It’s Just a Bruise

Yesterday, during a spoiled pup’s morning massage, I noticed a dark purple bruise at the base of Roscoe’s scar line.  I quickly checked for any other such spots, and saw none.  It wasn’t there the night before, so it’s acute appearance concerned me a bit.  Knowing that I can easily be the type of dog dad to over-react (especially in the last couple of months), I switched-on my clinical side.

Being a paramedic for the last 18 years, I discover that I understand what some of my colleagues mean when they say, “I can handle anybody else’s kids when they are sick.  The sicker they are, the calmer I am.  But when it’s my kids, most of my reasoning goes right out the window.  It’s not the same when it’s yours.”

I mentally checked myself back to reason.  I found a Sharpie and marked the borders.  I estimated its size as about a centimeter, and checked the time.  0630.  Hmmm….  Doc’s not in yet.  I’ll call the clinic this morning, and let them know what’s going on.  Whatever it is, he’s not ‘crashing’.  He seems happy.  Good appetite.  No panting.  Nice pink gums.  We are okay, at least for a couple more hours.

When my morning at work kind of settled down, I gave the doc a call and told her what was going on.  She told me her afternoon was booked solid, but when I got home to check it.  If it is any bigger at all, even a millimeter, then I should come drop in on them for a CBC.  I left work early and checked the spot as soon as I came through the door.  To my relief, it was almost totally faded.  My Differential Diagnosis:  Worried Dad.  Well Dog.  I called and let her know I wouldn’t be coming in.  Everything looked fine.

We got up this morning and everything seemed fine still.  I let the pups out to do their business, then fed them and started getting ready for work.  As I finished getting dressed, I heard Roscoe scratching.  It’s that time of year in Texas, and anything with a pulse seems to have some kind of allergy to some living thing without a pulse.  Like clockwork, this is typical for Roscoe, right about the third week in April.

When I laid him down to check him out, I saw that his skin at the scar line was not just red from allergy or scratching, but actually looked bruised.  It was fine, literally 15 minutes prior.  The area was larger than a centimeter, about ten inches in diameter, bruised, but not as dark purple as the spot the day before.

“Crap,” I said to Roscoe, looking in his eyes, “I should have taken you in yesterday.”  He answered my doubting words the way I would expect him to.  He gave me a couple of really slobbery kisses, sliming my freshly-showered face.  Always forgiving.

I assured myself that clinically there was no good reason to have taken him in yesterday after the spot cleared, but also convinced myself quickly that this redness wasn’t a normal allergic reaction type thing.  I loaded him in the car and headed to the vet.  A call at noon confirmed my gut feel from the morning before.  Platelets, which should have been above 150,000 were measured at 6,000.  Day 15 after chemo.  Day 14 is the standard ‘nadir’ for effects of chemo.

“Did you say ‘six’, or ‘sixty’?” I asked.

“Six,” said the vet, “I called (the oncologist), and he said while it is extreme, it was to be expected.  Start Vitamin K, and he would plan on reducing the next round of Carboplatin by 20%.”

“Six?” I said, still kind of freaked out, “Does he need FFP?”

“Roscoe is fine.  We’ve got him in isolation, and he’s already started on Vitamin K.  He’ll turn pretty quickly,” she assured me.  She continued, “The good news is his red cells and neutrophils are awesome, considering the hit he took to platelets.  They are both within reference range for normal.  This is how we all figure out how the second treatment should go.  It’s all part of the plan.  Let it play.”

So I take another breath, and let it play.

End of day:  Roscoe is home.  His energy today was the highest I’ve seen in over two months.  He was pulling on the leash so strongly this morning that he even made me jog across the parking lot at the vet when we first got there.  He seemed even more energetic when I picked him up.  Seems like he’s ready to call it an early night, though, after getting to see some of his friends at the clinic for the day.

Sweet dreams, my prince.