Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - I need some best/worse case replies

I know we are not far into this (diagnosed 7/16, ill for 1 week prior) but the food thing has me a bit overwhelmed Bonnie's PCV/HCT did come up from 17% to 22% in a week (last appt was 7/28) and she is VERY playful with a great attitude much of the time. Although she has bit stretches of blah However she has gone from a dog that inhales everything in front of her to a dog that I spend as much as 1 1/2 hours 4 times a day trying to get her to eat SOMETHING She has gone from her normal weight of 79 lbs to her low of 62lbs at our last vet appt. ALL her muscle is gone. I have seen skinnier dogs but not many young dogs this de-conditioned Now most days through sheer persistance I do manage to get her to eat the targeted 4-5 cups or more of something in total a day She is not vomiting she just never wants what I have. Each and every meal is different What she ate yesterday is a total OMG gross today and so on. believe me I have tried everything from canned food of all varieties, canned tripe on up to meat of all types, mashed potatoes, scrambled eggs and so on. EVERYTHING Today was an especially poor food day, but a really good happy want to play day...... I have limited funds and while I adore and love this dog (I lost her dam the light of my existence just 2 1/2 years ago when this litter was 2 1/2 weeks old from bone cancer- she was 4 years 11 months old) and she is a near clone of her dam; I have to be realistic. Thusfar we have spent what, compared to many of you have spent, a "paltry" $1500 and counting on vet care and lots on food items Can some of you who have "been here" give me some good/bad stories for comparison of dogs at this same point? At what point do they start eating like real dogs? Stop looking like I should be on "Animal cops" and when did you decide to give it up? I have had many terminally ill dogs in my care in the past 10 years: sub aortic stenosis died at 14 months, plus several with cancer, 1 with diabetes and a couple who just got old. I have made life/death decisions on rescue dogs. I have this girl's almost 12 year old sire who is starting to "get old" fairly fast the last month. I am no stranger to death and grief This illness is just so cobweb like Thanks Diane and Bonnie

Rottlady NH USA

Diane, Bonnie is trying to fight two different illnesses, not just one. Dogs with autoimmune hemolytic anemia very rarely lose a significant amount of weight because they are on prednisone and that makes them very hungry. However, Prednisone is also a muscle waster and dogs tend to become very frail in appearance after being on the drug for more than a few weeks. Fat and water shift around, making dogs look dumpy. Dogs that have some form of tick disease are fighting a battle against a foreigner. They are usually put on doxycycline which is very hard on their stomach and that makes them not feel like eating. They can't figure out why they feel so nauseous and they naturally associate it with food. So they stop eating it. So there are two very serious events happening. We are hopeful the tick disease/bacteria battle is being won. And it is apparent that the autoimmune activity has ceased by the latest results of the blood test. So one battle is done, the other one we are unsure of. What has your vet told you about her prognosis? Has he/she seemed optimistic about this last blood test? I would weigh this carefully in making any decision. I can tell you what I did with Chance. I carefully monitored his "will to live." As long as he seemed interested in the world around him, what was going on in the household, barking at squirrels in the yard, happy to see a neighbor.... well I honored his desire to be around. If he still wanted to pee on the hydrant across the street, that was fine by me. And I did everything I could to see that he would survive, and he did. Does Bonnie seem like that to you? Is she happy to see you? Interested in the yard? Notices things happening out in the street? Or does she go off by herself and lie in a quiet dark corner? There is a drug called mirtazapine that is an antidepressant and it is used not only for senior adults, but also for dogs, to enhance appetite. It is very safe and works very well for dogs. My vet specialist prescribed it for Chance when his heart condition worsened. Within a week his appetite was back, not to normal, but he was coming to the bowl and eating! If Bonnie's lack of eating it upsetting you and you want to do something, then ask your vet if they will prescribe this for you. They can start with 7 pills to see if it will help. That won't cost very much money. If it works, then you can get more. Sometimes getting a dog to eat is like priming the pump. I would never tell someone on this forum to give up. But I also understand when it is time. I don't know enough of what the details are to say if this is that time or not. I do know that a close friend of mine told me in the first month that Chance was sick in 2007 that it was "time" and that I needed to have him put down. I didn't take her advice. Instead I contacted Dr. Dodds and she helped me save his life. He was with us for another 3 years after that. I had MANY special times with him after he got well and never regretted treating him. my best patrice

Patrice NYS

oh no Bonnie is still very up. She would love to chase the chipmunks, barks at people, tosses her toys. That is part of what is so hard. For the most part, with a few hours a day of blah. She seems really happy She is also starving and rushes each chance of food, but when offered any she wrinkles her nose, backs off and goes in the living room and lays down as far away from the item as possible. Sometimes she will dive in, eat what seems like with determination but after 1/4-1/2 cup she shuts off and goes away and lays down just like someone flipped a switch. she is no longer drooly or queasey looking and she does not vomit anymore Her once a day stool is soft formed

Rottlady NH USA

Please read some of the success stories http://www.cloudnet.com/~jdickson/successstories.htm There is hope for Bonnie:) Cheryl & Ginger

Cheryl & Ginger Pinevile Pa

Dear Diane, Bonnie sounds like she is certainly wanting to fight on.... I DO understand how frustrating it is to have a dog that is refusing food. I went through this with my Millie, and we really only got over it about 5 months ago. She'd have episodes about 2-3 weeks apart, where she would refuse food for some reason we could not put our finger on and this could go on for 4-5 days sometimes. I could not tempt her with anything. It must be one of the most frustrating things I've ever experienced, and we could not find a reason for it! Patrice also suggested to me at the time that we try Millie on Mirtazapine - and it worked wonders! I highly recommend it, and it helps you just as much because you are not anxious around feeding, which I'm sure they sense! Unfortunately, muscle wasting is a side effect of Prednisone usage, but when you can reduce Bonnie's pred, this will start to resolve. As Patrice said, the Doxy would be making her feel quite ill. Sounds like Bonnie is a fighter. Sam & Millie.

Samantha Geelong

well today got no better. For the first time in days and days she vomited. She did so 4 times. But not actual vomit. She regurgitated up a mid sized puddle of brown fluid. Not blood. Did not have a bad smell at all. A vaguely familiar smell but not bad or puke or digested food.. It is also stiicky but thin and water like no mucous She then decided to not eat at all so I caved and played the bad mom and force fed her 1 cup of teeny meatballs before her 6 ish pm pills I'm going to give her a sucralfate 1 hour prior to her 10 pm meal She acts like she feels yucky again, after being pretty up just non eating all day. She has not acted this dumpy since the day we hospitalized her (16th)

Rottlady NH USA

Diane, I am sorry to hear this. When is Bonnie's next PCV test and vet visit? Millie had consistent vomiting of brown bile before her IMHA diagnosis - which may not mean anything at all, but perhaps it's best to get a PCV done as soon as possible to ensure Bonnie's PCV is stablising/improving. How long has Bonnie been on sulcralfate? Do you also have her on Pepcid? When Millie was first diagnosed, they did not put Millie on stomach protectants at all. Of course she didn't eat, and then she had blood in her faeces due to damage to her stomach from the meds. I wonder if Bonnie has an ulcer or something due to the meds?? Can the vet prescribe something to help Bonnie if she has nausea? I wonder if Maxolon can be used if this doesn't interfere with any other meds.... Please do also ask your vet about Mirtazapine.... it worked wonders with Millie and will certainly ease your worries about food! I hope that things improve, thinking of you and hoping Bonnie can turn a corner. Sam & Millie.

Samantha Geelong Australia

today was the first day I have used the sucralfate. A friend had some for her old dog that just died and I called the vet office and asked if I could use it on Bonnie. They said yes just not more than twice a day because it does interfere with medication absorption I was using pepcid on Bonnie twice a day for the last week The brown stuff does not smell or look like bile, and it is NOT blood (not by look or smell) the vets were not concerned they think it is dissolved pills Her next visit is Wed tonight she did eat 1/2 cup of food on her own and then I force fed her another 1/2 cup. I feel like such a meany

Rottlady NH USA

Is Bonnie on Cyclosporine? I am hoping and praying today is a better day. Cheryl & Ginger

Cheryl & Ginger Pinevile Pa

If Bonnie is keeping the pills down, I wouldn't worry so much about the food just yet. If she is on prednisone, her appetite will improve over time. The illness makes her sick. You can try any kind of food to entice her. I used canned cat food. The prednisone will kick in full force soon, and you will be amazed at how much she will want to eat. At least her HCT numbers are going in the right direction. Good luck!!!! Ronda

Ronda Illinois

You should REALLY watch when you give the Doxy with respect to antacids. Make sure they are well apart from one another. Also, IMO, I think the doxy dose is too high. You are giving 150mg every six hours when perhaps you should be giving 150mg every 12 hours instead. Vomiting and nausea is a common side effect of Doxy and this is very likely the reason for the upset stomach. I'd also have them run a chemistry panel (A full one) ASAP. Do you know any of the current chem numbers? I know that with high liver values toxins can actually shunt to the brain and make them *feel* sick...thus causing nauseation and food withdrawal. Just a couple thoughts for you to ponder.

Johnny

This thread was discussed between 01/08/2010 and 02/08/2010

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