Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - AHA In Puppy 9 months

I have a nine months old Maltese x Shih Tzu who has IAHA. The vet has never seen it in a dog so young. He had a blood transfusion one month ago but his red blood cells are not regenerating and he has less than 1 percen regeneraton at his last blood cell count. He is on Imran and macralone tablets. The vets feel there is nothing more they can do for him and he is not regenerating. He is still quite b right, eating, greeting me etc. but his future is grim. He had a PCV test 10 days ago and the vet told me he would only live 2 to 3 days. I am finding it very distressing knowing there is nothing more they can do for him. I don't want to put him down yet as he is not suffering and is eating well. They have no idea what could have caused this. He took a bite out of a toadstool shortly before he got sick but he spat it out and did't eat it. The vets think it is unrelated.

Julie Australia

Julie, I am so sorry to hear your most beloved Maltese/Shih Tzu has been diagnosed with AIHA. While AIHA is a very difficult disease dogs who have been diagnosed with it CAN and DO survive and go on to live happy healthy lives. If you have not read my Web site on AIHA/IMHA as yet you might want to do so when you can. The URL is: http://www.cloudnet.com/~jdickson/ Be sure to follow the links on the first page to many other sites on AIHA/IMHA that will be very helpful to you and do read the SUCCESS STORIES pages. The will show you what has worked for other dogs in terms of treatment options as well as give you a lot of HOPE. I have seen several dogs even younger then your dog who have had AIHA/IMHA. Some of them as young as 4 or 5 months and most of them have done very well. Many times with AIHA/IMHA it can take a long time for dogs to turn the corner and start to recover. The fact that your dog is "quite bright, eating and greeting you" are all good signs. Is it possible for your vet to consult with a specialist in your area to get another opinion? If so, I would suggest you have that done. Know that both you and your beloved canine companion are my thoughts and prayers during these most difficult days.

Joanne MN

My little dog Scruffy the Maltest Shih Tsu is still the same. He can run and greet me in the morning and he is eating well. He seems to be more lethargic as the day goes on but he can still bark. He must be such a fighter. I can only hope the the medication he is on is going kick in. The problem is two blood tests have told of non regenerating anemia. The vets has consulted with other vets and he was in a vet hospital for the initial blood transfusion when his PVC got to 8. It went up to 17 after the transfusion but dropped to 11 10 days ago. It is a month from his transfusion. She told me basically that he would only last 2 - 3 days but he is still going. The imuran does take time to take affect so I am hoping this is helping him. He has put on over a kilo in weight due to the drugs. They feel doing another transfusion would be pointless as I would be back to the same result as it wore off. I am taking it day by day but he is getting hugely spoilt and every day I am making it special for him. I am feeding him three small meals a day as he is always hungry and am giving him liver for one of those meals. This disease is so cruel as before it came on (suddenly) he was such an active little guy who loved to dig holes all over the backyard and run and jump. Thanks for advice on the web site. I have learnt so much about what is happening to him that vets just cannot explain in such detail, it is so valuable and it it helps you cope with it. I am not doing any more PVC tests at the moment just observing him and how he is responding.

Julie Australia

Julie -- I am sorry to hear that IMHA has hit a dog so young, a puppy. But as Joanne has noted, we have seen it all on this forum. Your dear Scruffy sounds like he's holding his own. Maybe he ingested something that triggered the IMHA, and his body is just taking some time to regenerate. He is, after all, a puppy. Please take care and hang in there. And please keep us posted. There are many knowledgeable people on this website, so you're not alone.

Brenda VA

i would suggest going to a specialist, especially if your vet is saying 'there is nothing more they can do' ...of course there is! right off the bat there is medicines that you didnt list that could offer some possible relief, including prednisone or cyclosporine...or a combination of both. look into adding those into a treatment plan, but i would definately get a 2nd opinion via a vet that has a history in dealing with this disease. good luck to you and your puppy! i hope you both are well

josh california

Thank you for your advice. I will discuss this with my vet. The vet I am under put Scruffy in Imuron which is a cortisone in additon to macralone. I think macralone is another name for predistone. I know it is a steriod. The Lort Smith Animal Hospital did the transfusion and they put him on macralone. They are one of the largest vet hospitals in Victoria. The vet did tell me that other drugs were extremely expensive and I am on a very limited income. He has put a lot of weight on and is very thirsty and drinks a lot. He seems to have stabilised but is not making improving progress. He sleeps a lot of the time to conserve energy. He loves just to be with me. He is eating and is able to walk a little and can still wagg that lovely curely tail which I think is the best of all. If he worsens suddenly I am considering having him put to sleep so he doesn't suffer as he has been through so much already. His blood tests described his condition as severe worsening non regenerating anemia and suggested he have a bone marrow test but they have no doubt of his diagnosis of AIHA. His last PCV test was 11. I thank everyone for their help and advice. It is a heartbreaking condition and puts you through every emotion imaginable. The vet expected him to rapidly deteriorate in one to two days and it is now 12 days after this diagnosis, so there is still a faint hope.

Julie Australia

Can anyone tell me how long red blood cells last in a dog before they are completely used up. Scruffy had a blood transufsion one month ago and the vet does not want to transfuse again as his pathology tests were so bad. Less than 1 percent regeneration. They told me he would only last 2 to 3 days but is still alive two weeks after his last CBC count. He is weak and sleeps a lot of the time but can still wagg his tail and get out of his basket and can eat and walk (slowly). I believe his blood transfusion would be gone by now and am wondering how long normal RBCs last that he would have had before he got sick. It is so hard as I don't know how he is going to be every day. He is still on all his medications Inuram and also macralone (steriod). I don't want to have him put to sleep until it is apsolutely necessary. Thanks.

julie Australia

Julie, I don't know all the details of your lab work. However, Chance was diagnosed about a year ago with non regenerative anemia. Very similar to your "less than 1% regeneration." It's very serious, in fact Chance was not making white blood cells either. Double serious. A bone marrow biopsy didn't necessarily tell us anything we didn't already know. We had one done, but in the end it really didn't help with the treatment at all, it only confirmed that his condition was dire. I think specialists like to do them to confirm their diagnosis. My vet was exactly the opposite of yours. When we did not know what was happening and Chance's numbers began to drop she said to me, "Patrice, when this happens to humans we give them transfusions. We care for them to make them feel better until we can figure out how to help them make blood again." Transfusions last a variable amount of time. It depends on so many things that it's hard to say for sure. If the hemolysis has stopped (the destruction of blood cells by "self") then any transfused red blood cells will probably last somewhere near the normal 120 days. Other blood elements do not last as long. We are constantly making and losing white blood cells. Platelets don't last very long from a transfusion either. If Scruffy is still making white blood cells and platelets, you are ahead in the game. But that's not a good reason to refuse to give another transfusion. The most important thing is that the next transfusion be done safely. There can be compatibility issues with donated blood so it's important to cross match any future transfusions (each time) to make sure it will be the right match and not cause any reactions. Getting blood from a source that provides safe and highly matchable blood is the best thing if your vet is unsure about another transfusion. Please contact Dr. Jean Dodds at www.hemopet.com and find out if you can get her special donor blood all the way to Australia. If not, she will probably know where you can find some where you are. We actually used the vet's donor dog Jake. His blood was a good match for Chance and the fresh whole blood transfusion was like a miracle for him, it improved his condition a great deal. Julie, I can tell you that this can be accomplished and you can do this if your spirit is willing. Right now Scruffy is counting on you to pull him through. It will be through your effort that it can happen. The most important thing you can do is to educate yourself as fast as you can about this condition. Read everything on the internet you can find about non regenerative anemia. Learn how to read the blood test results so *you* know what you are looking at. I often stayed up till early in the morning reading textbooks and papers I had printed off the internet. Please consider contacting Dr. Jean Dodds for help. Search this board for her contact information (search is at upper right hand corner of this page) or maybe someone can help me get it up here tonight. I don't have it right at my fingertips, only her email: hemopet @ hotmail.com. (Remove the spaces to send) I know she will help guide your treatment by email. She helped me to save Chance's life and I know she can try to help you also. my best to you patrice

Patrice NYS

Thanks for your help. I will make some searching for what is best to do. Unfortunately, there is limited places to get transfusions and the vet feels that as he is not rgenerating I am not going to gain anything as he will go down hill again when the transfusion wears off. His plakelets and white blood cells are normal and he did have less than 2 percent regeneration but this dropped to one percent. But as soon as they got the report which stated severe worsening non regenerative anamia they felt nothing more can be done for him except treat him with his drugs. He was a healthy dog that got struck down suddenly but that seems to be the nature of the disease. THe drugs he is on don't seem to have helped him much but I feel the Imuron has at least slowed the destruction down. Dr. Jean Dodds sounds fabulous and I will try to contact her for advice. After the initial transfusion his PVC went from 8 to 10 then 14 then 17 and then it started dropping again all within 10 days of the transufion, and within two weeks it was down to 11.

Julie Australia

Patricia thank you for offering me so much advice. Can you tell me how long your dog Chance went with non regenerative anemia before he started to get regeneration and also how many transfusions did he have. I am going to contact Lort Smith animal hospital who did the transfusion and ask them about Scruffy getting another transfusion even though the local vet thinks it is hopeless.

Julie Australia

Hi Julie Im not sure if I told you when we spoke, but Bert needed two transfusions. He took almost 6 weeks before he started regenerating. I was also told by one vet that there was nothing they could do for him after 10 days so moved him and honestly he is now 3 years old and you would never know he was so sick. He too was very tired as you describe, but he didnt wag his tail for weeks. So I think that sounds positive in Scruffy. The transfusions are really important in buying time for the drugs to work effectively. We all know how hard this is, it is gut renching to see a healthy puppy go from being so playful to doing nothing. It was one of the most difficult times of my life. Hang in there, we are all praying for you both. The key thing to remember is there is no quick fix for this, it takes time. Hence the reason transfusions are so important and the importance of making sure who is doing them knows what they are dealing with. He does seem to have fight in him, the tail wagging and you did say he was eating, to me positive things. Sending prayers Scruffys way. Lisa

Lisa West Aust

I am so sorry about your puppy. My golden retriever, just 4, was diagnosed n oct. 9, 2003, put in icU and died there 8 days later. Druing that 8 days he had transfusionsof 2 units of blood each time, twice. it would bring his level upp a little that day, but it would go back down rapidily, his neer got out out of theteens. We do know that his was brought on by proHeart6, the 6 month heartworm preventative injection. It is also known that vaccinations sometimes bring it on. Had yur Scruffy had any vax , ec within 6 weeks of being diagnosed?

sandra texas

Julie, Chance was non regenerative from about May 2007 until about late August 2007. He received 3 transfusions. He is around 100 lbs and received 40mg prednisone to start, that was upped to 80mg by the specialist. When I contacted Dr. Jean Dodds in mid June she advised us to begin with no more than 225mg cyclosporine. Our vet suggested Atopica, which is the veterinary formulation of this drug. He was on what she calls a pulse dose schedule: atopica mon-fri, sat and sun off. Pred 2x day. In addition we had him on other drugs to minimize the side effects of the prednisone: pepcid to control stomach acid in response to the prednisone, sucralfate to protect the lining of the esophagus and stomach, Denamarin, a veterinary formulation of Sam-e and the essence of milk thistle, silymarin, to protect the liver and help repair damage. Because he was not making white blood cells he was constantly at risk for infection so we had him on a variety of antibiotics nearly the whole time. It varied depending on any infections he might have had, or if he didn't have one we would pick the one that he had the fewest problems with. We had to monitor his temperature about 4 times a day in order to determine if he was developing any opportunistic infections. He is also hypothyroid so he gets .6 Soloxine 2x day. I always have him on several vitamins and he gets a home made diet. When we received his diagnosis, the specialist said it would be dangerous to continue with raw food so I began to cook all of his food. It was not until the middle of October did we feel that he really had been through the worst of it and would survive. He lost a lot of hair, all his muscle tone and had a variety of skin problems such as raw elbows. But his RBC and WBC numbers began to rise and his out of range chem values began to drop down or average out as we were able to decrease the prednisone. Dr. Dodds advised us throughout this time with suggestions for dosages and schedules. I never allowed Chance to go below a pcv of 18 and had a transfusion at that point. I think, after reading many posts here, that dogs vary in the level that the pcv can drop to before they seem to feel very bad and start to have serious side effects. He is a large dog so perhaps that had something to do with it. Or perhaps I just knew that it was too low and perceived that it was making him uncomfortable? What is important to impress upon your vet is that *autoimmune destruction can occur at the red blood cell precursor line in the bone marrow.* It doesn't matter that you find the cause of this as much as it matters to treat it like an autoimmune condition! If they have done all the proper diagnostics already, looking for tumors and cancer, tick diseases, ingestion of toxic substances like meds, rat poison, certain foods, and zinc coins, then you are indeed left with the possibility of an unknown cause. If you are up to contacting Dr. Dodds, do it now. Make sure you have your blood test records when you email her and be concise. Subject it something like: Scruffy Your last name, Maltese, Possible Non regenerative anemia. Patrice

Patrice NYS

I took Scruffy out to the Lort Smith Animal Hospital where he was assesed by a team of different vets including advice from specialists at the University. His PVC had dropped to 8 exactly what it was when he had the first transfusion. He needed an immediate transfusion that would have had to be cross matched at a different hospital where they had the facilities. All the medications he was on had done nothing at all to help his bone marrow recover. They felt that the AIHA was a secondary conditon to an unknown primary first conditon. He has an elevated temperature and was rapidly declining. They also felt he had a mass near his liver of unknown origin. I was told that had his PVC droped to 6 he would die. After a heart renching consultation it was decided he had suffered enough and I decided to put him to sleep and end all his suffering. Their opinion was that even after a second transfusion that his chances were very remote to recover as he had no responce at all to very strong medications that he had been on. It has been a horrible roller coaster of emotions and I thank everyone who has given me encouragement and advice. Everything posted has helped me immensely to cope. Scruffy had been quite bright and was able to eat and greet me but over the last two days his conditon declined very rapidly and it was obvious he was in serious trouble.

Julie Australia

Sandra Scruffy had had no recent vaccinations or heart worm medication. He had Advocate a flee treatment but had had that before with no problems. He took a bite out of a fungus growing on a tree but spat it out a couple of weeks before he got ill. He became ill whilst I was away on a week's holiday and my son was looking after him. When I left to go on holiday he was fine.

Julie Australia

Julie, I am so saddened to read of your loss. Even when things are at their worst it is never easy to have to make that decision. I hope in the coming days you can remember the happy days you had with Scruffy and know that he is at the bridge with a lot of our dogs healthy and happy waiting until you are reunited once more. Penny

Penny Lytle Creek Calif

This thread was discussed between 26/06/2008 and 03/07/2008

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

This thread is from the Vetnet archive. The live Vetnet forum is active now.