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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - 3 Cocker siblings, 3 cases of AIHA
| Three cocker spaniels of a March 2001 litter. All three diagnosed with AIHA. My two boys have passed on; Buckwheat on April 10, 2010, Sweet William on July 15, 2011. Only Holly remains, and is now treated for another relapse of Evans since primary diagnosis in 2008. Buckwheat passed away a mere 27 hours after diagnosis. Too fast to make a decision, too fast to even treat. William was on the second relapse of AIHA, this one much more sinister and progressive. There wasn't enough time for the steroids to work. We had to say goodbye to both boys too early. Now Holly has muscle wasting and progressive myopathy with partial paralysis of both front and back legs. She is deaf and has survived a ruptured disc and surgery from a congenital malformation causing a missing vertebrae. She has ruptured both ACL's due to the high dose prednisone, with one surgery to repair the damage and give her a chance to walk again. It is unlikely we will take her off the pred now that we are experienced and understand relapses. We understand that her next relapse will most likely be fatal. We have decided, no more heroics. They all went through too much. William and Buckwheat both developed glaucoma in the month before the fatal AIHA crisis. Coincidence? Maybe, but now we watch Holly's eyes and her gums. When it is time Holly will pass away at home, in our arms, warm and loved, last touched by her family, nosed and sniffed by the rest of the pack, with the "normal" sights and sounds of home close by. When Holly's time is close I will hold her to my chest, wrapped in a blanket. She is a tiny cocker by cocker standards and has been adored during her time with us. I will kiss the top of her head, and even though she can't hear me anymore, I will whisper words of love into her soft black head and long fluffy ears. I will tell her how much I love her and ask her to wait for me with her brothers. My heartbeat and hers will mingle together until I can't hear hers anymore. We know that the end is not always pleasant, but I can make it as peaceful as possible for her. This little dog of my heart. We are not making a decision to give up on Holly, but to give her the end of life she deserves. |
| Liz Ohio |
| Hi Liz, Wow, what a sad story. Very sad that you have to go through all that with all of them. I am sure it has made big changes to how you feel about treatments and illness, suffering etc. I know just one dog going through this has changed me. Since the predniosone took all Dylan's muscle and left her paralyzed within 4 weeks, now that she is off prednisone, I have to be very careful to protect her from injuring herself, or one of my other dogs injuring her. I can't afford cruciate surgery. I have heard that AIHA is more common in Cocker's amongst a few other breeds. Unfortunate for sure and hte rtare certainly genetic links to the underlying likelihood of getting these diseases. I have also read recently that Glaucoma can be caused by an Autoimmune attack, so I would not consider it coincidence. The other thing they have in common is both AIHA and Glaucoma can be related to hypothyroidism. It is also becoming more well known that hypothyroidism can be caused by an autoimmune attack that is very often misdiagnosed due to inadequate testing. So is there a relationship? I do think so. I know how acute the attacks can be. I would think that if you want to use long term suppression though, that something other than prednisone should be used. From what I know and what I have heard, it won't stop a relapse if you are giving it at low doses, as it does not suppress the immune system at low doses. You already know what high doses do. Dylan is off all drugs after only 3 1/2 months and I have an emergency response plan in place to try and save her from a relapse, including always watching her pee and checking her gums and tongue and thewhites of her eyes (all showed signs previously). Her first symptom last time was hesitation to eat, so if she ever does so again, you can bet it will freak me out completely. I could not give her a low maintenance dose, as it is only making me feel more comfortable and not preventing a relapse and I am not prepared to give her other drugs either. In her case the evidence indicates a more acute attack where the cause was gone quickly (pcv back to 39 in 10 days). We have no idea exactly what triggered it though. Have any of the dogs been on Azathioprine, or cyclosporine? They are generally used for more long term immune system suppression. I almost said goodbye to Dylan in her anemic state and if it were to occur again, that is not the worst place to say goodbye. I also make no decisions today, but severe treatments and transfusions will not likey be used with her in the future either, although I do have an aggresive short term prednisone treatment plan designed for an acute attack like the last one. I will withdraw prednisone faster than I did last time provided I also see a fast recovery of her PCV again. Otherwise, I am not sure I would have the energy for a long fight. Again that is a decision for another time though. Good luck and I hope you have lots of time and never do see that relapse in Holly (maybe there is a little good luck there somewhere). Sincerely, Richard and my Dog Dylan |
| Richard Burnaby |
| Liz, I am so sorry you have had to walk this path so many times. I believe that these special dogs are sent to us because they will be so well taken care of. I am sure when the time comes Holly will "hear" your words as she already knows how much you love her. Take care Penny |
| Penny Lytle Creek Calif |
| Liz, I am heartbroken to hear your story and the recent passing of your William. I also have a cocker spaniel around the same age -- 10 this coming August -- who was diagnosed in October, 2010 with this disease I never heard of before. I am now told that cocker spaniels have a much higher mortality rate when IMHA strikes, and if they do survive, will very rarely make it through a relapse. Beau is now on what my vet considers his lifetime maintenance dose of meds -- 10 mg of prednisone every other day and 12 mg of azathioprine every third day. So far, so good. He suffered very serious effects from the higher doses of pred he was on in the beginning, but they too are resolving. No apparent side effects from this lower dose. I feel your pain with Holly. I made this same decision for Beau. Fortunately, we are not there but I know that time can come at any point. Beau is also my "heart dog" and I couldn't bear to put him through again what he has been through already. We take it one day at a time and appreciate each moment we share. I've had dogs that were euthanized at the vet's office, but about three years ago I had my beloved 14 year old German Shepherd die in my arms at home from what we believe was a very quick onset of bloat. At her age, which is very old for a German Shepherd, I knew heroics were not on our agenda. It was very peaceful and while very emotional, a beautiful natural progression. I hope and pray that you get to spend many more fun days with Holly. And that you and your family are more at peace when the inevitable occurs. Sharon |
| Sharon PA |
| Liz, Words can't explain how sorry I am for the loss of your two boys, and that your sweet Holly has also suffered from this horrific illness. I am sure Buckwheat and William felt all your love for them, and Holly does as well. I pray that you and Holly have many wonderful days ahead. I am new to this walk....I haven't thought about what we will do if Bentley does not respond to treatment. I hope I can make a decision with as much love and comfort for him as you have. All the best, Sally |
| Sally Louisiana |
| (((((LIZ))))) I remember you saying before about having two that had/have this disease. So sorry sbout the recent loss of William and the previous loss of Buckwheat! My strong thoughts and prayers are with Holly (and you) during this battle. I thought i had it bad with two cases....I can only imagine the pain and anguish associated with having to deal with a THIRD case! There is a hereditary genetic component associated with ALL autoimmune diseases. It lies within the Major Histo-compatability Complex (mhc) genes. I won't go into boring detail about htis but it is of note to say that all relatives are at increases risk is one is diagnosed. I learned this all to well with my Tessy and Sadie (sisters). Again, my thoughts and prayers are with you during your atruggle with Holly. Johnny & Tessy |
| Johnny |
This thread was discussed between 18/07/2011 and 19/07/2011
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