Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Gurgi possibly has IMHA

My dog Gurgi, a 10 year old beagle/Doxie mix, has been Anemic for 3 weeks now. I think it may have been longer, because she started eating dirt a few months ago. She has always been alergic to her vaccinations, and used to get a steriod shot along with antihistamines. On 6/24 we brought her to the vet and her red blood cell count was 26%. They did xrays and could not find anything wrong with her. We brought her to the emergency room on 6/26, and her count was 24%, they did an ultrasound and could not find any reason for the anemia. They had us make an appt with a specialist on 6/28. On 6/28 we brought her in and her count was down to 23%, and they took blood to send off to the UofM. We got the results back saying that she is making approx 600,000 red blood cells per day (or something like that), and that it does not appear that she is destroying her red blood cells. She has no signes of any auto-immune disorder. We started treating her for an ulcer on 6/29, since they had not found any "masses", no blood pooling, or anything else on the ultrasounds or xrays. We were told that the ulcer meds should work and that she should be showing signs of improvment within a week. There were no signs of improvement, only signs of her getting worse. We brought her back to the emergency room on 7/14, and her count was 13%. We had them give her another abdominal ultrasound, still nothing to see there. We had them give her a transfusion, and her count was back up to 22% on 7/15. They said that she must have IMHA with no signs of the disease, no jaundice, or any other signs in her bloodwork. So we started her on Prednisone on 7/15, and kept giving her the Pepcid. She has an appt today for a CBC, so we will see if the Prednisone is working and if her count is higher. Is it really possible that she has IMHA with no signs? Also, the specialist said the ONLY downside to Prednisone is increased drinking and uniation. I am reading other posts and they say there are many downsides. My fear is that the vets are not telling me everything. I fear that they believe she is on her "last leg" and won't make it, but they are not telling me. I understand this is a 50/50 chance she will make it by reading other posts. If she was diganosed with IMHA on the 15th, and I started her on Prednisone, how much longer until she shows signs of improvment? I am so confused, and no nothing about this disease. I will keep reading other posts, and try to educate myself, but if anyone has any advice, I have open ears!! Thank you for listening! Anit

Anit Minnesota

Hi Anit I am very sorry to hear that your dog is so unwell. There are many people on this forum who are well versed in IMHA, the symptoms, treatments, etc. I am "not" one of those people. I do have a standard poodle who was recently diagnosed though, and I know what a difficult time this must be for you. Please continue to ask your vet questiions until you get the answers you are looking for. Go on-line and research as much as you can. Your dog can not advocate for himself, and you are his only voice. I am certain, that the more educated folks on this forum, will be contacting you soon with advice, and some "pointed questions" you can ask your veterinarians. They have all been a huge help to me in my time of need. Keep checking back as this is a fabulous resource sight. My thoughts and prayers are with you and your dog. I wish you both the best of luck. Maureen and Mercedes

Maureen B.C. Canada

Anit, I am so sorry to hear of your most beloved Gurgi illness. Has your vet considered the possibility that this could be a tick borne disease and test for those diseases? Did your vet do a blood smear to check for Spherocytes? Finding spherocytes on a blood smear almost guarantees that some form of hemolytic anemia is occurring. A diagnosis of IMHA must demonstrate accelerated immune destruction of erythrocytes. Thus, beside documenting a hemolytic anemia, a search after antibodies or complement or both directed against erythrocytes is required, i.e., one or more of the following three hallmarks has to be present to reach a definitive diagnosis of IMHA: 1. Marked spherocytosis. 2. True autoagglutination. 3. Positive direct Coombs’ test. You can learn more at this Web site: http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00152.htm You also might want to visit my Web site to learn more about AIHA/IMHA. http://www.cloudnet.com/~jdickson/ Be sure to follow the links on bottom of the first page to more sites on AIHA/IMHA and do read the SUCCESS Stories pages. They will show you what symptoms other dogs had at diagnosis and give you a lot of Hope if indeed this is AIHA/IMHA. In regard to your question about prednsione, it can 5-7 days for prednisone to start to work. There are a couple of good links to info on prednsione on the treatment page of my Web site. Prednsione does indeed have lots of side effects but it can be a life saver for dogs with AIHA/IMHA. Did your vet also mention to you that if this is AIHA/IMHA there are other drugs available for treatment including Azathioprine and Cyclosporine, if not, it might be very wise to ask your vet what his/her experience with those drugs has been in the treatment of Canine AIHA/IMHA. I truly know how hard this is. Please be assured you and your dear Gurgi are in my thoughts and prayers during these most difficult days.

Joanne MN

Dear Anit, I am so sorry that you and Gurgi are dealing with these health issues at the moment. What Joanne says above is what you need to know in identifying if Gurgi does in fact have IMHA. It is not uncommon that a cause for IMHA cannot be found, but it is important to rule out the more obvious - tumours/cancers and tick disease come to mind. It is important to consider other factors such as her last vaccination or a very stressful event for Gurgi as triggers to IMHA. I believe Doxies are genetically predisposed to IMHA.... Please see Patrice's post under Lisa's thread "relapse for Winston", last post July 10. I am certainly no expert, but Patrice explains "anemia of chronic disease" - definitely worth a read in any case, and something to discuss with your vet. In regards to Prednisone - a major side effect of immune suppressant doses of this drug is liver damage. Most of us here have our dogs on some kind of liver protectant drug - Denmarin has been mentioned here, but I was using a natural remedy of Milk Thistle with my girl Millie. Stomach protectants are also important when on these meds - carafate (sulcrafate in the US??) and Pepcid can be used. Perhaps it is also worthwhile visiting a specialist teaching hospital, as they tend to be more experienced in treating this disease - if in fact it is IMHA. They may give you a valued second opinion at any rate. Please do not worry that Gurgi is on her "last legs" with this. My dog Millie was 11 years old when diagnosed, and she is thriving as an energetic and healthy 12.5 year old dog a year and a half after she was diagnosed. Please update here when you get the results of Gurgi's latest test. Feel free to post the results and we can all help you interpret and understand them. All the best, Sam & Millie.

Samantha Geelong

We have a Doxie with IMHA with no signs of what caused it in the first place. We did the ultra sound tested for ticks etc. We will never know what cause her anemia either. She didnt even show any signs, until we saw her gums were gray. We did do a blood transfusion and she has done very well since then. She'll be a year with this in Aug. We also give her Biopreperation which I feel has done most of her healing, but we'll never know if its the pred or that. Its just a gut feeling.

Pam IL

Anit, how's Gurgi doing? Haven't heard back from you. Hope things are heading in the right direction for her. My thoughts and prayers are with you both. Johnny & Tessy

Johnny

Just an update. I will try to keep this as nice as possible, but I am very upset with my vet right now. Gurgi had a blood transfusion on 7/14. Her PCV was at 22% on 7/14 after the transfusion. It has been dropping at a rate of 4 percentage points per week since this has started in June. She has been on 20mg of Pred per day since the 14, and has been on Azathioprine (sorry I don't know the dose, but it is 1/2 a pill per day) since 7/21. Her PCV keeps dropping at the same rate. We had a PCV done on 7/20 18.5%, and another done on 7/23 16%. I called my vet and said that you guys (thank you guys by the way I love you all so much!!!)said to check for TBD. My vet dismissed it immediately. (by the way when I say my vet, this is not my regular vet, this is the specialist that I have been sent to) She said NO WAY does your dog have that. I said according to an article I read it says that you can treat them for it while you are getting the tests back. I asked her if she had Imizol or Doxycycline on hand. She said she has Doxycycline, but refuses to give me any. I said "I demand that you do a test for Babesia Canis". She responded with "I know you want your dog to get better, but there is no possible way that she has Babesia. She does not show the signs of it, and it would be an extreme waste of money to test for it." I said, "She does not show the signs of IMHA either!! She is not Jaundice, she does not have the "spikey things" on her cells (I think that is the spherocytosis) and she does not have autoagglutination (not sure what that is, but the vet says she does not have it), and you are treating her for IMHA!!" With no help from the specialist vet, I called a lab that does testing for Babesia. They told me what I need to do to get the sample to them, and that the test was $35 (such an extreme waste of money!!!). I went to my regular vet and had them draw the blood. They had no problem sending me home with a vial of serum to send to the lab. I am sending it off today, and will get the results for Babesia Canis back tomorrow. The specialist vet has no idea the wrath that will come down on her if Gurgi is positive for Babesia. With all of the xrays and ultrasounds (when they thought she was bleeding internally, or had cancer), all the blood tests, Two transfusions (She has an appt to have another transfusion tonight) various appts, blood work being sent to the UofM, all the medicines that she is on, we are over $3500. If she has Babesia, and they did not test for it, she could have been better weeks ago, and I wouldn't have had to spend all that money. Gurgi is my baby. My husband and I have decided not to have children, and we treat our dogs like they are our kids (not saying people with kids don't). They mean the world to us, and there is nothing we won't do to make them better if they are sick. I don't care if she is 10.5 years old, I don't care if she will only live to be 12-14, and why put this kind of money into a dog. She is my baby, and I will treat her like one. I will do all I can to make her better, and the specialist vet isn't helping. The sucky thing about it, is that the specialist vet works at the same hospital as the emergency room. I cannot "tell her off", I can't demand another vet, cuz they just refer me back to her anyway. I don't know what to do. All I can do is wait for the test results for Babesia, and hope for the best. If the Babesia test is negative, I will make them do a Coombs test (which they have not done that either). The specialist vet wants to do an endoscopy on Gurgi. She is 10.5 years old and has a heart murmur. To me this is the last resort, cuz she might not wake up from the anestesia. I really just don't know what to do. Thank you all of you for telling me about TBD. I would not have thought about it, and I would not have found the website that forwarded me to the page to find a lab that tests for it. My vet does not seem to think it is possible, and for a $35 test, she could have tested for it, and at the very least give me peace of mind. I will let you all know tomorrow how the transfusion went and also the results of the Babesia test. Again, thank you all of you!! Anit

Anit Minnesota

Hmmm, if this is a specialist that deals with this disease I'd call them up and ask for FULL copies of all the bloodwork done to date. This SHOULD include full cbc's (complete blood counts), a full chemistry panel, and since this is a specialist make sure to ask for a morphology report (will tell you what the blood looks like under the scope). Get these copies ASAP (today) and post the results here for us. I'm assuming that the predisone and azathioprine should have kicked in by now so results should be seen if this is indeed immune mediated. Babesia...why are you only checking for this one? As far as I know there are several TBD's found in Minnesota...Rocky mountain, lyme, anaplasmosis (would likely show reduced platelet #'s), etc. Babesia would sound like it fits the bill a bit more but the blood numbers would still be good to see. A$$HOLE vets!!! I know this feeling!! Word of advise though...try really really hard not to burn bridges. I know...easier said than done but like you were saying....you need this place MORE than they need you! Remember this. Did they not notice ANYTHING at all onthe untrasound? Enlarged spleen or liver? Just curious....are you near any TCVM's? (Traditional Chinnese Veterinary Medicine)? Check out TCVM.com to find one near you. I'd take Gurgi to one if I were you. You'd be surprised what they can find out! How does her stool and urine look? Keep us posted. My thoughts and prayers are with you both. Johnny & Tessy

Johnny

I am in NH and most vets insist that we don't have most of the tick diseases and yet I know MANY dogs who have tested positive for E. Canis, Anaplasma, Rocky Mountain Spotted fever, babesia, Lyme and another I cannot think of the name. ALL the owners would never have ever found out what was wrong with their dogs if they had not insisted their vets send blood out for a full and complete tick panel My girl with AIHA also has mycoplasma hemocanis- a tick disease also that most vets say is NOT in the NorthEast at all

Rottlady NH USA

This thread was discussed between 20/07/2010 and 26/07/2010

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