Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Cocker Spaniel w/AIHA

My beloved cocker spaniel, Maxwell, was diagnosed with Autoimmune thrombocytopenia back in October of last year. I discovered one morning a few purple spots located around his groin area. He had no other symptoms that indicated any other problems. I went ahead and scheduled an appointment with the VET and he was surprised that I had even noticed these spots. As a precaution, he went ahead and ran a CBC and to our surprise the platelet count was less than 50. We immediately began treating Max with 20mg of Predisone daily. After a week, we added Azathioprine. We also had an ultra sound and Xray performed and all was clear. About 6 weeks of treatment with weekly CBC's the platelet count stablized. We began reducing the meds and a few weeks ago found out his Red blood count had dropped under "normal" range and registered 26. The VET immediately adjusted the meds to 40mg of predisone along w/Ranitidine and 50mg of Azathioprine. After a week of this therapy, the count dropped to 23.5 and we increased the Azathioprine to 100mg. We just had another ultrasound performed last evening on his spleen and liver. His liver is enlarged and he has fluid in his belly. We are now awaiting the results of the complete liver chemistry. I have done some research and it seems that it might be likely that Maxwell has "Evans Syndrome"; however, my VET is not convinced since it is a very rare disease. My concern is that while we are fighting this disease, Maxwell is suffering secondary side effects from the large amounts of medicine, especially prolonged predisone usage. Today, he is having a hard time walking, his heart beat seems to be accelerated, and he is shaking while resting. He has no appetite for his regular food and I am taking him to the VET first thing tomorrow morning as I believe he is becomming dehydrated as I type this post. I am hoping someone can give me some additional insight and most of all hope. Thank you and I look forward to receiving your comments.

Stephanie Kentucky

Hi Stephanie, I'm really sorry to hear about Maxwell, and his difficulties. I have to say, 100mg of Aza seems really high for a dog the size of a cocker, and I know that Aza is very, very tough on the liver. My dog was 65 lbs when diagnosed, and has always been on 30mg/day (now every other day). I don't have a lot of experience with Evans, but I'd have to say, it doesn't seem to rare on this board, unfortunately. Please visit Joanne's Meisha's Hope website, and you will learn more about Evans, as well as see some success stories and read about how those dogs were treated. Also, perhaps you might want to consult with an Internal Medicine doc or a vet teaching hospital if there is one in your area. All our best, and we hope Maxwell improves. melissa and tiggs

melissa slc

Stephanie, I hope that your Vet can figure out what is going on with Maxwell. I would double check the dosages of the meds like Melissa said. How much does Max weigh? If you go and read Joanne's site read the success stories. A number of those dogs had Evans syndrome as well. My Vet said AIHA was a "rare disease" as well and look how many new cases come up every month and that is just the ones who find this boaed and choose to fight. Thinking of you both. Penny

Penny Lytle Creek Calif

Stephanie, The usual dosage for Azathioprine is 1 mg per pound of the dogs weight per day when the drug is started. After time some vets will reduce the dosage to every other day. The veterinary drug handbook says this about Azathioprine "In recovering dogs with immune-mediated hemoltyic anemia, taper the withdrawl of the drug slowly over several months and monitor for signs of relapse. Rapid withdrawl can lead to a hyperimmune response" End of quote. Please do visit the Success Stories pages at the Meisha's Hope Web site http://www.cloudnet.com/~jdickson/successstories.htm There are several dogs on there who have recovered from Evans Syndrome and gone on to do very well. Be assured you and your dear Maxwell are in my thoughts and prayers during these most difficult days.

Joanne MN

I wanted to update Maxwell's status. I went ahead and rushed him to the hospital last evening since he could barely walk and his shaking was not subsiding. The swelling in his abdomen has increased substantially as well. They suspect a possible Azathioprine reaction, Maxwell only weighs 24 pounds and with receiving 100mg daily may be the direct cause. His liver values are elevated and his RBC count has dropped to 14. His stools are bloody and he can barely stand up. He is receiving fluids, ampicillin, baytril, and SAMe. My original VET is consulting with the hospital this morning to discuss course of action. I believe he needs a blood transfusion to get him through this crisis and in addition they are recommending a bone marrow aspirate in order to detect cancer or any other disease in the bone marrow. I fear I am loosing him and am scared that I will not know when enough is enough. He has been the most wonderful companion in the world and will be lost without him but I do not want to prolong his suffering for selfish reasons. I have visited Meisha's Hope website and have found solice in all of the stories. I am praying that I will have Maxwell's story to share... Thank you all for your support and direction.

Stephanie KY

Stephanie, I am sorry Maxwell is so unwell today. I hope they are able to give him a transfusion today. If your vet has not already checked for tick diseases, please ask them to do so immdediately. Since Kentucky is in the warmer part of the US, there are more tick diseases that can be contracted year round and there may be particular tick diseases prevalent in your area. Your local health department would be able to tell you these. The symptoms you describe could be attributed to a particular tick disease. There are treatments available for these diseases. I will be thinking about Maxwell today. my best patrice

Patrice NYS

I just returned from an Internal Medicine specialist. Maxwell has been admitted and the DR gave me a "guarded" prognosis. He wants to check the coagulation factor and he will be checking his heart since he has a heart murmur to ensure he can handle a blood transfusion. I did not want to leave him and thought he was going to die in my arms. I will definitely ask about the possibility of a tick disease. Please keep us in your prayers....

Stephanie KY

Stephanie, will do. patrice

Patrice NYS

Please know that we are keeping Maxwell and his Dr's in our prayers. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Thank you all for your prayers.... I just received news that Maxwell has Dilated Cardiomyotpathy (DCM). It's heart disease. I am in disbelief and cannot wrap my head around this news. His red blood dropped to 18 and his platelets are at 38. Good news is that he did not see any problems with the coaggulation results. He is receiving an injectable form of medicine to strengthen his heart in order to receive a blood transfusion in the morning. The doctor says if they tried now that it would certainly kill him. He also will be draining fluid from his belly since it is a result from both the liver and heart disease. At this point, my family is praying for a miracle. No one should ever have to face these types of circumstances. As they say, hindsight is 20/20 and wished I would have researched more about this disease at onset back in October. I feel extreme guilt that this outcome could have been avoided. There needs to be more awareness among the veterinarian community... I feel we should have been referred to a specialist months ago... Thanks again for everyone's support....

Stephanie KY

Stephanie, I'm sorry to hear this setback for Maxwell. It sounds as though he is now in good hands and since they are moving forward with treatment, that there has to be hope that he may improve and get heathier. Please do not blame yourself, I know it is hard, but we all make decisions based on what we know in that moment, and there is no way you could have known all of these complications would arise. It is true, many vets are not up on the latest and best information, but I do have to believe that your vet also did what he/she could with the information they had at the time as well. Many of us have made difficult choices when we didn't fully understand what is going on. It's so hard! And it is such a crazy disease that seems to take hold different in every dog that it affects. All our thoughts and prayers are with you and Maxwell, and we are hoping for a quick turnaround. melissa and tiggs

melissa slc

It is with the heaviest heart that I must write that Maxwell passed away peacefully this morning. Words cannot describe the pain in my heart. The hardest part was coming back to an empty house. No longer will I hear the pitter patter of his paws anxiously awaiting to greet my arrival home. He was taken much too soon from us and my life is forever changed because of him. Thank you for all your prayers.... I take comfort knowing he is with our creator and no longer suffering... Stephanie

Stephanie KY

Stephanie, I am so very saddened to hear of the death of your most beloved Maxwell. Please accept my deepest sympathies on your loss. Be assured you are in my thoughts and prayers during these most difficult days.

Joanne MN

Stephanie, I am so sorry for your loss. Treasure the memories of a healthy Maxwell, he will always hold a very special place in your heart. Take care, I am thinking of you during these difficult days. Brigitte

Brigitte BC Canada

Dear Stephanie, I am so sorry for the loss of your dear friend, Maxwell. I know how hard it is to come home to an empty house-it just doesn't seem right or that it should be that way. I'm glad Maxwell died peacefully, and please know that you gave him the best doggy life with lots of love. Take good care, Leslie

Leslie

I'm very sorry to hear of your loss. It is a hard thing to deal with. Remember the good times you had with Maxwell and all will get well. I will keep you and Maxwell in my thoughts. Know that we are here for you during these difficult times. Jonathan & Tessy

Jonathan

I am saddened to hear of your loss and hope that you will remember the happiness to help you get through this difficult time...don't forget that the Meisha's Hope website also has a loss and grief section that might be helpful. We will pray for peace and understanding for you and your family. Lee and Lucy

Lee Florida

Dear Stephanie, Please accept my deepest on condolences in the loss of your fur baby Maxwell. I pray for peace and strength for you during this difficult time. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Stephanie, I am so sorry for your loss. I know how painful it is to lose your beloved dog to this awful disease. Know in your heart that you did everything you could for you dear Maxwell and that he is now romping at the bridge with a lot of new friends while he waits for you. I hope that the good memories you have of your boy will help ease your pain. Penny

Penny Lytle Creek Calif

Stephanie -- I am so sorry to hear that your sweet Maxwell has passed. As you said so well, it is a comfort knowing he is no longer suffering. You were a great doggie mom, so try to think of the wonderful life you shared with Maxwell during the tough days ahead. As hard as the grief can be, we can all thank the Lord that he blessed us with these sweet loved ones in the first place. Our lives are enriched because of them. Please know that you did all you can do. Take care and let us know how you're doing. I'll keep you and your family in my prayers.

Brenda VA

Did anyone experience any of your dogs stomach being so bloated. ALiki's stomach for the past 2 days is bloated. I mean big all around. I am scared, we are bringing her to Vet tomorrow. Can anyone share their experiences or let me know if this is normal. Thanks, Tina

tina ny

Stephanie. I'm so sorry for your loss. Reading your post brought tears to my eyes. Think about your doggie every day and remember him with joy. God bless you. carol

carol vanc wa

Tina - Please take Aliki to the VET ASAP... do not wait until tomorrow... My Maxwell just started showing signs of bloating on Monday... I don't mean to scare you but you must act quickly... I will also send this to your e-mail...

Stephanie KY

I wanted to thank everyone for all their kind words of comfort... I know time heals all but I feel as if my heart has been broken into a million pieces... I wanted to share a small glimmer of Maxwell... We adopted him from an animal shelter in December 2000 shortly after he'd been struck by a car causing him to loose his right eye. He soon adjusted to his disability and we never ever saw him as handicapped. He enjoyed running and chasing his ball, long walks, boating on the lake, but his biggest joy aside from food was simply being by our side. I used to joke and say he was my shadow and looking now at all the pictures and videos, he looked more like an extension of my soul. We had him for 8 short years but within that small amount of time he taught us what unconditional love truly meant. I am forever grateful for my time with him but will miss him dearly for the rest of my life. My soon to be 4 year old daughter is having a tough time and wanted to see if anyone had any suggestions on how I might help her through the grieving process. I was thinking about visiting the bookstore in hopes of obtaining a book that might help her understand. My husband and I are trying to keep Maxwell's "light" shining through sharing stories with her but find it very difficult when the emotion takes over. Thanks again for allowing me to express my grief. I pray that everyone who is battling this terrible disease strength and hope...

Stephanie KY

Dear Stephanie, I'm so sorry to read about your baby and I hope that he gets better and stays that way. I lost my best friend in the world to AIHA on 3/10/09, and I am still trying to deal with the loss. Fletcher was a 6 year old Chocolate Brown Cocker Spaniel who NEVER had any illnesses. On Saturday 3/7/09 he appeared weak and I took him in to Cherokee Emergency Vet Hospital and they discoverd that his red blood cell count was 12. They gave him Prednisone and other meds but his condition just kept getting worse. We tried a blood transfusion last Monday but by Tuesday morning he was jaundice and failing. The worst part about losing him was not knowing what caused such a robust, healthy dog to deteriorate so fast. I wish that I could give you some advise but unfortunately I don't have any, even for myself. I will say a prayer that Maxwell gets better and stays with you as long as possible. It seems impossible to me that in 2009, we can't isolate and prevent AIHA.

Jim McArdle Georgia

Stephanie, There is a lovely story that you can share with your daughter called the Rainbow Bridge. It can be found in many places on the internet. Here is one place. http://rainbowsbridge.com/Poem.htm My deepest sympathy for your great loss, patrice

Patrice NYS

Stephanie, I'm so sorry to read of Maxwell's passing. I tried to post earlier, but for some reason it didn't post. Thank you so much for sharing your moving tribute to Maxwell, he sounds like he was always a real trooper. There is a wonderful book about loss called the Fall of Freddy the Leaf by Leo Bascalgia (I might be spelling his name wrong) but it is perfect for children as it explains death and dying through the metaphor of a young leaf moving through the seasons. All of our love and thoughts are with sweet Maxwell and your family. melissa and tiggs

melissa slc

I so sorry about your loss of Maxwell,What a wonderful story. I just heard about this site yesterday on the radio, a pet hospice program, here they list several books that may help http://pethospice.org/PET%20LOSS%20SUPPORT%20FRAME.htm Laurie

Laurie CA

Stephanie, When my dog died MAF sent me a wonderful book called "For every Dog an Angel" by Christine Davis. It is really geared towards a young person but guaranteed to make you cry too, but in a good way. It is probably available in most book stores but can be ordered on line. Penny

Penny Lytle Creek Calif

Thanks everyone for your support and recommendations on reading material - definitely will check all out. I have to confess - we adopted another cocker from our local shelter last evening. Mid-week I searched on Petfinders for available cockers in my area for rescue and low and behold one cocker by the name of Maxwell appeared before my eyes. We were torn as we are far from healed from loosing our Maxwell but came to the conclusion that no other dog will ever fill the void but there are many dogs that deserve a warm and loving family. He was a total mess - mats from head to toe and smelled like he spent his life in a barn with a bunch of cattle. His coat had to be completely shaved but even without a coat he is a handsome white and brown cocker - 7 years young. I am blown away by his renewed zest for life and how anyone could have neglected this beautiful spirit.... I know Maxwell sent him to us in an effort to take away a little bit of the pain but there is not a day that goes by that I do not cry for him but have faith that I will see him again... God bless everyone and I definitely will be checking in from time to time to see how everyone's furbabies are doing... Keep up the FIGHT!!!

Stephanie KY

Stephanie, That is amazing that you were kind enough to open your hearts and homes to another soul in need. I am a huge proponent of rescue, as I now have three and volunteer for two groups here in Utah. We need more families to adopt and open their hearts. I know without a doubt that Maxwell (the first) was looking out for you and sent you another angel to help you heal. Keep us updated on how you and your new guy are doing. We know that no one could take the place of Maxwell, but I am happy to hear that this sweet new baby is there to help you on your journey! melissa and tiggs

melissa slc

Stephanie -- that is wonderful that you adopted this sweet little cocker into your home. It's funny how things happen that way sometime. A friend of mine who lost her shih tzu to IMHA thought she'd never have another dog, and then several months later, she learned of a shih tzu who was in a difficult situation and needed rescuing. He looked like her sweet boy. She adopted him and now her home is happier. They still miss their Buddy, but they have a new dog to love. Best wishes to you.

Brenda VA

Stephanie, I'm very sorry about Maxwell. I also lost one of my dogs to this disease. I'm happy to hear about the new little cocker spaniel you adopted - it seems like it was meant to be ! I've adopted two dogs from our local humane society that were terribly matted and physically neglected, and one suffered emotional abuse/neglect. It took a little time, but they both turned out to be wonderfun additions to our family. I'm sure that your new Maxwell will appreciate being adopted by you, and given a great life with someone who will care for him and love him. Sue

Sue

This thread was discussed between 04/03/2009 and 16/03/2009

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