Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - AIHA - Peanuts

I have a 4 yr old neutered male beagle named Peanuts. About a week and a half ago I've noticed him acting strange. He kept licking certain spots of the carpet in my room. He also kept chewing on random things such as bricks, metal, wood, and so on. He seemed more lethargic as well. He also ate his kibble slower than usual. I checked in his mouth and noticed his gums were a bit pale. Next day I brought him to the vet. The first thing he noticed were his gums. He said he was anemic and took blood to send to the lab. The following day the doctor called me with the results and confirmed that he had Auto Immune Hemolytic Anemia. His RBC count was 1.3 (normal is 5.0-9.0) and his HCT was 8 (normal 36-60). So he immediately wanted to do a blood transfusion. So after that was said and done I picked him up later that night. He was definitely less pale than when I brought him in. He was really tired when he got home and just slept all night. The doctor put him on Pred and Doxy twice a day. He didn't have much of an appetite the next day and was just resting. I noticed when he urinated the color was dark red. The doctor said it was normal right after a transfusion and said just to keep an eye on it for the next few times. Still his urine was dark red a few times after that. The doctor told me his body is probably rejecting the blood and we would check the blood values in a couple days. Peanuts started to act normal for the next couple days. The only thing was he didn't eat his kibble but preferred boiled chicken breast and white rice (Doctor recommended). He was a bit tired at times but what to you expect when your RBC's are that low. So here I am today 5 days after the diagnosis with the latest results from the blood test. RBC count 1.38, HCT 9. Obviously still very low but slight improvement. I don't know if the pred is kicking in or if its just residual from the transfusion. I will have another blood test for Peanuts in a couple days to see where we're at with him. I'm looking at him right now laying on my bed just resting. Gums a bit more pale. I just hope he can be a success story so we can boost the percentage of dogs that actually survive this disease. I just want to say this site is really great and had given me a lot of knowledge and hope.

Erwin CA

Erwin, Sorry to hear about Peanut, I really hate this disease! You need to check his PCV sooner than later, a HCT of 9 is really low! Our dog was monitored every day sometimes 2 a day after the transfusions. They can crash so quickly, not to scare you but If it was me, especially with gums more pale, I would insist to be tested soon. I ended up taking our dog to the emergency vet because of the same thing, and they had to tranfuse her again, and she was at 11. I am sure more people on here can give you good advice as they have more expertise so please listen this is a great site! Be proactive though, good luck in your fight to save Peanut! Heather

Heather

Dear Erwin, I am so sorry to hear about Erwin's diagnosis. HCT of 9 is extremely low, and I'd be getting a PCV test done every day to keep an eye on this. If you can afford it, a stay at a Teaching Hospital/emergency vet might be in order so that Peanut's can be montiored 24 hours a day. I think maybe another blood transfusion may be something to discuss with your vet as soon as possible. Do you know if there is a trigger for Peanut's IMHA? Has he recently been vaccinated? Has your vet run a tick panel? It might be a good idea to have an x-ray/ultrasound to check for tumours, as cancer can be a trigger for IMHA. A lot of times, a trigger cannot be identified, so do not worry if you can't work that out. It is important that the Pred is dosed correctly. Can you let us know how much Pred Peanut's is on and his body weight. It would also be a good idea to talk to your vet about adding a second immune suppressing drug such as Cyclosporine or Azathioprine (Imuran). Your vet can also give Peanut's an injection of Dexamethasone, a powerful immune suppressent which can kick start the suppression. Please ask your vet if Peanut's has regenerative or non-regenerative anemia. This is very important to understand. Non-regenerative anemia is harder to treat, and dogs may require several blood transfusions until the anemia can be resolved. Please also discuss with your vet the use of low dose aspirin as a preventative measure for blood clots. Blood clots do claim the lives of many dogs with IMHA/AIHA. Please keep us posted on Peanuts, there are many knowledgeable and supportive people on this site. Our thoughts are with you, Sam & Millie.

Samantha Geelong

Erwin, I am so sorry you had to join this forum but you have come to a wonderful place. I am just going to get straight to the point. Your Sweet Peanuts is critical. This isnt something that you can recheck in a few days. Peanuts need to be in the er right now. I have been on this forum since 2002 and I can honestly say I have never heard of someone coming on here and say their vet told it was normal to pee blood as a side effect of a getting a blood transfusion. My advice is to get Peanuts into a specialist that knows what they are doing. A pcv at 8, or 9 for that matter, are more less one in the same......they are critical. I am sure you are a wreck but do you know if the vet has treated cases of AIHA? I get the impression that they did not fill you in on the seriousness of this disease or treat it as such. Please, please get your Peanut into emergency care. Just by you coming on here shows how much you love your sweet boy. Teresa

Teresa va

Erwin, I am so sorry you have to go through this with Peanut. As people said before, this is a serious disease, but with the right care you can overcome it. First of all you need a vet on board that really knows what they are doing! AIHA is quite rare, so your average vet is not very well informed on how to treat it. Transfusions are usually done around a HCT of 15% and usually dogs are not let to go home at this point either. Please go to the Meisha's Hope website to learn more: http://www.cloudnet.com/~jdickson/index.html Make sure to go to the success stories, they will give you hope while learning more about the disease. Since you are in California it would be easy for you to get in contact with Dr. Dodds at hemopet: http://www.hemopet.org/ she is the expert on AIHA/IMHA I am sure your vet is a good vet, but it really does not sound that he is on the right track. There should be a second immune suppressing drug given to Peanut, azathioprene or cyclosporin. He also needs a strong stomach protecting drug. Please keep us posted, best wishes, Brigitte

Brigitte BC Canada

I am sorry to read about Peanut's diagnosis and I hope and pray he can be treated successfully too. I agree with the others and think you really need to have his PCV tested today as soon as possible. Often a PCV which is in the single digits will require a transfusion. Also ask your vet about adding Imuran and Cyclosporine. Try to find a vet that has an experience in treating this disease. Are you anywhere near Dr Dodd's if so try to take Peanut there or at least getting a phone consult ($45.00) Sending prayers for Peanut. Cheryl & Ginger

Cheryl & Ginger Pinevile PA

I am sorry to hear about Peanut contacting this disease. I definitely think you need another vet. Lucky was doing the same thing. He was licking furniture and anything metal. At the time I didn't know it was related to the AIHA. I really hope he can be treated sucessfully. Keep us updated.

Jerry

Erwin, I'm so sorry to hear Peanut is going through this! I've gotta echo the advise already given. Seeking a specialist is an important step. Dr. Dodds may be closer than you think. I strongly urge you to contact her BUT make sure you take Peanut in TODAY for a recheck. If the PCV drops any further the body could potentially start to shut down or go into shock. Certain levels of oxygen are needed for the body to survive and there just isn't enough right now! Ask about adding another drug to the mix. I'll be keeping Peanut in my thoughts and prayers. Take the advise above...you won't regret it! Johnny & Tessy

Johnny

Dear Erwin, so sorry to hear about Peanut. You are right there is great information on this site and Meisha's Hope about this ghastly disease. Read the earlier posts on other's cases and you will learn a great deal. I don't like hearing that the urine was that dark and my gut is you have a kidney problem going on...You should have a number of diagnostics to confirm that this is IMHA/AIHA. These are chest exrays, stomach exray, ultra sound of liver and spleen to rule out ingesting of a metal object or tumours. If all that is negative a bone marrow aspiration is next....my advice having just gone through this with Juliet (she did not make it) is to get immediately to a specialist (veterinary internist) and get that doc to contact Dr. Dodds. Please do not wait...I did wait and believe we lost precious time. Good luck to you and Peanut! With you in spirit. Pat

Pat Vermont

Thank you all for your kind responses. Earlier this afternoon Peanuts went to the vet to recheck his blood. It fell even lower than the first time I brought him in. His HCT was 7. He seemed weaker today than any other day. So my vet referred me to a 24 hr clinic that specializes in these situations. He faxed them all the blood test results and Hx of Peanuts. When I arrived there with Peanuts the doctor told me he is very lucky to even be alive right now. So the new plan is to give him another transfusion to make him stable. They will also do a bone marrow biopsy to see if it's regenerating his RBC's. If it's not the prognosis is bad. He will be staying there over night with close supervision. I will get the results tomorrow. Peanuts is the first dog I've ever owned. He means so much to my family and I. He still has more living to do. Obviously he is not giving up even with his low blood results. And I don't plan on giving up either. Thanks again everyone for your support.

Erwin CA

This disease, syndrome is very fast moving and unrenlentless. It comes on without a symptom and kills within days. Not to be negative but it is extremely serious and fatal. It is costly. It is overwhelming and it is relentless and unforgiving. I wish for you the survivorship that you and your beloved dog deserve. You may be the survivor as there are many. Don't give up hope and I'll pray for you guys.

Mary

Erwin, It sounds like Peanuts is in very good hands now. While a pcv of 7% is about as low as it gets, there IS plenty of hope. Bless your heart. My Jacob had an all-time low pcv of 9%. Sounds like your Peanuts is a fighter just like my boy was. He was also my first dog ever, as an adult that was solely my responsiblity. He has since passed but it wasnt directly from the aiha. He lived a good long life and passed at 13, with over half that time LIVING with this disease. I tell you this to give you hope, as there is plenty. Easier said than done, but please take care of yourself and try to get you some rest. You need to be strong for your boy. Please keep us posted. And know that you and your boy have lots and lots of people thinking of you and praying for that pcv to start climbing. Teresa

Teresaa va

Erwin, Summer got her DX December 23.She had am HCT of only 12, when we got her to a vet who could help her it was 6%,after some aggressive treatment she is hanging in there,last week it was 35 ....she is right now sleeping at the foot of my bed. Today we went on a 2 mile walk. There is hope,I am hanging on to every bit I can get! Carrie and Summer

Carrie DFW

Just called the clinic for an update on Peanuts. They say hes doing very well. His PCV after the transfusion was 27%. One of the vets told me he's pinker and more energized than when he came in. Obviously the question is will he maintain it or will his body reject it again. They told me he will be on cyclosporine and doxy. I will be picking him up this afternoon. The bone marrow results haven't came in yet. Will update soon.

Erwin CA

Thats very good news!!! Sometimes they will require a few transfusions to buy them some time befor the meds kick in. Please keep us updated on how Peanuts is doing. Cheryl & Ginger

Cheryl & Ginger Pineville PA

So glad Peanuts is doing better after the transfusion! Praying the meds kick-in quickly! Blessings, Cindi & Tori (IMHA)

Cindi PCB

So when I picked up Peanuts today he greeted me with a wagging tail and he wanted a belly rub. He looked awesome. On the car ride home he was whining. This is actually a good thing because he always whines on car rides. It's just the last couple weeks going to the vet and back he didn't even have the energy to do that. So we'll see if his new meds can stabilize him. No results yet from the bone marrow biopsy. Another thing weighing on my mind...

Erwin CA

Erwin, Glad you have your boy home! What part of California are you in? It sounds like Peanuts is a real trooper and I hope that he continues upwards on his journey. Penny

Penny Lytle Creek Calif

Hi Erwin, I am glad things are starting to look up, and I definitely think that Cyclosporine is going to help Peanuts. Is he still on Prednisone? Erwin, you can get a good idea of whether Peanuts is regenerating red blood cells or not if you have a look at his blood tests. His reticulocyte count should be higher than normal. If it is low, then you know there is a problem. This might help put your mind at ease, or give you an indication of what is going on while you wait for the results. If Peanuts does have non-regenerative anemia, then it is definitely worthwhile having his thyroid checked. Many dogs with non-regerative anemia have benefited from a thyroid supplement - you have to kick start that bone marrow! Good luck, and please keep us posted. Sam & Millie. PS - Peanuts is such a cute name - I love it!

Samantha Geelong Australia

Yeah very good to have him back. I'm from the San Francisco Area.

Erwin CA

Thanks Samantha, I named him after the comic strip. He is currently on 100mg cyclosporine daily, 15 mg pred BID, 100 mg doxy BID, and sucralfate to coat the stomach.

Erwin CA

Erwin -- glad to hear that your sweet little Peanuts is feeling much better after a transfusion and his meds. Hope he continues to improve. I'm really partial to beagles -- they are the best breed.

Brenda VA

My wife and I just came home from the vet. Peanuts is PCV is now 33%! We didn't really expect this since his 2nd transfusion was just two days ago. That's 6% more than after that transfusion. It's the best I've seen him in a couple weeks. We have another appointment Tuesday. Oh and the bone marrow results came in and confirmed it was the regenerative form of AIHA. So I'm just hoping his PCV shoots up more in the next couple days. Other than that I am so relieved. I haven't been stressed like this in so long. I just want to thank my wife for contributions from bringing Peanuts in out of the vet and waking up early to give him meds. She is wonderful. I know this battle is not over yet. But with the support system of this thread and my wife I know Peanuts is will overcome this.

Erwin CA

That's great news!

Jerry

Erwin, just love to read these good news. You AND your wife have done a terrific job. Beagles are such tough little guys. My first dog was a beagle! Peanut is well on the way now. Please keep us posted and let us know what meds and supplements he is on. Try and get all the print outs from the CBCs. This will help a lot to understand what is going on. It is great to know he is regenerative. Best wishes, Brigitte & the poodle boys

Brigitte BC Canada

Erwin, It is indeed stressful. I am glad you and your wife are working together on this. That is not always the case. Try to relax if you can you don't want Peanuts to have to worry about you. Remember it is a marathon not a sprint. take care Penny

Penny Lytle Creek Calif

This thread was discussed between 26/01/2011 and 30/01/2011

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