Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Holly's bloodwork April 20, 2009

Hi all, Just wanted to share some great news! Got Holly's bloodwork back early this morning and GREAT numbers! Her hematocrit was 54.7 down just a little from 2 months ago, but at this point I do believe this is around her average range. She has been off of the aziathioprine now for 2 months and currently just taking 2mg of Prednisone on Monday & Friday. It was just so great looking at the blood results and only seeing 2 high marks compared to all the other ones in the past with highs and lows. Even her platelet count is now in normal range. The only one tiny thing that concerns me is that her Alkaline Phosphatase count went up 129 points to 465 as well as her Lipase only up about 50 points to 1100. So not quite sure why her Alkaline Phosphatase count is up especially after going off of the aziathioprine. Any thoughts on this from anyone?? She is still on the same dosage of milk thistle. I emailed Dr Dodds to see if we can now reduce prednisone and her thoughts on the increase of the Alkaline. It has been such a long road, 2 years, 1 month, but I do believe I can for sure see that light at the end of the tunnel. It is very close! Keeping all other fur-babies in our prayers. Linda

Linda Sapphire

Thi is great! I know you are on a cloud oer this great news.

Sandra TExas

that is really amazing, very happy for holly, 55 is an awesome count

Josh California

Linda, That is such wonderful news! Congratulations on the good mommy work you have done. It happened this way because your *daily care*. As for the high alkph. Combined with the high lipase I am going to guess that she has had some level of pancreatitis. Until you know for sure, and Dr. Dodds will be able to advise you better, keep Holly to a lower fat diet with smaller, more frequent, meals. Make sure she has access to clean water all the time. I would think about reducing the fat to less than 20% a day until you know what is happening. Watch for signs of discomfort and food refusal. Please keep us up to date Patrice

Patrice NYS

Way to go Holly!! thanks for the update Laurie

Laurie CA

Linda, That's a wonderful number. I'm glad Holly is doing so well after this two year battle. How long has she been on prednisone and when did you start weaning her off of it? I'm trying to decide what to do about Darcy's dosage. The holistic vet said maybe we should go down from 5mg/day to 2.5, but she hesitated when she said that. She said it was up to me. I don't want to rock the boat right now, because she's acting so good, but she has been on it since being diagnosed end July last year. She's still on the doxycycline, too, and the Soloxine. I've noticed a marked improvement since she's been on the doxy. Karen

Karen NC

Congrats, bravo!! Wonderful news for Holly! melissa and tiggs

melissa slc

Wow... thats great news... Well done to you both on all the hard work over the last few years Samantha & Madison

Samantha Perth Australia

Thanks everyone for your support! Patrice, I did hear back from Dr Dodds, and we are going to reduce prednisone to 1mg on Monday & Friday, as far as the ALK P she said she suspects because of extended usage of steriods, so I emailed her again to refresh her memory of how it had come down to 336 and now up again. How would we know if it was pancreatitis? The only other change that I did notice is her Neutrophills came down from 4824 to 3332 still in good range but like a 1500 point drop? Karen, Holly has been on Prednisone since first diagnosed in March 2007, at that time was 10mg a day. The first decrease in prednisone was done in July 2007 down to 7.5 mg but she had so many ups and downs with retic and other problems that it was held for months without doing to many decreases. She was originally put on cyclosporin and in June 2007 stopped that and next month started on aziathioprine because her PCV started to drop. What is Darcy's PCV count these days, sorry, so hard to keep up with everyone. So now I rely strictly on what Dr Dodds tells me, two months ago she mentioned that Holly might be one of the dogs that stays on very low dosage of prednisone for a long time, when I asked her why she thought this, she said to avoid a relapse. Hope this helps. Thanks, Linda

Linda Sapphire

Patrice, Just one more thing, we have Holly on Natural Balance dog food, the low fat stuff, but have noticed lately that she is not drinking near as much water as she used to when she was on the aziathioprine. Would that have anything do to with it?? Linda

Linda Sapphire

Oh yes, one other thing, the day that Holly refuses food, HA! will be a day that I will be really concerned. Even when she was having seizures when first diagnosed, she never lost her appetite at all which was SO amazing to us, she will snap your finger off if you let her, and knows exactly the time each and every meal, snack is coming, I am not kidding it is like having an alarm clock right next to you! She does get 3 tiny meals, breakfast, lunch and dinner, and then in between gets her natural cookies (1), rice cakes, green beans, apples and bannana. She is just a eating machine!!! Linda

Linda Sapphire

Linda, A dog with pancreatitis generally feels very ill and behaves that way. Vomiting and food refusal are high on the list. If she doesn't seem ill, then it is most likely not pancreatitis. A high lipase number is a common sign of pancreatitis but it is usually paired with another enzyme, amylase. Lipase can be associated with the liver as well, so this is most likely what is the problem. Go back to treating her as though she were on high doses of prednisone by providing protection to the liver. Restrict the load on it by looking carefully at the fat content of the food. But also look at the protein content. Try to aim for less than 24% total protein in each meal. 20% would be better. Some liver diets use 17%. The liver is the organ that follows the digestive tract in finishing up with digestion. It must process the final products of digesting fat, protein and sugars. But it also processes all the meds etc that are sent through the digestive tract! If it is overloaded, it will begin to respond with higher alkph, alt and even lipase numbers. These numbers indicate that liver cells are dying to process things and that there is a signal for new cells to be made. Dr. Dodds' liver diet is an excellent example of a diet that is designed to avoid stressing the liver. It doesn't include meat that contains red blood and there are enough other things in the diet besides the fish so that the protein content is lower. Neutrophils are white blood cells and their numbers are the largest of all the types. As long as they are within the normal range, I wouldn't be concerned. Humans and dogs fight off infections and other immune system problems all the time without our knowledge. It is when there are high numbers of WBC AND symptoms and signs of infection that it becomes apparent that the immune system is struggling. patrice

Patrice NYS

Way to go Holly!!! WOW 55 what an awesome number, Gingers pcv was only 40 at her highest and the last time she had it check it was down to 36. Tell Holly we are proud of her and she is definitely is a success story. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Linda, I am new to the group. Could you tell me, Holly's breed, age at diagnosis, and weight? During your 2 year weaning process, did she ever relapse? Congratulations on Holly's success! Ella, Bella, and Baby Henri

Ella Seattle

That is a great number. Hopefully the higer numbers will level off when you reduce the pred even more. Johnny & Tessy

Johnny

Linda, Great number for Holly! Hopefully the other out of range numbers will sort themselves out soon. Congrats to you both Penny

Penny Lytle Creek Calif

Patrice, as always THANK YOU for your detailed information, I always understand it when you tell it which is so GREAT to have someone like you here on this board. Holly is a happy girl these days, not acting sick at all, but I always just worry about everything and anything. I never realized that high protein would be hard on the liver, so good to know. And like you said on the Neutrophils are within normal range which is great, because when she was on the aziathioprine, those numbers were always very low as well as her WBC, but I just happened to notice it on the blood tests. The funny part was that we have not changed her diet in any way in the last year or so. Same apples, bannanas, green beans, rice cakes and of course her kibble, so I thought for sure that her ALK P would be even lower this time then 2 months ago after stopping the aziathioprine. And again it really is not that high, I mean it has been a lot higher in the past. So now hopefully since we are decreasing the prednisone again down to 1mg a day on Monday & Friday it will lower again. Dr Dodds did email back saying this: Dear Linda: ALK P is the "dump" enzyme of liver cell metabolism -- i.e. the feces of the liver cell. When levels go up it just means that the liver has been working harder. Jean Hi Ella, Holly is a dachshund, 4 years old now, was diagnosed at 2 years. When we first adopted her, she was really underweight at 10lbs to the point that all her ribs were showing, and of course over the last 2 years she is now up to 15lbs, so about 2-3lbs over weight, but I will let her have this after all she has been through. Basically never relapsed, after 6 months her PCV was mid 30's and then went to low 30's with lots of up and downs along the way in the following year. In the beginning it was always drilled in my head from her internist about the retic count, that is all the internist watched so each and every time that went up she would stop us from decreasing any meds. It was at that time about 6 months ago that I contacted Dr Dodds for help and she had us do an ultrasound and came up good and she told us from here on in, DO NOT test the retic count we are not going to worry about this anymore. So since the decreases with Dr Dodds, her PCV has been holding good. Linda

Linda Sapphire

This thread was discussed between 21/04/2009 and 22/04/2009

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