Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - 11 Year Old Maltese Shitsu X with IMHA

Hi, My name is Samantha. My 11 year old Maltese Sh*tzu X Millie was diagnosed with IMHA on Thursday. I was very shocked, and extremely frightened, I still am. Millie was vomiting bile for about 1 week and her appetite had decreased. She was still loving going for her walks though, no sign of lethargy. I took her to the vet Monday 19th, they thought kidney problems initially, and her PCV was around 36. We took her home on Wednesday night 21st, she was still burning hot and had unusually pink skin. We took her for a walk and she was so tired and I had to carry her home. Straight back to the vet on Thursday morning, different veterinarian who immediately suspected IMHA. Blood tests showed a PCV of 14. She was immediately started with an injection of Cortisone and on tablets. By Friday morning, the vet rang us and told us she had not responded and that she wanted our permission to do a blood transfusion. This morning (Saturday 24th), and Millie's PCV is up to 25. She came home, and is lethargic somewhat but her gums still look pink and I'm monitoring any changes closely. She is on Prednisone twice a day, and Imuran (which can take a few weeks to kick in). I am terrified of what might happen, and take every little sign that she is relapsing. The vet said her cells have stopped clumping, and she is regenerating red blood cells - which she told us to take as positive signs for a recovery. I had never heard of this disease before, it's comforting to read other experiences and know we are not alone in dealing with this. We only adopted Millie just over a year ago, but she is the sweetest little dog with the most gentle heart. She does not deserve this. She was vaccinated just over 3 weeks ago, vet thinks it has to be linked. I will never vaccinate Millie or my other two dogs again. What is everyone's thoughts on vaccinations? Samantha.

Samantha Australia

Samantha, I'm sorry to hear about Millie but rest assured you have come to a good site for information and support. We can all empathize with your situation. It sounds like your vet is familiar with treating AIHA and that Millie is getting some good care. A couple of things you might want to ask him about: 1. Ask about adding sucralfate and/or famotodine (Pepcid AC) to Millie's medication regime. These two medications will protect her from developing bleeding ulcers which can be a side effect of the prednisone. 2. Is your vet concerned about pulmonary blood clots? I know that a lot of dogs get these in the early stages of this illness and they can be fatal. Ask about ultra low dose aspirin or heparin. I sometimes think that my dog's vaccinations are what set off his AIHA as well but there has never been anything conclusive. I, like you, have opted to discontinue the vaccinations but then, he isn't at high risk of contracting any of those diseases anyway. One other thing, ask your vet for copies of all of Millie's CBC printouts. That information may be good to have in the future when you are trying to remember numbers and dates. In the early days, I remember being so scared that my dog would crash. I think some days I checked his gums every 10 minutes. Good thing he was patient with me! Please keep us posted with Millie's progress. deb

Debbie BC Canada

So sorry to mear about your Millie. It sounds as if the vet is using the correct meds - just be very careful if her PCV heads up and then stabilises that they don't reduce it too quickly and by too much. Stomach protectants are often needed and as Debbie says ask the vet to check for possiblity of clots. Millie will want to drink loads and need to pee all the time - she'll also eat more. Has the vet done any scans to throw any light on what might be causing this - or checked for tick diseases. I suppose it could be the vaccinations. She'll have little energy so don't expect her to do much at all. Hang in there and good luck - our Millie (westie) responded well initially and only crashed once stable and the vet reduced the meds too quickly. Your Millie may well respond - it takes a while and it can be nerve wracking waiting. A blood transfusion can always be done to buy time whilst the meds kick in. Thoughts are with you both and good luck. Clare, UK

Clare UK

Samantha, I am so sorry to hear about this sudden and frightening diagnosis. From your description of what your vet has done it sounds like you have an excellent attending vet who knows the protocol for initial treatment. That is a very very good thing. I was helped extensively with my dog Chance in 2007 by Dr. Jean Dodds of Hemopet.org. Dr. Dodds is world famous for her research work with canine blood diseases, thyroid disease and vaccinations. I am including a link to her current 2008 vaccination recommendations. http://www.itsfortheanimals.com/DODDS-CHG-VACC-PROTOCOLS.HTM I suggest once Millie is stable and has recovered you print this and discuss it with this vet you are seeing. The current accepted recommendations have changed recently and vets are more prone to follow a three year booster schedule. If you read Dodd's protocol carefully you will see that she recommends that the initial vac series be given but then the titers monitored through the dog's lifetime. My best patrice

Patrice NYS

Samantha, I am sorry that your Millie has been diagnosed but it sounds like your Vet is an excellent Vet. Most everyone on here had never heard of this disease until their dog was diagnosed. It is an emotional roller coaster ride dealing with this but know that you are not alone in your fight. Penny

Penny Lytle Creek Calif

Thank you everyone for your words of support and advice. It's great to hear from people who have experienced this. Millie is stable (PCV still at 27 today), but no improvement. I'm hoping that's because the meds haven't fully kicked in yet. I'm a little worried because her poo seems to have some blood in it, but the vet thinks that could be due to the transfusion. She's constipated and bloated, and her has a very high respiratory rate. We are expecting very hot weather (40 degrees celsius) over the next 4 days, so keeping her cool is my main priority. Thanks again for your support and advice.

Samantha Australia

One more thing - the vet has suggested removal of her spleen if she doesn't improve. Does anyone have any thoughts on this? I haven't heard this mentioned at all by anyone? It sounds risky to me in an anaemic dog....

Samantha Australia

Hi Samantha. Glad to hear that Millie is doing okay. The rapid breathing is probably due to the high doses of prednisone and the fact that she is anaemic. My dog had the same thing until we were able to reduce his pred. I wonder if there is blood in Millie's poo because she is constipated and having to strain to have a bowel movement. There are people on this site who have had experience with the removal of the spleen and I'm sure they will offer you their thoughts on this. Good luck to you and yes, try to keep Millie cool. deb and Duck

Debbie BC Canada

Samantha, Chance had his spleen removed in early 2007. It wasn't until several months later that he developed a severe non-regenerative anemia and neutropenia (lack of white blood cells). We will never know exactly if the two things were linked, just that we have some theories. I did extensive research on the spleen, most especially with regards to AIHA. In order to understand why your vet is suggesting it's removal it would be helpful to understand the functions of the spleen. The major job of the spleen is to store blood and remove old worn-out red blood cells from circulation at about 120 days and recycle the materials that they are made of. It does this with narrow tortuous pathways that require the RBC to squeeze around tight curves. The young healthy RBC can do this, the old ones can't and break apart. This is normal, you are destroying and making RBC every day of your life. The process that creates new RBC is called reticulosis. This occurs in the bone marrow and these baby blood cells mature there and then are sent into general circulation at about 4 days. In a dog or person with anemia, the marrow may respond heavily with many reticulocytes and even send them into circulation earlier to try to change the anemic state. Reticulocytes are the gold standard that defines anemia and is something that should be watched carefully on blood tests. In a normal state, there should be approximately 1% or about 60,000 reticulocytes in general circulation (give or take). In severe anemia, you may see numbers like 5% and 400,000. As the pcv rises towards 38-55%, these numbers should diminish and return eventually to 1%. Most especially in dogs, the spleen provides a kind of "instant transfusion." It holds a large quantity of blood and releases it when there is a need for more blood in general circulation. This would be, for instance, useful when a dog suddenly jumps up from rest to chase an "enemy." It can hold so much blood during sleep that the dog can experience something called nocturnal anemia, or anemia of general circulation. The spleen is also very active in protecting against certain tick diseases. This narrow pathways can also break up RBC that contain tick parasitic organisms. The immune system mounts an attack on the parasite within the spleen. Removal of the spleen leaves a dog or human very open to these particular tick diseases. The spleen is very active in the immune system and manufactures elements of it. Removal of the spleen is possible without severe consequences because other organs are able to take up the jobs, for the most part, that the spleen has. In rare cases the spleen can provide an odd function, but one that it did in the womb, of making blood. So now understanding the functions of the spleen, we can see that it is deeply involved in controlling RBC in circulation and in aiding the immune system to function. It can also be the location of great destruction of RBC (and platelets) during autoimmune hemolytic anemia as relates to it's functions. There can be confusion about whether RBC are "self" or "not self." It can mount an attack on RBC, thinking that they are not part of the body, but rather a foreign element. Veterinary hematology textbooks thus reference that removal of the spleen could remove this greatest source of RBC (and platelet) destruction. There is not agreement about the success of this surgery. Some texts I have read say that there has not been valid success. If your vet is mentioning it, it is probably because they did read it in a text. Ask them if they have actually ever done this surgery for this reason and if they were successful. Removal of the spleen is not a particularly complicated surgery, the spleen is easy to get to and the job is well within most vets capability. The risks are that in a very ill dog, the surgery could be too hard on the dog. There could be a risk of severe bleeding and something called DIC disseminated intravascular coagulation. This is a very serious and sudden condition and requires great skill to control. The incision is quite large and requires great care for many days. My vet is a very good surgeon and she was able to remove the spleen, plus a 7 lb growth, without any of these risks. But at that time Chance was not ill in any other way. It was not until later did he develop anemia. A dog without a spleen will tend to have a slightly lower, but normal for them, PCV packed cell volume. Their blood volume will just be a little lower and there is no reserve to fall back on. So, I would ask your vet if they have ever performed this surgery for the reasons they state now and if they were successful. Do they feel capable of doing this surgery and are they able to handle emergencies like the need for a transfusion or DIC? Can Millie survive this surgery in her condition? What do they feel the long term repercussions of this will mean for Mille's recovery. my best patrice

Patrice NYS

Hi Samantha, my dog Wylie (who is also 11+ now) had her spleen removed in April after onset of AIHA and after an ultrasound showed a growth on it, luckily it was benign. I had a 2nd opinion from an internist when Wylie was first diagnosed. She said most senior dogs, (this age) AIHA is caused by cancer of the spleen and recommended an ultrasound. I did that, a growth was found and that is why her spleen was removed. Because of your dogs age, I would do a an ultrasound of the spleen, for the price I have spent on this illness it was a drop in the bucket (about $200) to rule out any problems with the spleen Now that being said, There are vets that want to take the spleen out without any known disease/growths and from everything I have read up on it here it sounds a controverisal procedure to try and stop AIHA. Laurie

Laurie CA

Thanks for the great advice on the spleen. I'm really worried now, her poo seems to be very red, it looks like a lot of blood and she is definitely a lot more lethargic. The vet wants to see us on Friday, but I think I'm going to call them when they open in less than an hour. Am I being too over the top? Monday she was great and seemed to be coming good, and yesterday and today she has just gone downhill... I can't sleep at night properly, I keep waking up to check that she is still breathing. She is struggling so much, and it's breaking my heart, I really feel at a loss as to what to do.

Samantha Australia

I would definately get her in asap in my opinion a week is too long especially after a transfusion. When Wylie was first diagnosed and she didnt get as bad as most dogs here. yet vet had me in every 3-4 days for the first 2 weeks to make sure she was stable and getting better. One thing to ask is can the Imuran be causing some of her side effects? I have read a lot of dogs here can't tolerate it it all with very bad side effects, and just as many with no problems whatsover, Wylie was one of these. Wow I was confused, 2 Samanthas from Australia posting within 2 days with dogs named Millie and Madsion. IAty first I thought you were both the same. Good luck to Millie Laurie

Laurie CA

Samantha, It is okay for you to be very proactive at this time. Do not think about anything else but making sure that Millie has proper care. If you stay calm with the vet, they will acknowledge that you are seeing something that is not right and will want to see her immediately. This might be a side effect of some of the drugs she is taking, but only the vet can really determine what it is with an exam. I remember staying up half the night reading vet textbooks and watching Chance carefully. I got very little sleep. But I was very determined and I put my needs aside for a period of time. I sympathize with you. You should make it clear to your vet you don't fully understand what is happening right now and it is upsetting you. Let us know what happens after you call the vets, patrice

Patrice NYS

Thanks so much Patrice. I phoned the vet and have an appointment in an hour. I have collected a sample of Millie's poo to show her. She had blood tests yesterday which showed her PCV still at 27 (as it was when we got her home on Saturday). I am putting Millie first, and trying to work at the same time.... I am working from home the next two days, and then my husband will be home with her on Friday. I think I am staying awake on adrenalin and nervous energy anyway. Another thing I read that concerns me is autoaggulitination, which Millie has. I have read that dogs that have this happening are more likely to not survive IMHA than dogs that don't have it. I have also tried to contact her previous owners to get an idea of her history (we adopted her 14 months ago after they had planned to take her to the pound). I'm trying to take it one day at a time.... Samantha

Samanta Australia

Hi Patrice, Update on Millie. I took her to the local vet that diagnosed her. After I showed her Millie's poo, she agreed that wasn't right. She did an ultrasound and an X-Ray and looks like there is some fluid (most likely bleeding) somewhere in her abdomen, potentially liver. Millie's PCV had dropped to 21.9, and her platelets (I think?? this is new to me as they weren't a problem before) were 98 (the vet discribed them as her 'clotting' cells). The vet basically said that the treatment wasn't working and she needed more help than they could give. So she referred me to the Emergency Animal Hospital (near Melbourne). I rushed down there this afternoon, and the vet who saw me was fantastic. They are testing everything possible to determine if she does in fact have IMHA or whether this is the primary or secondary factor in Millie's condition. I should have gone there in the first place. It's all been very frustrating because I knew something was wrong, but nobody (including my husband!!!!) would listen. Millie is by no means in the clear, it could be bad news and I'm prepared for that (as prepared as I can be!). I am comforted in the fact that I refused to take the 'wait and see' approach with her symptoms and got her the help she needed today. Any later and she could well have died here at home. I am astounded by the lack of care that people give to their four-legged companions. When we adopted Millie, she had rotten teeth and severe oral disease (with bone destruction). We immediately had her teeth removed and her mouth cleaned up. Who knows what else happened to her before we adopted her, we have no way of knowing if any of this is linked to her current condition. However, in her year and a bit with us, she has been cared for and loved like nothing else, and I'm sure she knows how much we love her and how much she means to us. I will keep you updated and hopefully have some good news when I next post. Thank-you for your support Patrice, it's nice that there is someone else out there who cares and understands what I'm going through, and can give sound advice at such a confusing and emotinal time. Samantha.

Samantha Australia

Samantha, I am happy that you refused to take the wait and see approach. It is hard at first to question things because you feel that you aren't the Doctor and they should know the things you have discovered by finding this board and the additional links. Unfortunately a lot of Vets either have the mind set that this disease cannot be beat or just aren't that familiar with the treatment options. Millie is very lucky to have you being her doggy Mom. I am sure the 14 months she has been part of your life has erased all the years of neglect in her mind. A lot of times there is no way to know for sure what caused this awful disease to strike our dogs so save your energy for the fight. Penny

Penny Lytle Creek Calif

Samantha, Patrice has been a godsend to this board and has helped so many of us taking her time out to fully explain and answer questions, THANK YOU Patrice! ditto to what Penny said, Millie is so lucky to have had you the last year. With this disease we learn every little nuance and and change in their bodies and have to trust our instincts and act on it. When Wylie had her relapse I knew, her energy level was fine, but when we took her for a walk, she stopped like I cant go anymore I tired. I told my husband shes had a relapse and I am taking to the vet NOW. He thought I was crazy, even my vet when I went in and told him I thought she had a relapse, he said oh no, I never had a AIHA dog relapse. He was almost embarrased when he said I was right, her PCV was down to 27. My prayers are with Millie Take care Laurie

Laurie CA

Oh poor little Millie - hand in there Samantha - we all know what you're going through and believe me you're doing everything right. This is a really hard disease to fight against you never know what it's going to throw at you next. My thoughts and prayers are with you - we lost our Millie (2 year old westie) 3 weeks ago to this awful disease after a 7 month fight but I think we could have beaten it if we'd not made a couple of mistakes. Some dogs do make it and our Millie responded well initially - we also had bleeding etc so I know what you're going through. Clare, UK

Clare UK

Samantha, I am so sorry that there was something more serious going on. It's not what I had hoped. It's excellent that you are seeing a specialist. Platelets are the clotting agents in our blood. If you get a small cut in your skin and bleed, they come to the location and form a clot to halt the external bleeding. But they also work inside the body, unseen, to prevent unwanted internal bleeding. Having the platelet level drop is more serious. I cannot lie to you. They have probably already advised you of this. The may use the term immune-mediated thrombocytopenia to describe this condition. This means that the body would be destroying its own platelets in a mistaken attempt to remove what it believes is something "not self." One particular reason that this can happen is exposure to a tick disease. I can assume that since you are seeing a specialist they have already tested for this possibility. If Millie does have a tick disease, the treatments are well known and recovery, if begun early enough, is possible. Be sure that you ask them SPECIFICALLY if they have tested for these diseases and what the result were. There are other reasons that this can happen, such as but not limited to, tumors, liver or kidney diseases, and something called DIC disseminated intravascular coagulation. There are tests for each one of these things except DIC which is a condition where clotting happens indiscriminately throughout the body. A specialist will have the capability to administer an emergency protocol to attempt to halt this condition. If anyone would like to read more about this condition here is my reference for information: http://diaglab.vet.cornell.edu/clinpath/modules/coags/diseasef.htm Samantha, I will be thinking about Millie all day and hoping that she is in good hands. my best patrice

Patrice NYS

Dear All, Another update - thanks for your support. Millie had a lot of diagnostic tests run last night, I finally have some answers. My vet's initial blood tests showing decreased PCV and platelets yesterday seems to be false. The hospital has tested her twice to make sure, and her PCV is holding steady at 27 and they mentioned no alarm with the platelets, they said at this early stage, her IMHA as 'well-managed' and she is responding to her medication. I take that as good news. They have found she has early stage congestive heart failure. Her heart is enlarged, and their is fluid on her lungs and her abdomen (this is causing the laboured breathing). She is on nasal oxygen to help her stay comfortable. They have found no evidence of tumours on ultrasound or x-ray at this stage, but the vet said potentially there might be a tumour on her lung but they need to test the fluid to determine this, as it may not show up on the scan. I'm anxiously waiting these results. From all my reading, fluid on the lungs and in the abdomen is a result of heard disease primarily (not necessarily lung cancer), which fits with Millie's heart condition. I'm hoping this is true, but nothing surprises me now. However they are worried because tumours can trigger IMHA, which would make sense in Millie's situation. I am angry because we knew she had a heart murmur, but the vet's even last week said it was nothing to worry about!! What the?!?!?!?! I am comforted because right now she is in the best place she can be and hopefully getting the best care I've been able to find so far. I am the lucky one to have Millie in my life not the other way around, she has been a delight. We love her to pieces and desperately hope for more time with this precious little dog. Thanks for all your support and kind words, it is very comforting and a lifeline. I will update this evening (Oz time), when I get the results on the fluid. Hoping so much that there is no tumours. Then we can get on with battling her IMHA and heart disease. Thanks again, Samantha.

Samantha Australia

Samantha Please know that I am keeping you and Millie in my prayers. It sounds like Millie is in a good place right now and I hope she can return home to you soon. Please keep us posted on how she is doing. Don't forget to take care of yourself too. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Samantha, That's actually very good news. If a blood sample isn't handled with great care, platelets can clump and simulate the low numbers that they may have seen. In healthy dogs, its pretty clear that it is an error in handling. In a very sick dog, it becomes more alarming when there is a very out of norm number like this. It does no harm to ask the vet if they think that the numbers on a CBC complete blood count are accurate when they see something like this. They may say, well no, lets do the test again. Heart murmurs come in all flavors. Chance has, what the specialist calls, a "plain vanilla" heart murmur. It causes him no harm and he has no restrictions on activity. He is 11 and is a very large dog so it stands to reason that he might have this. It's the same with humans. Many people have small heart murmurs but they aren't serious. A heart murmur is caused by the valves in the heart leaking a bit when the heart pumps. This means that a little blood doesn't pump out when the chamber is emptied. Congestive heart failure has more to do with the strength that the heart has to pump. The muscles become larger in the attempt to pump the blood harder, but can't keep up as well as they should. The lungs become congested because the blood must first be pumped to the lungs to pick up fresh oxygen. The heart is less able to pump blood to the body so some of the fluid in the blood stays behind in the lungs. There are certainly medications and other treatments to handle this very well. Some very lucky dogs even get second hand human pacemakers to help with this. Yes, tumors can cause this kind of severe anemia. It is excellent that they are attempting to determine this. It is a step that is often missed. I am hoping that they find nothing of importance. my best patrice

Patrice NYS

Dear All, Firstly I wanted to say to Clare I am so sorry to hear about your Millie, but thank you so much for your support and continuing to support others going through what you went through despite your loss. I have another update on Millie. No conclusive result on the fluid test, however they have left open the possibility that there could by be cancer in the lung or stomach lining that is not a tumour (eg. mesothelioma). This apparently can be determined by a biopsy, but they are waiting to see over the weekend if Millie's symptoms are attributable to her IMHA and see how she progresses before delving into this possibility. I'm worried, but trying to stay positive. I would obviously love to rule this out or deal with it. We went to see her today, she's really perked up and it seemed the fluid in her abdomen had lessened, as her tummy skin seemed not as tight.... She was desperately trying to come out of her oxygen tent, but unfortunately we could only spend 10 minutes with her in ICU then we had to leave. I don't want to get my hopes up, but I am somewhat encouraged by her demeanour tonight. We miss her. Samantha.

Samantha Australia

Samantha, I am sorry to hear about Millie. Keep your head up! Your doing all the right things. I would really urge you to discuss asprin with your vet. I lost my boy Ollie to a blood clot, and one of the last things the vet said to me was something about the fluid build up being a result of Ollie throwing clots all along. I wish I was as fluent as Patrice in the terminology of this. There is a name for the fluid retention as it pertains to blood clots. Just thoughts on a different angle... Its good to hear that the fluid went down, keep an eye on it and again I would encourage you to ask about the Asprin. There is a study out there on asprin. I'm sure someone here could link to it.

mj ny/ut

Sorry to hear about your Millie. Sounds like you are in good hand with your vet hospital. A good vet is so important. I had great support from Lort Smith Animal Hospital in Melbourne when my Scruffy developed IMHA at 9 months but my initial treating vet just advised me to strait away to put him down but I insisted on a referral to Lort Smith. They were willing to refer me to Werribee University Teaching Hospital for a 2nd transfusion. You will get lots of excellent advice from this forum.

Julie Australia

Hi Julie, Millie is at the Werribee Teaching Hospital currently - she's in their ICU and they have been fantastic with her. Went there last night and saw Millie and their facilities - absolutely fantastic. They seem to really care and are very thorough in checking for other underlying problems, rather than just assuming IMHA is the only problem Millie has. They even diagnosed her with early stage heart failure (which my normal vet didn't pick up). Very very impressed with them. I live in Geelong, but I will still take Millie there for follow up appointments and my other dogs and cats there for general check ups and any other issues. mj - I spoke with the vet this afternoon, and they did say that they thought the fluid retention was due to blood clots, so they are giving her Asprin for this... thanks for that advice. It certainly makes sense. The latest update on my Millie is that she is doing well, PCV still stable at 27. She is staying at the hospital over the weekend due to the extreme heat we are experiencing. Mills is off the oxygen and breathing well on her own. I am cautiously happy... Thanks for all the support and good luck to all. Samantha.

Samantha Australia

Samantha, Stable is the best word I have heard so far. That is excellent. It is also excellent that they are not just throwing a singular diagnosis at this and are doing more extensive testing to map out the things that can be contributing to this. Recognizing the need for aspirin therapy is an even more positive step in stabilizing her. I, too, am guardedly optimistic about her condition. You have made a wise choice. Ask plenty of questions, do lots of research on the internet to read about things you don't understand fully. Keep copies of all lab work in a folder. You can learn to read and interpret this information so you will know what to look for on future tests. I will be thinking about Millie over the weekend, patrice

Patrice NYS

Hi Samantha. Hope you are coping with the heatwave. You are with the very best facility in Victoria and you can rest assurred that they will do everything possible for her. I found out the hard way that you need to be with a specialist right from the start. Local vets just don't have the expertise. All the very best for you and Millie

Julie Australia

Thanks Julie... We are really struggling with this heat - kind of wish I was at work in the air-conditioning... that blackout last night didn't help either - chaos on the roads!!!! Did you find a good vet at Lort Smith who was up to speed on IMHA? Werribee told me that I should just take Millie back to our local vet once she is released, and there was no need to travel to Werribee to get her checked. I'd rather make the journey and be comfortable with the treatment instead of saving some travel time and be on edge about whether she the vet knows what to do? What do you think? Samantha.

Samantha Australia

Samantha, I think the question is whether your local Vet is willing to listen to your input and will work with the Doctors at Werribee. When Millie gets stabilized you could do the simple things like PCV checks with the local Doctor and know that you could always take her to the specialists if needed. I was super paranoid at first and insisted on complete blood work being sent out to the lab not just the PCV being done in the office. You might want to start a spread sheet if you haven't already so you can chart drugs given, lab results, your personal observations of how Millie looks and acts. Your head can really start spinning while you are on this ride so it helps to have it written down so you can keep track. Hope you have your girl home soon. Penny

Penny Lytle Creek Calif

I would thiink 3 weeks after vaccinations would be a pretty good indicator that the vax brought it on--it is know they are the cause of AIHA many tijes. My golden retrieer's was brought on by his ProHeart6 heartworm prevention injection. It turns out tha was one of the leading reactions and listed on their warnng label. I did not know this til after his death. Also, the day he gor the ftl injection, death was added to the warning label. Then months after his death, the FDA had them pull it from the market because of the high number of deaths and adverse reaction. it was off the market for almost 4 years being reformulated and just retunred a few months ago, but it is not going over big like it did when it first came out. People remember. I sure hope you little girl improves and there is no cancer or other problem.

sandra texas

Hi Samantha I would advise you not to go back to your local vet for monitoring as once you go back they they virtually take over the case. I made this mistake when I left Lort Smith and the local vet did the monitoring due to the distance to travel to Lort Smith hospital. They did not have the expertise at all. Not enough tests were done and I was advised that nothing more could be done for him. I got copies later of the CBC's which advised for a bone marrow aspirate which I was not even told about. When they told me nothing more could be done I believed the local vet. By the time I returned to Lort Smith it was too late. He was too sick. Werribee hospital could have done a 2nd transfusion which might have given him more time as they are the only facility for cross matching blood. But Lort Smith vets with advice from werribee decided he would have little chance by this time as he had no response to treatment. I wish I had gone straight to Werribee or stayed with Lort Smith from the beginning as I believe much more aggressive treatment could have been tried. I reluctantly had him put to sleep and regretted that I left it to the local vet to treat him. His conditon was advised as severe worsening non regenerative anemia. He was only a puppy 9 months old maltese x shih tzu named Scruffy. Dearly missed even now after 7 months.

Julie Australia

Our dog developed AIHA 3 years ago, and with the first episode, we had him at the emergency animal hospital for a week and he received 3 blood transfusions. After coming home, we had him on steroids for 9 months, and on the advice of our local vet we weaned him off the steroids gradually. Less than a year later, he had another episode that came on more agressively than the 1st, and trusting our vet, we had blood tests done, but didn't admit him to the hospital. Within 3 days, our 7 year old westie had passed away despite steroid shots and oral medication. Although our vet was and is very good - this condition requires specialty treatement which he was just not familiar with. We still don't know exactly what caused this - our suspicion is a groomer improperly cleaning their nail clippers which caused an infection and resulted in antibiotics throwing the immune system out of whack. My two cents for what it is worth - deal with the vet hospital for this type of treatment, avoid commercial dog food, and vaccinations if possible, and bring your own nail clippers to the groomer. If they are professional they won't mind or be insulted!! Good luck, and all sick puppies are in our prayers. BTW - we now have a new goldie pup who is doing fantastically.

Debbie Ontario Canada

Debbie, Congrats on your new puppy! Penny

Penny Lytle Creek Calif

This thread was discussed between 24/01/2009 and 05/02/2009

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