Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Codys AIHA, now diabetes from prednisone

Our 2 yr. old Shep/mix Cody had been on prednisone for 1 year for his AIHA. He now has diabetes from the prednisone and needs insulin shots 2x a day. We are considering a spleenectomy in hopes of weaning him off the pred. He also has a mersa staph infection on his leg from his weakened immune system, that's been impossible to heal. There is an obvious "Domino effect" going on here with drugs/side effects. This is a miserable life for such a wonderful dog, and our money is running out....any insights on the spleenectomy would be much appreciated.....Thanx, Tammy

Tammy N.J.

Hi Tammy Im so sorry to hear of your troubles with Cody, it just doesnt seem fair, and I know all about the money running out. Unfortunately I dont have any insights here on the splenectomy but I know others have, so Im sure they will tune in soon. Best wishes to you and Cody, lets know how he goes. Silka

Silka Melbourne Australia

Dear Tammy, I am so saddened to read of the difficulty you are having with Cody's care. This is a lot of stuff for a 2 year old dog. My initial reaction is that I wonder what dose of prednisone he has been on for this long and my second thought is, why haven't they looked at another immunosuppressive drug to switch him to? If he is having such serious side effects, he should be removed from this in a slow but gradual way and shifted to something else like cyclosporin. I am truly sorry to hear about the MRSA. It is not common, but dogs have been contracting this very difficult to treat staph infection. Vets are reporting that this drug resistant form of staph can pass from human to dog or from dog to human. So do be cautious in your home if you ever have any contact with elderly or immune compromised people. What I would recommend is that you ask your vet to consult with Cornell University. They have successfully treated several dogs in our area with this condition and have been studying it for several years. They will know what to do. I would like to know exactly what they tell you the reason is for removing the spleen. I am curious what they have told you? The spleen can be a site of destruction of red blood cells and platelets. Our immune system has functions that are active inside the spleen, so it does stand to reason that if you remove the spleen, you remove one source of destruction of RBC. I have seen this recommended in some vet textbooks, but it's not on the top of the list of treatments. However, it's not always the perfect solution. In addition, this surgery can be very hard on a dog. If Cody is not well now, it might be a difficult recovery for him. My dog Chance had his spleen removed in 2007. He had a large mass on it that was later found to be benign. But it was a difficult surgery, there were 2 vets and 4 techs to perform it. It took Chance several weeks to really recover from the incision. Dogs (and humans) can live without a spleen quite well, other organs take over its job for the most part. There is one tick disease that the spleen protects us from that would prove to be very serious without a spleen. So you would have to take extra precautions against ticks in the future. If this were me, I would be very hesitant to do this unless I had definitive proof from the vet that this will, in fact, make Cody's condition better. Here would be my plan of attack... Get the MRSA under control, this is very hard on the immune system. You may find that once Cody is treated for this successfully, his general health will improve significantly. If your vet is hesitant to contact Cornell, do it yourself. You may have to call a few numbers to connect with the right department but I know they are treating it there. I would also pursue putting Cody on cyclosporine. This will target just one part of the immune system, not all of it (like the pred does), and it would help him fight the MRSA battle better. my best patrice

Patrice NYS

Tammy I as sorry to about Cody's health problems and I hope he feels better soon. I too am questioning why he has been on prednisone for a year now, what is his dosage per day. Please check with vet regarding a safer drug that has less side effects when used long term, such as cyclosporine, it is an expensive drug, but once he is stabilized you can begin to reduce it and once that is done the cost will be lower. Before I would have his spleen removed I would find another vet one with experience with AIHA and get a second opinion. Please read everything you about this disease and have a talk with your vet, you need to be Cody's voice. Read the treatment protocol on Meisha's Hope website and perhaps you could contact Dr Dodds @ hemopet@hotmail.com Sending our prayers, Cheryl & Ginger

Cheryl & Ginger Pineville PA

Tammy, Here is an excellent resource for owners whose dog's have contracted MRSA. http://tahilla.typepad.com/petsmrsa/ my best patrice

Patrice NYS

Hi everyone, Thank you soooo much for your thoughtful insights and advice regarding Cody....he's been on just 40 mg./day of the pred. which they said was minimal for his weight of 60 lbs. My Vet said the cyclosporine would also weaken his immune system, that's why we haven't switched drugs around. Also his PCV had improved alot on the pred. from 18 to 38 and holding.....so again we all thought he was doing O.K. We just found out it was a MRSA staph infection when they cultured it.......I rescued Cody 2 yrs. ago, and 4 days after having him he "crashed" and almost died.....we never got a definitive diagnosis at that time....but something tells me he didn't respond well to his vaccines and developed the AIHA back than....and than after he was neutered he got worse. To develop diabetes so early on is a rotten blow for him....our hope with the spleenectomy is to wean him off all drugs and than he wouldn't have diabetes, which is from the pred. Thanx again for any/all info. on this and best wishes to everyones babies that have this miserable disease.......Tammy

Tammy N.J.

Tammy, with a PCV of 38 I'ld strongly consider weaning him to a lower dose of pred. The cyclo WILL weaken the immune system but it only targets the part that needs to be suppressed (killerT Lymph cells) where as the pred will suppress all elements of the white cells...I think. The doctors have got to know this about cyclo you would think. There's been lots of discussion regarding pred and diabetes. That's why most doctors will try to wean the dogs as soon as possible. Do you have to give him insulin shots? It can be hard to keep a food and shot schedule to maintain proper sugar levels. Do you check it yourself? You can use a normal human glucometer. I'll keep Cody in my thoughts and prayers. Johnny & Tessy

Johnny

Tammy, how long has Cody been at 38? I would also talk to your vet about lowering the pred, that is still a high dose for his weight if he has been holding at 38. "our hope with the spleenectomy is to wean him off all drugs and than he wouldn't have diabetes, which is from the pred. Thanx again for any/all info. on this and best wishes to everyones babies that have this miserable disease.......Tammy" For me this raises a red flag about removing the spleen to correct the diabetes I would suggest you contact Dr Dodds, she is an AIHA specialist and will do email/phone consult, I believe the first consult is $30 She has helped many of our dogs through this horrible disease Her email hemopet@hotmail.com <hemopet@hotmail.com>

Laurie CA

Hi.....Cody's mrsa infection is responding nicely to zeniquin (antiobiotic for mrsa)...100 mgs./day....the insulin is helping too.....our Vet said the spleen is a major site of red blood cell destruction.....so removal of the spleen my help...other organs compensate in dogs, when this is done. She said most dogs don't get diabetes, staph infections, swollen limbs, etc....this early on, and she fears he'll have to be put to sleep at a very young age with his various complications. We're obviously stabilizing him with his blood sugar and mrsa before doing any surgery. Hope 2010 is a HEALTHY HAPPY New Year for ALL!!! Tammy and Cody

Tammy/Cody N.J.

P.S. We've tried a couple times to wean Cody down from his prednisone, and both times he crashed and got real sick again....this crazy disease sure is different for different dogs...I just read Minks' success story....treated, better and drug-free within a year.....that's really great for her and her owners....

Tammy/Cody N.J.

hang in there and don't give up. He is young and can heal faster and quicker than older dogs can, at times. things will turn around when you least expect it. I'm thinking of you and Cody.

Mardi Northern Cali

Sending prayers to Cody and wishing 2010 is a very good year for him. Have you tried him on Cyclosporine? It has much less side effects then the pred and has worked great for Ginger, she has been on it for about 1 1/2 years now and is doing just fine. When we lowered the dosage her PCV went back down too, so she must stay on it for the rest of her life. Please keep us updated on how he is doing. Cheryl & Ginger

Cheryl & Ginger Pineville PA

This thread was discussed between 20/12/2009 and 01/01/2010

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