Hemophilia- any help appreciated - Page 1

One of my dogs is suspected of having Type A Hemophilia. He's been in the hospital since Friday night with facial swelling and dark black/purple bruising around his eyes and spreading down his neck with no known trauma. Eating and drinking and acting fine. Initial bloodwork came back normal. Normal amount of platelets. Referred to specialty hospital from initial emergency vet due to lack of equipment to quickly assess clotting times. PTT clotting time severely extended by about 2/3. Initial suspicion was poisoning, but due to this (apparently in most rodenticide poisoning cases the PT is what's extended and his is normal) the new best guess is hemophilia as all other bloodwork was excellent and no evidence of any liver issue was evident. This is the same dog I posted about a few months ago who was suspected to have a liver shunt....there goes that idea. Liver values are awesome now! ;-)  My gut was that the Interceptor was the culprit there, but you know I'm just some crazy naturalist...........  Anyway...good news about the liver, but it makes this more perplexing. He did not bruise or bleed badly with any of the blood draws, so it's not like he bleeds like stuck pig. I know hemophilia has many variations; any experience? Does this sound right? Is there something missing? 

I should add: no punctures, no clear starting point for the bruising or swelling. He was thoroughly inspected for anything resembling a spider or snake bite, though I didn't think a snake bite was possible because I was outside with him and if a snake bit him, I would expect him to yelp, jump, make some sort of reaction, not just walk in nonchalant and eat his dinner. 

I'm sorry I don't have pics. I was more concerned w/getting him to the hospital and didn't think about it until later. 

They should be able to tell from his clotting times on his bloodwork? over here to get a heam clear cert clotting time has to be under 15 seconds (If i remember correctly)

You need to get the diagnosis without it you are peeing into the wind unfortunatly.

Jenni i cant remember if youve told us how old this dog is ?  Whatever, Haemo. can 
take a while to develop ... my mentors 'odd' mutation pup [as recorded elsewhere]
didn't have huge problems with it until she had him euthanised by which time he was
2 yrs old, so if that is anything to go on / repeated in other cases this may not be so
unusual.

My partners retired Mali has a blood clotting disorder, always got lumpy bruises and visible blood under the skin in some areas, notably along one side of her ventral midline, but not the other, though she clots ok if she gets a cut and did not haemorrage when she was spayed.  The Cambridge Vet School never got to the bottom of the problem, but the prime suspects were tick or mosquito borne diseases.

Margaret N-J 

Have a blood sample sent to Cornell first thing tomorrow. Their lab is the gold-standard for clotting disorders in dogs, especially the Factor VIII variations in GSDs.  They're generally pretty quick about getting the results back, too.

Tick panel's been done to rule out RMSF/ehrlichiosis/Lyme?  Babesiosis and canine bartonellosis have been on the rise in recent years, should be included on the differential list as well.  Clinical signs you describe aren't typical, but diseases don't read textbooks. 

Phone call already in to Cornell. We need to know how long to wait before sending blood, since he has had 2 transfusions now. He is home; I just picked him up. Boy is he happy to be home! Sorry, I forgot the basics in my first post. He is barely 2 years old. 4.5lb Chihuahua, unknown breeding. He was picked up stray. To my knowledge, he has never had a tick. He is so tiny and light-colored, things are obvious on him. I will mention it to his regular vet, though. She may as well test that too.

He was outside with Capri for a few minutes while I got their dinner ready. He came back in looking fine, ate his dinner, then an hour and a half or so later, he was swollen and looking like a raccoon. Do tick diseases come on that fast? Looking at his hospital wounds, he is very bruised now, abnormally so for simple blood draws and IVs. Interesting that you guys have seen this come on later. He was neutered at a year old without complications. Living in my house w/multiple dogs and a 3yr old boy, I find it hard to believe he's never been bumped before...........
I wonder if maybe he tried to squeeze under the deck since my bf blocked it off, hence the bruising to his face. He used to go under there all the time.

Thanks to all who responded. Keep 'em coming if you have any other ideas for or against this diagnosis. I'm so far into this for $2700   and no solid diagnosis yet.....hopefully Cornell will be conclusive. 

Jen - The pup in question had enough small signs to get the diagnoses;  but he
didn't start to get major bleeds and bigger lumps and bumps until he was adult-
sized, say 10 months or so;  then it was all downhill from there, hence his
euthanasia at around two.

Thanks. I would think that mine must not have as serious a form if he's 2 and these are the first signs? He is barely 5lbs..

Cornell says only 48 hours must pass between plasma transfusions and the test, so as soon as I hear back from his vet I will hopefully get that scheduled. 

Around 20 years ago I had a 1/2 year old male GSD who had hemophilia. I didn't notice anything abnormal about him since I got him when he was 9 weeks old. One day I noticed he had a big lump on his hind quarters. He wasn't limping or anything. I took him to my vet and she couldn't figure it out. The lump went down and later it swelled up again, bigger. The vet referred him to a university clinic and the vet there told me he had a tumour in his leg and the leg should be amputated. I refused and told the vet to just remove the "tumour" It turned out the "tumour" was actually a blood clot. Thank goodness i didn't listen to the vet and his wrong diagnosis! The dog had some clotting abilities. They did a test to confirm that he had hemophilia. Total cost was $400.00ish Back then you didn't have to mortgage your house to pay big fat vet bills. 

Maybe the dog just bumped into something and broke a blood vessel which caused abnormal swelling. A friend of mine fell while out running in the bush. She didn't feel any pain but had a huge lump on her knee. When she got home the bottom half of her leg was black and blue and it took weeks before her leg looked normal again. She isn't a hemophiliac. Just a fluky thing.

Also i don't think the lyme disease tests are accurate. If no diagnosis could you get a script for a round of doxycycline just to be safe?
Good luck. I hope your dog is ok .
Juno 11