Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Feeling helpless

This is probably more of a vent than anything, it's that helpless feeling you get when someone you love is sick. To be honest I've never heard of AIHA before this. My little mutt, she's a 2 year old boston terrier/chihuahua mix (Moochy), has been diagnosed with AIHA although they're not ruling out a tick born illness at present. She was a little strange on Monday night but only for a few minutes, then she was back to normal. She stopped eating on Tuesday and just wanted to lay around(Very out of character), unless you mentioned that you were going to go get the mail or for a walk, she was perfectly normal during her walk but later that night when we walked down to get the mail she kinda walked behind us. (Not something she does) I thought she got into something outside that might have made her sick. I took her to the vet Wednesday morning, they were worried about the colour of her gums,since she wasn't eating or drinking she was dehydrated when I took her in, so they started her on an iv and once they saw blood work they decided to put her on a mega dose of steroids and some antibiotics. Her blood was thick from the dehydration so they worried that their readings may have been off but couldn't take anymore to send to an outside lab. Today I took her blanket and a toy to make her feel like I didn't abandon her and was glad to see her tail wagging she even kissed my face. She wasn't supposed to run around since she was anemic but they said when they let her out to go to the bathroom they couldn't stop her from playing outside. She started eating this afternoon and really seems to enjoy the stuff the vet is feeding her. Now her new blood test showed that her blood is agglutinating. They've sent a sample to another lab to check for tick born illness and just to get another opinion. RBC was 3.1 yesterday and is 2 today. The hematocrit was at 24% yesterday and has dropped to 16% today, really worried that it might get low enough to need a transfusion. They said that the steroids would take 3 days to work and that there is the possibility that she could come home Saturday IF she's responding by then. I think I've been on every website that exisits on this subject but if any of you have a link that you think would be helpful or any advice at all, feel free to fill me in. I'll continue to look through the different threads on here and see if I can find some answers myself. I was a mess yesterday, and today I kinda still am, although the doggy kiss this morning helped.

Chelsey Kansas

Chelsey, So sorry to hear about Moochy. You have found the right place. The people on this board have a wealth of experience between them. I was in the same place as you 7 weeks ago and their knowledge and support has been invaluable to me. Jasper took about 5 days before any signs his medication was starting to kick in and any real improvement. Stick with it. His rbc was as low as 2 the first week. Check out Meisha's Hope website as it answers alot of questions you may have. It can be very daunting, many of us hadn't heard about AIHA until faced with it. Good luck to Moochy and yourself, Jackie and Jasper.

Jackie pembrokeshire; west wales; uk

shoot me an email ^^^ and i can send you a good share of links to check out- i cant directly post them here because this site tends to ban my IP address when posting other sites

josh california

Hang in there and hold on tight!! The people here are great and you Will get the info yoy need. I cannot emphasize that there is a chance , like with my my buddy Angus that you may never know the cause of this horrific disease. There will be alot of ups and downs with this, and the stress of it all can and is exhausting.. You ARE in the right place and we ARE all here to support you and to hold your hand during this time.. Good luck, be strong Pat K

keefer Downingtown

Chelsey, Keefer is correct, hang in there and hold on tight. It could be a long and bumpy road! This is a great board for friendships and information. So any questions you have ask away and I am sure however can help you will. Take care, Linda

Linda Sapphire

Sorry to hear about Moochy. All of us here had never heard of AIHA before our own dogs started getting sick. All the lucky people on this forum have dogs that are still recovering from this. Others have lost their dogs, but still offer support. Monitoring this link and referring to "cloudnet.com" you will learn more than you ever thought you could about your dogs immune system and all the various results from the bloodwork you will be having done. We all replace our "older" red blood cells every 120 days and absorb them in our spleen and the by- products of the reabsorption are used to produce new red blood cells in the bone marrow. Our immune system "tags" the old cells and starts this process. Something in our dogs triggers their immune system to tag all the red blood cells to be destroyed. The spleen cannot easily handle this overload, the by-products of bilirubin turn the stools orange and the dogs in addition to becoming anemic with the pale gums etc., become jaundice. The goal is to get your dogs immune system to stop the destruction of the RBC's by giving large doses of prednisone, along with one of the immuno suppressants such as cyclosporin or Imuran. The prednisone works in the short term (with loads of side effects) and the other immuno suppresant works in the long run. In the short term,(the first week or so)if the dogs PCV is very low, they might have to keep your dog on an I.V.for fluids, possibly give it a unit of packed red blood cells to help get the PCV number up a little. Some also choose to give a unit of gammaglobulin. Generally, they will run addition tests to rule out "tick borne" causes, an ultrasound to make sure that no tumor is causing it. Their goal is to get your dog stabilized so Moochy can come home. Then your job begins! The medications your dog will get usually cause their liver functions to go totally off the charts when the blood work comes back. You will be getting blood work done often at first and then spaced farther apart as they begin to stabilize. The long term goal is to slowly, slowly, wean them off the prednisone and then off the other immuno suppresant. The first weeks are the worst...you don't know if your dogs going to make it and even when you think they might, they start to experience the side effects from the prednisone. Panting, Hunger, thirst, loss of muscle mass and strength. Frequent urination and occasional accidents in the house. But you love your dog, and we will all be here to help you to cope because we have all gone throught it before you. Regards, Ron & Daisy (3 months into it)

Ron B San Mateo

Chelsey, Sorry to hear pf Moochy's diagnosis but like Ron said we are all here to help you and her through it. You might want to start a journal so you will have easy reference to drugs and numbers etc. It can be so overwhelming at first and it is a hard road but I am sure you have read some of the threads already of the dogs that have beaten it. So hang in there. Penny

Penny hydra@tstonramp.com

Hi Chelsey, I am so sorry that your precious Moochy has been diagnosed with this horrible disease, but as others have mentioned you have come to the right place for support and lots of knowledge. I have been blessed to find this site. My minature dachshund Tipsi was diagnosed with IMHA about 4 weeks ago. She spent 2 weeks in ICU after having a whole blood transfusion and then several plasma transfusions. She not only faced the IMHA, but also acute pancreatitis, acute renal failure, ITP, and DIC. The doctors gave her a very poor prognosis but she somehow beat the odds and is still fighting today. She is much better and has been home now for 2 weeks tomorrow. So know that there is definately hope with this disease. It can be beaten. I noticed you mentioned that Moochy's blood was showing signs of agglutination. Tipsi was having this problem as well and they put on her injections of heparin to try and prevent the clotting. Have your vets mentioned this treatment to you? I believe the time it takes for the steroids to work in a dogs system may vary from dog to dog. Most people think that the prednisone will take effect immediately, but for Tipsi I believe it took a good 7 days. Another immunosuppresive drug that she was put on is called mycophenolate. I haven't heard many people on here mention it, but it worked well for her. The doctors initially tried azathioprine but this caused Tipsi to vomit and also caused the pancreatitis in her. So I would be sure to monitor Moochy's responses to the drugs they put her on. I wish you two the best of luck and if you ever have any questions please feel free to ask me. Take Care, Layla & Tipsi

Layla Raleigh

Chelsey, I am so very sorry to hear of your most beloved Moochy's illness. While AIHA/IMHA is a very difficult disease, dogs who have been diagnosed with it CAN and DO recover and go on to live happy healthy lives. If you have not read my Web site on AIHA/IMHA as yet, you might want to do so when you can. The URL is http://www.cloudnet.com/~jdickson/ 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. Most of the literature indicates it can take 5-7 days for prednsione and/or other steroids to start to work. We do see them start to work sooner in some dogs and later in other dogs so do not get discouraged if Moochy does not start to recover right away. Also many times (most in fact) other drugs in addition to steriods are necessary. The two additional drugs used most often,at this time are Azathioprine and Cyclosporine. Has your vet mentioned these drugs to you, if not you might want to ask him/her about them and his/her experiecne with them in the treatment of AIHA/IMHA. I know this is so hard but remember dogs CAN and DO survive AIHA and go on to live happy heathly lives. My Meisha (the inspiration for my Web site) and all the dogs on the SUCCESS Stories are proof of that. Be assured you and your most beloved Mocchy are in my thoughts and prayers during these most diffcult days.

Joanne MN

Thank you everyone, for the wealth of advice and the support. I just want my little fur baby to pull through this, even if it means medication for the rest of her life, she's brought so much joy to my husband and my life. He's been out of the country and I know that he feels even more helpless than I do. Thankfully, he'll be home tonight and we can do double the research on this disease. I want to be Moochy's advocate in this fight, I'm doing my best on this steep learning curve. Thank you all again. You can be sure that I'll let you know her outcome and if I have any questions I'll try and bend your ears.

Chelsey Kansas

It's good you have another person to help you with the care of Moochy. My wife monitors Daisy throughout the day, and I try to take over in the evening. You will find that your dog will require frequent trips outside as the prednisone makes them very thirsty and consequently must go out every 2-3 hours. It is almost like having a baby again that requires care 24/7 initially, and the sleep deprivation that goes with it can be difficult for a single person. As you monitor this site, you will see references to Dr. Jean Dodds, D.V.M. She is a vet in Southern California, an expert in hemotology, and has advised many on this sire regarding the continued care of their dogs. If you Google her name you will find some of her recommendations. Essentially, you should split your dogs normal amount of food into 3 or 4 feedings to keep them more content and to prevent any ammonia build up. She has a "Liver Cleansing" diet that you may or may not feel like trying, as you have to cook for your dog to implement it. Milk Thistle is a help to get the liver functions back down. Amounts to give can be found on her web site. Our dog is three months into this, and we are just to the point where we are reducing her level of prednisone and seeing improvement in her sleep patterns and some of her normal behavior is returning. She was a healthy yellow lab, and it is hard to watch her struggle to climb stairs etc. But from hearing from others I am pretty sure this will improve as she is weaned off the meds properly. Good Luck with Moochy. P.S. One thing I found helpful was to get a copy of the blood tests, the Chem 25 and the CBC and I put them on an Excel spreadsheet along with the "normal" values so I could more easily track her improvement or relapses as we went along. At the top along with the dates of the blood results I recorded any meds or blood given etc. and as we have started to reduce her prednisone I have kept track of the dates, etc along with the blood panels as they are done. A little anal, but you will be more interested in your dogs care than the vet will with all the animals they see.

Ron B San Mateo

This thread was discussed between 18/10/2007 and 20/10/2007

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