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Could My Dog's Leukemia Be a Misdiagnosis?

by Terrie

Reader Question
My 10-year-old Lab mix was diagnosed with leukemia last week. His red blood cell level was so low our vet said a blood transfusion was the only option, and suggested we take him to a veterinary college 2 hours away for bone marrow testing. He has severe separation anxiety and some fear-based aggression and takes daily anxiety medicine, so we decided any treatment would be torture for him. The testing wouldn't cure him, only confirm what's wrong, and transfusions would need repeating because he doesn't seem to be making red blood cells. His gums and tongue are almost white, his back end is weak, and he's gone from 51 to 31 pounds in 6 weeks. We went home with a steroid, and the vet said he might have 2 weeks. That was 11 days ago. What are the chances this is a misdiagnosis? We haven't gone for a second opinion because we're afraid the stress would make him worse. Should we do more tests?


Answer from Our Team

We're sorry you're facing this. Leukemia is diagnosed from a blood count and a blood smear reviewed by a pathologist, and confirmed with tests such as flow cytometry and sometimes a bone marrow sample. In-house blood machines can misclassify cells, and some high white counts are a reaction rather than cancer, so a confirmed type matters. However, severe anemia, very pale gums, weakness and rapid weight loss together fit an aggressive acute leukemia, which unfortunately moves quickly.

If you'd like more certainty without stressing him, ask your vet whether a fresh blood sample can be sent to an outside laboratory for review or flow cytometry. That usually doesn't require moving him, though the sample needs to reach the lab within a day or two.

Choosing comfort care because of his temperament is a valid, caring decision. Keep his pain and stress low, and use a good-day/bad-day calendar or a quality of life scale to help you know when it's time. Signs that he's struggling include not eating, labored breathing, collapse or being unable to get comfortable.

See leukemia in dogs and quality of life and when to say goodbye.

This is general information, not a diagnosis. Please follow your own vet's advice.

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