Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Help sudden voracious appetite

first, I want to thank everyone on this board for the caring information you give and sharing your experiences to each of us. Wylie has this sudden voracious appetite. When she first went on the pred she was at 50# 15 mg twice a day, and she acted acted like she was starving. She has now been on 5 mg every other day for a month, no problem, that got much better, but the last 5 or so days she is again ravanous, my husband said today at lunch she practally bit his hand off for food, wihch she has never done, he said she was running around in this hyperactive state. This entire time she has been on again a half a 10 every other day. They gave me new pills, 5 mg which started on Friday, so she has had 3 doses, could these pills pill be formulated wong? she is acting like she on heavy duty pred. I know th sizes of colors othe the pred, her 1 mg were small round and these new ones are smaller oblong. or this the some other diseases that pop up mimicking this? I have an appt later this week but wanted some thoughts on this Thanks Laurie

Laurie CA

Boogie takes 1/2 a 5 mg pred once a day. Hers are small oblong. She has also gotten 5 mg that are small and round. I asked her vet and she said they are the same thing. Boogie's appetite also seems to vary. A couple weeks ago, her appetitite was pretty poor. Now she is hungry all the time again. Practically bites my finger off when I give her a treat. Her dosage is very small compared to what it was, so I'm not sure how all this works. I would think you have the correct dosage if it's smaller than what you had before. Sue

Sue Moorpark

Wylie had her check up on Wed. Her PCV is holding at 40. Except she lost 2# in 18 days. She lost 8# from the spenectomy and had been holding steady until recently. The vet ran a full liver and CBC the only thing is her ALT went from 119 to 138. He thinks her ravenous appetite is from not enough fat. I said she has been on this diet for 4 months now so suddenly losing weight along with the starving doesn make sense. I said I am feeding her a lot more she should be gaining weight. I have her on a homemade diet fo 50% chicken/nonfat yogurt, eggs and 50% carb, potato or oatmeal and veggies. m He wants me to add safflower oil to her diet I did write to Dr Dodds to see if she has any thoughts on this and am waiting to hear back Any other thoughts out there? Laurie

Laurie CA

Matilda has been reduced to 5mg prednisone every day for the past 4 weeks, and is getting ready to go to 5mg every other day starting Monday - if her blood work comes back good- and these past two weeks she is just a little wolverine around food. She has also developed a most disgusting habit of eating my other older girl's poo if I don't watch her like a hawk. I am thinking that maybe since the reduction of prednisone, her stomach feels a little better - and she just wants to eat - EVERYTHING. Her weight, however, has remained stable, so I don't think the fat content has anything to do with Matilda's reaction. Matilda is on a homemade diet as well - very similar to what you are doing Laurie. I would love to hear what D. Dodds says. jeanne

Jeanne Texas

Corticosteroids in large doses alters the body's fat redistribution and metabolism. Think of folks who are being treated with high doses who develop moon faces etc. In addition there is a great deal of muscle wasting over a period of time. Water will also redistribute and create a pot belly etc. All of these side effects really fall under the description for Cushing's disease. However the cause is the prednisone and the type is called Iatrogenic or caused by corticosteroids. (And thus reversible when the prednisone is removed) However, that won't instantly change the body composition back to it's normal state. There has been a great deal of muscle loss and fat has redistributed to many locations. Dogs thrive on high quality protein and moderate fat in their diet. Carbohydrates in the form of grains are not very digestible in dogs and in fact can cause digestive problems like gas. Other carb sources like vegetables are not very digestible unless they are processed. You can pulverize raw veggies or lightly cook and process them. This helps the transfer of the nutrients in them. Many ingredients in kibble type food are often just fillers (like peanut shells)and may lead to allergic reactions like skin problems. Dogs often have trouble with wheat, corn and soy for example. Adding oil to the diet is one quick way to add fat. However, it is simply adding fat calories. In addition, just adding large quantities of fat all of a sudden can lead to diarrhea or even overload the system and cause an attack of pancreatitis. Moderate amounts of high quality proteins and fat served out over several smaller meals a day combined with a 15-25% addition of steamed processed vegetables is an excellent diet for recovering dogs. If you do not know what a raw or homecooked diet consists of and would be leery of what we call raw meaty bones, then the addition of food grade steamed bone meal or crushed egg shell is *essential* to balance the ratio of calcium and phosphorus. This need not be a complex and costly project! There are many many resources on the internet for beginners who have never made their own dog food. The key is balance over a period of time rather than worrying about balance each day. The addition of a quality vitamin supplement will help even out any small nutrients you may miss. All of the ingredients I buy are human food grade at the store. I use eggs, ground turkey, ground beef, liver (use 1oz per 10 pound of dog per week: thus 100 lb dog gets about 10 ounces in 7 days), occasional tins of fish, cottage cheese, small amounts of yogurt, frozen vegetables like green beans and carrots (cooked and pureed) or fresh seasonal vegetabes, in addition to raw meaty bones. If you skip the bones, add in the ground eggshell or buy the bone meal (food grade). If there have been significant liver problems, use less beef products and add in more cooked fish. You can get frozen fillets for less money. Dr. Dodds likes to add white potatoes as well. Some dogs like small amounts of fruit. It depends on the dog. Cassie loves many fruits, Chance turns his nose up. Avoid raisins, they are very dangerous. Avocados are also questionable. A real treat and one that is easily digested by dogs (what we call medium chain fats) is virgin coconut oil. This is pretty pricey but used in small quantities (maybe a tsp or so a day depending on dog size). This can be used to increase fat calories over a period of time. A small 8 oz tub might cost $10 and last a month or more. It must be high quality virgin, not the white coconut oil that is sold for frying. After a period of time your dog will recover it's muscle back and appetite will even out. Fat deposits will reduce. It may take several months. Resist the urge to bring the body weight up to normal right away, as you will be adding more body fat and not muscle. Provide plenty of clean water during the day, remove in the evening to avoid nighttime accidents. Slowly increase activities to improve body tone, according to the dog's level of tolerance. patrice

Patrice NYS

Thanks for the info Patrice I do added eggshell. I am wondering with the spleen removed she needs to have her diet adjusted. She has been on this mox for 4 months with no change buit since having the spleen removed I wonder. I did hear from Dr Dodds and she said it could be inbalanced for her needs and suggested olive oil or coconut oil. I get the Whole dog jouranal there was a wonderful write up on coconut oil last year. We did think Wylie got a bout of pancreatitis a few years ago and she was in the hospotal for 3 days, the test was negative and we never did figure out what caused it so I am very scared of changing anythin especially with the spleen being removed and the AIHA. OKAY this morning she was not as ravenous so I wondering if its the Denysol, there are no know side effects and it could very well be the prednizone, her prednizone was dropped fro 5 mg every other day to 2.5, but still doesn't explain the weight loss. My other dog has been on a raw diet for years and has done extremly well and all the bacterial scare in the people food I have been trying ti switch him to high quality kibble, but he is having ear problems, and digestive problem so I am going to keep him on the raw.

Laurie CA

Laurie, That's good to hear that you have been doing this for a while! You have nothing to worry about because it sounds like you have done your research. I wrote it pretty generic for anyone else who has questions about a recovery diet. We have to look at the functions the spleen provided to see what is now missing. Since both you and I have dogs without spleens, it's pretty important to know this. I would have to say a major function of the spleen in dogs, (a little less in humans) is storage of blood. When there is a sudden great need for blood the spleen actually squeezes muscles around the spleen to put all that blood back into circulation. My vet calls it an instant transfusion. It happens in response to stress hormones like adrenaline. So in a dog without a spleen, there is no reserve and most all of the dog's blood is in circulation at all times. Other organs like the liver may store some blood. The next function is to act as a part of the immune system by producing and utilizing certain types of white cells for defense. This is actually one reason why some vets recommend splenectomy for AIHA. It reduces the activity of the defense system that has gone awry and is attacking the red blood cells. The next function is to help rid the body of older red blood cells that have become worn out at around 120 days. The spleen has narrow winding "tortuous" pathways that the cells must navigate, sometimes squeezing around corners to travel. When a RBC gets older it becomes more fragile and actually breaks apart as it tries to navigate the curves. The elements that made up the RBC are now recycled or eliminated. This is a normal body function. It is thought that the liver and kidneys help provide this function once the spleen is gone. Blood smears may show some odd blood elements in general circulation in dogs without spleens. Probably the most important function of the spleen is a very ancient need. Within those tortuous pathways, the spleen is able to break up RBC that contain certain diseases, like tick diseases, and the immune system is able to come to the rescue (via WBC) and destroy that suddenly exposed spirochete. Without the spleen, the dog is unable to mount much of a defense against tick and some other diseases. My vet warned that Chance would be, in essence, defenseless to something like lyme disease and contracting such diseases would be more life threatening. All that said, dogs and humans do quite well without a spleen. Nutritionally, which was your question, anything that contributes to providing the body with assistance to maintain proper blood volume is very important. I pay a little more attention to fluid in foods. Hot weather or excessive exercise can reduce the blood volume more quickly than in a dog carrying around a pint of so of extra blood in the spleen. Add in a sudden rush of barking at the fence and a spleenless dog may experience lower blood volume, sudden low O2 to the brain and feel faint. I am not sure what level of sodium should be added to a raw or cooked diet, but most foods have natural sodium. Perhaps in the summer a single shake of salt might add the right amount. In addition, most spleenless dogs are going to have a naturally lower normal PCV. Chance sits right around 37-39%. My vet did a small unscientific survey to find out what PCV all the dogs in her practice without spleens generally had and this was the case. Not to worry about except if there was some kind of urgent blood loss as in an accident. I think Wylie is very busy right now rebuilding loss muscle tissue and making all the other things like hormones that are needed to repair the body from illness. It certainly makes sense that he is hungry doing that. If you want to think of it as being similar to the craving that you and I have for certain foods: "I have to have a salad right now, or I need a glass of milk". There is probably a need for more protein and fat. Fat helps produce hormones for body functions. Proteins are the building blocks of cells. Carbs are simply energy. Dogs can create that kind of energy from protein and fat also, but easy to digest carbs are certainly ok to give a dog that has been ill. I have been paying a great deal of attention to vitamin and mineral needs, esp. the B group, C (in the form of easier to utilize Ester C), E and fish oil. In addition I give Chance regular B12 shots because tests show he is low in this. B12 is absorbed differently than other vitamins through a cellular process in the small intestine. If that process is faulty, it must be given parenterally, it cannot be absorbed via a vitamin pill. (B12 plays a particularly important role in blood production) Obvious needs for calcium and other minerals come from the raw meaty bones he gets. Iron comes from the small amount of liver in his diet. If foods like this aren't given, then there must be some other source to provide them. Patrice

Patrice NYS

Thank you Patrice for the in depth information. I havn't found anything that indepth in doing my research. I forgot you had mentioned awhile back Chance didn't have a spleen. Good to know about the excercise, because she does want to run around I also Found UC Davis, which is the the teaching hospital in Calif does dietery consult. so I Printed off the information and will pursue that. How many mg of vitamin C do you give? Laurie

Laurie CA

There is a lot of conflicting information about supplementing vit c in canines. Some breeders believe that this is an essential nutrient that helps prevent hip dysplasia in dogs that are genetically prone to it. Scientists and nutritionists might fall on the opposite side of the spectrum. I choose somewhere between the two extremes! Vit c is important in producing collagen, a building block of skin and bone, among other things. Thus, the thought that it helps prevent hip dysplasia by encouraging healthy bone growth. Relatives of Vit C such as the bioflavonoids and in particular Quercitin are known to be anti inflammatory and can be very helpful for dogs with allergies. So look for a vit c that has those additional ingredients that include citrus bioflavonoids, hesperidin and rutin and quercitin. All of these items are extremely safe. What is interesting to note is that the canine physiology of utilizing vit c is different that in humans. They have the ability to metabolize their own source of C. But, again, there is discussion about whether they produce an adequate amt or not! In any case, vit c is water soluble so in general the excess is washed out in the urine. However, it has been shown that excessive amounts generally leads to diarrhea. So, the guideline for vit c dosage most folks who feed a home made diet use is the diarrhea one. Start with a moderate amount and increase until there are loose stools, back off until the problem resolves. I use 1000mg daily for Chance at around 100lbs. So for a 50lb dog, try 500mg, 250mg for a 25mg dog and so on. Ester C or something similar is more easily digested. If a dog is particularly small, it might be an easier route to buy a specific canine vitamin for that size dog than to try to split vitamin pills. I know that many of the major dog supply sites on the internet have their own brand of vitamins. Read the ingredients, but don't expect to see any kind of regulation governing what's in them! It can be very different from brand to brand. I get most of my vitamins at vitacost and save a lot of money buying the ones I want. I also use Rite Aid a lot because they have BIGOF sales. My grocery store has their own brand which I often use for the C.

Patrice NYS

Thank you Patrice I have vitamin C I have been giving her, about 250 mgg a day and wasnt sure, because its pharmacuetical grade. I also bought some liver today and am unsure how much to give so I gave her a tsp. I am going to get coconut oil since I have read so many good things about it for dogs.

Laurie CA

This thread was discussed between 18/06/2008 and 29/06/2008

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