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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Fluctuations Over a Day?
| How often can the level of anemia fluctuate over the course of a day? Or two? I'm finding that Beau is not so good one hour - very pale and awfully lethargic - and within a couple hours can be much more energetic with good color. And then back to tired and pale. Maybe it's my imagination because of course he's scrutinized more closely when I'm home over the weekend, or perhaps he's not getting the same amount of rest he's used to while I'm at work. Anyone else experience this type of instability? Could the PCV level change back and forth that quickly? |
| Sharon PA |
| Sharon, This is, in fact, will happen over the course of a day. It's not that the PCV is dropping so much as it is the blood volume may be changing. This can be because of dehydration. Lift the skin away from the back of the neck and then let go. The skin should quickly return to normal. If it stays up, peaked, for a long time, that signals dehydration. In addition, canines have a greater ability to sequester (store away) large volumes of blood in their spleen on a regular basis. In fact, I read a paper about Nocturnal Anemia. Or apparent anemia during sleep. The spleen is surrounded by large muscles that can contract very strongly. This sends the stored blood back into circulation very quickly. It is a survival reaction and is part of the "flight or fight" physiological response. Dogs, if you haven't noticed, can become alert pretty quickly when they are awoken from sleep! My vet likes to call it an instant transfusion. From now on, please try this. Several times a day gently press your finger into the gums in the mouth and then release it. Watch the amount of time it takes for the color to reappear. This is called refill and is a good indication of how well things are working. I also used to pull the lower eyelid away and check the color there. Sometimes it would be pink, other times pale. I also got good enough that I could tell how Chance was doing by glancing at the color on the inside of the ear. It could be pink or gray. Finally, I would monitor Chance's heart when he got older. He had a moderate heart condition and there would be times when his heart beat would change, leading to fatigue and symptoms. Lay Beau on his right side. Bend his left elbow up to the chest and note the location of that point on the left chest. Then lay your hand over that area and count the heart rate. Dog's heart rates are not even, they normally fluctuate with breathing. Are you still using prednisone? Any of the drugs you are using could lead to side effects like fatigue. Watch to see how close it happens after giving meds. Be sure to ask your vet about this when you have the next visit. my best patrice |
| Patrice NYS |
| Patrice, Thank you so very much for the great information and putting my mind at ease. I do often press on Beau's gums and the color reappears quite rapidly. Do I understand you correctly that the speed of the refill is actually more important than the actual color -- dark pink, light pink, pale or grey? I believe that the blood volume changes, coupled with the effects of the prednisone and other medications, may account for much of Beau's issues with fatigue. He goes to the vet tonight for another PCV and I'm hoping at that time perhaps they can begin to reduce the amount of prednisone he is getting. Unfortunately, last time they attempted this, his PCV dropped and still hasn't rebounded (from 38 to 32 to 27 to 28 over the course of the past two months). However, after 4 1/2 months on 40 mg/day (40 pound cocker spaniel), this may be getting to be too much on his system. Soloxine was added to Beau's repertoire about two and a half weeks ago. I understand this can be hard on the heart. Since he's been a puppy he's had a heart murmur, and now at 9 years old -- I'm really afraid if I attempt to glean anything by monitoring his heart beat, I will really drive myself nuts! However, I had not thought of this exacerbating his activity level and that is helpful to take into consideration. Thank you again -- your advice and knowledge is helpful beyond belief! Sharon |
| Sharon PA |
This thread was discussed between 13/03/2011 and 14/03/2011
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