Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - HELP! 2 yr old chihuahua non regen & biopsy in hrs

Hello! I have a 3lb chihuahua named lola who is my world..this peppy little girl ran out of steam this weekend and has been fatigued and lost her appetite etc..no nausea or abnormal stools..no bleeding either..we took her to our local vet at which point he diagnosed her woth a virus..she got worse so we brought her back on wednesday..he took her blood and the results had us in the car at 8am this mornong (tgursday) ..we are currently at a specialty hospital an hour or so away and I have chosen to stay the night in the lobby just incase..she received a blood transfusion around 3 in the afternoon wgich made her get a little energy back ..her bloodwork from our local vet showed a very low RBC and WBC count along with low platelet..the day shift vet told us that lola has non regenerative anemia..apparently lola is not producing rbc at all..she believes that this means there is something wrong with her bone marrow like cancer or other hopeless things. Of course I cant give up on my baby girl so ive been scouring every website and have asked the vets three million questions..whats bothering us is that noone will give us a guess or anything..they have no clue as to what it could be or.kust dont want us to cry in their office again. Its almost 3am now and the internal medicine specialists that will be performing her biopsy arrive at 7am ..they ned our approval in order to perform the biopsy but I wasnt guaranteed a face to face question session..so I figured camping out in the waiting area would make them feel bad enough to talk to me ..what do I ask? We hate that she has to be in the back caged up being that she is happiest in our laps but I do want ger to be monitered..we also dont want to prolong her suffering (that is if she is indeed suffering) if were just going to hot a dead end. Our daytime.vet felt that it isnt an immune systrm problem so if shes right that may rule out certain things.. So basocally its seems to be some sort of anemia but its the underlying cause that is scaring me to death. We discussed pancytopenia..hemolysis..neutropenia..anisocytosis..and a million other things but our night vet is even worse..it was like talking to a wall. I am waiting to see if they are going to give her the remaining half bag of blood transfusion but I feel so helpless. She is only two and hasnt gotten sick like this before. She has a heart murmur but I dont know if thats of importance. Her lymphocytes are low as well. Our local vet thought that it was regeneratove anemia which I will bring up to this doctor so theres another conundrum..reading about aplastic anemia as well and seems to match up ..nut then again they all fit somehow..i saw a woman named patrice post some great info about her dog chance who had low red and white like lola..i wrote down cyclosporine because she said it saved his life ..please please I need guidance I just cant give up and let the vets opinion be the final pne like we have done in the past. Thank you for your time. Lola thanks you too. And sorry for spelling errors..i am typing via phone not so good with touch screen.

Christina New jersey

Hi Christina, Very sorry to hear of what you are going through. I have to agree that not all doctors and vets are very good at communicating. Although I am very experienced in the pain you are suffering, I am not that experienced with your situation, or what sounds like some form of pancytopenia/neutropenia... There are some on this list who may be able to help, but are not likely to be here at this time necessarily. I do know that people on this list will look for things like cancer and tick related infections as a potential cause of the problem. Any other infections or unusal situations? Have they put Lola on prednisone or any other drugs? I can say this for sure though, keep doing what you are doing, keep fighting to talk to the vets and keep fighting for answers. Yes there may be a time when you have to choose to let go, but I believe as long as Lola is not serioulsly in pain or discomfort, I would keep fighting and I would demand as much as I could get from the care facility. It is better for your dog to be able to be with you during this time, but some emergency places are a little cold and detached. I think you are well within your rigths to push for what you beleive is best for Lola. Push to see her and spend time with her, even if it is not a long time. I would never give up until "I" personally thought that either my dog was in too much pain or discomfort for too long, or I knew I could not save her. I have let go of my first dog who could not be saved, and on the other hand, fought with every once of energy to save my current oldest dog from AIHA. I know everyone here is a fighter and will agree. If you can, get your blood results and post the details. This is important for the people here who are more knowlegable. Also, email Dr. Dodds hemopet@hotmail.com. Tell her a bit of your story and email her your blood test results. She is one of the most knowlegable people in blood diseases and she will help everyone as soon as she can. I have seen her donate blood for transfusions in a case where the people could not afford it. I don't know how she does it, but she helps everyone. She started Henmopet, providing a canine blood bank for transfusions. Email her!!!! She will likely know much more than anyone else. If anyone can help, she can. I wish you the best and hope you find answers you seek soon, good luck and feel free to ask any questions of us too, Richard and Dylan

Richard Burnaby

Richard & dylan Thanks so much for your quick response and encouraging words. It means a lot especially when sitting in the waiting room at this time. What I should have added was that lola rarely is outside, and the few times she has, we carry her. Spoiled I kmiw.. She started with a 103 feverand we believed our local vets diagnosis since it hit her so suddenly She seems to be in no pain, just tired and down. She looks even more pitiful with the thimble sized cone around her neck Her levels were so low I think the vet had said she hit a low of 10%...me nor my mom knew what pcv was but we realized its severity..after researching for over 15 hours straight, I feel much more aware of these terms and diseases..after the transfusion, the color went back into her gums and tongue. My mom said she thought lola was going to pass away last night and I think we literally got her here with only moments to spare,, Since this is still kind of the first day of treatment (even though they have no clue as to what theyre tresting)..i dont think shes on any of those harsh drugs yet..im just worried that her levels are too low to handle a biopsy and if this sounds like a dead end I just keep trying to prepare for the worst which im apparently not too good at being that after daytime vet gave her gut instinct instantly got sick. Local vet blood test says .3 wbc - 2.81 rbc -7.2 hgb - 20.6 hct - neutrophil low 40 - lymphocytes im not sure -monocytes 12%..auto platelet decreased..im going to go try and get her cbc from after the transfusion. Many many thanks And I had already emailed her! This woman sounds like a god!

Christina New jersey

Christina, Quick. Stop and take a deep breath. Nothing they can do right now will either make Lola ill or will make her instantly better. You have some time here. Ok? Got your breath back? Take another long deep breath. You have been hit with tons of information and have absolutely no background or experience to know what you should be doing. Your vets are telling you a lot of things you clearly don't understand and some things sound like they even conflict with other things they are saying. You have the right to be confused and a bit angry. You are probably frightened and feel panicky. With the information you have available to you, you will make the best decisions you are able to. We all know here on this forum that these decisions are made of out love and concern for Lola. We also want you to know that any decision you make is the right one. Lola has agreed to follow with you as her Master. Be strong and give her that leadership. As you go through this coming morning it is very important that you calm yourself and appear to be composed. Try to listen carefully to everything that is being said to you and think carefully about phrasing questions. Be sure to thank everyone for being available at such crazy hours. Acknowledge their skills and experience. If you are calm like this, they will be more likely to allow you to stay with Lola during the morning for some parts of the testing. Ask politely to be with her. I was faced with the decision about a bone marrow biopsy with Chance. You have a few hours before the test, correct? A bone marrow biopsy is taken, usually in the hip, but sometimes in the shoulder. They give a general anesthesia. They will take small bores of different diameters and draw a plug of marrow up out of the bone. They will examine this under a microscope looking for different cell types. They want to see if there are healthy reticulocytes (baby blood cells) and precursor cells that are the building blocks for red blood cells, white blood cells and platelets. If these precursor cells are low in numbers or missing altogether then they have a good idea why Lola is not making blood. They will also be looking for evidence of certain types of bone marrow cancer, but I am somewhat doubtful that is what they will find. I did allow them to take a bone marrow biopsy on Chance. They actually bored in several locations trying to find anything. The end result was that his marrow was "acellular" or a fancy name for there were no cells in his marrow. So this could technically be referred to as aplastic anemia. (Do you get this part about medical terms that by putting an A in front a word means none?) It was a shocking result. But I already knew that he wasn't making blood and the test did not bring us one step closer to a treatment. In hindsight I would not have done it this way if I had it to do over again. But that is not to say that others should not have the test done. Each dog is different. However, it is very important to note that the cause of Chance's condition was not cancer, but an autoimmune attack on the precursor cells in the bone marrow. It took very strong immune suppressing drugs to stop the damage. But we were successful, Chance got better and lived 3 more good years until he passed at 12. There is always hope with these very difficult cases!!! So what do you need to know today, right now, to get you through the next 24 hours? Ask them pointedly if they feel this test will give them a good idea for a treatment plan. If they say yes, ask them if they could outline the top two possible outcomes they feel are the most likely. What is the name of each condition, what is the cause, what are the test results that point to each condition, what are the possible treatments and the possible outcomes for treatment. Very carefully write these things down. What would I want to see? I would want to know if they have done a comprehensive tick disease panel. These symptoms you describe can all be caused by certain tick diseases. Ask them if they would consider treating for a tick disease just in case. I would want a good chest and abdominal x-ray to rule out any growths (either malignant or benign). If they see anything unusual, then I would want a follow up with an ultrasound. I would ask to sit in for this test. They are looking for certain types of growths on the spleen, heart and lungs. Not all growths on the spleen are malignant. If they find one, keep your hopes up that it may very well be benign. Do not discuss euthanasia with them at this point unless Lola is in great pain, totally unresponsive or seems different than you have ever seen her before. Do you have someone with you? Have that person be responsible for tracking down and getting copies of all tests and reports "for our home records." Be polite but stay firm that you need these copies. If you have a regular vet you trust say that you are going to stop by on the way home to ask your vet for advice and you need the test results with you. Compose a short email to hemopet @ hotmail . com (remove spaces to send). Address it to Dr. Jean Dodds. *Briefly* explain where you are and what is about to happen. Tell her that Lola's tests are showing pancytopenia. Ask her if she is willing to consult with you to get Lola on the correct protocol. Do that as soon as you finish reading my post. She will respond very quickly or one of her office colleagues will. She has a protocol specifically for what is happening right now to Lola. And yes it does include cyclosporine or the veterinary brand name is Atopica. You do not have to make any binding decisions tonight or tomorrow morning. If you are tight for money call your local vet and see if they would be willing to have Lola at their clinic later today to be monitored. It will cost less than the specialty vet. I need to get some sleep but will be back in about 6-7 hours. Ok? my best patrice

Patrice NYS

Hi Christina, Dylan came very close to dieing from anemia and was so week I thought if I moved her she would die for sure. If I carried her to the car, to the vet, then on the table? She was so low she could not stand or walk and has a bit of brain damage now. Minor, considering and something new for us to do together, rehab that is. The transfusion will perk Lola up and it will buy time for them to find out what is wrong. Many people have done several and saved their dogs as a result. The good you see is from the doner and until Lola starts producing mature rbc's, this will help so you can take your time and learn more and think clearly and make the best decisions for Lola. ALthough I did not choose to do a transfusion, if I were in your shoes, I would not hesitate to do another if there is a chance to save her. with Jagger, I did a lot and spent a lot to have one more day with her and it was the best day we ever had together. I had to say goodbye the next day though as then I knew for sure we could not save her. (The emrgency vets are the ones we fought to be with our her and although we did not spend all night with her, we did spend a lot of time that night and next day with her (my own vet would have let us stay all night and day with her). I am still very sad today, but extremely grateful for Dylan making it and doing well so far. It was much harder, but she is here and as long as I had hope, I fought hard for her. Contact Dr. Dodds, she already responded to one of the others who emailed her very recently. Remember, you do need to get rest and food too, so make the most of your time that you cannot see Lola. She needs her rest too. I hope you find out a lot more about Lola's problem very soon, Richard

Richard Burnaby

Hi Christina, I agree with Patrice that you will get better help if you are respectful and polite. These people are likely very busy, especially at night. Although I can be forceful I know full well that getting mad, or mean won't help you or Lola. That is not what I mean by fighting for her. I mean, do your research like you are, do what you can and I too belive that any cedicion you make IS the right one. You are under a great deal of stress, no doubt, but calm and trational decisions nad knowledgeable questions will go along way to help you get what you want for Lola. I too think that it is important that you be calm and and reassuring to Lola. You have it under control, you will help her. I know from how much you have done already and so does she. Again, I have to agree with Patrice when it comes to asking questions that lead to a plan. What are we going to do, why, what is the benefit, what is the drawback, does it help? Will we learn we can treat this. It may lead to more tests, what are they and what might we learn from them? When I learned with Jagger that further tests would only lead to knowledge and not treatment, I had to let go. Patrice and the others here can be of great assistance in helping you with knowledge, questions and answers. Dr. Dodds too. You are no where near that type of decision and there is still a lot to be done. Hang in there, you are doing great things for Lola. I remember talking to Dylan about her letting go if she needed to, but she is here to be with me like Lola will fight strong to be with you too, despite her pampered ways (I know she could be outside if you let her too ;-) Wishing you the best and good luck, Richard

Richard Burnaby

Patrice, Thank you so much for all of your suggestions. Right after I posted a reply to richard and dylan, one of the techs brought lola out for me all wrapped up ..she was shivering like crazy but was generous with the kisses..it made the hours beyond worth while. For whenever you get back on here, I just want to touch on a couple things you mentioned,,vet told me she didnt see any baby blood cells,,i feel like since she isnt producing red and her others are so low thatshe may have aplastic, but obviously just a guess going off of the info.. Thevet also felt that its not any immune problem but I dont know how or why.. I will ask for tick panel ..i will try anything ya know? As for cyclosporine..i did write that down after I read numerous puppy anecdotes about the disease and treatment. Im still smiling from lolas brief visit and could barely get out the words thank you I was crying so much! Thank you all its nice to have such wonderful people giving helpful advice and support.

Christina New jersey

Richard, Thank you. Its so hard. I have actually been very gracious..i vent to my mom afterword but when were talking about lola I cant thank them enough.. Ots just so frustrating because these questions that you and me think should be answered or at lwast attempted, they have just been saying I dont know. I will try again since each consult is with a different doctor..i just hope the internal medicine people have time to talk because I wasnt guaranteed any conversing. They said its circumstantial. Ugh well here comes the sun! Also, im so aorry about jagger..that made me cry just reading it! Then again im on an emotional rollercoaster with no signs of stopping anytime soon. Thank you once again. I appreciate it more than you know!

Christina New jersey

Sorry you had to join us on the rollercoaster; I certainly don't want to make it worse for you. My fight for Dylan’s life has changed me more than my fight for Jagger’s. It was sad, but that is life and I smile, or cry every time I think of her and I have a beautiful pastel of her here in my living room with us. Like I said to Dylan, she will always be with me. (Smile this time; I have great memories of her and 4 dogs here now too) I too am very grateful for people on this list and my vets who helped. I feel it is important for people and their dogs new in their fight to have support and have help, beyond just the veterinarians. You are their guardian and that means more than anything; I really don't know what I would have done without the support here. I am happy for you that you had a good time with Lola and found friends at the hospital. Glad you have Patrice's help and hopefully Dr. Dodds soon too. Richard and my band, Dylan, Stevie Ray, Joey and Jimmi

Richard Burnaby

Christina Please know that Lola is in my prayers. When you get a chance list all the med Lola is on and the dosage. Make sure they have her on aspirin for blood clotting and it does take a few days and sometime weeks for the med's to kick in. Dr Dodd's does do phone consult see if the vets treating Lola would speak to her directly and if not you should. Take care of yourself, get rest and make sure you are eating Loyla will need you when she comes home. Keep us up dated on how she is doing. Ginger was on pred, azathioprine in the beginning and then cyclosporine was added later and it really did help her. Don't forget a something to protect her tummy too. Also try to get some pet tinic. Sending a big hug Cheryl & Ginger

Cheryl & Ginger Pinevile PA

richard, Nice try, but I still teared up at that! Thats really sweet though..they just let me hold her again for almost an hour this time..she got to nap with me so that makes me feel a little more at ease. The internal medicine crew just arrived and they have to do their rounds to make sure everyone (including lo) is stable..then im going to try to get one of them to speak with me so I can run all the stuff you guys gave me by them. Cheryl & Ginger, Thank you for your kind words and prayers..it truly means a lot.. We havent even been able to discuss meds yet because everyone seems to be afraid to put a label on it until after the biopsy..as of nlw im pretty sure theyve just been monitering her and keeping her hydrated but fingers crossed I get somewhere with the internal med docs. I will run everything by them and will update on here as soon as I find something out! Cant thank you all enough!

Christina New jersey

Christina, I'm so sorry you are dealing with this....we have been facing a similar situation with our Pomeranian Bentley for the last two weeks. I don't have enough knowledge yet to add much, but can attest to the wonderful help the folks here have given me. They have been an incredible source of information and support. And do e-mail Dr. Dodds....I sent her two e-mails yesterday, and both were answered immediately. Best of luck with Lola, and take good care of yourself too. Please update when you can. Sally

Sally Louisiana

Christina, What hospital are you at with Lola? You may be in my area (Philadelphia suburbs), seeing that you have a Rowan address, and believe me -- I've been through alot of the specialty hospitals. The doctor I found most knowledgeable with IMHA is Dr. Klag at Veterinary Specialty Hospital in Langhorne. He's been a God-send and has given me back my Beau! Thinking of you, Sharon

Sharon PA

Sharon! I am right by philly..i mean distance isnt really a factor for me ya know? But it is basically the same distance away as this place is..were at garden state veterinary specialists in tinton falls..i live right outside atlantic city ..what was wrong with your pup? Im waiting to talk to an internal med person now before she gets her biopsy ..im doing all of this from my phone right now so I will look him up shortly. And sally.. Thanks for reaching out! I hope little bentley has a speedy recovery! i did email dr dodds a few times..just waiting to hear back. Keep me updated with your pup!

Christina New jersey

While im waiting so I dont go insane..i uploaded some pics from my phone of lola so you all could see the little cutie ..i hope it worked..the album is 'mobile uploads' http://m69.photobucket.com/albums/sugarplum6090/Mobile%20Uploads/?pbauth=1_uLEBonVPfaLdh1h3YMYz2Y5ez0tLGJ67r0vODMzPxm7Gzj8PvP9BrkNfElaccYDPr0MvWBs2nJFtWnZh19RzXLfHsFkwlQ3KwfBaWN971PRYsJD0SYwhMiLyJn1iOCtOmykOsuQxBDw2CQWFteX6l5z%2BW7kAZKM8ky%2F4PpqVGSU%3D :)

Christina New jersey

Christina, Beau was diagnosed with IMHA back in October. He was seeing my regular vet who claimed to be knowledgeable about the disease but then basically told me she could do nothing more for him and sent him home with me for the inevitable. She wanted him to have the bone marrow biopsy along with other invasive tests, which I refused to do. Long story short - Dr. Klag at VSEC in Langhorne modified his treatment, got him off the high doses of meds which were at this point making him worse instead of better, and has helped to get Beau to a place where he now enjoys a fabulous, active life. Unfortunately, you and Lola aren't at this place yet and you must deal with the initial diagnosis, assessment, treatment plan, etc. You will find many many very helpful people on this forum, as well as Dr. Dodds whom I know you must be familiar with by now. When you do get Lola over this hurdle though, keep in mind that if you are not satisfied with the treatment she is getting, a trip to Langhorne is not that far for you. Also note -- your "local" vet may see a few cases of IMHA, but not nearly the amount an internal med specialist sees. Also, it sounds as if up until now Lola has been treated by the critical care vets at Garden State. You may see a big difference when the internal med specialists come on duty. It's the difference between the "birds eye view" and the "worms eye view." Good luck! And hang in there! Sharon

Sharon PA

Okay just spoke with specialist and she seemed to know.more but that news wasnt so reassuring..lolas pcv count went from 10 up to 20! I know its still low but its good news to me and she is only 3 lbs I dont know the norm..so she received her blood transfusion in the afternoon yeaterday (thursday) so that definitely helped and they are considerong giving her the rest today..after biopsy that is..theyre also going to check her pcv again and do a cbc and other tests to confirm..roght now she is diagnosed with pancytopenia since she has a low count in rbc, wbc, and platelets.. because of this shortage in all three..she doesnt feel like its an immune problem so she is afraid to start meds before we know because that could kill her as well..she thinks its something with her bone marrow and said worst case scenario is bone marrow failure due to fibrosis and she doesnt want unneccessary meds to over surpress her immune system.. She alreadg started doxycycline for ticks and unicin (not sure what that is)..she said the ultrasound looked fine since shes so tiny, Theyre doing a thin needle that sucks out bone instead of the big ones that take chunks. Aspirit or something When I asked about pet tinic she said that theres no point right now since she has none to build off of.. Help!

Christina New jersey

Christina, Please... relax, breath and stay calm -- Patrice gave you that advice earlier and it is excellent advice! It sounds like Lola is in good hands and they are going to do what they can to get to the bottom of what is happening with her. Praying that it all works out well for Lola, and you! Take good care -- of yourself and Lola! Sharon

Sharon PA

Just an fyi pet tinic is just a Vitamin and Iron supplement. You can get some when Lola comes home, if needed. Sending prayers Cheryl & Ginger

Cheryl & Ginger

thank you guys- i appreciate the support

christina new jersey

Christina, It's good to hear that Lola is stable this morning! And so nice of the techs to bring her to you for a visit. 20 is good. I agree this is non regenerative. The term aplastic is a description not a diagnosis. It's describing the condition of the marrow. They are puzzled by the cause and are trying to nail down the diagnosis. I have been there, done that. There was never a time, from start to finish, with Chance that we had a definitive diagnosis! If I had continued with the prednisone-only treatment that they had recommended, Chance would have died eventually. I want to repeat here that Chance's bone marrow biopsy showed the same thing, no cells in the marrow. I was led to believe there was no hope of recovery. However, Dr. Dodds intervened. She has 25 years of experience with dogs that have similar conditions and she told me that this bone marrow failure was most likely autoimmune at the precursor cell level (in the marrow). Her approach was to treat Chance as if this were the case since there would never be a diagnosis. The specialist had said something similar, that he was puzzled and could only guess that it was of autoimmune nature. I felt, after a month of high prednisone treatment (start late June 2007), that Chance was only getting worse and I needed help from someone. I talked it over with my vet and she was delighted to work with Dr. Dodds. We started the protocol (late May 2007) with cyclosporine (as Atopica) a day later. I have a medical background and began studying a large veterinary hematology textbook to research what was happening. I eventually read it cover to cover. There are some real academic experts in this field. However, treatment protocols are widely different from clinic to clinic and vet to vet. There is very little standardization. Much of the toolkit a vet brings with them to the examining room is their wealth of clinical experience based on the hundreds of dogs that they have treated before. I realized that sometimes it requires faith in that clinical experience rather than the written text. Within 3-4 weeks Chance's tests began showing moderate regeneration (larger numbers of reticulocytes, baby blood cells) in circulation! Within another month his levels had returned to nearly normal! By September I knew he was going to live and by October he was back to normal, putting on muscle mass again, going for long walks and his coat returned to normal. See the first three photos here to see the difference. http://www.flickr.com/photos/patricel/2857651904/in/set-72157602714279765/ Please contact Dr. Dodds before you make any decisions. You can listen to what she says and either use her advice or not. She is able to explain things very clearly so that you will understand. Unisom (doxylamine) is really the same thing as Benadryl. It is an antihistamine. This is not uncommon to give a strong antihistamine after a blood transfusion to attempt to quiet any allergic reactions. My vet gave Chance shots rather than oral meds. The bone marrow biopsy technique is called aspiration. They bore into the bone of the hip or shoulder to take a marrow core sample. This is examined under a microscope. They may take several samples to find what they need. Are you getting all the paperwork? Make sure you are keeping a note book and keep a folder for the paperwork with you. How is Lola now at lunchtime? my best patrice

Patrice NYS

Patrice you are really helping me keep hope ! Im waiting for the vet to bring lola into visit me..i think she just got over the groggyness from aenestesia..i feel like her symptoms sound identical to chance, but I realize that this could be completely different..wouldnt ya know that I told my sister about dr. dodds and she had gotten plasma from her for her king charles cavalier spaniel..she raved about her..we are still waiting to hear back from dr dodds so for now I just wait.. Me and my mom arent sure if we should take lola home tonight or if they,should moniter her..lola is kind of like a human ..or she thinks she is..she hates dogs..and men..and not being able to have me in sight..i just dont want her to stress herself too much..when the vet brings her out to me she says that lolas yapping away nonstop but then when I hold her she will relax and nap.. Also, since its the weekend, we have to wait for the results until at least monday if not tuesday..did you go through that with chance? I dont want her pcv to ever dip that low again Thanks so much patrice, I will write again once I see how she is post biopsy and what the vet says.

Christina New jersey

Christina, How are you doing? How is Lola? I think any vet, or specialist would be honored to work with Dr. Dodds and already know of her. If they don't, I probably would go find another as she has defined blood transfusions for dogs and is now in the process of trying to accelerate a change in how thyroid problems are diagnosed and quite frankly misdiagnosed. Many vets have also learned what they know many years ago and as Patrice says, rely on clinical experience to teach them now. This is not always a good thing, since things do change. Dr. Dodds is certainly trying to speed up this process by helping us dog owners at the same time as she tries to inform the vets. I was fortunate with Dylan both in how the disease presented itself so clearly and how treatment could be well defined and worked. But it worked much better because of the research I did and the things I saw and the questions I asked. My vet took everything into account and together we were able to save Dylan not only from AIHA, but the treatment as well. I am also very frustrated by the lack of a real treatment plan for the different varieties of problems that are related to AIHA/IMHA and other related disorders. Also the lack of a true plan in how to differentiate them in most of the people and their dogs that end up here. Chance's problem is so obviously different from Dylan's and yet I do not see this understanding. The fact that many vets do not know that the immune system can attack the body at any level, is unfortunate. Autoimmune thyroid problems are misdiagnosed for the same reason. They just don't know. We have proof it can occur in the bone marrow at the pre-curser cell level and why not? Chance is proof! Sometimes you do have to take a chance to find out too (ie treatment) as you cannot "know." I have had to take chances every day in order to reduce prednisone and risk the return of AIHA, but I do so with knowledge, observation and intuition AND help from people here AND a vet who is willing to listen and learn and do whatever is necessary for Dylan's unique case. We worked together and once you get through the emergency phase, you will continue to need to do so for Lola so who you work with will likely be an important choice. Every dog ever diagnosed has been put through treatment that is a best guess situation at some point. There is often no obvious fact or and certainly no single plan. This is true for many things, not just AIHA/IMHA. It would be nice though if there was some sort of intelligence and decision making process to define how to attack this. I am a problem solver and I attack problems with a plan on how to differentiate the cause and define the outcomes as quickly as possible. Divide and conquer! It is how search engines are built. Define tests that clearly show autoimmune vs no autoimmune (ticks, cancer, etc), acute versus chronic, what cell types are impacted. The more you can eliminate with each question or test, the closer you are to really providing a solution. I know that people are not all that good at this and that includes vets and technicians and even specialists sometimes. Dr. Dodds wrote her book on Canine hypothyroidism for this reason. They are not doing the proper tests and making incorrect conclusions. She defined very clearly how you can tell it is caused by an immune attack. Unfortunately so far I have not seen such a clear definition for the multitude of problems that can cause anemia. Hang in there; it seems you are getting closer to knowing which way to go. You have still not stated that you have contacted Dr. Dodds, so I will say it again, do so. Another intelligent opinion will help. She knows how to define what matters, especially to you, as she really supports your role in treatment as an expert. Good luck, Richard PS, Jagger changed my life in her life, not her death. I have Dylan because of her, I am here because of her and I have met you because of her. She is in all of my dogs and in most things I do. I am never without her. And I could not see you pictures, unfortunately. If you look at the thread on dylan, check out the Youtube site and her photo album. If you want a good laugh to lighten your spirit, watch the three hosers video and maybe the Joey hose ones. If you want to see Jagger's influence, watch Stevie Ray with her puppies. I Say this becasue you need to relax and rejuninate and that includes your mind. You need to be able to think clearly fror Lola when the time is right. Good luck!

Richard Burnaby

im holding lola..she got her biopsy..looks like in both shoulders..but I wouldnt know because doctor sent tech in and is too busy and will call me..no no no...vet tech said doctors making lola stay overnight again and all we can do is wait for biopsy results to come in on mon or tues.. .. I need to know her pcv and her cbc info..i also need to know what she thinks were going to do with lola while waiting for test results..vet tech has bo answers because she just started her shift..shes too tiny I hate seeing her like this. I was holding it together but I cant anymore. I just want answers. sorry for rambling Im just venting aloud

Christina New jersey

Richard I havent read your whole post yet but my mom..sister and myself have emailed her..no response yet..i am hoping I get one soon though because she sounds great!

Christina New jersey

Okay. They cant give me the cbc because they already sent it out..herpcv went from 10 on thursday..to 20 thursday night..and today its up to 27....the vet says its still rising from the transfusion yesterday. I was hoping lola was getting back to normal on her own. thats all I know for now. Once again thank you all,so much..i feel so much more levelheaded with your advice and kind words.

Christina New jersey

Just wondering if Lola is eating and drinking or do they have her hooked up to an IV? Maybe if she stablizes and is eating and drinking on her own they will let you bring her home soon, do you have a 24 er vet center close by just in case? If she is just goig to be there waiting for test results and they are not treating her until they get the results from the test, I would ask about bringing her home if they feel she is stable enough, you know her best how is she acting? Cheryl & Ginger

Cheryl & Ginger Pineville PA

If you have not done so alreay go to website below http://www.cloudnet.com/~jdickson/index.html You will learn a lot about the disease and also about the treatment options. Make sure to go to the link of the success stories

Cheryl & Ginger

Christina, that is what the transfusion was for, to buy time. It cannot fix the problem, unfortunately. She has done well from it and so you can relax a little. It means they can do another if needed (I don't know about the financial side, but I am guessing you will do whatever it takes from how you speak of her), so you have time to figure things out. They still need to get on treatment as soon as possible, as it does take time for drugs to take effect and to build new blood cells, but you don't have to be anxious or in a panic. You will know more soon, I am sure. Richard

Richard Burnaby

The doctors are not taking me seriously it seems because of my young age..they are shooting all of my recommendations down as well as the ones that jean dobbs has made. I am trying to figure out a solution now. Shes still hooked up to fluids but she has been drinking from me everytime she visits.

Christina New jersey

Christina, What has Dr. Dodds suggested to you? my best patrice

Patrice NYS

Christina, It is very important that you have Vets that you feel comfortable with. You have to be Lola's voice. You might want to consider Sharon's suggestion and change doctors if the distance is no different than where you're at. I know a lot of Vets that are not open to input from owners at all and then there are others that appreciate that you are willing to be so involved. This fight is emotional enough without having to add any extra stress. Keeping you and Lola in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Hi Christine, I certainly agree with Penny's comment. I know many young people who are great guardians. All guardians deserve respect from care givers. Especially given the severity of the situation. It is important that your vet respect you and your input and certainly your questions. All decisions are yours to make and they are obligated to inform you and work with you. You are paying them, so they certainly work for you. For Lola's future I think it is in her best interest that you have the opportunity to work as a team, as that will provide Lola with the best care. If they don't take Dr. Dodds seriously either, I would be doing my best to find better care. Either that or telling the vet straight out what the situation is. This is where the terrier in me comes out. Good luck, Richard

Richard Burnaby

Christina, I am so sorry the communication doesn't seem to be going well with the vets at Garden State. All patients, human or animal, need an advocate and you have been an incredible advocate for Lola so far. With that said, be very careful that when you are making suggestions or recommendations, the doctors aren't perceiving that you are "second-guessing" them. That doesn't go over real well. Especially with a complicated diagnosis like you may be facing for Lola. Of course you can request that they discuss the medical issues with Dr. Dodds personally, but be prepared that they may not choose to do this. This does not make them bad doctors, it just means they are confident with the direction they are following. While Beau was seeing the regular vet, I had her send Beau's blood sample to Dr. Dodds for a consult regarding thyroid function. Shortly after that I began to see the specialist at VSEC, who felt he had a complete handle on what was going on with Beau and didn't need to consult with Dr. Dodds. I felt comfortable with his decision and he has since proven that he did in fact know the correct road to follow to get Beau better. Comfortable is the key word here. If you feel comfortable with Lola's care, your advocacy role is not quite as crucial. However, it is always important that they keep you apprised every step of the way on what is going on, what their treatment plan will be, and why. I'm sure this whole thing is very mind boggling for you. I know at my old age it is! Hang in there! Praying for you and Lola, Sharon

Sharon PA

Welp, I took dr dodds advice..i tried to get our vet to start doses of thyroxine like dodds suggested but she wouldnt believe me when I told her that it wouldnt hurt her either way. She then told me her gut says that lola is very sick and she thinks its the worst case scenerio. (bone marrow failure / cancer) Is weird as it sounds, I respect that she actually told me how she felt straight up. I then called dr dodds and spoke with her about this. She reassured that thyroxine would do no harm and to print out the article about it and give it to the vet ..so I did. I demanded to start the doses. Dr dobbs also said that she disagrees with the vets gut feeling because lola is so young. I agree with her..i hope shes right Bone marrow results come in tomorrow (we hope).. My mom and I are waiting for lola so we can try to feed her some chicken (unlike our other dogs, lola is not food driven and would soon rather starve then eat from a stranger) ..shes still hooked up to fluids. Fingers crossed..tomorrows the big day! Many thanks again and please let me know if you can think of anything else.

Christina New jersey

Hi Christina, I am just a bit confused by the logic of the specialist. Even if her gut is right and it is worst case, that is still a guess at the moment. There is no harm in trying something if the alternative has no solution, or a different treatment with a poor prognosis. I am not fond of what I call the shotgun approach, but Dr. Dodds' advice is hardly that. It is an experienced hypothesis from probably the most experienced person on this issue and that could save Lola's life. Why would anyone resist tryng to help even if they thought is was bone marrow failure due to cancer? Bone marrow failure due to autoimmune attack is just as likely or more so. I am sure the specialist is experienced, but I worry about the fact that if they figure there is no solution they will do nothing except encourage you to say goodbye. I doubt anyone here would support that approach. I am not saying this is true (I am not there to know). I agree with Sharon though too, that in your efforts to get help for Lola, that you make sure you still show respect to the people providing treatment. Some people do not deal with that very well, especially certain Doctors and Veterinarians. Holding out hope when there is so much still to know and so little certainty is a very good thing! You are doing great :-) Richard

Richard Burnaby

Christina, I am very sorry to hear this. I should have seen this coming a mile away. It's not the first time this has happened to a member of this forum and it won't be the last. Dr. Jean Dodds is well known and for the most part is considered an expert in the fields of canine thyroid, blood diseases and vaccinations. She is currently engaged in a landmark study with another vet that is researching the length of time the rabies vaccination is valid. Currently, three years is the accepted maximum. The goal of this research is to show that this vaccination can be viable for 7 years. (The Rabies Challenge to donate to this research project). She has just recently released a book on canine thyroid disease that will probably become the bible on hypothyroidism. She and her husband run a not for profit canine blood bank and testing laboratory in California. She ships canine blood products around the world. However, there are detractors. They feel her methods of clinical research and treatment are faulty. They feel if a major study has not been undertaken to substantiate a treatment protocol she uses, then it cannot be valid. A small group may even consider her a quack. I attended a workshop with her several years ago and asked her if this bothered her. She said it is all about saving dogs, one dog at a time. No, they don't bother her. She goes on doing what she believes in. The supplementation with thyroid medication in cases like this has been very successful in many cases on this forum. You have a choice. You can stay with the current facility or you can find another clinic to treat Lola. When I was told there was not much that could be done for Chance, I went to my favorite local vet clinic and asked if Dr. Dodds could direct the treatment by email. I received the best service from my local vets who were delighted to do this. They were grateful to have the difficult decisions made by her and they also learned a great deal about treating this condition. They were pleasantly surprised when Chance survived so easily. However, you need to be at this current clinic when they receive all the test results and see what they will offer you in the way of treatment. If they basically say there is very little they can do for treatment then you have every right to take your test results and find someone who will help your dog. I would suggest that you not burn your bridges. It would be wise to be polite and thank them for all their help and concern. That was a scary step for me, but honestly I would have stepped off the Brooklyn Bridge to help Chance. How is Lola doing tonight? my best patrice

Patrice NYS

Christina, Just want you to know I'm thinking of you and Lola tonight....I hope things are going better for your sweet girl. Keeping you in our thoughts and prayers. Sally and Bentley

Sally Louisiana

Hi all! So we have been doing nothing but bouncing ideas and possibilities off each other all night..i pretty much realized today that once we receive her bone marrow results. We are getting the heck outta here..regardless as to which way it goes. We are going to take her local or somewhere that will cooperate with our requests. What killed me was I spoke my woman doctor one on one..truly thanking her for what theyve done ..and that I was interested in starting the thyroid meds..after she made it clear that she was against startong it before the results were in..i told her that I did trust her opinion but I want to do whats best for lola in my mind..she then said if I trusted her tovlet her continue her treatment. So guess what.. After giving her the article about the treatment that dr dodd sent me . That I also wrote on saying to start treatments asap, she left. She went home. She told her tech she may do it in the morning. Im counting to ten in my head right now because I am still getting heated! Anyway, im not worried right now..im anxious and hopeful..thats all I can do. Im ready for the next step. Not to mention I just picked up mcdonalds french fries for her (first food I ever gave her on our 10 hour carride home) ..keep little lola in your prayers! Sally, how is your little guy doing??

Christina New jersey

Christina, Our little guy is back in the hospital, getting another transfusion tonight. His HCT was 17 today, and he was having more syncope (like fainting) and was very lethargic again. But his CBC did show an improvement in his Absol Retic, so he is now making new baby RBC. We had a bone marrow test done two weeks ago, and it was all clear...I hope it is the same for Lola. Our vets at LSU have so far not wanted to start on Thyroid meds either....I'm interested in the theory, and would be willing to try it, but I also have to respect the doctors there. They are talking of tweaking other of Bentley's meds, and I know we can only do a bit at a time. This clinic at LSU is the best Vet Teaching Hospital in our state, and we live 10 minutes away. I will ask about the Thyroid meds again later. We are waiting to see if Bentley is well enough to come home in the morning....reports tonight are that so far, he is tolerating the transfusion well and is even putting up a bit of a fight with the techs! Do you have any new test results on Lola? How is she tonight? Sending you all HUGS!! Sally and Bentley

Sally Louisiana

Hi Christina I hope Lola is doing better today and you get all the tests results you are waiting for. If you do decide to take her home, try to get copies of all her medical records, I would think you would have the right to them after all your are paying for her care. Any x-rays can be put on CD's. Are you far from Langhorne Pa, I believe the VSEC where Dr Klagg works is right off of I-95. Perhaps you could call now and see if you can get her an appointment for as soon as the can get her in, as long as she seems stable. http://www.vsecvet.com/ looks like VSEC is in levittown not Langhorne but it is still right off of I-95 and it states on the website dr Klagg is the owner. Also I have heard wonderful things about the http://www.vet.upenn.edu/ which may be closer for you Please keep us posted and know that Lola is still in our prayers Cheryl & Ginger

Cheryl & Ginger Pinevile PA

Hi everyone. im out in the waiting room..havent seen lola since arpund 5am..i want to get all my thoughts and questions together before speaking with internal meds doc..i want lola out of here..when I was with lola this morning..i was trying to ask the overnight vet some questions about her and she just kept saying I dont know..until I guess she got sick of me asking and said I dont know anything anout this..then why is she monitering lola...i got a copy of her blood work but what else should I ask to have a copy of..also..if she is eating and dr inking and her pcv is stabld..what can they do here that we cant do at home... i basically just want to know if I am taking a risk by pulling her from this place Thank you! I hope everyones having a wonderful day..hug and kiss ur pups! Ps..lola ate cheeseburger and french fries and was so happy! Bad mom I know but I had to! :)

Christina New jersey

Pcv is up to 34..they dont know why it climbed but dont think shes generating them..aa of last night her rbc and wbc are atill veryyyy low..like ,7 wbc instead of 4.0-15 and red 3.23 instead of 4.8-9.3..neutrophils are at 287. Come on lola!

Christina New jersey

I guess you should wait and see how her blood work is today and see how she is when you see her again and if she is eating, drinking and hopefully get to talk to someone who knows something about Lola's condition and treatment, do you know if they have her on predisone or anything else? You need to find that out and get some meds before she leaves and have a back up plan just in case you need to get her to another vet and make sure you can get an appointment with another vet ASAP. The sad thing is you may run into the same type of situation in another facility unfortunately it is just hard to find a really good vet. But at least you maybe able to find one closer to home. If the took x-rays or an ultrasound get copies of that too. Cheryl & Ginger

Cheryl & Ginger Pinevile PA

Hi Christina, I would think that if she is stable, that moving her and taking her home is probably okay, but not without a plan for what your are going to do. She sounds pretty weak still. Unless you can see another vet, you won't be able to start treatment anyway (I am assumming the hospital staff are still waiting for results), so it may be best to keep her where she is. Not sure when they may have to do another transfusion, or if there is another place that would treat her on Sunday/Sunday night before your local vet is open again Monday. You will want all the test results and blood type info from the transfusion. X-rays for tumors, tick tests etc. Dylan was fine through her anemia at home, as there was nothing other than a transfusion that could be done. Lola may need another soon, so that is important in your decision. Keep your emotions out of the decision. No anger and no fear!!! Caring for Lola, what is best for her? Even though you may not be happy it may still be the best place for her until Monday. You are doing great and glad to hear you are still spending time together. Richard

Richard Burnaby

This thread was discussed between 15/07/2011 and 16/07/2011

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