Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - AIHA Vets in Scotland

I was wondering if people could recommend vets who are particularly knowledgable in AHAI, possibly ITP too either in Glasgow or Edinburgh. I have seen a few names mentioned o this board and wondered if a specific person was "the best"? I want to make a decision soon as to who I would like to be referred to should I feel the need. I would like to be able to state a specific vet not just which hospital. Mitch is holding out at PCV 14/15 and platelet 66 as of last bloods. If they don't start to increase soon i think I may ask for a referral. He is currently hospitilised and that moving him with such low bloods could be risky but my vet is happy to referr if requested. Also had quite a bit of intestinal bleeding - is this quite usual? Coombs test was negative?

Kath Scotland

Just been reading through posts - it seems Rory Bell at Glasgow is the vet of choice?

Kath Scotland

Kath, is Mitch on a stomach protectant? These meds are very, very hard on their stomach and can cause ulcers, etc. He should hopefully be on sulfacrate or Pepcid, or whatever is like that in the UK. Good luck, you know in the meantime, your vet could probably do a phone consult with the other doc as well. melissa and tiggs

melissa slc

Hi Thanks for your concern. Yes Mitch is on Sulcrufate and today more protectants have been given to him to help him further. He had bleeding in the bowel before starting the meds and it may be that his Anaemia and Thrombocytopenia may actually secondary to something sinister that is going on internally.Coombs test was negative so this may in fact not be an Auto-Immune issue - at least not primary, but please don't evict me from the forum! More tests are ongoing but nothing invasive can be done at the moment because of such low platelets and the risk of bleeding. I cant remember who advised me re Ticks before but I looked into the incidence of tick borne disease in the area and although the chances are very low a test is also being carried out for ehlichiosis - not commonly found here though.

Kath Scotland

Kath, If you read through the success stories on Joannes website, you will see that a negative combs test does not mean it is not AIHA/IMHA. so no fear of being evicted :) From what I have read dogs can bleed from the nose or in the stools at the onset of Thrombocytopenia. so I would not quite rule that out. Take care and best wishes, Brigitte & Kahlu

Brigitte BC Canada

Kath Yes I would recommed Rory bell at University of Glasgow small animal hospital.If you saw my post earlier to Claire I gave her all the details and you just need to get your vet to refer you.Once Rory has seen your dog,if you live far away I'm sure he would consult with your regular vet and advise him/her by phone on tests drugs etc to save you travelling. I would ask for him specifically as I feel he is the most knowledgeable about this disease as I met a few of his colleagues when he was off on hols and although they were quite good I feel he has more experience with treating this disease and will also only do tests and procedures if he feels they are really necessary. With regards to the Coombs test Nollaig tested negative for this, but the vets themselves don't rely on this as it often gives false negatives.Nollaig def has pure red cell aplasia an auto immune bone marrow disorder. Any questions Kath just email me. Kathleen

Kathleen North Ayrshire

We were Coombs neg too, it really doesn't mean it's not IMHA, so no worries, you are welcome to still join us here, we would never evict anyone (unless they are a spammer!). Is Mitch on a low dose aspirin yet to prevent clotting? Keep us posted, melissa and tiggs

melissa slc

Hi Thanks for your info. I am in Fife, about 2 hours from Glasgow and a bit less from Edinburgh so either are accessible. As things are I am very happy with the way things are at my own vets - I have found nothing that contradicts what they are doing. I know they are also consulting outside the practice and one of the vets has quite a bit of previous experience. The vets (and I) are aware that the positive coombs is not conclusive but it is clearly a possibility. Mitch is not on aspirin at the mo- I will look into that. Whilst I am happy with my own vets all is well but will not hesitate to refer if need be. Luckily he is insured but my cover of 6000 is all I have (I am having a financial crisis on top of all this at the mo) so I need to stretch it out as there is nothing else left in the pot. Thanks for reading - it helps to share with you all. Kath

Kath Scotland

Forgot to ask- If his platelets are so low (66) with thrombocytopenia would he still need aspirin to stop clotting. We want him to clot (in the right way though) because he is at such risk of spontaneous heamorhage. Can anyone explain further?

Kath Scotland

Kath, Any kind of blood thinner is contraindicated in a human patient who has thrombocytopenia and the count is <50,000. Since your count is (I assume) 66,000, I would want to know for absolutely sure that this is also a contraindication in canines as well. I would be very cautious. The greatest risk when the platelets are so low is spontaneous bleeding, as you already know, but also something called DIC disseminated intravascular coagulation. This is inappropriate clotting that causes fibrin to develop in the blood vessels. It can happen in degrees, but can be a very serious event. Have a talk with your vet and discuss this with them and see if they have a protocol developed to handle this situation. Emergency clinics do have one because they handle these cases more often, but perhaps a small clinic will not. We were very concerned with this when Chance had his spleen and accessory spleen removed. My vets were very careful with him during this and immediately had a transfusion ready for him after the surgery. His platelets were not low prior to the surgery but DIC can occur any time there is a large amount of blood loss. I am sure your vets have already advised you to keep Mitch very quiet and I will echo that. I will be thinking about Mitch today patrice

Patrice NYS

Patrice I guess by your first paragraph that you don't think aspirin is a good idea with his platelets being so low? Do you mean be cautious about using it or not using it? He is not on aspirin and although I saw the vet tonight I forgot to ask about it. His PCV has dropped over the last week from 22 to 13/14 but seems to have settled at that over the weekend and his platelets have dropped from 77000 to 66000 over the last week. I am really hoping that after a bit of stability in the PCV things may start to improve. Full blood results should be back tomorrow. Kath

Kath Scotland

Kath, I try to be as accurate as I can when I posting about a specific question. In this case, I know for sure about humans, but my information about canines isn't. If this were me, I would treat this with great caution. A dog can survive with transfusions even with extremely low PCV's. However platelets do not transfuse well and that makes it a very serious condition that should be handled by an expert. I hope I haven't been too obtuse for you. I try to be brutally honest when I think there is life or death information. Vets may hedge answering questions of this nature, but I have no stake in this other than I care deeply that Mitch make it through this ok. I am not a vet, but I have a degree in physical therapy. I don't know everything, but I am always studying stuff to understand it better. DIC is a scary thing that happens not only to dogs but also to humans. I am still not convinced this isn't Ehrlichia canis. This would be a hallmark sign, low PCV and extremely low platelets. In the secondary stages of this tick disease, it can hide out in the spleen, affecting all blood cell types, but also the platelets. If they haven't tested for this, please, please ask them to do that. my best patrice

Patrice NYS

Kath, I 2nd Patrices suggestion of looking at tick disease. I found this http://www.outdoorsmagic.com/news/article.asp?UAN=6080&v=1 People will say oh we dont have ticks in the area they live and not look for it. Well we do have ticks here and Wylie was tested both in house for the common tick diseases and one sent out that tests for more. She came back positive with Rocky Mtn Spotted Fever, a tick disease that is not found in our area, I dont think even our state, so how did she get it. My vet was very perplexed. Patrice was very helpful gave me some good insite on this. So please dont rule out tick disease possibility. Laurie

Laurie CA

Hi Thanks for your replies. We do definately have ticks in the area and my dogs do regularly get them. I have read several research papers and so much information regarding ticks in the UK and the diseases they carry. If anyone feels it will help I will try to find them all again! I cant remember the statistics exactly but ehrliciosis or its new name anaplasma something! is found in ticks in the UK in the sheep tick which is prevalent in many areas including ours. Having looked at research papers it is a very small % that atually carry ehrliciosis but as it is a posibility and after Patrice particularly having drawn my attention to it i asked my vet about testing for it. I am not sure how long it will take but the blood was sent today. Is it an instant test or does it take a while. Kath

Kath Scotland

Kath, from my experience it takes 2-3 days. good luck, Brigitte

Brigitte BC Canada

Steph, Please read this description of *E. canis* on this page. http://dogsandtickdisease.googlepages.com/ehrlichiosis Do not confuse Ehrlichia equi for E. Canis. You are right that E. equi has become Anaplasma phagocytophilum. But it is a slightly milder tick borne disease. E. canis was "discovered" when military dogs began returning from Viet Nam. Unknown in the US, many of these valuable and loved dogs succumbed to this horrible disease because no one here knew what it was. This disease is known around the world now-a-days. While it may not have known in your area in the past, it's very possible that warmer winters from global warming have allowed it to migrate to areas it was not in before. It is very common for a tick to carry and transmit more than one tick disease. The common test in the US that is available as a simple yes or no result is called SNAP 4DX by Idexx. It tests for Lyme, heartworm and only 2 of the known tick diseases. This can be done as a routine test in your vet's office. Further testing can be done by Protatek Labs. They keep current records for all areas and the TBD that should be tested in those areas. Those tests take a few days, send the blood out and then wait for the results. Dr. Holland is an expert in TBD. I don't know what is available in Europe. I have to hope that they keep up with the US in terms of national health departments. There may have been ticks in the UK for a long time, but perhaps there were very few that carried diseases. Now with jet travel and warmer temperatures, I would expect any disease to be able to migrate to any country easily. Again, this all goes back to my wish that an Emergency AIHA IMHA Canine Kit could be available to all vet clinics worldwide. I get so frustrated that so much of the basic diagnostics are missed by vets. The conditions and diseases that should be ruled out are well known. The emergency treatments are pretty straightforward. Follow up care is trickier, but geeze, by that time the dog should be stable and able to travel to a specialty clinic. I guess for now it has to be done one dog, one clinic at a time. I am hoping that Mitch begins to recover very soon. my best patrice

Patrice NYS

I made that a bit confusing by not checking the names first. I appreciate some Ehrlichiosis spp. have more recently been renamed Anaplasma sp. The blood has been sent to test for Ehrlichiosis sp.(including the renamed Anaplasmosa sp)as this is actually much more likely. Ehrliciosis Equi has been found in dogs in the uk but not commonly. One of the ticks that carries this is found locally to us and are a real pest! Ehrlichiosis Canis is not (yet) a UK disease but it has been found in dogs imported into the UK. Due to this it is considered at high risk of being introduced in the future into the UK. The ticks that carry it are present in some areas of Southern England as the climate warms but not in Scotland - way too cold I guess. Lymes disease is the main tick disease here. Kath

Kath Scotland

Hi Kath, re: vets in Scotland with expertise, Kathleen has informed me about Rory Bell and yesterday my own vet was in contact with Edinburgh Vet School. I'm reading with interest about tick disease - can it and does it cause AIHA and specifically pure red cell aplasia ? My dog hasn't yet been tested for this, should she be ? Whether or not it is sheer coincidence, we've traced her illness back to when we went camping in Cumbria and she was bitten by a tick - which we removed. We did mention this to our first vets, but they ruled out any correlation even though she wasn't tested. Claire

Claire Cumbria

Claire I am just on my way to visit Mitch at the vets. Later I will list some of the pages where I got the info from. Kath

Kath Scotland

Hi This website gives you lots of info on different tick disease. http://www.defra.gov.uk/animalh/diseases/notifiable/rabies/pdf/appendix1.pdf It also says which ticks carry which disease. When you know which ticks carry the disease then you can search and see if they are an issue in your area on this site. Type in the tick species and you can check a map to see where it is found. I found loads of other really good info but can't find it all again. Another with good info http://www.cvbd.org/4008.0.html. I went to see Mitch, full blood results not back yet but he seemed really sad and his eyes are losing their spark. Will get the bloods later and see what the next move is. I didn't get a good feeling from him at all. Yesterday he seemed much brighter.

Kath Scotland

oops this is where you can find where the ticks are found. http://data.nbn.org.uk/ The one the carries Ehrlichia Canis in other countries is Rhipicephalus sanguineus but not in the UK as yet. Although the tick itself is found in more southern parts of England. The disease has been found in imported dogs. The tick in the UK that carries Ehrlichia equi is the Ixodes ricinus or as now called Anaplasma phagocytophilum. This tick is common in the UK but the disease isn't particularly so. E.Canis is the more serious disease and commonly causes AIHA and thombocytopenia in the states.

Kath Scotland

Kath I sincerely hope that Mitch improves; this condition is truly awful for the dog concerned and hellishly stressful for their guardians. Our own girl has also had a terrible day and optimism can be tested to the limit. Many thanks for the info on ticks. Best wishes, Claire

Claire Cumbria

This thread was discussed between 03/08/2009 and 04/08/2009

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

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