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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Bone Marrow Test Update
| I posted earlier that Darcy is scheduled for a bone marrow test in the morning. I had emailed Dr. Dodds earlier today and asked her advice. I just received her answer which was no, she would not put her through that. Guess I'll be canceling in the morning. I will be pursuing the thyroid panel, throxine medication, gastrointestinal sedative and PetTinic that Dr. Dodds recommended with our regular vet. Karen |
| Karen NC |
| Karen, We had the bone marrow biopsy done on Chance, but this was before I had contacted Dr. Dodds. I have said it several times here on this board, before you arrived, that in the end it did not tell us anything we didn't already know: he wasn't making red blood cells or white cells either. The specialist did five taps in different locations, all of which were *devoid of cells.* This left us pretty much right back at the beginning asking... why is he not making blood. It wasn't until after I contacted Dr. Dodds did she help me to understand that in some *very severe cases* of autoimmune or immune mediated blood diseases the autoimmune destruction begins at the level of the precursor cells in the bone marrow. It's as simple as that. It caused a non regenerative state that had a much less dramatic clinical presentation. There wasn't a rapid drop in PCV, there was no overnight crisis, just a slow but steady decline in white and red blood cells. Chance was just working on blood cells he had made in the last 120 days and over time they were slowly aging out. He was quickly becoming susceptible to many many infections with his protective white blood cells diminishing, (well except for those pesky killer t-cells!) It was becoming a crisis. We took his temperature 4-5 times a day and had instructions to bring him in immediately if it elevated above 103. He was on a half dozen different antibiotics over about as many months. The treatment is pretty straightforward, high doses of prednisone to start with, adding (in our case) cyclosporine (atopica) at a relatively high dose and wait for it to begin to suppress the t-lymphocytes. And it finally worked! About three months in and two transfusions later.... There are a whole bunch of tests that should be done: thyroid, chem screen, tick (SNAP DX4), blood cbc, blood smears to look for odd cells, ultrasound and x-rays of the chest and abdomen to look for tumors, a panel to test blood levels of cobalamin (B12) and folic acid, and etc. All things you have been exposed to by now. If there is some defect in the production of cells in the marrow, these will find something. Chance was very low in cobalamin (B12) and I began giving him B12 shots according to a veterinary schedule. This vitamin is essential to making blood. In some cases a malabsorption in the small intestine can cause this to be low. It is not a vitamin that can be given orally if this is the case. In Chance's case, Giant Schnauzers are the one breed known to have a genetic deficiency that causes this. We also had been giving Chance thyroid medication for several years, but we had the thyroid panel done again just in case the dose needed adjustment. But really, Jean was correct, what we needed to do was be consistent with his meds and give all the supplemental drugs that protect the body from damage from the prednisone. We slowly decreased the prednisone but kept the dose of Atopica until we were positive he would continue to be regenerative. I would never advise someone not to do something that their vet has suggested. It's possible that this test might help. In our case, though, it just didn't do much to get us any closer to a treatment. Now that I have read a veterinary textbook cover to cover, I know why this happened to Chance. And I am forever grateful to Jean Dodds. She will help you get through this. my best Patrice |
| Patrice NYS |
This thread was discussed on 11/09/2008
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