My freshly ex spouse came over late Xmas Eve evening for some finishing touches on present wrapping. When we came down from the attic around 10--me with still a lot of ribbons & bows to add--Rem was lying down instead of greeting us, ears back, and when he got up he had that awful hang-dog look about him like he did during his bad episodes in August & again when we discovered the cancer. His gums looked quite pale gray to me. He shivered a couple of times while he was lying next to me while I checked him over.
I took him to the emergency vet's, where he immediately perked up a little ("See, I'm feeling MUCH better, can we go home now?"). His heart rate was a *little* high. His gums were a *little* pale. But blood test showed a drop to 30 for his red blood, which is apparently a tremendous percentage for a day and a half. Probably indicates some bleeding going on somewhere. Except for blood in the urine (which I haven't noticed but haven't looked closely), Cytoxan doesn't cause bleeding, the emergency vet said. (Interestingly, white cells had gone way back up into the good range, but apparently they can fluctuate tremendously within a couple of hours.)
Since they share office space with our regular vet specialists, they were able to dig out Rem's folder to catch up on the medical details.
They wanted to check his blood every 3-4 hours through the night & wanted to have someone keep an eye on him in case bleeding became worse & he collapsed. I didn't think I could stay awake all night, I was so tired already, so I left him there.
Vet called this morning; count dropped to roughly 28, then 26, then 24-25, so something's still going on & they want to keep him until at least this afternoon. She said he looks good, though, better than last night--perky, with a good appetite. Apparently bodies can adjust themselves to the low blood count. But if he drops any more, they might want to do a transfusion so he has enough platelets in his system to attempt to stem the bleeding.
This has always been the biggest short-term risk--rupture of the tumor. If that's what's happened, there's nothing they can do except transfuse and pray. Smaller ruptures (which is probably what he's had before) can often close themselves up. But if it's more major...
Of course I'd been hoping that the risk was greatly reduced with the tumor shrunk so very much.
I guess I'm going to head over to the Clan Home to hang out with the family and hope for only good phone calls.