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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Good news - Harley's recovering
| My dog Harley is a 7-year old, Lhasa-Apso mix. He has always been full of energy, loved hikes and walks. On July 6, I thought it was strange when he wouldn't get out of bed when I got up for breakfast. He didn't want to do anything the whole day. He would walk around the house, but very slowly. He had no appetite. I even tried to give him some grilled chicken, his favorite, but he didn't want it. I thought it was just an upset stomach or constipation. I thought it would clear up after a day or so. It didn’t. This continued for 2 more days, so I took him to my Vet. My Vet took a Blood sample, gave him an injection of something and gave me Baytril tablets to give to him. He began to eat a little bit that evening and into the next day. But then he started going down hill again. On that Saturday morning, I took him back to my Vet again. He said it could be an anemia, but that since they weren’t open for the remainder of the weekend, that I should take him to the emergency animal hospital. As it turned out, it was best thing that could have happened. Don’t get me wrong, My regular Vet is very good and caring Vet, but I was getting the feeling that he might be a little over his head. He kept mentioning a 50/50 chance of curing Harley. I felt that he was preparing me for the worst, which I understand, but I couldn’t help but feel that the Vet was already giving up on Harley. The Vet never did mention the results of the blood test from 3 days prior. I didn’t find out that until the Emergency Hospital gave me the results that Harley’s PVC count had dropped to 19 when they took the first blood sample 3 days earlier. The emergency hospital carefully explained everything to me, even though it scared me, and I’m grateful that they did. At least I knew what I was dealing with and the options that I had. He was diagnosed with Immune-mediated Hemolytic Anemia. They explained my options. He had a 50-50 chance of survival, but it would be expensive. They explained that if Harley’s PVC count dropped below 10, they could do a blood transfusion. This scared me until I read other letters on this blog about some dogs that had gone through 3-4 transfusions, before they got better. The hospital kept Harley for a day and a half, using IV’s and medication to stabilize him. He dropped down to a PVC count of 17 that first night, but was back at 22 the next day, when they let me take him home. Medications Harley was put on were: Metoclopromide for nausea. Prednisone a steroid. Cyclosporine 2 capsules twice daily, imuno-suppressive to shutdown his immune system. Baby Asprin 1/8 tablet once daily, to help prevent blood clots. Omeprazole to prevent ulcers caused by Prednisone therapy. Harley did well for a day after, but then again refused to eat and was very lethargic. I took Harley back to my normal Vet, where he stopped the Cyclosporine. He instead changed him over to Azathioprine (Imuran) a different steroid. Harley made an almost immediate improvement. Within 2 hours after getting home, Harley was eating again and feeling better. This lasted 2-3 days, but he wasn’t behaving any differently. He was still lethargic and barely eating. They said that the Prednisone would make him extremely hungry, but I wasn’t seeing that, so I was concerned. I took him back to my regular Vet where another blood test was done. Harley’s PVC count was again at 19. But while at the Vet, it was noticed that Harley seemed to have a distended chest area. His body symmetry didn’t look right, even though he was down at about 24lbs. Harley had lost 7 pounds during the first couple of weeks of this ordeal. My regular Vet decided to do an x-ray and take a fluid sample from Harley’s chest. The Vet showed me the x-ray and said that he saw 2 large masses in the chest area. I was devastated. My thoughts immediately went to Tumor’s, Cancer, very bad things. But my regular Vet did not have an ultrasound machine and so he referred me to a Veterinary Internal Medicine Specialist. This was my low point, but as it turns out, was the best thing that could have happened. I worried for two days about “two large masses” on this x-ray. I finally got to the specialist and answers began to emerge. A new blood test showed Harley’s PVC count was still around 22. So we already knew that Harley had IMHA, Problem 1. But it wasn’t until the ultrasound was done that the other problems showed up. Harley showed a mild heart problem, mitral valve leakage, which is totally controllable with Benazapril tablets, once a day, was problem 2. Also during the ultrasound, it was discovered that Harley had 2 pocket of fluid, Ascites, problem 3. It was here that I asked about the 2 masses that the x-ray had shown. The specialist replied, “What 2 large masses? I don’t see any masses. Who said Harley has masses?” I was angry and elated at the same time. My regular Vet had assumed that 2 vague shadows on the x-ray were possible masses. I understand his caution. But this goes to show that x-rays alone are not to be depended on! Ultrasound definitively showed an unknown mild heart problem and that Harley had excess abdominal fluid. But why did he have this fluid? The specialist asked for a urine analysis, which revealed the 4th problem. Harley is now Diabetic. His blood cells were not working correctly and were leaking excess fluid into the abdomen. Harley had not had elevated blood glucose counts in the first week of this battle with anemia. But as it was explained to me, the Prednisone therapy sometimes triggers Diabetes. Finally, FINALLY, after 3 weeks, I had a clear picture about the health of Harley. Harley was fighting not one, not two, but four different problems at the same time. The specialist summed it up that “Harley was a very sick little dog”. But that each could probably be controlled, with a lot of patience and work. Harley spent another day at the hospital and then was ready to come home. But His medications changed again. The specialist didn’t like me using Omeprazole (antacid), so that was stopped. Harley was put on: Metronidazole – antibiotic. Benazepril – heart medication for mitral valve problem. Prednisone – Immunosuppressive medication Azathioprine (Imuran) - Immunosuppressive medication Baby Asprin – prevent blood clots Insulin – twice a day shots The twice-daily shots of insulin scared me to death. Harley is not a dog who allows poking a needle into, very easily. Luckily, the Veterinary Specialist showed me some tricks to get Harley while he is distracted with eating his meals. It turns out that it is easier than getting him to take his pills. A week later, Week 4, Harley’s PVC count was back up to 28. Great news. Harley’s appetite was good; he’d eat anything that was within striking distance. His energy was improving. Everything was now improving, slowly, but still improving. Week 5 and Harley is still making progress with his eating and energy. His PVC count is up to 32. But his blood sugar is still in the 300-400 range. But as the Vet Specialist told me, this is to be expected since Harley is still on Prednisone. Until the Anemia is conquered, we can’t expect the diabetes to be under control. It is now week 6, and Harley’s PVC count is back at 36, basically normal. So now we are slowly weaning him off of the Prednisone and Imuran. Harley will always be on the Heart medication for the rest of his life. I’m expecting that his Diabetes is going to be around for the rest of his life as well, but we’ll see how severe it is after we get him off of the Immunosuppressive drugs and can concentrate on his Diabetes. It has been a long 6 weeks, but I feel that Harley will be ok. He continues to make progress each week. He isn’t back to the way he was, but he’s back to being a happy, playful dog again and that’s all I can ask for. This disease can be very expensive. I am up to about $4000 in doctor and hospital bills, so far. Luckily, I can afford it. I am truly sorry for those who can’t. It’s not fair. You can’t put a price on the love of a pet. I want to thank everyone else who has contributed to this site. If it weren’t for all of the other success stories, I would not have been able to get through this alone. You all gave me hope when I didn’t feel there was much of it left. That is why I have contributed Harley’s story. We had several bleak moments, and I felt very alone until I found this blog site. Thank you to everyone. I’m so happy for those of you who have also had success stories. I also am very sorry for those of you who lost your best friends. Thanks, Tom |
| Tom Colorado Springs |
| All the best for you and Harley I am so glad you are getting a good responce to the IMHA. You can cope with all the other things but the IMHA if it does not respond to medication you really have the battle ahead of you. My little dog had nothing after 5 - 6 weeks of treatment no regeneration of any description. I am so pleased to see that other dogs do respond so well and there are good success stories. |
| Julie Australia |
| Kudos for you and Harley in overcoming quite the battle. The continued sharing and success stories give hope to those in their intense time of need. Keep loving Harley and give him a huge hug for me. sharon |
| sharon pa |
| i am glad to hear harley is back in the high 30's... great news |
| josh california |
This thread was discussed on 18/08/2008
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