Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - I am so confused

I am so confused, and I am getting more confused and scared with each post that I read. Last week I took my 6y/o female min pin to the vet with a yeast infection in her ears only to find out she was anemic. I took her to a specialist who confirmed it, but said we had caught it in time because she was at 30%. Negative for tick diseases, and every other thing they tested for. Ultra sound showed an enlarged liver. Diganosed with regenerative anemia due to hemolysis, autoimmune hemolytic anemia. She was put on 15mg prednisone, and 50mg cyclosporine 2x a day. She was just reduced to 10mg prednisone because she was at 33% but not as dehydrated. Also continue with the 50mg cyclosporine. I was under the assumption that the outlook was guarded, but she had a pretty good chance of beating it completely. I am just so confused. Could someone please fill me in here on what is going on, and what to expect? and I had no idea blood clots were a thing to look out for with this disease. I feel so helpless, feeling her heart race and constant panting. I just don't know what to do.

Darina CA

Hi Darina, Your situation is much more like mine with Dylan than many of these other cases it sounds like. Yes there is always a lot of work either way, but AIHA and destruction of mature red blood cells where the attack is stopped is easier than when it is deeper and in the bone marrow. If is still a fight, but you are not dealing with clots and no reticulocytes. Dylan is off all prednisone, her anemia is gone and although they can relapse, she is doing great and that can be your outcome too. Try to relax a little. Panting is from the prednisone, that is good! I will post more in a bit, just wanted to see if I could help you relax little before I get my coffee. Richard and Dog Dylan

Richard Burnaby

The prednisone has many side effects, increased drinking and peeing are the ones you will deal with the most to start with. What is your dog's weight and name (I like to know). Please relax, you are not alone. Your Doctor seems to be doing the right things, but there are more things you can do to helps still. The liver is likely enlarged from cleaning up the mess along with the other organs involved. Blood cells are being broken down, degraded and removed from the body like they are foreign invaders. AIHA is often "idiopathic," no known cause. I have no idea what caused Dylan's attack. Many of the other cases you are reading have very different problems with non-regenerative anemia, platelets and even White Blood Cells being attacked at very early stages, in the bone marrow for example. This does not sound like your case. And yes, you have caught this and stopped it, or at least slowed the progress sooner and it seems to be a slower process than in Dylan, which is good too. Dylan was almost dead in 4 days from her first symptom, since her attack was very, very fast, like some others I have heard of since. What you can do to help is: Pepcid AC (Famotidyne is generic form), 10mg 15 minutes or more before meals. Dylan did not do Cyclosporine, but I believe it needs to be given before meals on an empty stomach. Some do more for stomach protection to protect against ulcers, like sucralfate (vet prescribes), but this needs to be given when no other meds are given, don't worry, we can explain this better later. I gave Milk Thistle throughout Dylan's treatment. It helps the liver and there are other things you can do for the liver, so ask your vet what they recommend. Others will have suggestions soon. Pet Tinic is always suggested. This is an Iron Vitamin B supplement that really helps build Red Blood Cells. Most of us have had our dogs take this too. It is available at vets and online. The other thing you can do to help is calm reassurance. Dogs are very good at body language and your worry will be very concerning to your dog and have a negative impact. Yes outcomes are guarded, because there are so many difficult cases, but you may be one of the more lucky ones with a better prognosis (still a ton of work and a roller coaster ride though). Your dog is tired. That is all they feel. They are low on oxygen circulating to the body. They may actually not even notice it much, but it is still important to keep their activity restricted. They need all energy to fight the disease. And don't worry about panting, it is completely normal and not a worry. Once prednisone is reduced further it will go away. Prednisone is a hormone that stimulates metabolic activity which generates heat. They pant to reduce heat and keep body temp normal. It means the prednisone is working in their body. This is a good thing. We are here to help and you have come to the right place. There are many more people here with great knowledge and even more experience than your vet. Most recommend getting help from Dr. Dodd's, but quite frankly if your case is like Dylan's that is probably not necessary. at least not yet. Take care, lots of happy hugs for your pooch. Richard and my survivor, Dog Dylan (diagnosed March 19, off all meds July 6)

Richard Burnaby

Darina, I am so sorry you had to find this forum and what you and your dog are going through. Confusing describes it pretty well. Most of us had never heard of AIHA before our dogs got diagnosed. It is a steep learning curve, but you came to the right place for advice. I don't know what i would have done if i would not have found this board over 2 years ago when my dog was diagnosed. A very good source of information is the Meisha's Hope website that Joanne Dickson created: http://www.cloudnet.com/~jdickson/index.html Please make sure to go to the success stories because they will give you lots of hope that your little girl (what is her name?) can beat this. this is a serious disease, but many dogs have recovered and live a happy and healthy life after. Best wishes, Brigitte & the poodle boys

Brigitte BC

Quick note before I play with my dogs. You are very fortunate. You did catch this early and got a quick and correct diagnosis and have not seen the depths to which it can go. Dylan's PCV dropped to 20 in one day and was below 10 2 days later. She has slight brain damage from the anemia. Prednisone became her problem as she was very sensitive to it, but your doctor seems to be doing a good job with that. Just keep an eye out for anemia to get worse. I can help with understanding how to see that. Watch for infections etc, as the immune system is suppressed and stay clear of dogs outside your family. Dylan has a normal PCV and it bounced back quickly. I am currently working her back into shape as prednisone caused muscle loss in her. This is to deal with later, but she is doing absolutely fantastic for a dog who was near death 6 months ago. Your dog is doing great, everything is relative. Richard and Dylan.

Richard Burnaby

Hi, Darina, So sorry you are fighting this with your sweet pup! But sounds like you have caught this early, and that is a very good thing!! There are LOTS of success stories, and MANY dogs that recover from this. Richard has given you some great advice on meds, supplements, etc. I'd say it is a GREAT sign that your pup's PCV went up so quickly! She is responding to meds already!! Keep relying on the meds to do their work. Like Richard said, watch for any unusual signs, and new behaviors. It gets a bit easier as you go along. Hugs to you and your pup! Sally and Mr. B

Sally Louisiana

Darina~ Your dear doggie has a very good start on overcoming this disease. Try to stay calm and understand that it is a journey that we have all been on or are still on. We enjoy each day and are grateful to love & play, not taking anything for granted. Tori our 10 yr old miracle poodle, as her IMHA onset was sudden, critical and near fatalin Aug of 2010. She went into remission this past June, but is now in a battle with ITP, causing her body to not make enought platelets (the agent in the blood that causes it to clot). [This DOES NOT happen to many dogs, but for Tori it did.] Like you, we caught the ITP quickly and her chances to win this one, too is far greater than had we not be careful to note any change in her behavior, physical appearance, eating and playing habits. It is a confusing blood disorder, but the more you read and inform yourself the better you are at helping your pet and the vet. The treatment for AIHA/IMHA will cause some side-effects like, larger appetite, need for drinking water, frequent bathroom outings, a need to stay cool, panting and rapid heart beat, as you have already experienced and some muscle loss and weight gain. BUT, as she improves and the meds are slowly decreased, she will return "back to her self" by the time she fully recovers. This place has been a God Send to us. There are many more on here that can better help us to manuver through this. So hang in there! Keep positive and be hopeful. Blessings, Cindi & Tori (IMHA/ITP)

Cindi FL

Thank you guys for responding. Her name is Belle, and she's 6. Her regular vets said she was anemic, but that was the end of it. Not to worry, they said; but the word 'anemic' didn't sit well with me so I took her to the specialist that I used to take my first dog to when she got very sick (you name it, she had it... except for aneima). The specialist jumped on it immediately with the tests and the meds, and thank God I took her! She said we couldn't delay in treatment. I've never known a vet to go in during her off hours to make sure my dog was treated, but that's what happened and I'm so grateful; but it's all so much to absorb. Belle's a little chunky, she weighs 29lbs (but she's not a little Min Pin, she's actually a giant) so we have to have her on a very restricted diet because the Pred will put weight on her, 7oz already actually. I feel so sorry for her and helpless because she's so tired, so hot, and so flippin' hungry! I was told that with her being a meatball already that if she put on weight with the Pred, that the weight and the steroids could set her up for diabetes among other complications. I've learned to take her vitals, and take her temperature. She had a very high fever when this all started. Just touched her and new she had a fever, she was so hot. Sometimes it feels like her heart is pounding out of her chest, just beating so hard. What are some things to look out for? I find myself on edge whenever she moves, or I think I heard something weird, or the crazy panting starts. Thx :) I really appreciate it Darina

Darina CA

What did the vets say Belle had going on... Blessings, Cindi & Tori

Cindi FL

All I know is the autoimmune regenerative aneima diagnosis, I'm still trying to figure everything else out. Darina

Darina CA

One thing folks here (and on the Facebook IMHA group) recommended was to take Mr. Bentley's daily food intake, and split it into three smaller meals....so he now gets breakfast, lunch, and supper. This seems to help him from getting so ravenous at any point during the day. He too had the excess panting and thirst for awhile....soon he became tolerant of the prednisone, and those side effects have eased a bit. You may also see muscle loss in Belle, another common side effect of prednisone....it will slowly return once the med is reduced. I'd also suggest keeping a notebook for Belle....for several weeks, I kept a daily diary of Bentley's activity level, and anything different about his clinical signs (loose stool, more lethargy, etc). I also get copies of all of his labwork, so I can compare results week to week. If you get copies of Belle's latest CBC and post her numbers, we can give some info about what it all means....That has helped me understand what the illness does to Bentley's body. Keep an eye for the pink tongue and gums....that's a good sign for a good HCT!! You're doing fine, Darina....it's a lot to learn!!! Sally and Bentley

Sally Louisiana

Darina, You have come to the right Place! So many nice people here with good advice. We found this site when our Lucky was on her down hill. After she received a blood transfusion, it helped her for approx. 1 week. Her levels were in the 30's. She never went back up to where they said she should be. She'd decline go up a couple %'s drop more go up Etc. The Specialist called as Lucky was maxed out on all Medicines and she wouldn't improve. The Specialist Said that our Little Lucky had the worst case of Autoimmune Disease that she has ever seen. A blood Clot did contribute to her death, but she was Maxed out on all meds. for a long, long time. We had questions after reading these threads, We were just too late. Your Baby has a Good Chance. Look at what your vet. said as well as all of the "Success" stories on this site. I am amazed and so Happy for the others here. I think that Lucky may have been with us still, if we had known about this site. I didn't even know about Vitamin B's until I was told about it on here. The Vet thought that it was a Good idea. Just an Idea that was too late for our little Baby. Read these threads and get all of the information that you can and Don't be afraid to ask Questions. Luckys Little Girl told us Everyday, "Where there's Life, there's hope." Prayers for you and your Fur Friend.

Kathy Calif.

This thread was discussed between 20/09/2011 and 21/09/2011

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