July 24 Another Decline

Repeat testing showed Patient 26-519's PCV had fallen again to approximately 9–10%.

The veterinary team consulted additional advisors as the investigation expanded beyond the more common causes of severe anemia.

Heavy-metal toxicity (like lead poisoning) remained among the possibilities being considered, even though Patient 26-519 did not display some of the neurological signs that can accompany certain toxic exposures.

Testing was also performed to look for evidence that her immune system might be causing red blood cells to clump together or be destroyed. Those tests did not provide evidence of that process at this stage.

The possibility of additional advanced diagnostics, including bone marrow evaluation, was now being discussed if the anemia continued.

At the same time, Patient 26-519 became less tolerant of assisted feeding and began spitting out some food.

Treatment of a critically ill animal is continually adjusted according to how that patient responds. Several medications were reduced or changed to decrease potential gastrointestinal effects, and additional supportive treatment was provided for nausea and digestion.

The goal was not simply to continue adding treatments. It was to balance treatment of possible disease with the patient's ability to tolerate that treatment, all while reducing stress and handling as much as possible.