Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Dylan stadning once again

Hi, Well it has been just over 2 months since Dylan was diagnosed with AIHA and almost exactly 2 months since I thought she would die from the anemia. Two weeks after that, although her blood had bounce back almost immediately (PCV of 39, up from about 10) and her strength had bouned back, it looked like prednisone was going to kill her and when she stopped being able to get up and walk a week later, I was very stressed and concerned. Well now after only 6 weeks of immobility, I turned during dinner prep to find her on her feet! This is a miracle I had not even let myself hope for yet. I could tell she was not anemic at any time over the last 6 weeks and that it was the effects of prednisone that was wasting her away. I have aggressively reduced her dose to 7.5 mg twice per day (from 45 mg 2X per day) and now we are skipping every 4th dose. I hope to be giving her prednisone only once per day soon. Although my vet has been a little resistant to the weekly reductions I have pushed for, each time I have convinced her that I see Dylan getting stronger after each reduction. She went from not being to lift her head to eat or drink, to getting on her elbows to eat and drink, to rolling over in her kennel (although she could not initially move her rear feet and needed help to avoid hurting herself), to rolling over on her own with her back legs too. If I had observed weakness, I would assume the anemia was back, but gaining strength is all I have observed from her behavior. This weekend she started eating sitting up and walking for 5 and 10 minutes while we were at the BC Regional Dog Agility Championship. She could not stand on her own though and I help make sure she did not fall while walking (using a harness and sling towel, but not holding her unless needed). This year I could not compete with Stevie Ray for the Championship (3 time winner), as I took care of Dylan and scored the event instead. Today she stood to beg for her dinner. I was in tears immediately. Then she did it again. Now I have to keep her from hurting herself as she finds her renewed strength. This is a far greater prize than any trophy Stevie Ray could have earned. This last weekend, Dylan was full of life and happiness and now she can stand and walk again; even better. She still shows no signs of anemia, but I am always diligently looking for any sign of the disease. I am ecstatic. 2 months from certain death to standing and walking again. A miracle indeed! Richard :-D and soon to be independent again, Dog Dylan :+)~

Richard Burnaby

That is wonderful news and I am so happy for you and of course Dylan. A large part of her success is the love and support you have given her over the last 6 months. I pray for continued recovery for Dylan. Looking forward to seeing some more photos of her. Cheryl & Ginger

Cheryl & Ginger Pinevile PA

Richard, so glad to hear Dyland is making a rapid recover and able to stand again. I would be very careful onreducint the pred that much. You are dropppong her from 90 mg a day to 14 mg. At the most it should be 25% unless very serious side effects as it can cause cushings disease which shuts down the adrenal glands. Someone hsould be able to comment in more clinical terms of why it is so important not to reduce too much too fast. Take care Laurie

Laurie CA

I stopped by to check in on Dylan :) And to my surprise, she's making big strides!! Wonderful news. I do agree though watch reducing too quickly it can cause more complications. I the pred side effects, its what ulimately cause me to lose my best friend :( I miss Gunner everyday, but I have comfort knowing I did all I could an that he is at peace ! Keep me posted !

jacki jacki.fusion@yahoo.com

Hi, thanks! I am not dropping this all at once. I am observing my dog in great detail after each drop and all signs are currently stronger for the day and week following each change. Each time we have dropped, I have waited to see changes and we do see changes, all of which are positive. No sign whatsoever of anemia, or any others signs of AIHA. Believe me, I would not lower the prednisone unless I was as close to certain as I can be. The behavioral changes are quite obvious. Like "standing" for the first time in 6 weeks and sitting up to eat, also the first time in 6 weeks. I am not about to make a decision because of fear either and waiting too long to drop prednisone because I am afraid of AIHA is not going to happen. I know how prednisone kills and many dogs with AIHA die from prednisone and its effects and/or subsequent euthanasia as a result. I am not prepared to let Dylan die from either cause. I do appreciate your words of caution and they are the same words offered by my veterinarian. Now that we are seeing positive signs of recovery from the prednisone, I do feel we can take things more slowly now, but it is hard not to want to see more good signs sooner. Her standing there last night gave me tears of joy for some time afterwards. Richard

Richard Burnaby

Hi, I have also read up on prednisone withdrawl and signs of withdrawing prednisone too quickly (in addition to AIHA returning) and in Dylan's case we are seeing the fist signs of the adrenal glands kicking in, which is one rason to make sure withdrawing prednisone is not done too quickly. She shows no signs of pain from the withdrawl and only increased strength and mobility including reduced paralysis in her hind end, originally caused by prednisone. She has not been able to move her hind legs until this last week. And now that she can sit up on her own, she is changing sides in her bed on her own regularly. She is moving around in her kennel, facing the back, turning to the front etc., all of which were impossible before last week. She does not drink continuosly anymore and a normal drinking pattern is a big indicator for being at a good level of prednisone. These are no obvious behavioral signs of anemia whatsoever, or low PCV and although we have not measured it recently, I am betting the numbers are better now and are no longer dropping. She had a PCV of 39 only 2 weeks after AIHA diagnosis (after a low of about 10), but it dropped slightly each measurment since (35, 2 weeks ago); we beleive due to prednisone in this case. I don't think there is any question that high dose prednisone will interfere with recovery and I beleive that occurs right away along with desired immuno-suppression. I know we are getting to a point where AIHA returning is a danger and unfortunately, every dog with the disease will need to lower prednisone and risk this same possibility of a relapse. There is no happy choice that eliminates this risk, unless you would rather your dog die from prednisone. I have faced Dylan's death with both the anemia induced by AIHA and the weakness caused by prednisone. I don't want either to occur and I take both possibilities equally seriously. Sincerely, Richard

Richard Burnaby

Richard, Congrats to you and your girl. I think sometimes we have to make decisions that are contrary to what is recommended. It is indeed scary to chance a relapse but at the same time with your close observations and past experiences with your wife I do understand the choice you have made. I truly hope that every day Dylan gets stronger and healthier. I can only imagine the joy you must have felt seeing her stand. Thoughts and prayers to you both for continued improvements. Penny

Penny Lytle Creek Calif

Thanks for the kind wishes everyone, I could not be happier and have not been as happy at any time over the last 2 months. I knew that the day I saw her standing would be emotional for me. It is a huge step in her recovery. One I thought was still a ways away. I was in tears for at least half an hour while I finished making their dinner. I was not expecting it at all yet, although we had a great weekend and saw a lot of excellent improvement. Of course after I settled down and became more coherent, I immediately went back into caretaker mode, knowing I now have to protect her from hurting herself. Despite her ability to stand and walk, she is still unstable and may fall and hurt herself. Another problem I am very happy to have. Richard

Richard Burnaby

Dylan continues to get stronger. She eats standing, drinks standing and last night she started getting up to go for a pee on her own and is doing that regularly now. It is amazing what a little time off from the prednisone can do. I suspect her liver and her capacity to make red blood cells is also improving. Every aspect of her behavior indicates increasing strength. She is up on her elbows and sitting up a lot, always alert to what is going on around her. She always gets up when friends visit now and that was only a dream less than 2 weeks ago. I still use her harness when I think she needs to poop, as that is a very difficult position for her still and I think she can still use my help there. I am still restricting when and where she can get up and go, but she is pretty cautious of her instability and won't walk when my other dogs are near as she feels they might bump her (and rightly so). I think soon we may begin going for short walks for food treats, as I think excercise will do he some good now. Richard & Dog Dylan :+)~

Richard Burnaby

Regarding advice and whether I "follow" it. Really I am (and I do appreciate it). I am just much more picky about tailoring everything to Dylan. Most advice suggests to be cautious, as removing prednisone too quickly has consequences. I agree completely. Whether it is AIHA returning, or adrenal glands not being allowed to kick in as prednisone is withdrawn, both are valid concerns and I am watching very closesly for both. I know what I will see in Dylan's behavior in both cases and I don't see it at all. I am very cautious about removing prednisone, but as always I trust behavior to guide me, not some predetermined schedule that works for most dogs (this is how veterinarians have to work). Dylan's very survival depends on me doing the very best I can for her. That I always do; I have no regrets. This is really the only difference. Because she is only on prednisone, I know that any change in behavior, positive, or negative is a direct result of the prednisone reduction. I can see very clearly before I make another change, that the prednisone reduction has improved her condition and that the effect has stablized. That is the only measurement that matters to me. Lately the improvements are massive. Standing and walking versus lying on her side, unable to lift her head or roll over. Hmmmm? Maybe the difference to me is that I consider prednisone as dangerous and a killer (as I have said previously, its use is not new to me)! I know it is necessary, obviously! But it is my opinion that I need to be at "the best dose" for her current status at all times and that any extra and uneccessary dosing is to be avoided. This is equally important to avoiding AIHA. I don't think anyone else believes this, but I already know too many dogs who die from prednisone and the Iatrogenic Cushings disease it causes and I would rather Dylan not be one of them. I now feel she won't be! Of course I don't want to see symptoms of AIHA either. That is a given! I am also very grateful to all that have offered help and support. Dylan is recovering and that is a direct result of everyone's help and support. Richard

Richard Burnaby

Richard, you are the proof that every dog with AIHA is different and we can certainly learn from that. You are also the proof that nobody but the dogs guardian knows him/her better. I am so happy about Dylan getting better every day! one thing that I find interesting and unusual (?)is that her PCV rose incredibly fast in the first few days. You say it bounced back almost immediately. I find that very curious and I am kind of suspecting that the cause for her AIHA is something she ingested? I would be interested in your thoughts. I also wanted to mention that we had weekly reductions at one point, on orders from Dr. Dodds. It only happened at the beginning of the ordeal and maybe 2-3 times. They were pretty drastic and I was very worried. That was before I knew to trust Dr. Dodds:) After that we went back to slower reductions and all was fine and just like Dylan my dog bounced back after these reductions. It is such a fine balance..... Sorry I forgot, is Dylan also on a secondary immune suppressant? azathioprene? chyclosporin? I hope Dylan will keep improving and you will keep your strength to look after her! Best wishes, Brigitte & the poodle boys

Brigitte BC

Hi Brigitte, Thanks. I have certainly considered ingestion as a souce for triggering AIHA. With the diet I feed, it is always possible and I don't know for sure if she did not eat something in my yard either (the crows drop a lot and it was gargbage day the day before). She may also have had a sting from a spider, or some other environmental trigger. I did change laundy soap at that time, to a more environmentally friendly soap (coconut based), but? I am not sure why you would think that ingestion of something as the trigger would impact her recovery per se. I would think any initial cause might be similar if it was sufficient to stimulate sufficient anitbody production. I am curious about why this might be so, as I have not found much information on triggers. Her attack was quick (no time or chance for misdiagnosis, red pee 12 hours after the first symptom) and it did take her to near death from anemia. My expectation would be that whatever entered her body; toxin, or something that released a toxin, or whatever substance the trigger may have been, would enter the blood stream (any method) and that is where the attack on her RBC's took place. I am certainly interested in learning more about the trigger process for sure. Does something enter the blood and then get incorporated into the RBC's that are then recognized as foreign? Or does some factor stimulate antibody production and in the process of making an antibody, get confused and make it to a nearby, or similar protein in the cell walls of RBC's. Hmmm, so much more to learn. I think the main reason it bounced back was the fact she was on prednisone within 36-48 hours after the attack began and 24 hours after her first symptom. Her first blood test, 24 hours after her first symptom showed that the destruction was mostly still intravascular (within the blood vessels). Although she did deteriorate considerably further; it may still be the attack was not deep into her body and spared some, or all of her ability to make RBC's. I certainly also credit her healthy diet for her recovery as well. I stopped giving her Pet Tinic and will use that if I put her on a liver sparing diet. I am certain she is getting everything she needs in her diet and now that we are much lower and less frequent with prednisone, maybe her liver will start to do better too. Another good reason to get as low as possible as soon as possible. The slow decline since then I attribute to prednisone inhibition (as does my vet) and I look forward to doing another test in the future. At the moment I am not in a hurry to do a blood test and will continue to observe her closely for any sign of anemia. I want to see how the lower prednisone impacts her liver and rbc level. As for the weekly reductions, they don't worry me. I begin to see behavioral change within a few days at most and then I see her stablize and that is important in considering the next reduction. If the signs were not clear; then I would have to wait, but they are very, very clearly stronger only and this has been true each and every week. It is this clarity that has made it possible to reduce prednisone more rapidly than might be done otherwise. I know things are not always so clear with AIHA, or with any canine problem. I have dealt with physical injuries to my dogs and many of my other canine friends who are very active athletes and diagnosis and the cause is often difficult to isolate. Prednisone reduction is also a bit easier becasue she is NOT on any immunosupressants. Changes in prednisone are not complicated by interactions with other drugs, only the interaction with her body. This was an important consideration in the beginning, as it adds clarity during the reduction process. If they are needed; yes use them, but I am not one to use what I call the "shotgun" approach and neither is my vet. We saw prednisone working and we saw recovery, so no need to add one to her protocol, as prednisone reduction would be and has been easier without it. Richard PS. So you do AAC agility and I beleive your dog Ripley is in my BC/Yukon Regional database, although I do not see Ripley as having competed (pulled?) in 2010. Dylan had a great time at the 2011 BC/Yukon Regional as I did the scorekeeping once again. Are you going to be at the Regionals (and Nationals) next year in Nanaimo? I am working with the Regional group (Patti), as I did the last 2 years here. I am hoping to run my 3 Staffies (Stevie Ray is a 3 time BC/yukon Champion) in Nanaimo next year. Dylan is retired with her ATChC and will come to visit with her agility friends.

Richard Burnaby

Hi, I did read Dr. Jean Dodd's new book on Hypothyroidism and one of the things that is more general that she constantly talks about is being your dog's guardian. I am already aware of this, as it is not much different than my expereinces with MD's too. I am fortunate to have already spent the time to find a veterinarian that values my input and opinion, as I do know Dylan better than anyone and it is "my" responsibility to care for her. I really liked the way Dr. Dodd's constantly stresses being active in your dog's care and she really empowers people to do so. I think everyone should read her book for both the discussion and information on hypothyroidism and also equally importantly, for the guidance she provides in looking out for your companion at all times. I really think this is important for dealing with unique individuals with unique expressions of AIHA. I am sure she feels the same way about our role as their guardian in AIHA diagnosis and treatment as she does for hypothyroidism. Richard

Richard Burnaby

One quick note, I am working on photos of Dylan and a "Dylan with AIHA" video, but I have only recovered enough strength myself to begin catching up on house work and some important tasks. Funny how getting a good night's sleep can make such a difference. Richard

Richard Burnaby

Hi Richard, yes I pulled Ripley last year. He was just too stressed at his first out door trial and we all know what stress can do! So we trained all year and he is now happy competing at any location with me. He got his MAD last month after competing for only 16 months. Sorry but I had to brag..... I have started Dr. Dodds book too and find it very informative. I would certainly recommend it to everybody. On the subject of triggers, there was a dog on the forum at one point that ate some piece of metal and that was the trigger. Once the metal was removed the blood improved immediately. It was really just a gut feeling. I just found it curious how quick Dylan bounced back. It usually takes at least 2-3 months to get to a half way normal level. I am no expert by any stretch of the imagination and can't really give you an explanation how the different triggers could influence the healing process. Best wishes, Brigitte & the poodle boys PS: I will certainly see you in Nanaimo next year!!! Hopefully running with both my poodles. Enzo will start competing in August.

Brigitte BC

Hi, Interesting regarding the case you mention; in that case it would seem that the presence of the toxin was causing confusion in the immune system? Of course we never know for sure. I would think that all possible triggers are present for a period and then cleaned from the body. A sting of some sort, chemical, others like this would be eliminated within a week as well. Maybe some lasting effect in some cases, like chemical poisoning, but a vaccine for example is mostly elimninated, again with the exceptions possibly of chemical toxins, which might not be eliminated from the body very easily. Once we see where Dylan's blood work goes after her prednisone is reduced, it might be more clear whether she has some lasting effect. The other aspect is that dogs fed a raw food diet generally have higher PCV, hemoglobin etc. I would assume that a stronger ability to build blood is the reason for this. Again, it is wait and see time, but I think that early detection was more likely the reason for her strong recovery and possibly her diet. Triggers are one area I would like to know a lot more about. Generally there are 2 aspects to getting autoimmune diseases, however. There is also something in some individuals that makes them more likely to respond to a trigger with an attack by the immune system. And then there is the trigger that causes the actual attack. Not every individual responds to the trigger, or toxin with an autoimmune response, so something in their history, or genetics, or environmentally induced changes to genetics (we now know the environment in the body modifies gene expression) increases this likelihood. I am interested in finding out more about both aspects of the disease. Richard

Richard Burnaby

Photos of Dylan on facebook, before and after AIHA. There are a lot, but I am trying to cronical her physical progression. Unfortuyately, I did not start taking pictures right away (pre-occupied I guess), but I did take video, which I hope to post later some time. http://www.facebook.com/media/set/?set=a.177206759001413.58939.100001362714581&l=9a192fafa5 Richard

Richard Burnaby

Richard, thanks so much for sharing all the pictures. They brought back not so good memories for me. I wish I would have taken many pictures too. Not that I want to go back there, but to show people that the "pred head" WILL go away and the muscle WILL come back. Kahlu was swimming again 6 months after diagnosis. I know with your great care Dylan will be back to her old self soon. Looking forward to meet her, happy and healthy in Nanaimo next year! Best wishes, Brigitte & the poodle boys

Brigitte BC

Sorry, I meant to put a disclaimer on it, but I am sure everyone who goes and looks is somewhat aware of what she will look like. "Pred Head" seems to be a common phrase amongst guardians of AIHA dogs. I am looking forward to having her "regular head" back again as I do love her face and ears (and her beautifull and soft fur, which I so wanted to save from the effects of prednisone). She is so attentive to her surroundings, with her big antennae ears and alert eyes. Necessitated originally by her fear, but it is not so much fear anymore as it is a desire to see and greet people that gets her going. :+)~ I will be posting more photos of her recovery as it goes along. This and the video I am making I hope will help make people aware of the fact that dogs do recover and that caring for them is an important job, as it makes a big difference. I also look forward to meeting you and the poodle boys in person in Nanaimo. Richard, Dog Dylan, Stevie Ray and Double Trouble (Jimmi and Joey)

Richard Burnaby

Hi Brigitte, I just read your discussion of going to faster reductions on Dr. Dogg's recommendations. Same sort of discussion and concern. One thing peple don't seem to realize about prednisone is how high the dose is we are giving our dogs in the beginning. It is way higher than for anything else and also maintained for longer than used in other conditions. Although AIHA is more deadly, prednisone at the level we give can kill just about as quickly. It 's effectss can be long lasting too, like in the case of bone loss. Reductions initially (20-30%) have very little chance of causing withdrawl side effects, due to how much higher than the natural level of cortisol we are providing with prednisone (pred is also 5X more potent). The adrenal glands won't begin to kick in until 20% or less of the original dose we give. This means you can do more frequent and greater withdrawls initially. Where Dylan is now is where we need to be more cautious, especially now that we are giving her days off. AIHA could come back quickly, or slowly who knows? Her adrenal glands are very likely working on days off the drug, which is still fairly high on the other days (15mg/day). You also had a cocktail of drugs to be concerned about (Aso and cyclo in addition to pred) and that does likely mean you were able to drop pred and not necessarily worry about AIHA. The problem is you do have interactions you have to be careful of. Dylan did not have interactions to worry about and the effects of prednisone are very clear as a result. Both my vet and I wanted one drug to deal with and it was a good decision and has helped keep the effects of dropping prednisone very clear. More importantly, every minute counts; every day counts when you are eating away at muscle and bone! Now that she is recovering, I don't feel I need to be in as much of a hurry and I do need to be cautious of her adrenal glands and making sure AIHA does not return. Today she regained her independance and began going out for unassisted pees and poops. Still very supervised, but all I do is open the door. Unbelieveable in my opinion. I thought we were still weeks away. For the most part, I am still concerned about getting to a minimal does of prednisone, but I want to make sure we don't rush and I feel now we can lower prednisone without rushing thanks to her improvement. Personally, it is the overdose conditon I think that is maintained far longer than necessary in most dogs and likely prevents some of their recovery in all cases. Another post today about prednisone complications, bone loss. Muscle loss was bad enough. I am still hoping that although Dylan will likely take prednisone for the remainder of her life, that it is as infrequent and as little as possible. Broken bones are not something I want to have to deal with, really. She already has arthritis, which was under control before AIHA. Anyways, every time I hear of prednisone being the main problem, I feel I need to keep pushing people to be more aware of the real implications of not reducing it where possible. Every day at high levels matters later. Richard

Richard Burnaby

Funny; "Dr. Dogg's" - I wonder how that slipped through? My apologies to Dr. Dodd's although maybe that is a good slip of the tongue as she really is the Doctor of Dogs.

Richard Burnaby

Hi, More photos, Dylan cruising about in the yard :-) http://www.facebook.com/media/set/?set=a.177206759001413.58939.100001362714581&l=9a192fafa5 After 2 weeks (at 2 X 7.5 mg every second day), down to 2 X 5 mg every second day. It was easy to see progress like standing, but much harder to see the difference between weak anemia and weak muscle. She continues to gain strength in standing and other activities. She is very alert and likes to stand and sit while I do things in the kitchen. Slow progress, or is it fast? How do you know what to expect? Just keep an eye out and well; first time to my back fence in almost 2 months. Improvement still, so taking a day off prednisone really helps. This is where it is a little nerve wracking in some ways, I would say. Certainly don't want a relapse and if there is any, to catch it very quickly. But it is nice to have her up and about. I am very careful of my other dogs being around her and any chance of her getting hurt. Happy Dog Dylan and Richard

Richard Burnaby

Hi Richard, Dylan looks so much better! I can tell she is still weak, but also that she is clearly stronger than a month ago. I was wondering if to prevent a relapse it would be better to give a smaller dose every day than a larger every other day. I know that you gave this a lot of thought and was wondering what your reasoning was for doing it this way? I know that you don't want to do blood tests because it completely stresses Dylan out. This is where I would be a nervous wreck. Do you know a vet tech that Dylan would trust that would be willing to come to your house to take blood? Just a thought. I would find it hard not to know where she is at, I would need a little peace of mind. It looks like her belly is nice and pink! That is such a good sign! How are her gums? Best wishes, Brigitte & the poodle boys

Brigitte BC

Hi Brigitte, Dylan is okay with getting her blood done and loves going to the vet (she used to get adeqquan shots in the but for arthristis and it is always a pwoer feed. She hardly notices the needle) amnnd loves everyone who feeds her). I am looking forward to making the trip. She loves them and behaves much nicer to them and to me in front of them (quite funny actually). She is now stroong enough to walk to the car and walk into the vets office, but probably still needs a hand getting into the van. I just wanted to make sure the prednisone reductions had time to show up in her blood work. I want to know if the prednosione is interfering with RBC production or not and by waiting, I know everything else is getting better, so the RBC counts should be too! If not, then I know there is more to it, or that prednisone. If it is closeto before, but not higher, then what does that mean? AIHA, or prednsone suppression. Dylan actually has a bit of "leather belly" from the prednisone and a bit of irritation I have been using epsom salts on. All her other issues have been clearing up and I wanted to see if this would too. I will check that soon with my vet if it gets much worse rather than starts getting better. Because she is strong and getting stonger, blood tests are not going to tell me a whole lot more than I already know and hopefully confirm what I want to see, which is her getting stonger and she clearly is (how fast hsould this be and how much should I feed her?). I will be testing her blood before the next reduction for sure. Yes, there is a reason for dropping doses every second day rather than overall reduction, or removing one dose each day. The cycle of higher prednisone helps keep the immune system suppressed and the day off helps the body recover a bit between doses. By increasing this to a day, instead of just going to one dose per day, there is a longer period without prednisone stimulating the body. It is the day off that is giving her liver a break and her body (muscle, bone, etc) a break. It is the peaks every second day that helps keep AIHA away. Now back to reducing the overall peak dose so it is a bit lower, as that is still high enough to impact her body significantly. This daily on/off cycle also allows the Adrenal glands to begin functioning in between prednisone doses, like excercising them. As always; I want to continue to see gains in strength, more standing, more walking, more stability, more muscle on her body (which I am feeling and seeing). I watch her pee always, I look at her gums (not as pink as they can be, but not much different than previously, hard to tell) and the whites of her eyes (no sign of rbc breakdown) regularly for signs of AIHA. Her tongue is pink and with severe anemia it is not, nor does it have any strength, but it is not a good indicator of mild anemia. I watch for other weakness, like her eyes, head and nose; things that might be less likely to be impacted by loss of muscle. I watch her attention and track how much she stands and sits up to watch me. I watch her breathing to make sure it also fluctuates the way I expect in a non-anemic dog, which is regular and strong. When relaxed, it is not too shallow, but also not too rapid. Relaxed, but not disappearing. All seems good so far (fingers remain crossed) and I am very happy for her of course, but remaining vigilant. I remain determined to have a happy Dylan for some time to come! Richard :-)

Richard Burnaby

This thread was discussed between 24/05/2011 and 09/06/2011

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

This thread is from the Vetnet archive. The live Vetnet forum is active now.