Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Aiyana is crashing

Our sweet Aiyana has taken a turn for the worse...Yesterday afternoon I noticed she was markedly weaker than she had been, her gums were almost white, and of all horrors she was turning her nose up at food. I had to go help mom with my father...and just thought I would wait it out and see how she was last night. I was able to coax her to eat dinner last night she seemed a bit more comfy,and steady on her feet. This morning she looked awful, her gums were white, she fell over while urinating in the yard. We rushed her into the Vet and her PCV has dropped down to 20, she was 25.2 on Tuesday. Our Vet said we are losing her, and does not recommend a blood transfusion or spleenetomy, but was willing to try anything I asked, so we started her on Azathioprine (sp?). Please pray for my sweet girl... if we are going to lose her, please let her go quietly in her sleep...and Lord willing if she is going to rally, please be soon. Blessings, Julie and Aiyana

Julie IL

Julie, so sorry to hear about Aiyana's recent turn -- that is the most difficult part to watch your baby struggle. You both are in my prayers. She sounds like such a sweet girl. Sharon and Angel Raven

Sharon CT

Julie, I am SO sorry to hear about Aiyana. I know exactly how you feel. I will certainly pray for you both. Please know that I am thinking about you. Karen H.

Karen H. Missouri

Praying for strength and comfort as you struggle with this difficult time. God Bless Julie and Aiyana. We understand your pain, know our hugs are with you. sharon and angel Brandy

sharon pa

Julie, I am praying for you and Aiyana. Her PCV doesn't sound that low. Darcy's has been as low as 8 and I have no idea what it is right now, but her gums are very pale. Thankfully, she is still eating. Have you thought about giving Aiyana a little of the Paul Newman canned organic liver (a spoonful or two because it is rich and too much can cause tummy upset) and PetTinic (this has iron and vitamins and I believe it gives them energy). Darcy seems to like boiled Irish potato and baked/boiled chicken breast when she goes off her kibble. I have learned to feed a little at a time and not force too much because it might be thrown up. Just wondering why the vet doesn't recommend a transfusion. Has Aiyana had any in the past? Has she has a bad experience with a transfusion. Sometimes a transfusion can give them time for the meds to kick in. I don't know anything about Aiyana's history. Darcy has had three and she developed pancreatitist after the last one and it was really bad. She did okay with the first two, but didn't show signs of feeling better until the second day after the transfusions. I wish the best for your sweet baby Aiyana. Please keep us posted. Karen

Karen NC

Julie, I am so sorry to read of Aiyana's new problems. I will keep you both in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Thank you all, Aiyana is definitely weak... but she is interested in food again (that makes me feel better LOL). Her tail is wagging, and she seems to be resting quietly. In answer to some questions...We have had to take into consideration Aiyanas advanced age. She is a very large Golden Retriever and almost 13 years old, so has already surpassed "life expectancy". We will not put her through anything invasive because we feel it unfair to her, she really does not have the strength to go through a major surgery. Transfusions are usually to buy time for the meds to work... Aiyana has already been on meds for this for almost two months. The best choice for us, is to pray she will come through, but not doing anything to harm her further. We could put her through the splenectomy (although that can be a double edged sword), or transfusions, possibly get her through this for her to die of something else shortly after... I just don't feel it fair to her. This is definitely not what we wanted for the end of her life, but it could be something worse too, and in that we are blessed. We will love her, and enjoy her for as long as we can...if I see her losing quality of life, we will do right by her, because that is what we owe her. This is a choice we have had to make - I am not saying it is the right choice for all. Having been down this road before, we know what to expect from this disease, and what our chances are. Blessings, you are all in our prayers, and thanks again, Julie and Aiyana

Julie IL

Julie, There is great power in good home nursing care, love and positive thoughts. I will be sending many of those your way tonight. patrice

Patrice NYS

Julie -- Like you, I'm glad to hear that Aiyana's appetite has returned and her tail is wagging. Those are such good indicators! The two of you clearly are fighters, and I'll keep you in my prayers. Please take care and please keep us posted.

Brenda VA

Hi Brenda I have such a soft spot for Goldens as I have three of them and have at least one for the last 30 years. I so agree with you as being truly blessed to have had Aiyana for 13 years. Just remember that the azathioprine will take a few weeks to begin working so you won't see any improvement right away. We are sending our Golden prayers your way. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Thanks again everyone For all the prayers and support. Aiyana seems to be more herself this morning, her gums are a bit pinker. I know the meds could not have kicked in that quickly, but we did increase the prednisone yesterday too, so heres hoping. She is suddenly starving all the time.. well moreso than before LOL. I fed her at 8:30 am, and by 9:30 she was pacing and looking at her bowl again. Could that increase in pred. have taken effect that quickly and cause that much of an increase in appetite? I gave her a snack of baby food, that way I was able to get the Azathioprine into her also. which brings me to another question.. dosing? My vet just says pred. and aza. with food... should I split them up, which is what I am trying to do now, or is it ok to give them together? This is her schedule right now... she is on the liver cleansing diet. 8 am: ranitodine and SAMe 8:30 am: 1 cup food - 30 mg. prednisone, milk thistle noonish: 1 cup food (this is where I was going to insert the 50 mg. Aza. 5 pm: 1 cup food - 30 mg pred, milk thistle 8 pm: ranitodine and SAMe 9 pm: 1 cup food 25 mg Aza. blessings, Julie and Aiyana

Julie IL

Hi Julie, glad to hear that Aiyana is doing a little better. I've always given Tiggs his Pred and Aza together, after feeding. For many months, we gave the Aza in the am, but it seemed like Tiggs didn't always feel that great afterword, just seemed kind of drowsy. I'm not sure if it was the Aza, but he seemed more alert as the day went on, so I asked my vet about switching to dosing the Aza at night. So, that's what we do now. But I still give it with the Pred and only after eating. Tiggs Aza dose though is only 30mg/day (1 pill only per day). I keep meaning to try Milk Thistle, I hear from all of you that it's great for their poor livers...I'm putting it on my shopping list now! Keep us posted, we are really hoping Aiyana feels better soon. melissa and tiggs

melissa slc

Julie, Your protocol looks pretty good. I would, however, move that milk thistle to the same time as the Sam-e and put at least an hour after that until the first meal. But giving both after an overnight fast is an excellent place to dose. Has your vet discussed protective doses of aspirin to protect her from clots? Prednisone sometimes gets a bad rap, but it was and still is considered a kind of "wonder drug." When immediate suppression of the immune system is needed or super quick reduction of systemic inflammation is needed, prednisone is often the drug that doctors pull out to use first. You will notice, if Aiyana has had any stiff joints or lameness, a big improvement in movement! The side effects can start pretty quickly too, as it is mimicking what would happen if the bodies adrenal glands began overproducing cortisol. This would include an increased appetite, greater thirst and subsequent need to pee more. You may see immediate fluid shifting in the body tissue. The prednisone and the aza work in different ways to suppress the immune system. The do not conflict with each other. From the standpoint of reducing stomach irritation it would probably be best to keep them separate. Large doses of pred do need to be divided in two or three doses through the day. I have not personally used Aza so perhaps others can advise you how they dosed it. I would also advise adding otc pepcid one hour before the first meal. So give Sam-e and milk thistle early in morning after overnight fast, one hour later give pepcid and then after an hour feed first meal. You may also want to ask about sucralfate, to coat the stomach. That could be given at bedtime. my best patrice

Patrice NYS

Thanks again all, And Patrice you are such a wealth of info... between Joanne and you, I think most of us are better educated than our Vets in this area LOL You mentioned pepcid, Aiyana is on ranitodine which is zantac, is that not the same thing? Question about aspirin, is it safe while on pred, I thought it wasn't? My vet did not mention anything about clotting, I hope thats not another worry for us... we have our hands full here already. blessings, Julie and Aiyana

Julie IL

Julie, I'm so glad your girl is feeling better. My vet told me I could give the aza and prednisone together with food. It seemed to work fine that way last summer. I do give sucralfate at bedtime. I hope things continue to go well for Aiyana. Take care, Karen H.

Karen H. MO

Julie, I was told no aspirin or asprin type products like Rimadyl or NSAID's with Prednisone. We are sending tons of healing vibes for your girl and praying for her. Lori

Lori New England

Ultralow-dose aspirin is now thought to be helpful in preventing clotting. You might want to check out this abstract http://www.ncbi.nlm.nih.gov/pubmed/15934255?dopt=Abstract

Joanne MN

Joanne, Excellent research on your part. I have been too busy to search out the reference I remember having "somewhere." Having talked with several owners in recent past whose dogs succumbed to inappropriate clotting, I am becoming more aware of this. This study shows the amazing difference in long term outcome with low dose aspirin & heparin! This, of course, does not mean that it guarantees success, but it points to more successes. patrice

Patrice NYS

I'm curious as to what dosage constitutes "ultra low" when it comes to aspirin. I suppose it is dependent on the dog's weight. Can it be purchased that way?

Reid Hanson Wisconsin

This thread was discussed between 29/11/2008 and 01/12/2008

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