Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Help

I'm going through issues with my8 yr old 120 lb Rotti Gunner , his RBC dropped to 8 and he had to have a transfusion last week and got him up to 20. He is currently on 60 of Pred 2x per day , Imuran 75 ml , Doxy and a 1/4 of a baby asprin. But he doesn't seem to be bouncing back. I've been researching online everything possible and came across BioPreparation f3+ and the story of the dogs were exactly like mine and this seemed to work. Then I stumbled upon this site and read a story of a lady Shannon and her dog and she mentioned the BioPrep . I'm hoping I can get some good info and get my buddy better . I've spent $4000.00 bucks in the past week. I want to say money is NO object but at some point it is sadly :( . They want to do the Bone marrow thing and I'm just not sure . He has always had a very good diet , but I'm making more of an effort to add extra iron (liver) Chlorophyll and B vitamins into everything I make . Any tips would be helpful at this point . He has always been good up till now !!!! Thank you for any help and advice you can provide to me .

jacki Phila

Jacki, you will find many people here who know a heck of a lot more than I do. And as soon as someone knowledgeable reads this they will respond. It often takes awhile to bounce back. This IMHA is a real roller coaster. I would suggest you order some pet-tinic you can find it on amazon.com You did not say what his current PCV/HCT level is. That is really the number to look at. I don't think you will find anyone here who had a sickly dog before this stuck them. One day they are health and happy, the next... Another forum that may help is forum.dog.com I will be praying for Gunner. Carrie and Summer

Carrie DFW

Jack, Iam so sorry your dear Gunner has been diagnosed with AIHA. It can take some time for a dog with AIHA/IMHA to start to recover. In fact most times a dog will get worse before he gets better after the diagnosis. If you have not read my Web site on Canine AIHA/IMHA as yet, you might want to do so when you can. The URL is: http://www.cloudnet.com/~jdickson/ Be sure to follow the links on the bottom of the first page to many other sites on AIHA/IMHA that will be very helpful to you and do read the Success Stories pages. They will show you what has worked for other dogs in terms of treatment options as well as give you a lot of HOPE. One dog on the Success Stories pages had a PCV as low as 3.....yes 3 and went on to recover and now is doing well. Be careful about the amount of liver you add to Gunner's diet as too much iron can be harmful. I know this is hard but please do hang in there. While AIHA/IMHA is very difficult disease dogs CAN and DO surive it and go on to live happy, healthy lives. Sometimes, however it does take a long time for that to happen. Be assured you and Gunner are in my thoughts and prayers during these most very difficult days.

Joanne

Whoops Jacki....I asked in the other thread if you could tell us about Gunner....nevermind that question! ~~~smacks head on table~~~ I think you can do much better than Bioprep!!! You'll find loads of information online that claims to be able to *cure* this illness but I can assure you there IS NO simple cure to this disease. He's only been on meds for a week or so so it may take time for the meds to kick in. you could always discuss with the vet the possibility of adding Atopica (cyclosporine) to the mix. It's expensive but works really well *with* the other immune suppressors. Carrie mentioned Pet tinic above....this is a great idea. I'd also look into getting milk thistle into the big guy to protect the liver from the damaging drugs. Stomach protectors??? If none...get one! I wouldn't do the bone marrow testing if it were me. The treatment would remain the same regardless and all you'd be doing is putting Gunner through unnecesary stress! Not needed! What exactly do you feed him diet wise? Do you know the trigger ...what caused the disease? Ask for and keep copies of ALL tests done at the vet. It's important to keep track of these! How's he doing clinically? Lots of thoughts and prayers, Johnny & Tessy

Johnny

Jacki, unfortunately this disease is not a sprint, but a marathon. And a marathon on a very rocky road at that. This disease certainly has taught me patience..... You mentioned Bio Preparation in an other post. I would suggest to just put it in a drawer for now and (as Johnny recommended) get yourself some Petinic. It is a supplement with Vitamin B, folic acid and iron, something that would be very beneficial in your dog's diet. You could use the bio prep once Gunner is on a lower dose of the immune suppressants. Check with your vet before you give it, this stuff is pretty powerful. Make sure Gunner gets the best quality food you can afford. I always laughed at people who cooked for their dogs, but guess what..... steamed chicken, Turkey and fish, mixed with all sorts of veggies like kale, green beans, squash, beets and carrots. Fruit and berries are ok too once his intestines have adapted to all the medications. At this point, with his immune system suppressed, raw food is not a good idea. Make sure you have lots of fresh water available for him all the time and be prepared to take him out LOTS for pee breaks. I would discuss with your vet if you could check Gunners thyroid. A lot of people suggested that to me and putting my dog on a supplement really made him turn around. If it were me, I would not do the bone marrow biopsy. It was an option for us at one point. I asked the vet if it would change anything in the treatment and she said no. So I opted against it. It could be stressful for the dog and is expensive. Of course there might be situations where it could be helpful, somebody might be better able to help you make that decision. Keep updating us on how Gunner is doing. Get all the print outs of the CBC and post his values for us. How is he eating? there is always somebody here who had the same or a similar experience that can help. Best wishes, Brigitte & the poodle boys

Brigitte BC Canada

WOW great feed back thank you for taking the time to write back to me . Some background on Gunner's Case He has had "autoimmune" issues in the past and have always been able to treat with pred. He has been totally fine for a few years. Jan. 1st of this year while out on our walk I noticed he was dragging behind and not acting right. I looked inside his mouth and noticed the pale gums . We took him to the vet the very next day and they took Xrays and did blood work which showed his Red Blood Count was at 12 !!!! Everything else.. white BC, platlets were normal. My vet put him right on Prednisone,amoxicillian, Doxycycline and pepcid . Xrays didn't show any internal bleeding that they could see no tumors etc . We took him back the following day to test the blood again and it was still at 12. At that point we thought the meds might need a few days to kick in. He was still eating, drinking going to the bathroom normal. Took him back a few days later and we walked into the office and he collapsed on the floor. I was freaking out ! Everyone came running they tried to get blood from him and nothing was coming out , put him on a stretcher and back to do Xrays. He's RBC was now at 8 !! My vet then told us we needed to take him as an emergency to the Vet Hostpital for a blood transfusion and ultra sound . Which we of course did. They gave him IV fluids and transfusion and his blood count held at 20 over the 2 days he was there, they sent us home with a new a new med Imuran. When the test results came back they seem to think its not autoimmue related and the word non regerative was tossed around. And they suggested we go do the bone marrow test (which I'm very unsure about) . We just spent 4000.00 this past week and I almost feel as though that want to just do a ton of tests, but not getting any answers ! We took him back to my vet a few days later and he has been holding at 20/21 . His is acting very lethargic but does perk up once in a while. He has always been a pretty good diet, but since all this I have added things with more iron and Chorophyll . Doing tons of research and googling online is when I stumbled across the BioPrep and the story I read seemed to be Gunners exactly. We ordered it but haven't gotten it yet. Of course I was going to run it by my vet before but I felt it was almost a last resort . Today the ER vet called to tell me his tick panel came back that that he did text positive for one of the tests, but that the Doxy would be working for that and she didn't think it was all related. I'm still waiting to hear back from my regular vet and see what she makes of all this . I've read about getting a B12 shot every 3 weeks and also a Nandrolone(?) injection which is supposed to help stimulate marrow. I found this site by accident and I have never even heard of Dr.Dodd , but I'm curious and willing to hear what anyone has to say on this issue. It sounds as if you've all been through a similar situation . Thank you for taking the time to help me through, I'm open to trying anything ! Fondly, Jacki

Jacki Phila

Jacki, I do know it is hard, but you must try to be patient. It takes so long to get results sometimes and we want our pets well now. Please let the people on this site help you. Buster had a RBC of 8 when he had his transfusion. It went up to 27 right after it was done and then dropped to 17 where it stayed for a while. Gradually it started to go up again and now he is off of all drugs and doing wonderful. It is very costly to treat, our cost was easily $5000.00 and I am still paying when I have my fearful moments and rush him to the vet for minor problems. Be sure to give him his drugs on time, feed him a healthy diet, don't worry so much that he has no energy and pray. It can be overcome. We are proof of that. Many prayers, Ronda and Buster

Ronda Illinois

Jacki, I am glad you gave more insight into Gunners case. I have a few suggestions. You say money is not an issue, but of course no matter how much money we have in the bank, it still is. (as you say too) So basically what I hear, you want to make the MOST out of your money. Since you have a diagnosis of tick borne disease (which one?) I am sure Patrice (our tick expert) will post as soon as she can. Because you say that Gunner had immune issues before I suspect he had the tick contact a while ago. The longer he had it, the more serious and trickier to treat. Where are you located? I highly recommend you or your vet contact Dr. Dodds at hemopet @ hotmail. com (remove spaces) also check out her website hemopet.org. You could send blood to her and you would for sure get the best opinion on Gunners case. I would certainly rather spend the money there than on a bone marrow biopsy. If Dr. Dodds recommends you do the biopsy, then at least you know it is necessary. Good luck and best wishes, Brigitte & the poodle boys

Brigitte BC Canada

Hey Brigitte, We just got back from my vet to follow up his blood work , he is still remaining at 20 ! When he was sick years ago my vet thought it may be Rocky Mountian Spotted Fever but then that was ruled out. Fast forward 4 years and now he's sick again, I had found a few ticks on him this past summer I was advised NOT to use frontline because of the "autoimmue" in the past as well as vaccinate him but then my vet told me to go ahead and use it this year since I had found some ticks on him. I got the call about the pending tick panel earlier today, it came back as a positive for Rocky mountian , but my Vet said on the very low end. He is already on Doxy which they said would be the treatment for that. I AM SO CONFUSED !!!!! The ER hospital said they doubt its the Rocky Mountian that has to do with all the other issues going on, but I don't know what to think at this point !! He has been treated for "autoimmune" issues in the past and the pred always worked. This site is helpful in alot of ways, but my vet thinks we should just keep him on the meds he's on now and not to add anything else just yet. But I'm eager to try vitamins , BioPrep something ............

jacki Phila

Jacki, I am so sorry you are dealing with all this confusion. There are many details to this particular case that need addressing. The tick disease is the seemingly most difficult aspect of his condition. Did he ever actually harbor RMSF? Is he experiencing the beginnings of the disease now? There are several reasons why the titer can be low now. I am not an expert, but I am on a tick list that discusses things like this all the time. We have a vet that assists us when we have questions like this. One of the members of the list has taken all this information and prepared it on a website: http://sites.google.com/site/blackgsd/rmsf The vet has addressed this apparent lowish titer. Read this below: "The cause of Rocky Mountain spotted fever (RMSF) is Rickettsia rickettsii. Dogs can, and frequently do, harbor Rickettsia of species closely related to R. rickettsii that are generally considered to be harmless (i.e., causing no disease.), but which do tend to cause the dog to produce antibodies so similar to R. rickettsii antibodies that they "cross-react" and cause low to middling titers on tests for R. rickettsii antibodies. Therefore a single low-to-middling RMSF titer cannot be unequivocally interpreted. "Such a low-end RMSF titer might be found in a dog... ...that is in the very early stages of an acute RMSF attack, OR ...that harbors one of the several non-pathogenic spotted fever group (non-pathogenic = not capable of causing disease) Rickettsial species, OR ...that had an acute episode of RMSF at some time in the past, and although recovered, still continues to produce R. rickettsii antibodies, OR ...there is also some emerging information which suggests there may be cases where presence of other, non-Rickettsial, pathogens (e.g., Bartonella vinsonii subspecies berkhoffii) can cause (for unknown reasons) low positive reactions on the RMSF IFA tests. "Diagnostic confirmation of RMSF by serology (antibody testing) requires comparison of two blood samples: an "acute sample" taken early in the acute attack (hopefully immediately the disease is suspected) compared with a "convalescent sample" taken 2 to 3 weeks later. The criteria for confirmation is that the antibody levels show a four-fold or greater increase from first sample to second. A mere two-fold increase from first to second sample has to be regarded as equivocal--could be a "real" increase; could be cyclic variation." I know this is quite confusing to you and I am sorry to place this in your lap like this. What I am trying to point out to you is that there are several possibilities why this current tick test you had done is apparently "low." They are correct that this lowish titer *may* not have much to do with his current illness. However, it is true that dogs that have RMSF are very ill. Read this description from Gil's webpage: "The onset of the disease is rapid. Four or five days after being bitten, the dog will become feverish (up to 105 degrees). Symptoms may include depression, loss of appetite, swollen lymph nodes, bruising on the skin or gums, tiny hemorrhages under the skin (petechiae), muscle pain, retinal hemorrage, swollen or painful joints. A staggering gait, difficulty keeping his balance, is the dog's most common neurological sign. Seizures are possible. A decrease in the platelets responsible for clotting (thrombocytopenia), is the most consistent finding in blood tests. If left untreated, RMSF either kills quickly (the disease runs its course in approximately two weeks) or the dog gets over it and is then immune. Symptoms may range from slight through severe to fatal." You can see that the course of the disease is very quick. The body fights it off and survives or the body fails to fight it off and succumbs. If the dog does fight it off, then they are immune. So current re-infection is not possible if he had the disease before now. Treating with doxycycline would not be effective. So it can be one of these scenarios: 1. He was infected a while ago, fought it off and developed antibodies. The test that was done is accurately reflecting this past immune response. This simply means that the body remembers for life. 2. He has become infected recently and is currently beginning to fight it off and antibody levels are not high yet. He would have to be very sick right now for this to be true. 3. He has been infected by one of these other pathogens. I am going to take a leap here and say that I don't believe this is the ultimate issue right now. Non-regenerative anemia in dogs can be very autoimmune related. How do I know this? My dog Chance had the most severe case of non-regenerative anemia my specialist had ever seen. He gave us no hope. I persevered and Chance survived. His case was autoimmune. The immune system was destroying the precursor cells that are in the bone marrow. They could not mature into normal red and white blood cells. Since Gunner has other autoimmune issues (as did Chance) I am going to guess that his condition is very similar to Chance's. I contacted Dr. Dodds and she consulted with my vets (through me) to provide a protocol that would work. This protocol is slightly different than the autoimmune hemolytic anemia protocols. For one, I know you like the idea of prednisone but I can tell you that Chance was on prednisone alone for several months before I contacted Dr. Dodds. It nearly killed him. The side effects were devastating. It was not until I added cyclosporine at the direction of Jean Dodds did he begin to recover. Treating a dog with autoimmune bone marrow failure is a long haul and the protocol has to be administered with that in mind. Long term prednisone will make the dog so sick that they will have all kinds of other issues. We did have a bone marrow biopsy very early and it confirmed what I already knew.... he had stopped making blood. In hindsight I felt I probably had not needed to do that test. It required anesthesia and could not define a cause or prescribe a treatment. It was very expensive. It merely confirmed what the blood tests were telling us. Can there be other reasons for a dog to be non-regenerative? Yes. Cancer of the bone marrow can do this. There can be exposure to heavy metals, chemicals or poisons. There can be severe nutrition issues that don't provide the proper elements to make blood properly and the cells produced are flimsy. An accessory cause to this might be something called a liver shunt or there could be a digestive disease in the small intestine. Your vet has to worry about all these other diagnoses. But you don't have the time or the training to also research them. And I am going to advise you, from my experience, not to lie awake worrying about them. Treat this like an autoimmune condition, contact Jean Dodds and become really good friends with your vet. You are now driving this bus. Ask politely, but be in charge. Your vets are highly trained and clinically experienced but it is likely that they are somewhat puzzled by this. The vitamins and supplements are a good idea, to a certain extent. Stay with the known. Good wholesome food prepared at home is the best thing. Provide some type of supplement like Petinic that pumps up those B vitamins and gives moderate, controlled levels of iron. Using supplements that make a lot of promises introduce unknowns into the treatment protocol. Your nursing care at home will properly supplement the treatment protocol that your vet will administer, hopefully via Dr. Dodds. I will be thinking of you tonight. patrice

Patrice NYS

I neglected to mention the importance of having a full thyroid panel done. Hypothyroidism can be a significant player in this condition as well. Dr. Dodds' website hemopet.org can explain the importance of the thyroid in blood production and she provides an excellent diagnostic test for this condition. p

Patrice NYS

Patrice , you are an angel. Some of what you wrote is hard for me to absorb right now, but I will be reading and going over this again and again. I'm going to copy this and let my vet read what you've said. They seem to want Gunner to stay on this course of meds right now. But I don't want to miss anything in the meantime. I do respect my vet and she has always done well by us in the past, but the fact of the matter is they see many patients and to me Gunner is my main focus. The only thing I'm not on board with is the whole Pred and doxy treats everything attitude. I think that cyclosporine should be tried. I have read about that a lot on here. I am going to suggest it again. It sounds as if Chance and Gunner have similar stories here, I'm not quite comfortable with the bone marrow test. He has been through enough right now and would rather try a different couse of med treatment and if all else fails opt to do that . I have never even heard of Dr.Dodd up until this site, I dont even know how to go about contacting her. But I'm willing to give it a shot ! Thank you so very much for taking the time to talk to me. I am in such a state of confusion with all this right now. I'm trying to absorb what they are telling me and research things that I don't understand. Thankfully I am or I would have never found this site !!! I am getting the Pet_tinics asap. And his diet is making changes, I've always cooked for my dogs Chicken ,brown rice,carrots,lean beef burgers with spinach so I'm willing and open to any suggestions I can control on the home front. I will keep you posted and again thank you for your time Patrice, it really means a lot to me and Gunner :))))

jacki Phila

email her tonight. make it concise and brief. she knows you hurt all over, just give her the details. hemopet at hotmail dot com. remove spaces and replace at with the at sign. dot is a period

Patrice NYS

Hi Jacki, I am so sorry to hear about Gunner. Great advice given to you already, it certainly gives you a lot to discuss with your vet. Azathioprine does have a side effect of suppressing the bone marrow so maybe talk to your vet about using Cyclosprine instead. keep us posted Gunner's progress.

Samantha Geelong Australia

Thank you once again for all the information you've all have provided for me. I just read alot of good things on Dr.Dodds website and will be having a consultation with my vet regarding different treatment options. They are totally pushing for the bone marrow test, but I dont feel comfortable putting Gunner through that at this time. Once I have all my paper work from my vet's office tomorrow I will be composing a detailed email to Dr.Dodds explaining the situation . They keep saying its non-regenerative, and if that's the case from what I'm reading here it CAN be helped, right ? I am going to find out if they did a FULL thyroid panel and also what the story is with the low positive RMSF titer ! In the meantime, I'm feeding him an amazing diet and have ordered the Pet-tinics and BioPrep, to have just in case we want to give that a shot. I'm not sold as of yet on the BioPrep quite yet , but if it's a matter of a last resort I'm willing to give it a try. Once again any advice is welcomed. I feel very blessed to have found this site and talked to so many caring people who have been through this situation. Thank you for all of your well wishes and prayers :) Love , Jacki and Gunner :)

jacki Phila

Dear Jacki, Yes - non-regenerative anemia can be treated, but it is more difficult than regenerative. I was fortunate that my dog Millie had regenerative anemia (if there is anything that is fortunate about our dogs having this disease!), but there are many dogs on this site who have successfully overcome non-regenerative anemia. It may require more blood transfusions, and quite often dogs who are non-regenerative have benefited from thyroid medication. Dr Dodds will be able to advise you on this for sure. Hugs to you and Gunner - hang in there! Sam & Millie.

Samantha Geelong Australia

I"m a huge fan of Bioprep. I think it has kept my dog healthy threw all the ups and downs of this disease. I dont know if it works or not. but I wouldnt have my dog stop taking it. I feel that it at least keeps my dog in her best condition while being on pred. So give it a try. I have a 18lbs dog and only give one pill a day. we have had her on this for over a year. In the begining the pred wasnt working, then started her on this and it was a huge turn around. no evidence that it was bio prep but in my heart it was.. Pam and Rosie

Pam IL

This thread was discussed between 18/01/2011 and 20/01/2011

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