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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - AIHA dog losing weight on Prednisone
| Hi, This is a long message from a frustrated, anxious owner, so if you want to cut to the chase please scroll down to the questions :-) Eddie is our beloved 8-year-old Cairn terrier. He lives in Sweden. He has been diagnosed with AIHA, and after a week's stay at the hospital, he came home on Sep 6, weak but glad to see us again. Eddie had a previous bout of anemia, not clearly diagnosed by the first vet - I went to a local hospital with him on a June Sunday and she later said his low PCV might be the result of the blood sample being refrigerated while waiting for the lab to run tests that Monday. Eddie pulled out of the first anemia himself - though not hungry at home, he ate a can of Hill's a/d with gusto at the hospital! Therefore, we put him on a cure of rest and a/d, and he managed just fine. We then went on a caravan holiday with him along the west coast of Sweden, and he loved every minute - especially negotiating the rocky skerries and islands and exploring the woods. He tested Coombs negative in June and the vet couldn't find anything to tell us. (As we began to review later, we realized Eddie had likely had small "mini-bouts" characterized by a few days' limping here and there, or fatigue, over the past two years. We didn't worry because these passed so quickly, and questions to the vet got the answer "if it continues, bring him in". Eddie was very active indeed, the picture of a bright-eyed, mischievous, lovable Cairn - but you all know this story - the dog is chasing a ball one day and completely exhausted the next...) The second bout came in August; he started panting and his legs collapsed under him. We took him to our original polyclinic vet, and she took one look at his inner eyelids and told us to rush him to a larger vet hospital - the only one in the region with a canine bloodbank. Eddie was admitted with a PCV of 19, and they said that if it dropped to 15 he would receive a transfusion. A week later he was released. He never got a transfusion, but was on IV, Imuran, Prednisone, and stomach medicine. He received canned i/d once his appetite returned. Before he was released he was taken off the Imuran because it wrecked his stomach. He's currently on: - Prednisone, 20 mg in two 10 mg doses per day (after my own question about getting 20 mg only once per day) - Protexin probiotic dietary supplement - Rani-Q, an over-the-counter stomach medicine - Sucrulfate On his return home, he had severe diarrhea again, and we changed his food to dry Royal Canin Intestinal - he's eating like a horse and shows extreme interest in any kind of meat we may be eating (of course he doesn't get any human food). That's the cortisone talking, perhaps. His diarrhea's gone, but his feces are soft - and in great quantities. It's almost like the food is not being digested. Anybody seen anything like this? Also, he's losing weight - from his match weight of 10 kg, he's now 8.4. He's so skinny, and going out for very frequent but short walks craves all his energy. How small can he get before there's permanent damage? It just feels like he's wasting away, and we just don't want to prolong his agony. On the other hand, if he has a chance for a quality life, we want to give it to him. Eddie does seem to have a strong will to live - he's fairly alert and interested in everything, and glad to be with us. My questions in short: - Weight loss - are we going to see this continue, and how far can it go? How much food is too much, is he is so obviously hungry? - The vet said rice is ok too - any other suggestions on what might stick to his ribs better? - Imuran - should he not be on this too, despite the stomach issue? - PCV on this bout started at 19 and has stayed there for almost 2 weeks (21 yesterday, Sep 10). When should we expect a rise? Can he hover at this for a longer time? When should we start pressing the vet for alternative treatments, and is it worth it? - Is walking better for him, or does it consume vital energy? He's easy to carry, especially now, though I have to fight not show him how it breaks my heart. - All the neighbors love Eddie, and all the other dogs on the street too. We are trying not to stress him, but quiet meetings with friends really seem to cheer him up. His canine friends are healthy and vaccinated. Any opinions here - to meet/not meet canine and human friends? I know I have a lot of questions, but if you can give me any advice or opinions, I would be so glad. This will help me when I call the vet again on Monday Sep 13, and for Eddie's next checkup on Thursday Sep 16. |
| Peggy Sweden |
| I don't have a lot of AIHA experience, my dog died 4 weeks post diagnosis but my girl did lose weight also My personal thought would be to cook his meals (since he is a small dog) instead of using a commercial kibble. That way you would be able to fully control all the ingredients, fat, calories etc.. and get him to eat the highest calorie most digestible food he can process |
| Rottlady NH USA |
| Dear Peggy, I am so sorry to hear your darling Eddie has been diagnosed with this awful disease. Dogs usually put on weight with the increase in appetite from the Prednisone. It may be a good idea to talk with your vet about Eddie losing weight. I had a similar problem with my non- IMHA dog, and one thing the vet suspected was liver shunts. Peggy, Imuran or Cyclosprine are often used as a second drug with Prednisone, so I would definitely talk with your vet about adding one of these to Eddie's med regimen. Be patient with the PCV rise, it can take time. Do you know Eddie's reticulocyte count? These are baby red blood cells the bone marrow releases in response to the anemia. A high reticulocyte count indicates regenerative anemia which is ideal and shows the body is producing new red blood cells. I would keep Eddie rested, and not get over excited. It would be fine for him to spend time with his human and canine friends, but he is really going to tire easy and rest is essential to his recovery. I hope Eddie is ok, please keep us updated. Sam and Millie. |
| Samantha Geelong Australia |
| hi Peggy, Forgot to ask if your vet had done ultrasound or x rays to rule out cancer as a cause? What about testing for tick disease? samantha. |
| Samantha Geelong Australia |
This thread was discussed between 11/09/2010 and 12/09/2010
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