale, so he run a blood test and we found out he was really anemic. He run parasites tests for Leishmania and tick-related infections, and started antibiotic treatment to cover them, but the tests came back all negative.
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3 weeks ago: he started developing clotting disorder symptoms, as we could see small hemorrhages in his gums (petechiae). This could be a sign of parasite infection so we mantained the antibiotic treatment, but additional tests where run to evidence that his clotting times where really really long, putting his life at risk, therefore a plasma transfusion was done in order to provide him with coagulation factors and treatment with vitamin K + tranexamic acid was initiated, we thought it might be a case of rat-poison injest (which i couldn't explain because i dont have any at home and i couldn't think of anywhere he could be exposed to any kind of raticide venom). After that his blood-tests improved a bit and I was able to take him back home, his state was good for 3-4 more days. Image tests where done, and both echograpies and x-rays didnt show anything abnormal. The jaw pain was stil present, but vets thought was something unrelated to what was happening in the blood.
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2 weeks ago, after a follow-up consultation to see his blood levels, his clotting capacity was back to critical, and his anemia got worst, showing that he was probably having internal difused bleeding. The tests shown that his capacity to regenerate red-cells and platelets was normal, therefore we focused our attention in the clotting factors. Von Willebrand disease is a known hereditary condition, but symptoms manifest at a really young age, he couldn't have survived 8 years without any treatment. Researching the litterature, we found some cases where immune-mediated conditions like Addison disease or Thyroiditis could affect hormone production and have a colateral effect on blood clotting, therefore tests where run and immunosupressive treatment was started with Prednisone before having any results, to gain some time. A second plasma transfusion was done as well, as the risk of internal hemorrhages in the brain or lungs was extremely high. This provided a small improvement in blood levels. The thought of an immuno-mediated condition took some relevance, and make us think that the initial jaw pain could be Myositis, which has an immunological component as well, but no cases have ever been described between myositis and blood disorders.
-1 week ago, blood tests shown that he was getting worse again, and he suffered bleeding behind his eyes, causing retinal detachment, therefore he became blind... a third plasma transfusion was done at this point, to try to get some time to the hormonal treatment to improve the clotting issue (thyroid and suprarenal tests came back slightly low, but inconclusive to insure that he was a case of Thyroiditis or Addison). From this point everything came down pretty fast, after losing his sight, he lost his hearing and smell, stopeed eating and having troubles to stay up on his feet, indicating a possible brain hemorrage. We agreed to put him down, as we reached a point of no return of neurological damage...
Many vets and university experts have been consulted along this process and I really think he received the best care possible. We treated all the possible options, parasites, poisoning, auto-immune disease, hormonal deregulation, symptomatic clotting, etc, and he fought until the end for his life, but it wasn't enough. For the note, he had never suffered any disease along his life, or presented symptoms of any kind (fanconi clear, and his renal function was good all along)
Even if it is too late for Cassius, I'm stil looking for some answers and hopefully, his case might help other dogs that could go through something similar.