Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Bobby - what happened?

Maybe this is part of a healing process but I need to tell Bobby's story because I'm desperate, confused and missing him terribly and everything happened so suddenly and I suppose I'm in shock.. I live in Portugal with my husband, and my dogs, Bobby and Frankie and they stay with my husband while I go to work in the UK for weeks at a time. 10 days ago my husband called to say Bobby was not eating and just sitting in his bed shivering. He took him to the vets who did a PCV which was 11-12% and the vets recommended a blood transfusion at the local hospital for the anaemia. At the time, the vet suspected tetanus as Bobby had previously had a back wound. The hospital ran blood tests, did the transfusion and called me to say he was stable. Two days later, the blood tests came back and the hospital told me he had two tick diseases but that they had a drug called Imizol which would resolve them. The next day,Thursday, I called and he was getting better. So I booked my flight back for Saturday, thinking that I could be there for a month with him for any recuperation. When I arrived, my husband told me the hospital had called to say Bobby was going downhill. When I got there, he looked desperate. I was horrified, lying down hardly able to lift his head, I could see his bones where previously (a week ago) he had been muscular and healthy and even drinking water exhausted him..he just laid and peed himself and was so disturbed by it, he tried to stand and collapsed, hardly able to breathe. At the time, I had no idea atall what was going on but begged them to do another transfusion. They said that his antibodies would destroy it...he died in the night struggling for breath. My poor Bobby was so trusting and vulnerable and I feel I've let him down so much but its only now (by asking for the reports and doing research) that I realise the lab reports didnt say he had tick disease, they said its possible but should be confirmed by serological testing. The original referring vet has since told me it was AIHA and we dont know the cause. I have so many unanswered questions and nightmares about Bobby being in such a condition when I fully anticipated taking him home. How can this disease be so destructive so quickly? Does anyone know why they couldn't give him another transfusion, I'd told them money was not an issue...the language barrier has been though as I've had to translate all the medical terminology into english. I also found out they only gave him 3 intravenous feeds in 6 days when he wasnt eating...is there any reason they couldnt give more? What would the normal amount be? Was it the inadequacy of the hospital or has anyone else experienced this. Bobby was only 5 and he was the joy of my life..thanks to anyone that may be able to help in any way Karen

Karen Thomson Portugal

Dear Karen, I'm so sorry to hear about Bobby. How distressing and heart breaking to have to see him in the state he was. I too am going through this, my little Maltese Sh*tsu X Millie is recently diagnosed. She is now in an Animal Hospital, but I had similar frustrations with my vet. I knew Millie was not improving this Tuesday, but the vet dismissed my concerns and told me to come back on Friday for another blood test. Wednesday morning I'd had enough, I knew from what I'd read and learnt on this forum especially, and how Millie was that something was wrong. I demanded answers to my concerns, and when they finally admitted that they couldn't give them to me. So I asked them to refer me to someone who could. I am now getting answers. Even my husband doubted me and told me to wait. I know Millie better than ANYONE else, so I just kept trusting my instincts and logic and got her the help she needs so desperately. My faith in vets is at an all time low. I also think that this disease is quite rare, with my vet admitting that they only see 4 or 5 dogs with this condition in a year. I am sure she was just reading from a textbook when she tried to treat Millie. I hope you can find peace and acceptance and let time heal your broken heart. Thinking of you, Samantha.

Samantha Australia

Karen, I am so saddened by your story and your loss of Bobby. This disease strikes with incredible swiftness and even if you had known what was going on from the start and had Vets that knew more about it doesn't mean that things would have turned out differently. Unfortunately there is so much that is not understood about treating this. Some dogs do recover and live for many years others like your Bobby are taken way to quickly. Try not to feel that you let him down. It is the most painful way I have ever known to lose an animal but in time I hope that the happier days with your Bobby will help ease the tears. If you need to talk feel free to email me.

Penny Lytle Creek Calif

Samantha and Penny, thanks so much for your caring messages, I wish I'd found this forum last week and had had enough information to learn all I could about AIHA. Samantha, follow your instincts, I know I would have done with the right information and had I been told how serious Bobby was. My husband too trusts the medical profession and didnt like to quesion them, that contributed to the loss of Bobby.. You know, eight years ago I had a dog who was diagnosed by the vets as having stomach cancer...I got all the medical textbooks out, sat up all night creating an A3 flow chart and I was convinced he had acute kidney failure. I went back to the vets and insisted on tests, they were so offended but the next day I had a humble, apologetic call from them confirming my self-made diagnosis. Keep going is all i can say, you have the chance I didnt have and all my wishes and support to you, keep me briefed on Millie too. She's lucky to have you. Penny, thanks for caring too...have you been through this? Is there anyone on this site who knows about information such as how many blood transfusions can dogs suffering from AIHA have? Shouldn't they be given intravenous fluids all the time? I need to find this information because I'm going to go back to the hospital, I know its too late for Bobby but if they could be better informed, it may save another dog in the same plight.. Love to you all and thanks for your support, its so comforting to know that there are others whose dogs are so important in their life...it is a rarity here in Portugal and noone even seems to understand why I cant pull myself together.

Karen Thomson Portugal

So sorry to hear about Bobby - this is a nightmare disease and it sounds like the vets treated Bobby very quickly which was good. We lost our little westie Millie after 7 months of battling so please don't feel too bad. We tried and tried with Millie but in the end had to let her go the drugs they have to use can be pretty awful too. I think each dog seems to repond differently and it strikes so quickly and without warning. Our thoughts and prayers are with you. Clare, UK

Clare UK

Karen -- I am so sorry to hear about Bobby. Like many people on this forum, I too, lost my dear beagle, Wiley, to this horrible disease, nearly four years ago. I hope you get answers to your questions -- Dr. Jean Dodds at Hemopet would be a good expert to try, since she has consulted on many cases on this forum. She is a recognized expert on blood diseases and vaccinations. It is terrible to lose a pet to this disease. Most of us never heard of AIHA/IMHA until our vets told us about it, and as we're trying to absorb the news that we're facing a life-threatening illness, we've also got to figure out how to fight it, because IMHA works so quickly. Like you, I didn't find this forum until after my dear beagle was gone, and I wish I had. The people here are so knowledgeable and they provide a support group whose help is truly priceless. I know you are going to beat yourself over this disease and wonder "if only I'd done this . . . " That is a natural way to think, because we love our dogs and given the nature of this disease, we can't help but think that there must have been something we missed etc that we should have caught, and then all would have been well. But try to get beyond that stage. You and your husband did the best you could with the information you had available at the time. You loved Bobby and you wanted to help him, and you thought you were. You all shared a wonderful life, that unfortunately ended in a tragic way. But try, though your grief, to get to a place where you can celebrate your life together and be grateful for the time you had together. Think that God graced your life with Bobby, who brought you love and joy. I admit that I sometimes still have terrible grief over the loss of my dear Wiley. We all know we'll never completely get over the loss of our beloved pets to this disease. My husband and I decided that we would honor our Wiley by donating to the Meisha's Hope Fund at the Morris Animal Foundation, an effort begun by Joanne Dickson, the founder of this forum, to find a cure for IMHA. Each time I send in a donation, I think that Wiley lives on in the search for a cure. It helps.

Brenda VA

Karen, I am so sorry to read of all the difficulties you have experienced with veterinary care. It has truly been a very difficult path you have traveled. You asked about blood transfusions. Canine blood transfusions are a bit more complex than human's. In humans there are really 4 types to match (and of course + or -). In dogs there can be as many as 11 different types. Each dog gets the first transfusion "free" from any complications. From that point on, every transfusion carries risks of reactions. They are not singular events but carry "baggage" from the last transfusions. That said, Dr. Jean Dodds is an expert in canine blood transfusions and prides herself in providing safe, easy to obtain canine blood around the world. www.hemopet.org General vets, the folks down the street, are perhaps not well versed in the intricacies of transfusions and probably don't do enough of them to be truly confident. Thus, the hesitation some people experience when they want to do one. My vet spent a whole afternoon studying and preparing for Chance's second transfusion. She accomplished a safe and successful transfusion that bought us some time. He had one more after that, also problem free. Here are articles that I would consider very authoritative and where I learned a lot: http://diaglab.vet.cornell.edu/clinpath/modules/coags/tfmed.htm http://diaglab.vet.cornell.edu/clinpath/modules/coags/bldtype.htm http://diaglab.vet.cornell.edu/clinpath/modules/coags/typek9.htm http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6506&O=Generic If you want to research more, use "canine blood transfusions" in your google searches. I would also recommend that you attempt to get Schalm's Veterinary Hematology textbook via an intralibrary loan to read the most authoritative text on this subject. It's a tough read but you can google all terms you don't understand. my best patrice

Patrice NYS

Thanks Clare, Brenda and Patrice (again)...for your wonderful support. Patrice, I'm researching, researching and researching and I've just found on a portugese website that one of the drugs they gave Bobby at the hospital had been recalled in August 2008. I know so many people but just not a friendly family vets when I need them...my vet seems good but since he's the one that referred us to the hospital, I think he's going to be a little cagey when I ask the sorts of questions I need to ask. I'm going to try www.hemopet.org and see how I get on, probably even more confused! with heartfelt thanks to you all

Karen Thomson Portugal

my just turned 4 year old golden retriever, Hunter was diagnosed ct. 9, 2003 and died Oct 16, 2003. He had never left ICU. He was given all the usual drugs and had 2 transfusions. He was also on IV round the clock. I had never heard of this horrible diseae until he was diagnosed. Now I hear of it to often. Some dogs are gone in a few days, some make it a few weeks, some a few monts, and then there are thelucky one that end up living a normal lenght life. I am so sorry for your loss.I do not think hee is any rhyme nor reason a to why this dog survives and thi one is lost. My Hunter had never been sick a day in his life. He was so ative, running and playing with his littermate sister, chasing squirrels, just running for the joy of running with his favorite toy in his mouth. we do know what caused his AIHA, and also called liver damager. It was the 6 month heartworm preventive injection, ProHeart6. After his death I was to learn tht AIHA, liver damage, and gasric bleeding were the 3 reactions causing most of the deaths. oh, the FDA had them pull it because of the high number of deaths---10 months after my Hunter was lost.

Sandra Texas

Ssndra, so sorry to hear about Hunter and it sounds like he had better care than Bobby - 2 transfusions and round the clock IV. I'm just beginning to wonder about the antibiotics Bobby had a month before this happened...maybe we never confidently know the cause but I do have an issue with the hospital care...I'm convinced it was really slapdash and Portugal is not renowned for state of the art care of its animals. In the UK, I knew brilliant animal hospitals but here, I'd never used more than a vet before so I was in the dark... You must be so frustrated hearing about the heartworm tablets, do you believe that was the cause?

Karen Thomson Portugal

This thread was discussed between 29/01/2009 and 31/01/2009

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