Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Cancer, now AIHA?!

My 8 year old mixed breed was diagnosed with mast cell cancer last September. The tumor spread to his spleen. He has been on Palladia (new chemo) for a month and his tumors are shrinking rapidly. He'd been getting weaker and weaker so I took him to the vet yesterday. They did a PCV and found him to be at 12% so they gave him a transfusion. They did some labs and determined that he has autoimmune hemolytic anemia ON TOP of his mast cell cancer! This morning he was throwing up so I took him back to the vet. They did another PCV and it was at 31%. I had to leave my boy there today to be monitored. The vet told me that he will need Prednisone 20mg twice daily until we can "stay ahead" of the disease. My guy is about 27 pounds. Here's what scares me. I am almost financially tapped out due to the cost of all of the cancer diagnostics and meds. I don't have much room left for this new disease. I am TERRIFIED!!! I read a few posts here and noticed that AIHA is financially draining. How financially draining? Are there any cases where our little guys can be taken care of at home? I cannot afford all of this hospitalization. I feel terribly guilty. The cancer just about ruined me financially, and now this?!!!!! The oncologist said to hold off on the Palladia until we get this under control (IF it can be controlled considering he has cancer on top of this!) The vet isn't sure how he got this disease. He said that cancer makes the immune system go crazy, so that might have lit the flame. :(

Kristi CA

Kristi,I am relativity new here myself, we got our diagnoses, December 23. I just want to say, I am sorry you find yourself needing this website. But there are some really knowledgeable folks here. A PCV of 31% is not bad. When my girl was diagnosed hers was 12 and went down to 6,she is now 27% and I am elated!!!!! If you need financial help look here: http://www.carecredit.com/ and here: http://www.humanesociety.org/animals/resources/tips/trouble_affording_pet.html Carrie and Summer

Carrie DFW

Kristi, Oh dear. My heart aches for you. This is such a blindsider for you. Mast cell cancer is very tough to treat. Mast cells are "islands" of immune cells distributed throughout the body that can be very active in allergic reactions. This kind of cancer is related to mast cells' autoimmune component. In addition this cancer has spread to the spleen. This makes these two conditions (mast cell cancer and AIHA), that seem totally different from each other, highly related. The spleen has multiple jobs. One job is to manufacture elements of the immune system. Another is to store many red blood cells, esp during sleeping periods. A third is to help the body destroy and get rid of old worn out red blood cells. It also helps the body fight tick disease, as part of the immune system role it plays. And, as part of that immune system function, the spleen can be highly implicated in AIHA. It can be a site of great destruction of red blood cells. Occasionally some specialists will recommend that the spleen be surgically removed in an attempt to stop this destruction. I am not sure if you are seeing a board certified veterinary diplomate or not. Specifically a veterinary oncologist. They could look at the details of this case and advise you about the best decision they feel you might make. I would possibly suggest that you also consult with Dr. Jean Dodds at www.hemopet.org. She is not an oncologist but is a specialist in canine blood disorders. She could also advise you what she feels might be the best course of action. See my post today to another forum poster about how to consult with her. To check if you are in fact using a board certified diplomate you can use this search engine to check. You can also find one near you if you are not. http://www.abvp.com/finddiplomate.aspx I will be thinking about you and your guy tonight. patrice

Patrice NYS

Here is a mapping program that shows them by location. http://www.acvr.org/members/directory/map_of_diplomates.html

Patrice NYS

That map is actually radiologists. Sorry. Here is the correct search engine http://www.acvim.org/websites/acvim/index.php?p=2

Patrice NYS

Thanks Carrie and Patrice. Papi has seen an oncologist several times. Th problem is, it's a 6 hour drive round trip and they are only there on weekdays (when I'm at work). The oncologist did numerous, expensive testing on him, then put us on one chemo protocol after another. The last time we were there they did a biopsy of his spleen cause they saw tumors on it in his CT scan. My vet consults with the oncologist over the phone. The oncologist told my vet to stop the Palladia (chemo) until we get a handle on the AIHA. I feel so sad because he was finally getting better, his tumors were shrinking a lot! My vet was worried cause he has never had to treat both MCT and AIHA at the same time. Maybe I will consult with Dr. Dodds. How often TYPICALLY do AIHA dogs have to get transfusions? I'm worried cause I'm at my limit financially. I really hope the Prednisone works and he gets better so I can treat him at home. Is this the drug of choice? Papi did well today at the vet. They called and said I could go and pick him up.

Kristi CA

Kristi, Then from a economic viewpoint, if this were me, I would consult with Dr. Dodds. She may also not be comfortable giving you advice because she is not an oncologist. But ask her specifically if she might feel it appropriate to surgically remove the spleen in this case. I have read plenty about the removal of the spleen and it isn't necessarily the best choice for most dogs and it has a spotty success rate. But this may be one of those times when it would be an appropriate approach. When you have time, I will tell you about my dog Chance and his spleen problems and how Jean Dodds saved his life. She *can* answer your question about blood transfusions. This is her area of expertise. Take this one step at a time. A PCV of 31% is not too serious yet. You have time to ask questions about the transfusion and make a decision. Prednisone is the first drug of choice to immediately halt the autoimmune destruction. There is no other drug (besides intravenous dosing of dexamethasone) that will work this fast and this well. It is a life saver in many different conditions, not only for dogs, but in humans as well. The downside is that the side effects over the long term are very potent. It is a wonder drug. But after a period of time the dosage must be reduced or the side effects become as serious as the condition. If the autoimmune damage has not stopped, then another drug needs to be added to suppress the immune system with less side effects. What is interesting is that some of these other drugs are also used in cancer therapy. There may be some crossover that would be effective in treating both conditions. Cyclophosphamide (brand name Cytoxan) is one of those drugs. It has somewhat fallen out of favor in treating AIHA because of the serious side effects. But it has been shown to be an effective treatment in some cancers. Does it treat mast cell tumors? I don't know. If this were me I would ask this specific question. I don't know exactly how to reassure you that this is a monumental task that you are facing and that you probably will not be able to understand all that your vets are discussing. Making decisions will be very hard. But we are all here to support you while you are going through this. Check here multiple times every day to read notes of support and friendship. my best patrice

Patrice NYS

My research is showing me plenty of references to the use of Cytoxan to treat mast cell tumors. In fact I found a research study that was looking at the use of Cytoxan with Palladia to treat other types of cancers. But the most interesting results I read were with the combination of Prednisone/Cyclophosphamide/Vinblastine. They had the highest rate of overall success in treating mast cells tumors, 78%. You can read this paper here: www.animalemergencycenter.com/images/vets_MCT_3.pdf Very interesting information. These two drugs, prednisone and cyclophosphamide, are used in treating AIHA IMHA also. I would like to know more about what the blood work says about the anemia. I am wondering if they are seeing evidence of hemolytic anemia or if this is considered non-regenerative anemia. If it is non-regenerative, it may be the cancer drug Palladia is causing bone marrow suppression. Thus the reason the oncologist wants to stop the use of that drug right now. my best patrice

Patrice NYS

Juliet(7.5 yr mixed terrier mutt) was diagnosed with IMHA on November 26th. To date treatment has cost nearly $3,000.00 with diagnostics,succesively increased medications, and 3 transfusions the last on Saturday. If your dog is smaller than Juliet's 70 lbs., it may be less costly. The most expensive part has been the transfusions at $650 each. CareCredit is good if you can pay it off in 6 months,after that the interest is high. I am in the virtually the same situation as you just from treating Juliet's IMHA and am terribly torn. We are on our way to check Juliet's pcv this morning. She is still eating and drinking, but otherwise she is not moving. I e-mailed Dr. Dodds and heard from her last night. She offered so kindly to consult with our Vet for free. I really don't know if Juliet is going to make it and I can't bear to watch her struggle. I can't tell you what to do or possibly know your financial situation, but I must be honest and tell you this is a costly disease to treat. I would, however, urge you to e-mail Dr. Dodds right away. Do not wait as I did. hemopet@hotmail.com Best to you and your pup. Pat

Pat Vermont

Is it typical for AIHA dogs to stop eating until the Prednisone kicks in? Papi hasn't eaten today so I took a food syringe and squirted 3 pumps of Hills A/D in his mouth. His gums are still pink. Are there any meds to stimulate his appetite?

Kristi CA

Kristi, You are right, once the prednisone kicks in, that should be pretty soon, Papi will get a pretty good appetite. Try and keep in more interesting than Hills dog food. if you cook some lean chicken or turkey, rice and potatoes that would be healthier and maybe Papi would be more interested. later you could add veggies. try and poach an egg. Just keep it varied maybe you find something that appeals to him. I am sure he feels pretty lousy and nauseous poor guy. Best wishes, Brigitte

Brigitte BC Canada

I have been boiling boneless chicken breasts and thighs and Juliet LOVES THEM. The prednisone shoud stimulate her appetitie...get some pet-tinic or Centrum silver to supplement her food and feed her lean chicken or turkey and rice. Avoid wheat and soy based products.

Pat Vermont

Kristi - Pure meat baby food (be sure it doesn't have onions) worked very well for me. In Chicago, I can get Beechnut brand that is just chicken and broth (I believe it's called "stage 2". They also had beef and turkey varieties but I used chicken b/c it was the lowest in fat (it's best to avoid fatty foods while they are on high doses of Pred due to the pancreatitis risk) and still very palatable. The other nice thing is that it should be very easy for Papi to digest and gentle on his system. I hope his appetite perks up soon - I am sorry for the battle you are facing right now. Best Regards, Bonnie

Bonnie Chicago

OK, thanks. I will try a variety. He's scaring me today cause he's just lying around and either panting or breathing rapidly. I called my vet and told him what was going on. He said Papi has just been through a major ordeal and it will take a few days for him to feel better and for the Prednisone to kick in. I hope he feels better after all of this. His tumors have been shrinking and I was so hopeful until this diagnosis! My vet sad the transfusion is good for 2 weeks so we shouldn't have any crashes. Patrice, We tried Vinblastine, as well as CCNU and now Palladia. His tumors shrunk on Vinblastine and CCNU, but then they grew back even worse. Since he's been on the Palladia, his tumors have continuously shrunk (knock on wood). He must feel terrible cause he's always been a big eater and very athletic. He's losing so much weight and wants to scoot under the bed and hide all day. :( My heart is breaking. Pat, I looked at my vet bill and his transfusion cost $180 (not including the hospitalization, catheter, etc).

Kristi CA

Forgot to mention. Papi has also been on Prednisone since early October. He was taking 10mg daily and we were tapering it off until we got the AIHA diagnosis.

Kristi CA

Hi Kristi! You're doing the opposite that I am! My Tessy faught through and beat AIHA only to be diagnosed with Lymphoma afterwards!!! Price wise they BOTH suck!! Every cent basically goes to Tessy's treatment now! Her chemo does cost more for each visit though! I've heard LOTS of positive news on Palladia! I can't help but wonder if they CONFIRMED AIHA through a coombs test? A side effect of Palladia is anemia which makes me wonder. I'm with Patrice in that Cyclophosphamide would be a good bet right now. I actually add several cytotoxic agents to the protocol now so that the cancer doesn't build immunity to just one! I actually can't see why they would keep with the Palladia once the crit is up over 35%. Do you know the recent crit? FOOD....I'd assume by now you know not to feed a diet high in carbs! This feeds the cancer remember! I'd add Pet tinic, Co-Q-10 (10mg/day), and an antinausea drug (cerenia?) daily if it were me. How's Papi today? Thoughts and prayers, Johnny & Tessy

Johnny

Kristi: Re the Transfusion costs: That's great...our transfusion charge was $200 plus the blood at $200, plus the rest..adding up to $650 each. And ours have only lasted about 5 days... All best...rooting for you. Pat

Pat Vermont

Sheesh, prices here are insane!!! I paid almost (I think) $900 for TEssy's first and only transfusion! I have to pay $80 just for a CBC (tax in)!!! Actually a full chem and CBC costed me close to $150 today when I had it checked for her Chemo!! Consider yourself very lucky!!! Johnny & Tessy

Johnny

Thanks everyone! What's crit? I will try and get a hold of Papi's labs today or tomorrow. How many days does it take for them to start feeling better? I came home from work and Papi looks so weak and tired. He's still not eating. I had to syringe more A/D in his mouth. He's drinking, though. Right now he's sleeping on the couch and I covered him up with a blanket. This is breaking my heart!!!!!!!! I e-mailed Dr. Dodds. I am very worried about him. Is it normal to take this long for them to bounce back? He had his transfusion on Monday and started on the higher dose of Prednisone on Tuesday. Palladia did see, to shrink his tumors drastically.

Kristi CA

Crit = hematocrit or PCV (packed cell volume). Did you ask the vet about using mirtazapine to stimulate the appetite? Have you tried homecooking some food for him to see if he'll eat? Get creative...just keep the carbs on the low side if possible. This is what I did for Tessy to get her to eat when she wasn't interested! Yes, it can take quite some time for them to start responding to the meds. Pending on what's used! Since you just started the higher dose of pred on Tuesday it could take several more days to fully kick in. Is he still puking at all? I'd assume you are using a stomach protectant??? Anti-nausea meds? I've got a slippery elm cocktail recipe that might help make the tummy feel better if it's still upset. When is the next CBC test? Johnny & Tessy

Johnny

Thanks Johnny! Sorry to hear about Tessy. What do you mean she beat AIHA? Does the spleen shrink? What happens? Papi's PCV when I took him in on Monday was 12%. After the transfusion it was 31%. I keep checking his gums and they are pink. He's still very weak, though. He just lies on his side and breathes rapidly (either pants or close-mouth rapid breathing). His PCV had been steadily declining over the past month since he started Palladia. The oncologist told my vet that anemia wasn't a typical side effect. Papi is off of the Palladia now until we can get a handle on this. His next CBC is scheduled for Monday. I went to the store and bought some chicken breast and boiled it along with some white rice. I mixed it and put a plate down next to him and he ate a few bites, so that really made me happy!! Dr. Dodds called me. She's sending me something in my e-mail to show to my vet (her protocol for treating AIHA, I believe). She told me to re-check his PCV tomorrow or Saturday. What is Cyclophosphamide? Chemotherapy? I wonder why my vet won't put Papi on it. I called the vet and asked for an appetite stimulant and they said there weren't any (!) I will ask them about mirtazapine. All they told me is that the Prednisone will stimulate his appetite. He's not throwing up anymore, but he clearly doesn't feel well. Sometimes he hangs his head down like he has a sour stomach. I was giving him Reglan for his cancer, but the vet told me to stop and said it would actually hurt him at this point. Currently he takes Benadryl 25mg twice daily, Prednisone 20mg twice daily, and Omeprazole 5mg once daily. I also give him Hi Vite drops.

Kristi CA

Kristi, Oh dear. You are so busy. All this must be very challenging for you. Please remember to take care of yourself also. It is very important. I went through many months of days like this. I had to make myself take time to read a book, take a bath or just get away to shop for a few hours. Yes, she is sending you the protocol. I have had it since Chance was first sick, now 4 years ago. It is very complete. In fact it is close to brilliant. I mentioned the cyclophosphamide because it is a drug that has been used for treating AIHA/IMHA but also is used in cancer treatments. It is called a cytotoxic drug. This means: cyto equals cell, toxic means bad for or damages. So the drug kills certain cells. It can have some harsh side effects, but it would serve you double duty for both conditions. It is a suggestion to ask your vet about. Prednisone has many side effects. In fact, the whole body is affected. The condition that it creates is called Iatrogenic Cushings Disease. This means that the symptoms are caused by the use of the drug and will diminish when the drug is removed. So one of those side effects is the panting. They will pee a lot, lose significant muscle mass and look dumpy as fat shifts around the body, look "hang dog," an expression that indicates they have a sad face, have higher liver values (including the liver being swollen and uncomfortable), they will have increased appetite, lose hair. Well you get the idea, the list is pretty long. It is not permanent. But the side effects can seem worse than the disease sometimes. It will pass when the prednisone dosage is reduced. Your vet should have advised you to begin using some form of stomach protection with the prednisone, like pepcid. Prednisone can cause serious stomach ulcers. Use one generic tab an hour before a meal for a smaller dog, or give two a day before meals for a large dog. Do not miss this medication. Also ask for sulcralfate. It coats the esophagus and stomach to heal any possible ulcers in the making. Give this with at least 2 hours on either side of food or medication administration to prevent it from interfering with absorption. On an overnight fast is best. It took me about 30 sec to find adverse reactions for Palladia. http://www.drugs.com/vet/palladia.html Temporarily discontinue the use of PALLADIA if ****anemia*****, azotemia, hypoalbuminemia, and hyperphosphatemia occur simultaneously. Resume treatment at a dose reduction of 0.5 mg/kg after 1 to 2 weeks when values have improved and albumin is >2.5 g/dL. Temporary treatment interruptions may be needed if any one of these occurs alone: ****hematocrit <26%*******, creatinine ≥2.0 mg/dL or albumin <1.5 g/dL. Then resume treatment at a dose reduction of 0.5 mg/kg once the hematocrit is >30%, the creatinine is <2.0 mg/dL, and the albumin is >2.5 g/dL. Most common adverse reactions: decreased Hematocrit 11.0% (of dogs have this reaction in any grade of mast cell tumors) In other words, this drug can lead to a decreased hematocrit. That is the PCV number you are so worried about right now. my best patrice

Patrice NYS

Kristy, Here is some info on cyclophosphamide and mirtazapine that might be useful for you to read: http://www.marvistavet.com/html/cyclophosphamide_.html http://www.marvistavet.com/html/mirtazapine.html

Joanne MN

~~~What Patrice Said!!!~~~ I'm a member of a few canine cancer groups adn now I'm kicking myself in the butt for paying closer attention to discussions not related to Lymphoma (what Tessy has). I know that most of the people using Palladia check the CBC and Chem regularly (weekly or bi-weekly) for these exact reasons! Actually, it's important to check the CBC and chemistry panel regularly for any chemo treatment a dog does! That's part of what makes treating cancer so expensive! Johnny & Tessy

Johnny

Kristi....just checking to see how Papi is doing. Continued thoughts and prayers. Johnny & Tessy

Johnny

Johnny, I have been trying to build up the strength to post this. I had to let my baby go on Jan. 14. He was getting sicker and sicker all week. I called the vet and they told me to wait until the Pred kicked in. By Friday he wasn't able to stand up. I had to carry him to the vet. They transferred me to the ER. The docs kept telling me he was in bad shape and that most dogs die from hemolytic anemia. They told me nothing but negatives. They said that most dogs with this disease, even with all of the ER care, don't make it past 3 days. And if a miracle happens and they make it past 3 days, they crash again soon after. I sat for 3 hours in the ER crying while my baby was in oxygen. My family was yelling at me to let him go. I just couldn't do it. Finally at about 9:30pm I gave in and I regret that I did. I am angry that the oncologist wanted to run so many tests over and over and charge me so much money and do nothing for him. I am angry that he was getting anemic little by little and my vets didn't sound the alarm and do something weeks ago. I am angry that he was getting sicker all week and my vets blew it off. I am DEVASTATED and HEART BROKEN and I miss him so much!!!!!!!!!!!!!!!! :(

Kristi CA

Dear Kristi, I am so sorry for what has happened with Papi. You have my sincere condolences. Please don't beat yourself up, you did what was right at the time and no blame will bring him back. When my dog Kahlu died at 3 1/2 a good friend sent me this poem, I hope it helpsyou too: A butterfly lights beside us Like a sunbeam. And for a brief moment its glory and beauty belongs to our world, But then it flies on again and though we wish it could have stayed we feel so lucky to have seen it. The great memories you have of your dog will eventually heal your broken heart. Run free Papi! Best wishes, Brigitte

Brigitte BC Canada

Kristi, I am so very sorry to hear about Papi. I wish I was there to give you a hug and sit with you. It is unimaginable to me how much heartache you have had to endure. There are so many things in life that are not under our control. It is a very powerful feeling to save a dog's life and I can imagine that it can make a person feel totally powerless when they can't. What I want you to know is that I am sure that Papi, in his doggie way, was so happy to be with you and loved you no matter what happened. I am sure that in his doggie way he is grateful to you for the courage you had to help him. And I am also sure that in his doggie way, he has forgiven you too. You are not alone here and I am sure that everyone would agree that we deeply understand your grief and we forgive you also. We offer you peace of mind. Please accept my deepest sympathy, patrice

Patrice NYS

Please accept my deepest condolences in the loss of your Papi. You did what was best for Papi despite how it made you feel you had the courage to put your feelings in aside and let Pappi go as opposed to seeing him suffer. Papi is running free and will be greeted at the Rainbow Bridge by some of the best dogs in the world that have succumbed to this disease before him. Give yourself time to grieve and one day you will have such beautiful memories of Papi and they will help carry you through your dark days. PUT ME TO REST Time to let me go my friend, Because my life no-one can mend, It's better to let me go this way, Than watch me suffer night and day. I'm happy to go, my time has come, My quality of life is no longer fun, I've been so ill, so it's not a bad thing, To let me go forever resting. Stay with me till I drift away, Fast asleep forever I pray, To relieve me from suffering and pain, What more can I ask from my best friend. Don't be sad, I'll be free from pain, Never to be ill ever again, I know you'll miss me being there, But all the memories you have to share. Thank you for being my best friend, And all my needs that you did tend, Try not to be sad, try not to cry, Now is the time to say goodbye Put me to rest. RIP Pappi Cheryl & Ginger

Cheryl & Ginger Pinevile PA

Kristi, I lost my beloved Golden Retreiver, Jack, this past August to this horrific disease. I feel your pain. I always knew I loved Jack but never understood how much a part of my heart and life he became until he was gone. His loss was extremely painful and I spent an entire month literally crying. I would be sitting out on the back deck and look at the spot he would occupy and just break out in tears. I felt guilty because I didn't know enough or do enough, altho, I actually did the best I could do. I would look up in the sky and see clouds and see his face, his smile, his grin. I was a total mess for about 6 weeks after he was gone and I felt so silly because my family and friends would call me and I'd just bawl. I never knew I could be so in love with a dog, he was like one of my kids. However, after the pain, grief, loss, you will become whole again. I now have another dog, Foxy, who is so totally different from Jack but in her own way, better. I will always remember what my Mother, who is now gone, told me.....the human heart has infinite capacity to love. THere are no limits or restrictions, the love goes on and on and on. I love Foxy although, I didn't love her at first, we had to fall in love with each other. Jack will always be in my heart and I do tear up when I see his pics and talk about him. He was just such a pure soul. BUT Foxy is quite the little lady and she too now occupies a special place in my heart. Life goes on and we each deal with our pain, grief, remorse in our own unique way. I wish you the best and what actually healed me was getting Foxy. I was dogless about 3 weeks. She was a rescue on her way to the "death chamber" and I saved her. She is most appreciative and very loving. She knows that I gave her a better life and she shows me every day how much she loves me, as I do her. The love between a dog owner and the dog is very special, almost spiritual. I'm convinced it is like no other bond. You will be fine, give yourself time to digest all this and then, advice not asked for, get another dog, ASAP. Do think about resuces, the economy is so bad and folks are having to give up really good wonderful trained dogs to shelters every day. Foxy is 5 years old, not that beautiful, altho she is to me and I shudder to think that she would have been put down because she is well trained and so great. You will be in my prayers, Mary and Jack and Foxy

Mary

Dear Kristi, I am heartbroken about your loss. It is so hard to watch our fur babies suffer and Papi seemed to be a real trooper. Dealing with the cancer and then the diagnosis of IMHA seems like it took such a toll on the poor guy. Please take care of yourself and most of all be kind to yourself. You did all you could. As Cheryl and Ginger posted; Papi will be greeted at the Rainbow Bridge by many wonderful dogs. With deep sympathy, Gwen and Gracie

Gwen Rhinebeck

Thank you Brigitte, Patrice, Cheryl & Ginger, Mary, and Gwen! I really feel like I could have done more for Papi. I feel like the vets didn't do enough and weren't proactive enough. I feel like I let him down, especially after reading of the dogs here who made it out of this disease. :(

Kristi CA

Kristi, The what if's are always the hardest to get through. Almost 5 years later I still think that if I had done something different I would have been able to save my girl. It is kind of silly to keep thinking these things as age would have taken her by now. You did what you could based on what you were advised by professionals. Papi knows that you did the best that you could and it was because you loved him so much you were able to let him go even though it would hurt you so much to do so. I hope the happier memories with your boy will bring a smile to your face and a healing to your heart. It does get easier as time goes on but you will always carry a little ache in your heart for your very special brave boy. Penny

Penny Lytle Creek Calif

Dear Kristi, I am so sorry to hear this news about Papi. Juliet crossed the bridge west on January 14 too. Like Papi she could barely lift her head and because her anemia was non-regenerative, the prognosis was not good for her. We are fortunate that the kindest thing we can do for our friends is to let them go rather than continue to suffer. I will think of Juliet romping in an ever green field with your Papi. We all spend time second guessing ourselves and our vets. But in the end, we are all just humans doing the best we can and I believe our canine friends know that. We and they have learned a lot from our IMHA dogs that we can share with others and I use all my new knowledge about food and care for a new friend. While I write this with a terrible lump in my throat, tears, great sadness, and some anger too, I am beginning to see daylight again. We have adopted a border collie/sheltie mix from a kill shelter via our 4H Rescue Project. We think Juliet would approve of us giving another dog a good home. Hoping that you can begin to heal soon. Pat

Pat Vermont

Dear Kristi You did not let Papi down one bit, you did exactly what every loving pet owner would do and that is give him a fighting chance.. but God had other plans for your boy. Papi would not want you to feel like you let him down either he would want you to be proud of what a loving and caring caretaker you were for him. I think that you were chosen to take care of this very special boy for a reason it may not be clear right now but in time the reason may become more apparent. Remember what all our dogs want are fun, love, attention, and good health… That means no pain or suffering… Which is pretty much what we want ourselves and just based on that you made exactly the right decision and did not let him down at all. Please know that you and your family are in our thoughts and prayers during this difficult time and know that you will get through this. Cheryl & Ginger

Cheryl & Ginger Pinevile PA

Kristi, I am so very sorry to hear of the loss of your most beloved Papi. Please accept my deepest sympathies on your loss. When you feel up to it, I urge you to visit the Loss & Grief page at the Meisha's Hope AIHA/IMHA Web site: http://www.cloudnet.com/~jdickson/loss.htm This page was written with input from those who have lost their dogs to AIHA/IMHA and contains many resources that will be very helpful to you during these most very difficult days. Once again, my deepest sympathies to you on your loss. Be assured you are in my thoughts and prayers.

Joanne MN

((((Kristi)))) I was just thinking of you guys the other day! This just breaks my heart reading this! Lots of us here know how hard it is to make the decision you had to make and it's NEVER an easy one to do! You did a very brave and unselfish thing for Papi that only a small percentage of pet parents would do! Papi was sooo lucky to have you there for her and I'm positive she knew this!!! It can be even more difficult when you have to deal with family also! Been there done that. I've been in heated arguments with family, friends and I've even come close to pounding my neighbor for rude comments he made one day! It just doesn't help with the situation and really burdens the effort of concentration one needs when dealing with this. It took me a LOOOONNNGGGG time to stop beating myself up when I lost Sadie last August and I literally cried myself to sleep thinking about the *what ifs* and *maybes* of what could have been done differently on countless nights!!! I think of her daily but now it's with a smile for the memories I had with her and just how lucky I was to have her in my life! It takes time but I'm sure you'll reach the time and place where the tears for her loss turns to smiles from the memories! You've got my deepest sympathies and condolences for your loss! Remember that Papi has lots of friends where she is now and is watching over you daily with a smile on her face! Lots of HUGS, Johnny & Tessy

Johnny

Thanks everyone for the kind words!!! I am so sorry to hear of other losses on the thread. How devastating! I wish I knew what causes this disease so I can hopefully prevent it in the future.

Kristi CA

Sorry for your loss. May the good times you shared fill the place of loss in your heart and home. Praying for you and your family. I agree, this disease is tough! We can only do what we can do and sometimes we have to let them go, no matter how much it hurts us. Pets are so much a part of our lives... Blessings, Cindi & Tori (6 mos IMHA)

Cindi PCB

This thread was discussed between 11/01/2011 and 13/02/2011

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