Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Dog has AIHA

Hello everyone. We have a 5 1/2 year old shepard/lab/chow named Milo... Milo was rescued from a humane society when he was just over 3 months old. He was born on the forth of July and when he was a puppy he was a little fire cracker for sure! :) Milo is such a good dog and has always been so friendly to EVERYONE! Milo used to be so active and suddenly over night it all changed! Milo vomited last Friday. I thought maybe something did not agree with his stomach. Sunday We went food shopping and came home. Milo had vomited all over my bed, love seat and couch! :( The following morning he was acting lethargic. We got him in to the vet as a emergency appointment, because it was Memorial Day. The Vet that was on duty took a look at Milo and wanted to do a X-ray to be sure he did not have any foreign object in him. He did not see anything except for Inflammation. He said that Milo had a gastro intestinal thing going on and put him on a chicken and rice diet. Sent us home with 2 medications. We came home and he would not eat still. (probably Thursday) The following day he was just not getting better (Tuesday) He was lethargic etc. We called the DR and they had us bring him in. A new Vet looked at Milo and said that she think's he may have been given rat posioning. (FROM The symptoms he had) She gave us Vitamin K to treat him for that and sent us home. When we got home we noticed blood coming from his nose. We called the VET And she had us bring him back in to be admitted, because she said it sounded serious. She was now on the fence about A toxic posioning or AIHA. (Auto-Immune hemolytic Anemia) That night at 1:30 in the morning she called us to tell us that Milo's blood lever was really low and he needed a blood transfusion. We told her to go ahead and do what she can to keep Milo alive! Milo had his blood transfusion and his blood lever went up. We were starting to feel a lot better about this!!! The blood work came back this morning and Milo Does have AIHA. :( They took milo off of the prednisone that they had him on, because it is causing ulcers in the stomach. The vet had us go to the pharmacy for 2 medications for Milo today. They started him on them. This morning Milo's blood levels dropped down to 17. They are supposed to be 35-40. :( He had to get another transfusion this evening. The DR called us this evening to tell us that she almost had to call us to send us to a different animal hospital, because she is running out of Donors for Milo. Milo is pooping dark stools which means internal bleeding. .... :( She said that after this transfusion that he got tonight, if it does not help then we may "have to make another decision" We are doing all we can to get Milo Healthy!!!!! Another decision is NOT AN OPTION right now. We did go back in to see him tonight and he was still lethargic. We did get to get about 5 (very little) pieces of chicken in him.. Everytime We go up to see Milo it makes it 20 x's harder on us. Leaving him there with strange people and in a cage is just depressing to uS. I just wish he would get better and we can take him home. Does anyone have any advice? Please!!! Please pray for Milo!!! Thank you!

Robin New Windsor NY

I'm very sorry to hear about Milo. Please check out the Meisha's Hope site below, it will give you some good information on how to attack this disease. http://www.cloudnet.com/~jdickson/ We will all keep you and Milo in our prayers tonight. And as Joanne says "dogs can and do survive". I'm sure she will reply to you in the early morning. Others will reply from the west coast tonight so check back often. Steve

Steve VA

Robin -- I'm so sorry to hear your dear Milo has run into IMHA. Everyone here understands how upset and anxious you are right now. I hope others weigh in, because I am surprised the vet has taken Milo off prednisone so quickly. It is one of the basic drugs to fight IMHA, and various drugs can be prescribed with the prednisone to protect the stomach. I'll keep you and Milo in my thoughts and prayers. Please take care.

Brenda VA

Thank you all for your replys. I really appreciate it and it feels good to talk with people who know how you feel. It's been such a hard time on all of us and we are just so upset! My 3 yr old son is so lost without his buddy! Milo and my son (Joe) have a love/hate relationship, but Milo has NEVER EVER snapped at Joe. He mopes around the house when Joe and I are not home. Joe is alway's asking about Milo and how he loves him and wants him home. How do you tell a 3 yr old something you can't even understand or comphrehend youself???? :( These are the medications Milo is on as of right now. Imuran 50mg MISOPROFTOL 100 Micrograms in place of the prednisone. I was told that the prednisone was giving him stomach ulcers? I really am interested in hearing any opinions/advice at this point. Anything I hear I will relay to the veternarian.

Robin New Windsor NY

Robin, I am so sorry Milo has been diagnosed with this awful disease. You need to find a specialist who is well versed on treating this and is open to your input. A number of dogs on this board have had to have multiple transfusions until the drugs kick in so it is important that you get her on soon. You also might want to check out Dr. Dodds site at www.hemopet.org Regarding the issue of blood availabilty. Keep us posted, Penny

Penny Lytle Creek Calif

Robin, I am so sorry this is happening to you. Try to stay calm and learn as much as you can as fast as you can. Please know that there are many folks here thinking about you tonight. If you have not already done so, ask your vet to perform a SNAP 4Dx test for exposure to tick diseases. They should have this test in their office and it is fast, cheap and very reliable. If there is anything abnormal about this test you should immediately talk to your vet about further testing with Protatek Labs. You should also discuss using doxycycline at a high dose if there is a possibility of a tick disease. You live in NYS and tick diseases are very prevalent, esp in the eastern and southern parts of the state. This is the season for ticks the size of this period . to be very active. They are carriers of several diseases that can possibly cause anemia and severe bleeding. Ask for copies of your blood work (cbc) and look for the values of platelets. See if they fall into the normal range or are they very low. This is the clotting agent in the blood. Rat poisoning is one cause of this kind of sudden attack and vitamin K is indeed one of the treatments. Depending on how long the exposure was internally (did he throw up most of it?), the treatment should work within a few days if you caught it early. It sounds like your vets have a fairly good grasp of the diagnosis of what is happening but they may not have treated a severe case like this very often. Most vets who have treated AIHA would not stop the prednisone like this in the early stages unless they are sure that a primary cause like rat poison or ingestion of a zinc coin was the definite cause. If this is AIHA, prednisone is your best hope right now to stop the destruction. There are meds that can be given to protect the stomach while you are giving the prednisone. You many need to find a specialist near you to take Milo for a emergency visit. Many dogs with AIHA have several transfusions and are on many drugs. A specialist is the right person to prescribe this cocktail of drugs. You can return to your regular vet once Milo is stabilized. Do not lose hope, there have been many dogs that were this severe and have survived. Be proactive and courageous. my best patrice

Patrice NYS

Robin, I am so very sorry to hear that your most beloved Milo has been diagnosed with AIHA. If you have not read my Web site on AIHA/IMHA as yet: http://www.cloudnet.com/~jdickson/ you might want to do so. Be sure to follow the links on the first page to many other sites on AIHA/IMHA that will be very helpful to you and do read the SUCCESS STORIES pages. They will show you what has worked for other dogs in terms of treatment options as well as give you a lot of HOPE. If Milo were my dog I would be very concerned that the vet took him off prednisone. While prednisone can hurt the GI system it is the cornerstone of treatment for AIHA/IMHA. Stomach protectants can be given to help prevent ulcers and other GI problems. In regard to this statement from one of your posts: “MISOPROFTOL 100 Micrograms in place of the prednisone.” I don’t understand that statement since Misoprostol is not a drug that will stop the destruction of red blood cells, it is used for the “treatment and prevention of GI ulcers” that is quote from the Veterinary Drug Handbook. Your vet might have meant that he/she is using Imuran instead of prednisone but it should be noted that it can take some time for Imuran to start to work. The Veterinary Drug Handbook says it can take up to 6 weeks to see a clinical response with Imuran. We do see that drug work in some dogs sooner but in some dogs it does take the full 6 weeks to “kick in”. So until the Imuran does kick in Milo does not have any immunosuppressive drug working for him to stop the red cell destruction. I would strongly, strongly suggest that your get a another opinion from a veterinary internal medicine specialist. AIHA/IMHA is a very difficult disease and needs to be treated very promptly and aggressively by a vet who is very knowledable about the disease. I truly do know how hard this is so be assured both you and your most beloved Milo are in my thoughts and prayers during these most difficult days.

Joanne MN

Sorry that Milo has been diagnosed with AIHA. I second and third everyone's comments. Your vet can probably get canine blood for transfusions from Hemopet (as Penny mentioned above) if there is not a live donor dog available. Oxyglobin, while sometimes controversial, is another option for transfusion if canine blood is not available and the need for oxygen to the tissues is critical. I especially think it's helpful to get an opinion from a vet who specializes in Internal Medicine. They are more likely to have experience both with this disease and with refractory (hard to treat cases) patients. Cyclosporine is another drug sometimes used if Prednisone and/or Imuran is not working well enough. It saved my dogs life when she didn't respond to prednisone. It is now 5 years since her diagnosis, so she, as well as many others, show that there are dogs and times when this disease can be managed, or even better, put into remission for long periods of time. Best to Milo & your family.

Ronda So Cal

I really can't add much to what other's have said - Matilda was just diagnosed this last march and I am still learning so much. I will tell you that this board has given me so much knowledge, help and strength - and also that if you can take the time to read the Meisha's Hope site you will feel like you are at least getting a handle on what you are dealing with. And do try to find a vet well versed in immune diseases. I was very very lucky that my vet knew about and had treated this disease before, and knew to send us immediately to a critical care unit until the meds kicked in and started to control the destruction of Matilda's red blood cells, since her counts dropped so rapidly. hugs to you, Milo and Joe - jeanne

Jeanne texas

Thank you all very much for your replies! I confused some of you about the Prednisone/Misoproftol.. The Misoproftol was to coat his stomach from the ulcers the prednisone was giving him. I was told when I talked to the vet today that they are using imuran in place of the prednisone, because it caused Milo dark stools and stomach ulcers.? He had a transfusion last night and his PCV was at 17 before the transfusion. This morning it was at 26. I just hope it does not go back down! She said they check it 2 times a day. So later we will know. He did eat for them today which is awesome! He was turning his nose up to food for a while now. He is no longer vomiting and he has no bloody stool. I hope this means a change for the better is coming, but she informed me that we will not know for a few days on what is going to happen with him. He is still in bad shape. He is not allowed to come home yet, which is OK with me I can make 3 visits a day to see him as long as he is getting healthy that is all that matters to me. Tonight will make 4 nights since he has been in the hospital. He has NEVER been away from home except for getting groomed for a few hours. :(

Robin New Windsor NY

Robin, The numbers will rise as a result of the transfusion but will probably drop without something like Pred to stop the destruction. I am not trying to take the positives you have seen away I just think you need to be prepared to consult with a specialist. Time is of the essence in this fight. Penny

Penny Lytle Creek Calif

Get your dog to a specialist/critical care. While my Bear is probably losing his battle as we speak the following are your options: 1) Prednisone - take something for his stomach 2) Imuran - immune suppressant 3) Cyclosphoramide (check spelling)- immune suppressant 4) Danasol 5) Cytoxan - immune supressant 6) Human Immunoglobulin infusion (expensive but coats the red blood cells so that it will fool the cells destroying the red blood cells) Try them all, no one knows what will or will not work, it is trial and error, I'm into this two weeks and on my 7th transfusion, as long as he is eating, drinking and feeling okay we are going on- once that stops then my options stop as well. Best of luck to you, this is a tough one to deal with.

stephanie houston

Hi Robin, I second everyone else's advice and comments and strongly urge you to call Dr. Dodds at Hemopet. I also believe yoiu should get a second opinion from a specialist, and download and discuss the treatment protocols for this which are online at Hemopet. I am confused also about the prednisone - it takes imuran a few weeks to kick in, is my understanding. If pred is causing bleeding, then a barium swallow and sucralfate and pepcid ac should do the trick - our kent had terrible ulcers for a while and the above worked. I also urge you to ask your vet to give Milo a barium swallow (this is a trick from Dr.Dodds we used on Kent) to slow and patch up the intestinal bleeding while he goes through transfusion recovery.IT worked wonderfully. Dogs can and do recover from this, please focus on the best and being as proactive as you can like you are doing by getting information that will help you and milo. Please check back here often as others will write in as well, and hang in there.

Christine Fl

Robin, I am sorry to hear of Milo's diagnosis with IMHA. Know of my thoughts and prayers at this time of stress and distress. Ann Marie

Ann Marie FL

What kind of Specialist deals with AIHA? I think we need to go that route with Milo. We went to visit him today (around 3:30pm) and he was still lethargic. His right eye (has blood in it again) He had a transfusion last night because his PCV was 17. It is at 26 as of this morning, but they do it 2 times a day so tonight at 8pm they are going to do another one. He was also having tremor type shaking. Almost like a shivering type of tremor. Every time I pet him he did it and he also was just laying there doing it. Usually when I go to leave he tries to get me to take him home with me, but he walked right to the back door to go back to his cage. When I got home I had so many questions. So I called the Vet. She called me back and I asked about the prednisone. She said that with the internal bleeding Milo has they can not risk giving him prednisone, because it was causing bleeding. (he had bloody diarhea) She said they have him on pepcid and the misoproftol for his stomach. He is also taking the Imuran. She said that it can take up to 6 weeks, but it "could" be working now. :( <<<LONG SIGH>>>> I am so stressed out from going back and forth with milo, taking care of a a 3 yr old, trying to keep my house cleaned, looking up information, and my hubby has health problems his self that we don't know what is wrong with him. It's like a ongoing stike of bad luck in my life. Not to mention the vet bill right now is already at $2600.00 and we got denied for pet care.. I don't care how much money it cost's we already exhausted our savings account .. I just want my dog back and I want him healthy! I miss him sooo much!!!!! I did ask the vet about the tremors and she said it could be because "he is uncomfortable" !@@ <eye roll> I also asked her if she reccommends we get a specialist and she said it depends on our comfort level. I gues the answer I was looking for was "YES YOU SHOULD" Which now I know I do need to take him somewhere else! I am going in tonight after 9:30. I want to get my son in bed so I don't have to take him with me. He get's nervous in there and starts to act up and I can't concentrate on milo. YOU can see photo's of milo at www.myspace.com/dats2cute He is such a awesome dog and I hope he can pull through this. I feel so sick over this!! If anyone could point me in the right direction I would appreciate it!!!

Robin New Windsor NY

If you have a larger veterinary hospital near you, you should be able to find a vet who specializes in Internal Medicine. They are usually not that hard to find. Try going on the AVMA site to search for one in your area. Also, you can give a call or email to Dr. Dodds (hemopet). If your treating vet isn't able to get past the ulcer business, I don't think it's a good idea to wait to talk to someone else. As others have said, there are meds to help this while giving pred (there is not bleeding elsewhere is there?) Now is not the time to be afraid of hurting your vet's feelings by a second opinion. Most vets won't be offended anyways when dealing with something which can sometimes be very difficult to treat.

Ronda So Cal

Robin, I am so sorry you have so much on your plate right now. At the top of these pages ia a link that says AIHA treatments which will take you to Joanne's site or if you have it bookmarked like most of us do she has a link to Internal Medicine Vets and hospitals on the treatment page. I am geographically challenged for other states so I don't know how close any of those listed may be to you. Please try to email Dr. Dodds and tell her what is going on with Milo. She is so giving of her time and knowledge and she responds really fast. She even called me at home one night when I had a question. hemopet@hotmail.com This is a very emptional roller coaster ride so take a deep breath and hang on tight. Thinking of you both. Penny

Penny Lytle Creek Calif

Robin, Have you asked if they have done a SNAP4 Dx test? It's very important that you have this test done. If you live in Newburgh, you are right in the hotbed of ticks in NYS. If this costs more than $30, I will pay for the test. Write me privately. Patrice Here is a link to a website to search specialists: http://www.acvim.org/Specialist/Search.aspx I have copied and pasted the first 2 pages of them, it looks like Ithaca (Cornell) is fairly close, but so are many of the clinics near NYC. For that matter, you could drive north to Albany and probably get an appt. sooner and with less stress. Cornell may give you special care via the veterinary college. There is also a list of ACVIM Diplomate by geographic location: http://www.acvim.org/uploadedFiles/pdfs/Directory/SAIM_Geo.pdf Dr. Suliman M. Al-Ghazlat Animal Medical Center New York NY Dr. Cheryl E. Balkman Cornell University Ithaca NY Dr. Stephen C. Barr Cornell University Ithaca NY Dr. Jeff D. Bay Upstate Veterinary Specialties Latham NY Dr. Jason M. Berg County Animal Specialty Group Yonkers NY Dr. Rebecca I.M. Berg NYC Veterinary Specialists New York NY Dr. Marjory B. Brooks Cornell University Ithaca NY Dr. John D. Broussard Animal Medical Center New York NY Dr. David G. Brummer Orchard Park Veterinary Medical Center Orchard Park NY Dr. Mark G. Burns Tribeca Soho Animal Hospital New York NY Dr. Joseph M. Carrillo Lincolndale Veterinary Center Lincolndale NY Dr. Sharon A. Center Cornell University Ithaca NY Dr. Jennifer Chaitman VIMA Specialists New York NY Dr. Deirdre Chiaramonte The Animal Medical Center New York NY Dr. Jean A. Ferreri NYC Veterinary Specialists New York NY Dr. Randi Alissa Fishkin Fifth Avenue Veterinary Specialists New York NY Dr. John V. Fondacaro Suffolk Veterinary Specialty Services West Islip NY Dr. Michael S. Garvey New York NY Dr. Lori Goeders Huntington NY Dr. Elizabeth E. Goldman Banfield, The Pet Hospital Saratoga Springs NY Dr. Richard E. Goldstein Cornell University Ithaca NY Dr. Brenda Griffin Cornell University Ithaca NY Dr. Kerry J. Heuter Animal Specialty Center Yonkers NY Dr. Sean Morgan Hillock Oakdale NY Dr. Ann E. Hohenhaus Animal Medical Center New York NY Dr. Patrick E. Hopper Wave Diagnostics Pelham NY Dr. Lisa Michelle Ireland Humane Society of New York New York NY Dr. Richard W. Jakimer Manor Veterinary Clinic Pelham NY Dr. Gerald F. Johnson Mercy Veterinary Hospital, P.C. New York NY Dr. Andrew J. Kaplan City Veterinary Care New York NY

Patrice NYS

I am so sorery to hear about Milo. Chances are you are like the rest of us and never heard of this disease before diangosis. And believe me, every single person here knows what you are going thru right now. I lost Hunter, my 4 year 2 month gold golden retriever to it Oct 16, 2003. But he was also fightig severe liver damage, both brought on by the 6 month heart worm preventatvie injection, ProHearr6. He fought hard and ha it just been one reaction I think he would have won the battle. Never give up hope. And also, WHEN Milo goes into remission, avoid all vax. It is known Vax can brng the disease on and surely can bring on a relapse.

Sandra TExas

Thank you Patrice. I need to talk to my Husband tomorrow morning and let him read all of the replys here. I believe in the beginning before Milo was Diagnosed, they performed a tick test and it came back negative. (i AM SORRY IF i SOUND REALLY STUPID RIGHT NOW, BUT IS their another kind of test to rule that out? I really don't know what kind of test they ran) I want to get copies of all of his blood work-ups and medications for my personal research. I wonder if they will give them to me? I don't see why that would be a problem right? Tonight I went up to visit with Milo. His PCV Is at 25.5 as of 8:00 pm. (down from 26 this morning) I brought him some chicken up and he ate it all up! I was so happy to see him eating. He even wagged his tail and stayed next to me (standing up) letting me pet him. I took him for a walk outside and he pooped. It was straight liquid and I got a tissue and looked at it. It was bright red blood. It scared me.. I too him back in to the visiting room and laid down on the floor next to him for a while, just holding him and talking to him! I showed him pictures of him and Joseph from my phone. (He probably does not care, but I tried LOL) Then I took him out to the waiting room and the receptionist told Milo he could have run of the whole hospital if he wanted. So I let him wander around for a bit. He seemed so much stronger tonight then he has been since before this all started!!! I was so happy to see him moving around and not having to lay down or get weak and fall on his hind legs! He tried to squat to poop so I took him back outside and once again bloody liquid. :( I mentioned it to the receptionist and she told the vet tech. (the vet was in surgery) They said I could call in a few hours and talk to the vet. I just now called and the Vet is still unavailable, but the vet tech told me it was from the anemia?? That they have him on Vitamin K to help it???? I just don't know. I feel so uninformed about this disease that I don't know what sounds "right" I am sure they probably "KNOW" much better then me, but I want what is best for my dog and I just want to be sure they know what they are doing!! I hope you all understand me? Tomorrow morning at 8 AM he is having another PCV. So from what I gather, it will be lower since he is pooping blood..? Correct?? So What NOW? I need to go in there and actually have a vet talk face to face to me instead of sencond hand phone calls. I am happy that he was more alert and seemed stronger, and that he actually ate! Made me feel really happy! I even asked him if he "Met any new chics in the back" LOL I mentioned kitty cats and his ears shot up like they always did!!! Tonight's visit brought a smile to my face, but I am so scared!!!

Robin New Windsor NY

Thank you so much Penny! I am going to call DR.Dodds. I would not hurt to try! I am willing to go any length at this point!!!!! I appreciate it very much! :)

Robin New Windsor NY

Thank you Jeanne!!! I will pray for Matilda and I hope that everything goes good with her Recovery!!!! ((((((((Matilda)))))))))

Robin New Windsor NY

I just wrote out a very long thank you post to everyone here who has been replying to me and helping me out! I ended up sending it without filling in my info, and lost it all!!!!!!!!!!! How depressing! I appreciate everyone's input and kindness!!!! You are all so helpful and I really thank you all!! (((((((Hugs))))))))

Robin New Windsor NY

This thread was discussed between 30/05/2008 and 31/05/2008

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