Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Claire & Shaunna

Hi everyone Just thought I'd give an update on Shaunna. She was admitted to the vet hospital (royal dick) on Monday, which we felt was the best place for her so she could receive specialist care... The situation we're in is not great and we seem to receive one piece of bad news after another, which is just devastating. On Wednesday, Shaunna's pcv fell to 14 from 17 so the following day they started a transfusion. They did half that evening and as she didn't show any signs of reaction, the transfusion was completed the next afternoon (yesterday) Her pcv rose to 18 and then to 32, which was the brilliant news we had hoped for - a pcv of 32 would sustain her, hopefully for a few more weeks to let the drugs kick in. Or so we assumed. Now for the bad news - her pcv fell back to 21 this morning, which once again places us in a very bad situation. The vet has attributed this dramatic fall to her immune system attacking the donor blood. We are now dreading her pcv check tomorrow. If her pcv had stayed at the higher end we would have brought her home in the next few days, which is what she needs. What's more, her retic count has hardly budged from 0.4 since Wednesday. She has now been on various doses of prednisolone for 18 days and atopica for 12 days. Now bearing in mind that Shaunna was admitted on Monday, she has eaten virtually nothing all week, and it is now Saturday. Have they attempted to sustain her by syringe feeding etc - NO ! With the exception of this morning where she apparently took a 'bit' food. Have I complained about this situation yes - has it got me anywhere - no. The vet we have been assigned is basically the bringer of doom and negativity and she speaks/talks as though Shaunna has no chance of beating this thing and finishes every conversation on a negative - she has even implied that I should be thinking about euthanasia if things don't improve this coming week. I am now left in absolute despair. Claire

Claire Cumbria

Hi Claire I am sorry Shaunna's test results are not what we were all hoping and praying for and I know that you are in such a very difficult situation and want only the best for Shaunna. There have been many others on this forum who been in the exact same place you have been in and I hope they will provide suggestions on what to do. Perhaps you could suggest to your vet that the do a trough test on Shaunna to make sure she is aborbing the correct amount of the cyclosporine. Here is a description of the test from Meisha's Hope website. It is very important to measure blood cyclosporine levels when the drug is being used.The therapeutic range for cyclosporine is from 300-500 ng/ml (nanogram/milliliter). One reason that frequent blood testing is necessary with cyclosporine is that there can be a great deal of variability in its absorption. One dog may absorb a larger percentage of the prescribed dosage then another. Cyclosporine concentration blood tests called trough tests are not able to be done "in-house" at veterinary clinics nor do most outside labs run cyclosporine levels. Trough tests are usually sent to veterinary teaching hospitals, to be run. The blood for the trough test must be drawn at the exact time a dosage of cyclosporine is scheduled to be given. This allows the lowest amount of cyclosporine in the body to be measured on the trough test. Since cyclosporine saturates the tissue, the dosage may need to be adjusted from time to time, another reason trough testing is so important. Please know that we are sending our prayers. Cheryl & Ginger

Cheryl & Ginger Pineville PA

WOW....I'ld like to tell you to seek out another vet but like you said this sounds like the best place (hospital wise) for her. The vet that brings all the doom and gloom talk needs a good slap. There is nothing worse than hearing negativity when trying to deal with this disease. If I were you I would explain your situation to Dr. Dodds and maybe she could consult with them on appropriate techniques/tests/coarse of action/etc. I'ld also be trying to get her to eat if at all possible. Proper nutrition is very important. FOOD FOOD FOOD! Have they checked her thyroid levels? If not that should be done as soon as possible. Having the proper nutrition as well as a normal thyroid is an important combination. Sometimes we have to be persistant with the doctors. If you can't visit daily then call throughout the day to make sure they are trying to feed her. Please keep us posted with any news you get. I'll be keeping Shaunna in my thoughts and prayers tonight. Best wishes and postive vibes sent your way. Johnny & Tessy

Johnny

What dosage of cyclosporine is Shaunna taking? One more thing you could do is post the results of the tests (CBC/CHEM profiles/morphologies/etc) here and maybe there might be something someone can notice. I used to do this and I found it extremely helpfull when people would explain the numbers to me. Johnny & Tessy

Johnny

Claire, I am worried about your Vet and the attitude she is taking with Shaunna. AIHA dogs DO recover from this disease. It is a situation that requires you and your Vet to pursue all the medical options available. That includes all medications used in combating AIHA and of course, as Johnny said, nutrition. If Shaunna is not eating, try offering her some sodium free baby food such as beef or chicken. I force fed my dog, Ren, with a syringe. It was a highly nutritious concoction of beef, spinach and high potency vitamins. She hated it but I knew that after a week of not eating, she had to have something to sustain her body. Has your Vet considered adding Imuran to Shaunna's meds? Sue & Ren

Susie delaware

Hi Claire, I'm so sorry that you are in this situation. Tiggs' PCV also dropped within a day of his transfusion, as do almost all of the dogs that get them. It is in fact their body attacking the new blood, that is 'normal' and not unexpected. It is a tool used to 'buy time' while the hopefully correct dosage of meds can take root and the dog can start regenerating new cells. In order for that to happen, the immune system of course needs to be suppressed, and for that to happen, the dosages must be aggressive and correct. I hope that she is receiving some fluids and you could also ask for some canned food, like Hills A/D, which is high calorie, and easy to digest. We fed this to Tiggs with tongue depressors and scraped it onto the roof of his mouth for a while. We later started to incorporate a little white rice, steamed, etc. Perhaps when you visit, you could try feeding him this way. Also, she may be feeling naseous, so you could inquire about a nausea meds, which were necessary in our case, as Tiggs vomited almost all of the food, water, and meds that we were getting into him. Try to stay positive, we have to be our furkids greatest advocates, and push the vets forward when they want to give up too easily. We will be hoping for the best and praying for Shaunna to turn around as soon as possible. Give her lots of love, and muster as much strength and confidence that you can, they pick up on those things. Hugs, melissa and tiggs

melissa slc

Claire, I am sorry that you are having to deal with Ms Doom amd gloom, as if you don't have enough worries as it is. I would tell her that you are aware of the odds but that you know of other dogs that have been in worse conditions and still made it and that you are going to treat Shaunna as such until Shaunna lets you know that she does not want to fight. Hopefully things will turn for the better soon. Keeping you both in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Claire Just thinking about you and Shaunna today, how is she doing? Cheryl & Ginger

Cheryl & Ginger Pineville PA

Claire, Try not to let your vets negativity get to you. Dogs do rebound from this disease. Keiko was diagnosed and transfused in June of 07. She is now a healthy 6 year old dachshund, taking a small doze azathoprine 3 times a week. Please stay positive and we will be thinking and praying for your Shaunna. Jess and Keiko

Jess BC

Claire I have been thinking about you and Shaunna all day.I hope you got better news today.Please,but only if you feel up to it,let me know how things are. Kind regards Kathleen and Nollaig

Kathleen North Ayrshire

HI Claire and Shaunna, I do not post very often anymore on this board, but i check it pretty regularly. I want to tell you that dogs do recover - I cant tell you how many times I was told to think about putting Kent to sleep, but he rebounded. He was a trooper, and i was his cheerleader. He got AIHA, with a count of 7 - was transfused, recovered. Got pancreatitis, then AIHA again with IMT - not good. He recovered!!! He did get a transfusion, and his hematocrit was never great again, but nonetheless was recovered and stable on pred. His liver was swollen to the size of a basketball from pred, but we attacked this with nutrition and supplements, and i am darn proud that we got his liver and all his values back to NORMAL after a while. There was a point that he had blood in his poop, his liver was swollen, and even Dr. Dodds tactfully suggested it might be the end. He troopered on another year after this, and he did not die of AIHA. His numbers had been bad during episodes, and he certainly was in critical condition during his relapse - hospitalized 5 days, transfusion, barium swallow, and he passed out several times, having to be revived with oxygen (it still tears my heart to read the reports). And he recovered. Slowly, but surely, baby steps. He survived, then thrived! for two years. and he did not die from AIHA. Hang in there, and reach out here, and do all your research and ask questions, ask them over and over until you get answers that you can understand and comprehend, and always ask: what are our options, where do we go from here. Make them work with you on a plan - not just doom and gloom. My vet was also doom and gloom the first year, then really changed. He never expected all the recoveries, but became very positive, saying my Kent surely was a cat with nine lives. I hope this helps a little bit, and be sure to ask your vets about getting your dogs blood matched and ordering blood ahead of time to have in case she needs another transfusion - i'm sure they can do that there. In our thoughts, Christine and Kent

Christine FL

This thread was discussed between 15/08/2009 and 16/08/2009

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