Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Help - AIHA and Phenibarbitol

Hi to you all, My 5.5 yr old Rottie Kayla began having Seizures about 4/5 months ago - we decided to see how frequent etc before treating and eventually started her on Phenibarbitol about 7 weeks ago - she collapsed on Monday and was rushed to the Vet. Coombes test is inconclusive but her PCV is 11 today and has just had her second transfusion - My vet is still administering Phenibarbitol - I think there is a link and this drug is the problem - anyone have any advise / articles / etc on this??? The Vet is saying she has AIHA but that Phenobarb has nothing to do with it - and taking her off the phenobarb will lead to seizure and in her weakened state this would most likely be fatal - PLEASE HELP? Anyone know any specialist VETs in this area I live in Wicklow Ireland. Many thanks in advance.

SineadB Ireland

Sinead, have they tested the thyroid yet for hypothyroidism? There's been links between hypothyroidism and seizures so I'd start there. Have you ever had the Phenobarbital levels checked? Have you had a chemistry panel done to check liver fuctions??? If not do so as soon as possible. I'm not sure of PB and AIHA but if I were you I'd get in contact with Dr. Dodds. She can consult with your vet for fairly cheap over the phone and she's the leading expert in treating htis disease. If anyone would know it would be her! Email her at hemopet@hotmail.com and keep it brief but concise. Is Kayla home now? My thoughts and prayers are with you all. Johnny & Tessy

Johnny

Sinead, Please read Misty's success story (March 2005) on Joanne's website. http://www.cloudnet.com/~jdickson/archives14.htm It looks like some dogs can have seizures as a co-symptom of AIHA. In Misty's case they did administer Phenibarbitol as part of the treatment and she recovered. I agree that another cluster of seizures could be very serious. This is a difficult decision for you to make and you don't have enough information to make it easily. There are some real experts in canine epilepsy. This website has been in existence for a long time and is the gold standard when it comes to information about canine epilepsy. I scanned quickly and there is a whole section on phenobarbital. http://www.canine-epilepsy.com/Resources.html There are 2 yahoo groups: k9epilepsy and k9eplileptics. In addition I found this very interesting webpage that has a support phone line. I cannot say whether this organization is still in existence.: http://www.canineepilepsysupport.co.uk/ Does your DOG have Epilepsy ? Do you feel alone and helpless ? Talk to us about it. The Canine Epilepsy Support Group was founded in 1991 by people like you, to help people like you. Talk to Anne Morley on:- Also, ask your vet if there is a remote possibility that these attacks that Kayla have been having are in fact not seizures but could be syncope episodes. I know first hand that they can look just like a seizure, but are really a "fainting" episode. This would be due to a reduced blood flow going to the brain. A place to start checking would be to see if Kayla's heart sounds good and an xray shows no enlargement. my best patrice

Patrice NYS

description of what a syncope episode looks like http://www.canine-epilepsy.com/Syncope.htm

Patrice NYS

Kayla is home after her second transfusion. Her PCV is 15. She has little appetite and is very thirsty - she can barely move. She was started on Phenibarbitol approx 6 weeks ago. On March 1st her Phenobaritone level was 105 (within reccomended range). On March 6th she was lethargic and on March 7th she collasped was taken to our Vet and on March 9th a PCV of 16 was recorded this droped to 11 and she recieved her first transfusion. Her count recovered to 15 and she came home, we decided to reduce the Phenobarbitol - she had a very minor 20 sec seizure March 10th - the vets advised increasing the Phenobarbitol again. She recieved her second transfusion today March 11th and is home tonight. Her current meds are twice daily - 5mls Antepsin 1 Pepid 30 mins later - 2 x prednisolne 25mg 2 x Imuran (just started today). 4 x 30 mg phenobarbitone She is barely able to move and eating little. I have read some articles / forums on links between Phenobarbitol and AIHA - some suggest stopping administering and dogs making a full recovery. This post is particularly interesting - does anyone know Sue below? Lisa, My 4 yr old Lhasa Apso Ernie was diagnosed with AIHA on 1st October, Like your Daisy he was on phenobarbital for seizures. To cut a very long story short it was eventually realised that the phenobarbital was what had actually CAUSED his AIHA. It's a rare reaction and not even my vet considered it until I found a couple of articles about it from veterinary publications. As soon as Ernie was taken off the phenobarb he started to improve and he has now been med free and perfectly healthy for nearly 3 months. This may not be anything to do with Daisys case but my first question would be how long has she been on phenobarb? The articles I found suggested that this reaction will happen within the first couple of months if it's going to happen at all. In Ernies case it was 6 weeks after starting phenobarb that he became ill. If any of this sounds relevant please post again, if it will help I'll mail you the articles I found and Ernies full history to show your vet. Sue Sue Northants UK

SineadB Ireland

What happened to my post???? It posted cause I saw it but now it's gone!!!

Johnny

I just saw this on a friends FB page!!! ..... "For pet owners who use phenobarbital for seizures for their pets. Please be warned that pheno barbital has been mis-labeled with hydrocondone 10 mg. / acetaminophen 500 mg. tablets basically Tylennol which is toxic and deadly to pets. If you suspect, please go to your pharmacist. Pets are dying from this mishap." Not sure if this applies to where you're located but thought it was a tad of usefull information. Is Kayla eating anything yet? It's important to get them eating. You may have to try home cooked goods for her to stimulate the appetite. When are you scheduled for another blood test? If you can remember you should ask for copies of the blood work. With regards to the PB....I'm just not sure and don't really know enough about the drugs used to treat seizures to comment further. Perhaps there may be holistic natural treatments you can look into. What you posted above about Sue is very interesting though. Would be worth further investigation. At the very least I'd be wanting to switch to one of the other drugs used in treating seizures just to be certain/safe. If I were you I'd be spacing the antepsin (carafate / sucralfate) further from the drug administering....by at least 2-3 hrs! If the stomach is coated then the drugs may not properly absorb. I'd also look into adding milk thistle daily with the food once Kayla starts to eat. Pet Tinic also but it may be hard to find there...hopefully some of the others here fromthe UK can chime in and might know where to get equivalents. Keep us posted on what happens. I'll be keeping Kayla in my thoughts and prayers. Johnny & Tessy

Johnny

Well that's a weird one!!! There it is now!

Johnny

Hi Johnny, She is eating very little - roast chicken hand fed only. I gave her some milk thistle earlier - she has vomited once today - that the fisrt time since this nightmare started. Her breathing is a little laboured and she isn't moving at all - she has gone out when we insist to pee and then returns to her bed more or less straight away. She is incredibly thirsty all the time. She is a little swollen - I would say retaining fluid and a little yellow in her gums and eyes. Her next bloods are due Monday. Awaiting a reply from Dr Dodds - if she has any advise I will be straight to the ER. As it stands she is due at the regular Vet on Monday - fingers crossed. Thanks for all your thoughts and prayers - hopefully we will still be here tomorrow and she starts to improve. Warm Regards, Sinead

Sinead Ireland

Eating, although it little bits, is a very good thing! You could try different things with her....scrambled eggs, steak (no butter), brocolli, boiled liver or beef heart, etc. She likely feels nauseated from the low blood levels and lack of oxygen circulating hte body. The excessive drinking is directly related to the prednisone...make sure she gets all the FRESH clean water she can handle. Be prepared to let her out every couple/few hrs and also be prepared for messes to be found on the floor! They really can't help this! It's alright to keep her very well rested and as stress free as possible. Have you considered giving the carafate (Antepsin) at a different time? I'd highly recommend changing the timing of this. ALSO, I'd recommend giving hte PB at a different time away from the prednisone and imuran. Try to give it at least a few hrs after or even a few hrs before?? Do you know if they checked his thyroid? If you feel concerned or worried in the least or if you feel she's taking a turn for the worse PLEASE do not hesitate to take her in to the ER vet. I don't want to scare you...only inform you that things can go downhill very quickly for some dogs and time is always an issue when dealing with these setbacks. Give Kayla some hugs and scritches for me. Johnny & Tessy

Johnny

Please know that Kayla is in my thoughts and prayers and I hope she can turn things around soon. I think it is encouraging that she is eating something even though a small amount, try different things that you think she will love, might have to be a little creative, somebody suggested giving her food on a dinner plate, so she thinks it is really special. The only thing my dog would eat was dog biscuits so that is what I gave her until the meds began to work and she felt better. Sometimes it takes time a few weeks for the medicines to begin to working so give her some time and take it day by day and look for very small improvements. Has your vet mentioned Cyclosporine? Sending a big hug to you and Kayla Cheryl & Ginger

Cheryl & Ginger Pinevile PA

more info on the phenobarbital recall http://atwork.avma.org/2011/03/10/important-recall-notice-mislabeled-phenobarbital-tablets/

Joanne MN

This thread was discussed between 11/03/2011 and 14/03/2011

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