Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Drugs that can motivate Bone Marrow to Produce Red

I was curious and although it has probably been mentioend before in other threads: Oliver has been on 50mg of Prednisone 2 times a day for about 1 1/2 months. He is now on Cyclo 300mg 1 time day for 6 six days. Prior to that he was on Aza 50mg a day for almost 1 1/2 months. Aza was removed 6 days ago. I know I am repeating myself. Nothing has really worked with boosting his red blood cells, only suppressing his immune system. His numbers have always continued to slowly decrease, except for after transfusion. Isn't there medications that can be added to stimulate or assist the bone marrow into pumping out red blood cells? Why isn't this type of medication given in conjunction with the immunosuppressents? Remember, I'm new at this so don't know the process too much. If the cyclo was to work, how soon could a response be seen with increased numbers? I know many pups have had to remain on cyclo for a long time and sometimes it is a situation where more transfusions are given, different dosages adjusted, etc. Whats genereally the next step if cyclo doesne't work? If anyone has time or energy to address these questions ad nauseum, I'd appreciate it....Blesses to all of you.

Mardi Northern Cali

Mardi Nollaig has been on lithium since February prescribed by internal medicine vet specialist at Glasgow Vet Hoospital as it's supposed to work to stimulate bone marrow.Although it hasn't worked for her so far.Thyroxine(soloxine) which Nollaig was put on just a few weeks ago also stimulates red cell production.I so wish I had pushed a lot more at the start i.e February for a complete thyroid panel blood test as they just kept saying she shows no clinical signs of underactive thyroid(but I disagreed she had poor hair quality and dry skin dandruff and had suffered a little hair loss in the past)Anyway it turns around Nollaig's thyroid was at the lower end of normal so certainly not working at it's utmost and according to Dr Dodds thyroid plays big part in red cell production. So I'm hoping along with the bioprep and the soloxine and the ronaxan(doxycycline)in case a tick/parasitic infection has/is suppressing her marrow(she was put on this at my insistence) and the nandrolone(as it's also meant to stimulate bone marrow)things will improve. Nollaig has been on Prednisolone,Azathioprine,Atopica(cyclosporine),leflunomide,danazol and none of them have worked.I have to say Mardi that was always my feeling too much emphasis was on stopping destruction of red cells and not enough on stimulating red cell production that's how I got researching on thyroxine,biopreparation,nandrolone and doxycycline. I believe some dogs have taken maybe 6 to 8 weeks to see a dramatic result from cyclosporine but my advice would be don't waste too much time if a drug does not seem to be working to ANY degree(i.e pcv not holding or even slowing rate of dropping) and try something else, especially if money is limited for transfusions etc...however Nollaig was on cyclosporine for 5 months and we stopped it last week as it wasn't making any difference and I decided the less drugs she's on the better.Nollaig was on prednisolone along with cyclosporine along with leflunomide and then along with danazol so they can leave Oliver on cyclosporine but try other drugs too but my advice would be get Oliver on soloxine as prednisolone is also known to make the thyroid level lower and you need it to be working at its max Hope this helps Kathleen and Nollaig

Kathleen North Ayrshire

Thanks Kathleen. I think that Oliver is pretty much the same as Nollaig with this disease. He is on soloxine as his thyroid test came back lower end of normal too. I just know that the last couple of days I have seen a real change in his "clinical" behavior. He is turning his nose up more at his regular food, but wanting other stuff. Very pale gums and hardly any energy. He just wants to lay on the floor in the bathroom and rest. I wish tomorrow wasn't a holiday here in the states as I would probably take him to the vet. I can almost bet a transfusion will be done very soon. Your info will be useful when I visit the vet on Tuesday. How is Nollaig? I hope you didn't mind I sent a note to your email inquiring about how you were and how nollaig is! Just wanted you to know I was thinking of you. Thank you again. Keep in touch.

Mardi Northern Cali

Mardi Did you not get my reply Mardi,I will resend it to your email,I hope you don't think I was ignoring you. Sorry to hear clinically he has got worse.Has Oliver been diagnosed with PRCA? Kathleen and Nollaig

Kathleen North Ayrshire

I didn' think you were ignoring me, not to worry. You have a lot on your plate. I believe it is PRCA. He hasn't had a bone marrow biopsy. Too far to go to get one. Vet is assuming this is the condition. Does the cyclo change the color of the poo? Weird question, I know, but I noticed last night and just now, that his poo is darker and has an almost, maroon, color to it. Not like blood, as far as I can tell, but just a darker color than usual. Usually brown/light brown, normal. Now I'm worried he has a stomach bleed or something. Lord it never ends.

Mardi Northern Cali

Dear Mardi, I don't know how long Oliver has been taking all his meds, but I do know Callie has not shown any improvement with Prednisone 30mg, Azothyroprine, and Atopica 100mg. (one month) She is now on Doxycycline at my insistance and today she looks like she is failing. She isn't comfortable anywhere and right now she is hiding out in a corner on our porch. Her gums and tongue are pale, her eyes dull and of course her breathing rapid. I even noticed her back legs seem to be bowing out (maybe just my imagination). Her infection in her front foot is still oozing puss....and we are giving her epsom salts baths 4 times a day. It seems to be helping a bit. I am just so saddened by her condition. I know with the holiday I have to wait till Tuesday too to go to the vet. I bought some canned pumpkin because I read on a holistic vet site that it sometimes helps and will give her some of that too with her meal. I am going to consult with Dr. Dodds this week and hopefully we can try a new course. I noticed Kathleen has Nollaig on soloxine and I will talk to the vet about that Tuesday. I am tempted to start weaning her off some of these drugs. I feel like if the disease doesn't get her, the meds will. I just need a shred of hope, as I am sure you do too!

Valerie Texas

I didn't notice any changes to Nollaig's poo however she was on that many other drugs as well as cyclosporine.One thing that Rory(Nollaig's specialist vet) mentioned to me the other day, as I was asking about Nollaig being on the ferrous sulphate(iron) tablets(she's been on these since February) and the bioprep as I was worried she would be getting too much iron and he said she would get rid of any excess iron in her faeces,he said you've probably noticed her poo's darker than your other beagles,although I have to say Nollaig's poo is more full of carrots,sweetcorn and all her other veg that she gets so multi coloured really!He said she won't be absorbing that much iron(I suppose because she's not producing that many red cells) but he said if she does start to produce many red cells she will need the iron so to keep her on both iron tablets and bioprep. If I were you, I would take Oliver on Tuesday as soon as vet reopens, and get him checked out and mention the colour of his stools to the vet.Is he on a stomach protectant because of prednisolone? Nollaig did go on tummy protectant when she was first on pred but when pred was reintroduced recently Rory felt it could affect absorption so she doesn't get it now and I trust him completely that he wouldn't do anything to harm her.I do give her probiotic fat free organic natural yoghurt as a tummy settler however everyday and she loves it, just give it well away from other meds. Kathleen and Nollaig

Kathleen North Ayrshire

Valerie, I'm sorry you haven't been getting results. We haven't either and it's just a little over 2 months. The pumpkin is good stuff. He was "clinically" great until a couple of days ago. Started cyclo on Tuesday night, 300mg 1 time day. I hope you are able to get things worked out and something "works". I know how scary, upsetting and helpless you can feel. I'm going through it too. Having the holiday doesn't help, does it! Ollie also has pale gums, etc. and has gotten worse in last couple of days. Same thing with sleeping in the restroom all the time. Used to sleep on the bed at night, etc. Now he wants to stay in the restroom. Maybe he likes the hard, cold floor, I don't know. Yes, Kathleen, he has been on sucralfate 2 times a day since he started with all the meds back in beginning of august. He also gets 1 1/2 tabs of a anti-acid 30-60 minutes after the sucralfate. I am wondering, and it may be too soon, if the cyclo is just not agreeing with him, or it's just the disease rearing it's ugly head in a more noticeable manner. I will most assuredly be calling the vet first thing Tuesday morning. I hope it gets better over the day/evening instead of worse. I'm almost tempted not to give him any more cyclo until the vet checks him. I don't want to mess up the consistency with that though. It's a dilemna. thanks for your input Valerie and Kathleen. I hope your pups get better too.

Mardi Northern Calif

Mardi Please check your email as Karen(who has the beagle Darcy who miraculously recovered from this disease prca, after 8/9 months)has sent you an email.I thought she could help you as much as she's inspired and helped Nollaig and I,she's a wonderful person. It might be that the cyclo... does not agree with Oliver and if that's the case he's better off it as the meds can also bring their troubles.However it could also be due to his pcv being lower,the only way to know that is get him checked over on Tuesday. Nollaig has been very lucky as clinically she's kept so well(apart from when the drug leflunomide suppressed her marrow too much and her white cells went dangerously low and she nearly died as she caught a life threatening infection and was in isolation fighting for her life for 2 weeks)so drugs can do damage too,azathioprine did same thing but she luckily didn't catch an infection that time.However cyclosporine is not known for this side effect of lowering white cells so wouldn't worry about that. Don't give up,stay strong. Kathleen and Nollaig

Kathleen North Ayrshire

Thank you again Kathleen. I will try hard to remain positive. It's just difficult sometimes. Every minute/hour/day can change things either for the better or the worse, as you know. I hope there isn't a problem sending emails to me as I haven't gotten one. Just to be sure it's, mardibess@aol.com. I will be back on later. Time for dinner. What is the time change difference? Is it Monday already there and about late morning?

Mardi Northern Calif

Mardi, I was in the same boat trying to get my timmy to respond to meds to stop cell destruction and to stimulate red cell production.Dr. Dodds recommended thyroid supplement eventhough timmy did not have a thyroid problem.This will stimulate bonemarrow cell production.Till this day i think it was one of the key factors of timmys turn around. Terry and timmy

Terry pa

Mardi,think you are 8 hours behind me here in Scotland in UK, so you'll be tucked up in bed at the moment, hopefully getting a restful sleep! Mardi,I just replied to the email you sent me and it came up this email address MBessellieu@co.humboldt.ca.us I have now sent it to the other address,hopefully you've got it and I've asked Karen to resend her email to this address also. Nollaig still bright and alert and wanting rubbed and wanting to eat 24/7!!! What a fighter I've got,I'm so proud of her! Terry, I hope the soloxine works for Nollaig as it did for Timmy. Hope Oliver bit better when he wakes today. Kathleen and Nollaig

Kathleen North Ayrshire

This thread was discussed between 06/09/2009 and 07/09/2009

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