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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Fitzi
| hello everyone, Fitzi and I are new to the group and curious if anyone else has an Irish with IMHA (immune mediated hematologic anemia). My Fitzi, Irish Terrier 3 yrs of age, was diagnosed with it on March 6th. He has been on a roller coaster ride since. His pcv's on the 6th were only 12.7%. He was immediately put on an IV and spent the day in hospital and received ampicillin, dex SP IV, metoclopramide, crenia, prednisone and doxycycline. By afternoon his pcv had risen to 23% (normal range is like 36-56). since then has been at home returning to the vet daily to have his blood check and meds changed a number of times to stop the vomiting. He had a nasty increase in his ALT to 1194 (normal is 10 - 100) and his ALKP was 5561 ( normal 23- 212). They believe the pred caused this so his dose was reduced and now those values are falling. he had a complete set of x-rays after a barium series (on March 8 )and it appeared he had a blockage on his left side. although nothing was felt upon exam. an ultrasound was done yesterday and all looked normal. this morning Fitzi had his pcv's this morning were 38%. Thats up from 28% yesterday. we attribute this to the start of CycloSPORINE yesterday. comments & opinions appreciated. Linda in Asheville NC |
| Linda NC |
| Hello Linda. Sorry you had to find your way here :+( but you will find lots of info that's for sure. It's good to hear Fitzi pcv has gone up to 38%. Keep us posted. Tricia |
| Tricia UK |
| Hi Linda, Wow we are neighbors! So sorry to hear about Fitzi. We have Holly, a dachshund, and she was diagnosed last year March 26, 2007 and still fighting hard. Not to be negative, but wow that is amazing that his PCV went up that high in just a short amount of time! Great news, are they positive that it was IMHA?? Holly last year was started on prednisone and also cyclosporin, but her PCV went up very very slowly. I have not heard of any dogs PCV on this board anyway rising up that fast that quickly. Keep us posted on his progress. Linda |
| Linda Sapphire |
| Linda Was Holly on the liquid or the pill ? Fitzi is on the liquid which acts very rapidly.Fitzi is also getting SAMe and Qing Ying both to encourage the regrowth of red blood cells. And he is on Denodyl 425 mg once a day. your question about his diagnosis is a good one. I will bring it up on Friday when he has his next check. Ya we are really close, maybe an hour apart? Linda in Asheville |
| Linda Asheville |
| Hi Linda, I am so sorry to hear about the suddenness of this diagnosis. I am glad to hear that Fitzi is doing much better! There are several things about this that do strike me as extraordinary. The first thing I see is that they threw every drug in their ar*enal at this problem. In some cases that is actually a good thing. If it is truly a diagnosis of AIHA, early administration of prednisone and dexamethisone sp can do wonders in stopping the immune system from continuing the damage. What I also notice is that they added doxycycline to the treatment protocol. They may believe that the very low pcv may be due to exposure to a tick borne blood disease. If they are a relatively progressive hospital, immediate treatment with doxy and subsequent immediate improvement in the condition may indicate to them that this might very well be the case. I am on a tick disease forum as well as this one and I have read story after story of dogs exposed to tick diseases succumbing to serious anemia and in some cases pancytopenia, which is a loss not only of red blood cells, but also white blood cells and platelets as well. Vets that don't make this connection often fail to treat or undertreat tick diseases. Treatment with prednisone can cause the kind of high liver values you mention. But doxy can also do that too. The Alkaline Phosphatase number you mention, 5561, is very high. I can share with you that at the worst point in Chance's treatment with prednisone his value was over 8600 and remained high for a long time. As we lowered the dose of prednisone and the addition of supplements that support the liver, his number came down very quickly. It's important to realize that the liver can often recover fully from insults like this. It is very regenerative. There are a few supplements you can add that you can buy over the counter or your vet can prescribe a med called Denamarin. If they have not done this already, ask them to look into it. The other thing I notice of interest is that they immediately wanted to do a very exact look at Fitzi's intestinal tract. This leads me to believe they thought he might have something like a coin in there. Coins that contain zinc can cause this sudden anemia and the passing of the coin through the system can remove the zinc from the system. They also may have been looking for tumors or internal bleeding to rule them out as a cause for sudden anemia like this. Cyclosporine would not be working this quickly, it takes several weeks to really start it's job of inhibiting the t-lymphocytes responsible for the destruction of red blood cells. *My personal opinion* is that you are very lucky to have these kind of vets available to take care of Fitzi. They did everything in their power to save his life and it looks like they did a stellar job. When they have more time, ask them if they would be willing to educate you a little on some of the things they have done. Make sure you keep copies of all blood work they do and keep notes of everything at home, like meds you give etc. As time goes by you will know all the lingo and will understand more of the treatment. Whether or not this is AIHA will depend on the results of the blood tests they have been doing and if they have looked at any smears of blood. Ask them. My best to you, Patrice |
| Patrice NYS |
| Patrice, I neglected to mention that they did, at onset, send off blood for Lyme, Rocky Mtn & Erh, all were negative. The initial treatment was as if he did have a tick borne disease. I do feel extremely fortunate to have Fitzi getting such fantastic and caring treatment from our local Vet. She is truly wonderful. My finances are very limited as I am on social security which I supplement with a bit of occasional per sitting. Our Vet has been donating many of Fitzis meds, not charging me for exams that are done daily. The other day another of their clients began asking questions about Fitzi's condition as I guess she had overheard a conversation the Vet had with me about the cost of the cyclosporine if I had to pay for it, it was one of the donated meds. This client then proceeded to pay the balance I owed ! This blew me away. Even now as I am writing this it is bring tears to my eyes. Thanks for all your advice and praise of our Vet. Linda |
| Linda Asheville |
| Hi Linda, Well, my suspicions were correct then, they were treating in case it was a tick disease. There are a couple of tick diseases that were not tested for as part of this group. Sometimes this depends on the area of the country you live in. Your vet is probably familiar with the particular tick diseases in your area. The local Dept of Health also tries to keep track of this. My good friend Gil Ash keeps this website up to help people understand tick diseases and how to treat them. She is an incredible researcher. There is information on this web site about how to protect the liver from medication damage. http://blackgsd.googlepages.com/home Depending on what happens next with the blood work, you may not need to use cyclosporine long term. You are already at a pcv of 38%. If Fitzi stays stable at this number or increases, you will be very lucky. There are some owners who wait for many months to see that high of a number. There are a few of us here that would love to see a number higher than 30%. My dog was non regenerative, meaning he couldn't actually make new blood because the destruction was in the bone marrow. We had him on high doses of prednisone for almost 2 months before the cyclosporine was added. Then it took several weeks before we saw some small upward climb in his baby blood cells. Cyclosporine is often used when the case of anemia is "intractable." This means that the current treatment of prednisone isn't working and needs something more aggressive. We needed to continue with it for many more months before Chance really recovered. You are blessed with good friends, not only in the stranger at the vets, but your vet herself is truly one of those people who has a "calling" in her field. Please let her know that frequently! My best to you, Patrice |
| Patrice NYS |
| Linda, Holly actually was taken down to an Atlanta Hospital,where she spent one week, because our local vet in Brevard was not equipped to handle this kind of disease and recommended us going over to Raleigh Durham or one of the bigger city vet hospitals. She had 1 blood transfusion and a bone marrow aspiration and like Patrice's dog, Holly's destruction was also in her bone marrow. She left the hospital on prednisone and liquid cyclosporin. It did take months for her PCV to climb very slowly, just a few degrees at a time, and just last week after almost 1 year, her PCV is up to 46.5 the highest ever, but she is still on 4mg prednisone and now rather then cyclosporin, she is on Aziathioprine, both daily. Would really love to know the name of your vet, especially being only 1 hour from us. Linda |
| Linda Sapphire |
This thread was discussed between 18/03/2008 and 19/03/2008
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