Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - 4 yr old Milly diagnosed 5 days ago

I'm into day 5 now and feeling desperately worried about my four year old, Milly, a cocker/cavalier king charles spaniel mix. I took her into the hospital last Tuesday night as she was lethargic, etc. They confirmed her diagnosis immediately with a blood count of 22, gave her a transfusion and started her on steroids, pending other lab results. Since then, her blood count has gone up and down, when it gets below 20 she gets a transfusion. She's getting her 3rd right now after her count dropped to 17. She tested positive for tick borne disease but they are not convinced it's the primary cause. She's got a UTI and is being treated with two antibiotics for these issues. Her disease is regenerative so her marrow is producing red blood cells but her body is killing the off pretty fast. Only about 36 hours since her last transfusion. They may start her on a third steroid today to see if she responds, but it's a slow acting one so we won't see any response right away. It's hard to know if she is responding to the pregnazone. The doctors tell me it's a roller coaster and we're just 5 days in but I'm getting the impression they're getting increasingly worried about her lack of response and just how fast her counts drop after each infusion. She's better for about a day then crashes. Like everyone here, I love this little dog to distraction and cannot bear the thought of losing her. I'm reaching out to everyone here for hope, advice, guidance.....anything that may help me help my pup. I've read other posts here and when I go back to the hospital tonight, I will ask for a full report of the meds she's on and all of her counts so I can follow up accurately with any questions. Thanks in advance.

Judy Medford

Sorry to hear that your Milly was diagnosed. Cocker spaniels are susceptible to AIHA so perhaps that's why they aren't convinced it's caused by the tick disease. With all that's going on (UTI & tick disease) it is no wonder she is not responding to the meds very well. Treating those is the first step and once they're clear you'll probably be shocked at how fast she begins to respond. She should be getting plenty of rest, water, and low fat food (rice & cottage cheese/hard boiled eggs/chicken or fish) Also, if she starts having diarrhea, add pumpkin to the mix. Fingers crossed for her.

Monet Sammamish

Thank you. I'm learning more and more everyday. Milly is just finishing up her third transfusion. She has been in ICU at the hospital since diagnosis as she has not been stable enough to come home so she is getting plenty of rest. She has no real appetite due to the antibiotics upsetting her stomach. She's on an appetite stimulant, IV fluids, blood thinner, as well as the steroids (3 types now). Though her counts improve with each transfusion, they degrade quickly thereafter. That's what's so scary. She's only 25 lbs - probably less now with little food over 5 days. Will get full list of meds and data on blood to post after visiting tonight. I need help/ideas on how to get her to respond. Thanks again.

Judy Medford

She may be more inclined to eat if you warm the food, use a variety (I had a lot of luck with Merrick can food and canned tripe), or use something with a nice texture (A/D by Hills, or you can wizz it in the blender with some water) Sometimes, they'll turn it up in a bowl but may eat from your hand, or if you smear it on their gums.

Monet Sammamish

Yes, I've been bringing in her favorites - cheese, turkey, etc. and feeding her little bits at a time. They're great at the hospital - they try turkey, chicken - anything they can get her to eat. Last night she ate a few animal crackers - go figure. But we're talking 3-4 bites once in a while. She was vomiting every day which complicated things but that stopped yesterday. Fever has gone away, heartrate is mostly stable though respiration is still a unstable.

Judy Medford

Judy, In your initial message you listed not one, but two potential causes for AIHA - tick borne illness and a UTI. I would push for an antibiotic that could help Milly in both cases, if one is available or have them treat her for one at a time. The tick borne illness would be the first most likely target. Given that Milly is regenerative, I bet this could very will help to resolve her AIHA. Tick borne illness is HIGH on the lest as a cause for regenerative non-idiopathic AIHA. Have them target this first, IMHO. There are many more highly educated people who frequent this board. Being educate and proactive about Milly's care will empower you to helping her get well. As for food, try chicken or beef baby food. Its often easier to keep down and dogs love it.

RobertN Superior

Judy, I would recommend contacting Dr. Jean Dodds. Her email address is: hemopet @ hotmail . com (address broken up so that it's not omitted by bulletin board filters. Jean is the preeminent leading researcher in this field. Her work has helped define many treatment protocols.

RobertN Superior

Thank you, Robert. I will definitely reach out to Dr. Dodds - maybe later tonight when I get back from the hospital with the latest results so I can be very specific. We are lucky to have an excellent hospital here - the MA Veterinary Referral Hospital- with extensive experience with this disease but you never know - they can miss something she may respond to and I don't want to leave any stone unturned. She is being treated for both the UTI and the tick borne illness. They started her on both antibiotics even before lab results were back just in case. Even though they keep telling me it's only day five, they caution me that if she's not responding in another 2-3 days, they will be very concerned about her prognosis. Thank you for the contact info for Dr. Dodds.

Judy Medford

Hi! How is Milly doing today? I Hope that things start going better for you both.

Kathy Calif.

Hi Kathy. So nice of you to ask. Milly is still in ICU. She finished her third transfusion yesterday at about 4 pm and her count rose to 30. It dropped to 28 last night and was 28 this morning and still 28 at 4 pm today. That's considered stable and really good news. Though her pattern has been to be this good for 24-36 hours following her transfusion. After that her numbers start to drop again. Another test at midnight and in the morning so I'm keeping my fingers crossed, praying, etc. for another stable number. They added Imuran to her cocktail today and gave her some iron too. Also full blood panel so we'll see where she's at with all her numbers. But, all things considered, today is a good day. Stable heart and respiration, wagging tail, eating, pink, happy. I know it doesn't mean much unless her numbers stay up but it's a well needed bright spot. Thank you again - so much - for reaching out.

Judy Medford

Judy, Even though it's not what we all want to hear when it comes to our Fur family, It is good news that she is staying Stable. I Pray that she will be out of ICU soon and that she'll soon be home with you, where she belongs. Please keep us posted. We Care.

Kathy Calif.

This thread was discussed between 27/11/2011 and 29/11/2011

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