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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Daisy getting Worse
| My 8 year old female yellow lab (75 lbs) was diagnosed in July, 2007. Her PCV was down to 11. After one transfusion, fluids, Prednisone, Cyclosporin etc. we got her PCV up to 29-30. She had her cyclosporin switched to Immuran 2 months ago. Her original level of Prednisone was 80 mg split into two doses. It has been graduly lowered down to 40 mg daily. She now has so much muscle wasting she sometimes cannot get up off the floor. We weren't due for a blood test for another month, but I wanted to see if we could cut her Prednisone dose down some to start to reverse the muscle loss. She has had excellent care from her group if internal medicine specialists. The news came back today that her PCV has dropped down to 26. The vet agrees we have to lower her dose of Pred. but is suggesting we consider removing her spleen so we can get her off the Pred. There is a blood test on her serum they need to run before they can consider the surgury. I am reluctant to elect the sleenectomy but it is so hard to see her struggle. I thought we had this under control, but now I am worried. I know we have some very knowlegable people on this forum. Have any of you had dogs that have undergone a spleenectomy? Any advice would be welcomed...Thanks, Ron |
| Ron B San Mateo |
| Ron, I am so sorry to hear about you lab. I remember vividly how dreadful it is to watch the wasting from prednisone. Are you still using any other drug besides the prednisone? You mention cyclosporine... you are now only on Immuran? There may have been too rapid a decrease in this second drug. We have been on prednisone since June and Cyclosporine since mid July. We have been decreasing very very slowly since then. At 100 lb, Chance is on 5/2.5mg alternating days and just reduced to 25mg cyclosporine. Please read my recent post about splenectomy in the thread titled Popeye update 12/15. What reason are they giving you for the need to remove the spleen? Most literature I have read indicates that a splenectomy for the sole purpose of preventing blood cell destruction is not necessarily very successful. If, however, there is a situation like ours, with a possible mass on the spleen, then, yes, this might be a necessary surgery. If she is quite ill now, this surgery might be extremely hard on her health. It's a relatively simple surgery, but there is the possibility for serious complications and the incision is quite large. Taking a long time to heal. I have never seen in all the literature mention of removing the spleen so as to lower the dose of prednisone. But I understand why they are saying this. The spleen acts like a blood cleaning machine. It circulates things the body finds foreign and harmful through tortuous pathways, thus breaking apart blood cells that contain these foreign objects. Special white cells come to the spleen and attack these "not self" things. If the body begins to destroy it's own blood cells, or sees them as "not self", the spleen could be a location of great destruction. Removal of it, so the theory goes, removes the greatest location of destruction. Dogs can live quite well without a spleen. Please give a little more information for us. There are a number of webpages I can refer you to to help you make your decision. Removing Chance's spleen and 7 lb hematoma saved his life in March, so from my view, it was a good thing. Your girl may not be healthy enough for this surgery right now. Patrice |
| Patrice New York State |
| i just wanted to add that reading your story reminds me of the horrible side effects that happened to my dog. the muscle wasting, the literally evaporation of all strength and ability to even move at times. this was all caused by the severe side effects...and they took a major toll on my dog. in my own personal opinion i think the side effects of high dosage prevention drugs do more damage than the disease itself (in some cases). we DRASTICALLY cut my dogs meds, both pred and cyclosporine and she has gained the majority of her strength back, 12 pounds, and the ability to walk and run again. granted we are on an anabolic steroid injection that seems to be the major factor in holding my dogs count, but her quality of life has been multiplied 10 fold compared to where we were when her doses were at extreme levels. I wish the best for Daisy. |
| josh cali |
| Patrice: Daisy was on 100 mg of Cyclosporin for two months. We switched to 50 mg of Imuran daily, which she still takes to this day. We are going to reduce her Pred. to 30 mg per day and re-test her in two weeks. Daisy is not really acting ot looking ill, she just has lost her strength. Cone head etc. We will take her like she is since I know she isn't suffering, but it is hard to watch them try to cope... |
| Ron B San Mateo |
| Ron, Your story sounds all too similar/familar. I wish you and Daisy the best! |
| Allison TX |
| Ron, Do you have your last two blood test results? If you do, could you post the hct(hematocrit) (or pcv), the rbc (red blood cell), hgb (hemoglobin) and look for something like retic % and retic absolute. These last two numbers would look something like 1.5% and 72,000 or alternatively 5.7% and 180,000. A drop from a pcv of 30 to 26 over a period of a month is not significant enough to worry. Variables during the blood draw and the process of getting the blood into the analyzer can alter the numbers by a few points. A drop of 10mg a day of prednisone sounds reasonable as it would equal approx. a 25% reduction. Patrice |
| Patrice New York State |
This thread was discussed between 19/12/2007 and 20/12/2007
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