Low Albumin and Polycythemia

Question
QUESTION: My 6yr old JRT has been diagnosed with Polycythemia 3 weeks ago by a specialist vet.  Cause unknown at this time.  Treatment was prescribed as Hydroxyurea (lowest human dose available) every other day.  We rechecked his CBC counts weekly as directed and they were on the low end of normal.  He was acting better, eating, drinking, and playing as he normally would.  We were told to keep him calm (yeah right, he's a JRT!) as his heart was slightly enlarged due to the Polycythemia.
Sunday (two weeks into treatment) he started to develop what looked like a rash on his belly and he was lethargic. Back to the specialist vet for a CBC count and a check up.  We were told he had an infection. He was given a shot and sent home with oral antibiotics. That evening he started vomiting and did not stop. Called the vet and were given recommendations on treatment (chicken soup, pepto-bismol, soft food made into paste and pedialyte).  We discontinued his hydroxyurea as it was pointless to give it to him if he was to just vomit it up.
Thursday (yesterday) back to the local vet CBC count was LOW and albumin was LOW. The rash was edema and he had petecia in his eye.
Back to the specialist vet as we were told that they overdosed him on the hydroxyurea.
My two questions are: Is Polycythemia something that occurs often in JRT's?
What are the other signs on low albumin levels that I can watch for to head something like this off if it happens again?  Had I known that the rash wasn't a rash I would have insisted on an albumin check.

ANSWER: Oh Jennifer, the poor thing, and poor you!! I can't believe you (both# had to go through all that.  I would be quite upset that they overdosed my dog, and that he was vomiting so much that he had petecia in his eyes!!! Sounds like the veterinarians are blaming eachother for the problems too.

By what you describe I am assuming he has RELATIVE Polycythemia - #not primary/Secondary absolute). I would say NO, Jacks aren't particularly PRONE to this, but they definitely do run on HIGH and get very excited and worked up. Truthfully you are the first case I've heard about, this is usually more common in a breeds like Basenji's.   Like you said, it's not easy keeping JRTs' calm, but it's really important to try, especially now. Some signs that you have already seen and experienced are lethargy, difficulty breathing, small red spots on the skin, shaking, seizures, troubles seeing, and a blue tint to the skin. Dehydration and loss of "plasma" can occur from severe vomiting and diarrhea; I don't understand why they said he had an infection, from what I have read, the red spots are a SYMPTOM of Polycythemia.Excessive amounts of calcium can cause low albumin levels.
I found this information on my vet-tech website, hope it helps.
Other symptoms include signs of weight loss (muscle wasting and decreased body fat). There may be vomiting and diarrhea but these signs are by no means always seen, and it should be emphasized that failure to exhibit diarrhea or other characteristic signs of gastrointestinal disease does not eliminate the possibility of protein-losing enteropathy.
Signs related to the underlying disease responsible for protein-losing enteropathy may be present, and physical examination may reveal evidence of thickened bowel loops, an abdominal mass, or cardiac abnormalities. If hypoalbuminemia is severe then this may be responsible for the sole presenting signs (swelling of the limbs,fluid accumulation in the abdominal cavity, or difficult breathing due to fluid accumulation in the chest cavity). Limb swelling and fluid accumulation in the abdomen are generally present when the serum albumin concentration decreases.

I HOPE everything works out OK for you and your Jack, you sound very involved, caring and will make sure they take good care of him!! I hope he recovers quickly for you, what a hard thing to have to go through. Hang in there and Best of luck.  


---------- FOLLOW-UP ----------

QUESTION: It looks like Zeus is coming home from the hospital today!  Yeah! Final word from the vet is that he is allergic to penicillin (the antibiotic shot they gave him for his infection) and human albumin.  his original diagnosis of Polycythemia still stands and we will monitor his cbc levels closely and give him tiny doses of hydroxyurea.
It was suggested to us that we never vaccinate Zeus again because of the Polycythemia.  Is there any issue with not getting him a booster shot every year?  Should I have his immunity levels checked yearly to make sure that he is still OK for rabies and such?
Thanks,
Jennifer

Answer
Hi Jennifer,
Some people choose NEVER to get their dogs vaccinated and they do OK.
You have very extenuating circumstances on your hands and I would follow doctors orders. If they can check his immunity levels yearly I would want to know too.
Down the road when he's healthier, you may want to consider doing 1/4 or 1/2 doses - which gives them antibodies but not mega doses.
Good luck with EVERYTHING, I can tell you love him so much. I'm sorry you had to go through all that!!! Here's to better days ahead.
Take care