Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Evans Syndrom

My heart is broken as I write this, my beloved 7 year old boxer has been diagnosed with this illness. I noticed over the past 2 weeks that he seemed more tired and was having difficulty getting on the bed, he also wasn't eating much and started to lose weight and was panting. As he has been a little overweight and dieting is a constant struggle I was glad to see he dropped a few pounds, plus he was alwa. I gave him a bath Easter Sundy and when I attempted to brush his teeth I noticed his gums were white. I knew than that something was very very wrong.I brought him to the vet and his hemoglobin was only a 7 and his platelets were only 43. The vet gave him high doses of decadron and antibiotics for the next few days. We rechecked his blood and his numbers although not great are increasing. I have never heard of this health problem and I am so sick about it, he is my best friend and I can not stand the thought of losing him or having him suffer. I am happy to have found this site so I can learn more about this illness.

luann Pa

Hi Luann, I'm sorry that your baby has been diagnosed with Evans syndrome. But, this is a fabulous place to learn and find support. First of all- do not give up. I hope you have found your way to Joanne's Meisha's Hope site and the success stories page- http://www.cloudnet.com/~jdickson/successstories.htm Start their for hope and a bounty of info- if we hadn't found that site, I don't think my dog Tiggs (the November 2009 story) would be there today- almost two years ago he was dx with IMHA, and he was also dx with ITP (the two diseases that make up Evans syndrome) this past year. He is in remission and off all meds today. First of all, you need a vet that is aggressive and well versed in this disease. It may be essential to get a blood transfusion ASAP, as in now. Also, he should be on very high, immunosuppressive doses of Prednisone and Imuran (Azathiaprine). He may also need antibiotics, and an anti nauseal, as well as a stomach protectant like Pepcid- this should all be done ASAP. Additionally, some dogs will go on Cyclosporine (Atopica). All of these drugs are the drugs are very good at tackling these diseases. I don't know much about Decadron, but someone else here surely will. Read up as much as you can and as quickly as you can, you will have to arm yourself with questions and knowlege as fast as possible, and push for aggressive treatment- many vets just aren't well versed in this disease, or they will tell you the odds aren't great for survival- that is not true- there is so much hope for them. Hopefully you can read through this site and Joannes today and get some inspiration and information that will help you in your battle. Please keep us posted, and do not give up. melissa and tiggs

melissa slc

Luann, I am so very sorry to hear your most beloved Boxer has been diagnosed with Evans Syndrome. Evans is AIHA/IMHA (autoimmune hemolytic/immune-mediated hemolytic anemia) and ITP (immune mediated thromboytopeina) at the same time. Melissa has mentioned my Web site to you so you can learn about AIHA/IMHA there. 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. There are several dogs on the Success Stories pages who have had Evans Syndrome. To learn about ITP check out this Web site: http://www.marvistavet.com/html/immune-mediated_thrombocytopen.html and you might want to read about Midnight the Miracle ITP dog who had ZERO platelets when she was diagnosed with ITP over 10 years ago: http://www.cloudnet.com/~jdickson/midnight.htm I know this is so hard but please do hang in there and have HOPE because as difficult as this is it CAN be surivived. PS. I can't remember all the Evans Syndrome dogs on the Success Stories pages at the moment but one that readily comes to mind is Casper, the May 2008 Success Story at the Meisha's Hope Web site; http://www.cloudnet.com/~jdickson/archives20.htm as you read other of the Success Stories you will find more dogs who have had Evans Syndrome.

Joanne MN

I too am so sorry to read that your furbaby has been diagnosed with Evans Syndrome. What type of drugs do they have him on and what are the dosages and how much does he weigh. Please know that their is hope for you dog and it does take time for the med's to begin to work. Is your boy home with you or at the vets and does you vet have experience treating this? Sending our prayers to you and your dog, please let us know what his name is. Cheryl & Ginger

Cheryl & Ginger Pinevile Pa

Dear Luann, I am so sorry to hear about your boy's diagnosis with Evans Syndrome. Please give us some more information about what drugs your vet has him on - he should be on Prednisone and ideally a second immune suppressant drug, namely Cyclosporine or Azathioprine. Stomach protectant medication such as Carafate should also be given. I just 'Googled' Decadron - it's Dexamethasone I believe. I think I've read that it's about 7-10 times stronger than Prednisone.... My dog Millie received Dexamethasone intraveneously upon diganosis, to "kick start" the immune suppression, this was just one shot, and we started the Prednisone and Imuran immediately. A blood transfusion is something you should definitely consider, especially with a PCV of 7. What is the PCV reading now? Just remember, he is not suffering. He will be very tired from the medications and the low red blood cell count. Because his platelets are low, he is at risk of spontaneous bleeding. Try to keep him quiet and settled. Rest is very important too. Please give us an update as soon as you can, we are all thinking of you and your boy. Please also let us know his name. Good luck, Sam & Millie.

Samantha Geelong Australia

Ekim"s Platelet count was 100 was 43 today his hgb was up to 7.7 was 7 and his hematocrit was up to 26.1 it was 18.9 on monday. He is on Decadron injections doxicycline and pepcid. Vet will be adding another immunosuppresant drug on Monday he is slower than usual as Ekim is very sesitive to meds especially steroids, thankfully he has been good with them this week. Oh and neutrophils are very high 19436. Thank you all for the responses.

Luann Pa

Hi Luann, Good news that the PCV and platelet counts have gone up! Sorry, I misread your original post and thought the PCV was 7, but you actually had written HGB. 26.1 is a good number, all things considered! Many dogs here have had PCVs lower than 10 when diagnosed. Another thing to consider is what could have caused this. Your vet has Ekim on Doxy in case of tick bites. Have they considered ultrasounds / X-Rays to check for any cancers? Has Ekim recently been vaccinated? We continue to hope for more good news for Ekim. Sam & Millie.

Samantha Geelong Australia

Luann, I'm so sorry to hear of Ekim's diagnosis. You have some great info above and should take every bit of it very seriously. I'd also recommend you have the thyroid levels checked. Ask for a full thyroid panel....might have to send away for this. Most of us would recommend therapeutic doses of thyroxine to help stimulate the bone marrow. This IS very safe and has been known to save lives. How does the stool and urine look? What exactly have they done as far as testing thus far? Like Sam was saying more info would be great to have. Myself, I'm all about the information and often times all we can do is guess and speculate until we know more. Not saying any of the advise above is wrong....just saying we could maybe offer more from more info. I always tell people to ask for and get full copies of all the blood work done at the vet. That way you can easily research and ask questions/give answers to us. Most of us here get copies and keep the results in a spreadsheet for easy access. Have they sent the blood to an analyst yet? This would be a very good idea. If you want to you could contact Hemopet and Dr. Dodds and have blood sent there. She's the best in this field and consults with many of us on this forum. She's a Godsend to so many of us. Her site is hemopet.com if interested. I usually get the "Profile 7200" done as it includes EVERYTHING! AND it only costs $115 but this doesn't include shipping and vet costs. The others here can back me up on the importance of a specialist like Dr. Dodds being on board. You know...if I were you I'd be wanting to start another immune suppressing drug sooner than Monday due to the fact that all he is getting is injections. It's important to have the steroids working before discontinueing the injections. You say that Ekim is sensitive to meds so it is also important to give them with some food. You may also want to look at other stomach protectants like sucralfate or Prilocek. These are better than pepcid. There's also a slippery elm cocktail recipe floating around this site somewhere that would also be SUPER great to have on hand to mix up when/if needed. This is good for stomach conditions and also does a great job in soothing the stomach. If you've been reading the other posts you'll notice I always recommend milk thislte and Pet Tinic. Again...I'm recommending this for Ekim. Both of these supplements are really important IMO. If you wanna know more on these just ask. Someone here will know what you need. ALSO, Melissa stated above that some say the odds aren't good for this disease. I thought I'd point out that without the support you just found here usually the odds ARE NOT good in many cases. Most vets just aren't well versed when it comes to dealing with and treating this disease properly. The support and combined knowledge here IMO is BETTER than most vets!!! Again, this is only my own personal opinion but I've seen the proof far too many times! I'm going to be keeping Ekim in my thoughts and prayers. Keep us posted on how he's doing and if you have any questions or concerns then by all means just ask. Johnny & Tessy

Johnny

Luann, I am so sorry you are faced with this disease. There is not really a lot I can add at this point. Main thing, don't give up, ask lots of questions, your vet and here. Read the success stories on Joanne's site, you can learn so much there. Best wishes, Brigitte Johnny, I know you know lots.....but we consult with Dr.Dodds not the other way around:)

Brigitte BC Canada

Luann, I am so sorry you have had to join this board but you have come to a great place for information and support. Keeping you and Ekim in my thoughts and prayers.

Penny Lytle Creek Calif

This thread was discussed between 08/04/2010 and 09/04/2010

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