From:
sindahise@yahoo.com
Date: 2005-06-08 18:56:14 UTC
Subject: Epogen Question - Teegre
To: ferrethealth@smartgroups.com
Message-ID: <750910.1118256974232.JavaMail.root@thallium.smartgroups.com>
Hi all,
You might remember me from about 5-6 weeks back. Teegre (approximately 2 year old female) had a sudden onset of severe anemia. Turned out it was related to an adrenal tumor (as we discovered.) She has had (on the 16th of May) her Right Adrenal removed (had a massive tumor) and her bone marrow had shut down due to a "toxin". Bone Marrow aspiration was done also during the surgery and that did come back showing no cancer. Belatedly -- because none of the vets up here thought to do anything and it took me awhile to find the research online -- we did get her started on Epogen (due to your help here). She has been on Epogen now since the 23rd.
My local vet absolutely REFUSED to do 200u/shot. I got one shot at that dose out of her but she INSISTED that 200u/shot was a SERIOUS overdose. (Teegre weighs 2 lbs and a touch - varies a little so estimate 2 lbs.)
We have been doing 100u/shot every 2-3 days (3 shots a week.) That was the most I could get her to agree to do.
Over the 3 week course her PCVs were 22 - 22 and then today 15.
The first 22 was with a blood transfusion still on board. The second one would have reflected ONLY her own blood. This one, of course, is VERY troubling as it reflects a severe drop.
I have forced my vet's hand and as of today we are up to 200u/shot 3x a week BUT essentially I've been told that I'm chasing rainbows and that the bone marrow is clearly not responding to the shots and that (A) the Right Adrenal must have a tumor despite the fact that the surgeon didn't see one or (B) that the bone marrow just isn't responding at all to the Epogen and has completely shut down.
I think my questions at this point are could she be right?
(1)Could the bone marrow have never responded to the Epogen and somehow Teegre has managed to "hold out" for this long just because she isn't actively destroying blood anymore? She hasn't had a blood transfusion now in almost 3-4 weeks.
(2)Could an adrenal (her right) that was seen by a very good surgeon, pronounced perfectly clean 3 weeks ago be suddenly so bad now that it would again have shut down her bone marrow? (This is the inference she is giving me.)
(3)And if 100u 3x week isn't helping enough to get her to produce blood does going to 200u 3x week do nothing? (Again this is what I'm being told.) She said that with the drop from 22 to 15 that CLEARLY the Epogen is no longer working and that doubling the dose from 100 to 200 will do nothing at all.
>From the beginning the vet has done nothing but talked about the AWFUL side-effects of this drug and how I am RISKING HORRIBLE complications by giving it. She admitted today - essentially throwing up her hands - that there's nothing to lose now (saying that we've lost everything, there's no point in not doing it) but she insists this drug should have been given in dosages around 50u OR LESS.
I'm so confused at this point that I don't know what to do other than I'm back to thinking that we might well lose Teegre after feeling that we had saved her.
Do I have hope at all or is she right? As we've backslid from 22 to 15 have we lost all hope?
End of ferrethealth Digest
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