Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - I need to vet vent re Riley

I guess Im upset as the latest blood results for Riley are worse, but Im also upset at the lack of sensitivity that the vet displayed when conveying these results - she is not my regular vet and Im still holding a grudge against her when Riley had a major bleed at home and she said it was "just leftover blood from the previous bleed". Anyway, Riley's RBC has decreased in a week from 4.06 to 3.63 and the PVC from 0.34 to 0.29, less than the week before! I was hoping to be able to reduce the pred medication, but now have to put it up again to another half a tablet - I guess this is what it is all about, monitoring the medication and watching for the falls, but she was asking ME when the drops occurred and I said it was on file, to which she responded "oh its too long to read". !!! When I asked about the platelets, she said "its normal" and I asked for the number as this is where we first started and last week they were 691, and she didnt want to give them to me, until I told her that I was tracking everything quite closely, so grudgingly she told me they are 496. Im sorry, I guess I was hoping for better results as it seems to me that Riley seemed a little brighter, but I guess not, and I feel sad. I then rang back and spoke to the vet nurse who I am friendly with and expressed that I was concerned with the vet's attitude - and I said I did not wish to deal with her again. Oh yes, and the vet terminated the phone call to say "so then, are you happy with that?". How very empathetic of her. Thank you for allowing me to vent here.

Silka Melbourne Australia

Oh yes, and she inferred that I had changed the medication to give this result, to which I said "I would never do that". Why would I?

Silka Melbourne Australia

Sorry to hear the person you dealt with was a jerk. Don't give up. There are plenty of other vets who will be by your side helping you and guiding you and Riley. One bad apple won't spoil the whole bunch. Feels good to vent doesn't it!!!!! Hang in there and keep us posted. Counts are still pretty darn good, considering.. :)

Mardi Northern Calif

Thank you Mardi for your lovely encouraging comments, I needed that. :)

Silka Melbourne Australia

Silka, I cannot believe she would even suggest that you would alter the drugs. Thank heaven for this board or a lot of dogs would have lost the battle before they even got started thanks to some Vets that seem to get their egos ruffled when we do the footwork they should have been doing. Penny

Penny Lytle Creek Calif

Hi Silka, That's absolutely disgusting to hear she would suggest you altered Riley's medication. What an awful thing to suggest. If you need down the track if you continue to have problems (I know this isn't your regular vet), Millie is seeing Leonie Richards at the University of Melbourne Vet Clinic in Werribee. Leonie is awesome, and as well as being very knowledgeable on IMHA / AIHA, she genuinely loves all the animals she treats. Every time we go in to see Leonie for a check up, she always gives Millie a hug, and talks to her and tells Millie how happy she is to see her (I know Millie can't understand, but she gets the tone in Leonie's voice). Millie always gives Leonie a big tail wag in return and lots of licks! Leonie always listens to my concerns, and involves me in the decisions we make. A couple of times, I have preferred to do smaller med reductions than she recommended, and Leonie has been fine with it without taking it as if I am questioning her. I know Werribee is a fair drive from where you are (it's 40 mins for me), but I am so happy with Leonie, I would never take Millie anywhere else. Keep us posted on how Riley goes. When is his next check up? Sam.

Samantha Geelong Australia

Thanks folks, I know Im new to this game, but this call really upset me, and I guess I was upset also at the lack of improvement in the numbers as to be honest, I felt Riley's demeanour had somewhat improved - just the other day he did something that he used to always do - stole my tights from the bed when I got home from work and trotted off down the passage dragging them behind him with his little head stuck up in the air. Also, not only did she challenge me with the medication, she wanted to know when and what had changed, and I said "its on your file, you can see that" and lo and behold, her answer was "oh the file is too long and I dont want to read all that". Yes, disgusting - I was so upset that I called back and spoke to the vet nurse and said I did not want to deal with her ever again, and I do know that Kim, my regular vet, had changed me from having a blood count with her to somebody else, while she was away. Samantha, I am really heartened by your recommendations, and to be honest, I do want to go there to Werribee to get a second opinion on Riley's tests and condition to see if all that can be done is being done - do you think thats worth the drive over there one weekend? I guess I worry about Riley in the car for that distance, unless I take someone with me to hold him. I am certainly not arguing the point that Riley needs to get another half a tablet of the pred as that reduction is when the blood results changed, but I dont want to be treated like an idiot. Oh and another thing, I asked her on the phone what the reciculocyte count was as I have my own spreadsheet and I know this is fair indication of how the regeneration is going and she said "there is nothing there" which I found puzzling as well. When I collected the report, guess what - 258, up from 146! Yes indeed Penny, I agree with you wholeheartedly. I did my own research on these bloods, and with the help of comments and threads here, learning to understand how things are faring. Grrrr...thanks again, for your encouraging support.

Silka Melbourne Australia

Oh dear, I was so upset by this Ive repeated myself. Sorry :(

Silka Melbourne Australia

Silka, We all know that frustration! I remember a few substitute vets that we saw when our normal vet was out- one guy was incredulous that Tiggs' had even survived this long- I can't even remember his exact words, but they were something like 'wow, they usually die...' I think some vets just give up or blame the patient or parent because they are frustrated that a pill just can't fix it. Try to focus on Riley's clinical signs- like you said, Riley seems brighter- those signs can be so much more hopeful that what the numbers say! Hang in there, you're a great mom! melissa and tiggs

melissa slc

Silka, Last year, when Darcy was very, very sick, I had to deal with an egomaniac internal specialist. Those who have been on this board for a while know exactly what I'm talking about. I took so much abuse from her that it was ridiculous, but, at the time, I thought she was my only hope to save Darcy. Finding another vet hospital with internal specialists would have meant traveling a great distance, which would not have been practical as I was taking Darcy every week for checkups, etc. I finally had my fill of the internal specialist after she ranted at me nonstop for 15 minutes just before taking Darcy in for a transfusion. Part of this anger on her part was her jealousy of Dr. Dodds, who had been consulting with me about Darcy. She said some horrible things to me. I rid myself and Darcy of her and found a wonderful holistic vet who has made all the difference in the world. These vets and internal specialists are not God, even though some of them think they are just because they have all these diplomas hanging on their walls. Those who behave like this are very unprofessional and lacking in good judgement and manners. Perhaps this incident is a good thing because it will, hopefully, direct you to another vet who will be just right for you and who will make a positive difference. Oh, and I might add that it was a lay person, not a vet, who directed me on the right path to Darcy's healing, so the vets don't know everything. Good luck, and may God bless you and may He heal Riley. Karen

Karen NC

Silka, do you get them to do a smear when they take blood? I'm assumming the destruction is not occurring anymore since you started to reduce the meds. I'ld be a little iffy on uping the pred again because of a drop if there is no presence of destruction at any level. This has happened to Tessy several times. Her HCT would drop several points and right away the concern was if we should up the meds again. Each time I decided that if there was no destruction then let's leave well enough alone. Each time Tessy rebounded. She just dropped a few points on Tuesday to 32 from almost 36. This is not the first time this has happened. Great to hear the platelets are falling to within normal ranges. That's always a plus to hear! For a PCV of 29 the retic numbers sound about right. The increase shows that the marrow is responding right to the decrease in circulating blood. I bet if there is no destruction happening you'll see an increase in the crit at the next visit. One last thing.....seek out other opinions. This doctor sounds like a real idiot. I left our original vet because of almost the same thing. There's no need of it and they should be told. If you're still upset do what I do. Snuggle!!! Call Riley up with you and give a good rub down. Works everytime. Hugs for you & Riley. Johnny & Tessy

Johnny

Silka, Good heavens! What an awful way for the vet to treat you! It's so important for you to have a vet you have confidence in. I know when we were dealing with both of our dogs' illnesses I took great comfort in how our vet treated me as well as the dogs! You need all the support and morale boosting you can get so do whatever you need to to get Riley to someone who will treat you both with the respect and care you deserve. Even if this vet isn't your regular vet, hit & miss just isn't good enough! Good luck, Christina

Christina Campbell River

Silka, i have two fabulous Vets in Beaumaris they held my hand every step of the way with Belle's AIHA illness. Their phone number is 95895159 Andrew and Nina are at 22 North Concourse Beaumaris 3193. Originally they sent me to the Mt Waverley Specialits which confimred their diagnosis. I can't say Specialists were at all supportive towards the end of Belle's life but i had my beautiful Beaumaris vets that were on call 24hrs a day for us. Please call them for a chat and tell them Effie Politis refered you. Just hang in there it's very impotant to find someone you trust as it's the worst time of your life when you are trying to fight for Riley's. Sending you lots of strength, Effie.

Effie Melbourne Australia

Gosh, just typed out a long email and forgot to fill in the fields! Thank you Effie, Melissa, Karen and Johnny for the encouragement, this is such a hard thing as Im sure you know. I did stop into the vet this morning to collect a printout and Kim was there, and it was quiet, so she called me in to discuss Riley's results and I talked about the other vet - she was quite upset about the impact that it had on me and surprised at some of the things she had said. Johnny I think there is still destruction as this is what the pathology report stated: "continued regeneration but Hct (PCV) has declined from last submission. No spherocytes seen in the smear but continued destruction of RBCs is the most likely problem. The leukogram is typical of the so-called leukemoid response seen in some cases of IMHA and is due to a mix of the regenerative bone marrow, antigenic (antibody) stimulation and anoxic damage due to anaemia." Any further advice in this regard would be much appreciated. Im starting to doubt the pathology comments as well. So I guess we go back up a half dose as that is when the numbers dropped. Kim has recommended that it all be given in the one dose as I had been splitting, some in the morning and some in the evening to break it up, but she felt all at once gives Riley the best shot. She is going to discuss the results with her consulting specialist - the guy who did the ultrasound - and see what he has to say, as she is concerned about the high "band forms" up from 2.1 to 6.1 and normal is less than 0.4. Effie, thank you for those contact details, I will keep them, as much as I like Kim, I am keen to explore a second opinion so that the diagnosis is not so narrowly confined. Im so sorry to hear about Belle, as I dont know about that but I do see you being such a support to others and I admire that. Riley was at the emergency hospital for 5 days and they were good there, though some better than others, but they just worried about the platelet levels, Im surprised they did not tell me that Riley was anaemic. Very odd. Thank you everyone - I was having doubts today and spoke to Kim as to whether I was doing the right thing by Riley and she said she would be the first to tell me if I wasnt. Thanks Johnny for the therapy advice, sounds good to me, Riley loves a good massage. The clinical signs cant all be wrong can they? Perhaps Im too hung up on numbers. I hope this post takes. :)

Silka Melbourne Australia

Hi Silka, Riley sounds like he is doing fine in spite of your vet's attitude. Sometimes I think they forget that you are paying them, not the other way around. I went back to the original vet that treated Scruffy for a routine vac with my new pup and yes her attitude was just as bad. I guess I needed to see it again for myself. I asked her if she remembered Scruffy and she said oh yes, you went further with treatment than anyone else would of, like what I did in trying to save him was a complete waste of time. It just confirms that you really do need to find the right vet in the first place. I would consider going to Werribee if you need a second opinion, as I have only heard good reports about the University Hospital. regards Julie.

Julie Australia

Silka, i haven't gone into detail about Belle's 11 week struggle with AIHA as i don't want to discourage anyone's hope on this board. All the meds Belle was on pushed her anemia into remission but destroyed her liver and pancreas in a very short time.The hospital in Waverley was good, it was the Specialists across the road from there that were disappointing towards the end. Belle spent some nights at the Emergency hospital in Highett they too were fantastic. Silka i will never be the same i miss my girl with all my heart. Just keep fighting and hang in there that's all you and Riley can do. Many hugs and prayers to you both, Effie.

Effie Melbourne Australia

Just remember Silka, you're the main one who will be able to get Riley through this,you have to be his voice and do a lot of research yourself, and then find a vet that will work along with you, and not one who just wants to be in control! I completely understand your frustration with this rude egotistical and it sounds to me lazy vet(can't even be bothered to read the notes but she'll take YOUR hard earned money though!), but please don't let her upset you anymore, she's not worth it. You and Riley forge ahead together and get him stable,you're not the first, as you've read, to come across vets who, if some of us had listened to them, without question,they would not be here today. Good Luck Riley and Silka Kathleen and Nollaig

Kathleen North Ayrshire

Silka, I am sorry I have not been following your treatment of Riley closer. I have not had a lot of time to devote to reading here. I can help you some with understanding the lab results. The report that the reticulocytes are up: 258 from a previous 146 does indicate regeneration. This is a response to lower blood oxygen and is a normal response by the bone marrow. The cause is directly related to the lower number of red blood cells and thus the lower amount of oxygen making it to the cells of the body. Your lab report: "continued regeneration but Hct (PCV) has declined from last submission. No spherocytes seen in the smear but continued destruction of RBCs is the most likely problem." So the question is, why are there less red blood cells than before? The first thought, of course, is that there is continued destruction of RBC. The indicator that there are no spherocytes seen seems to point that maybe, no, there isn't current destruction in the circulating blood. These cells show up because the spleen takes a little "bite" out of the RBC, thus an indicator of some damage. They are not the only indicator to follow to look for RBC damage. For example monitoring bilirubin levels might help look for the side effects of a large number of RBC being damaged (this is a yellow coloring that is released into the system when RBC are destroyed, the liver and kidneys must try to process this excess. If they can't, it "leaks" into the tissues). Another factor in the lower number of RBC is that the reticulocytes are somehow unable to mature successfully into RBC. Why? Is there an immune attack on them in the bone marrow? Could there be a nutritional deficiency that is contributing to the poor maturation process? In many cases if the available B12 is low, there can be a poor maturation response. This can arise from small intestine problems with digestion. Other nutrients are also very important to the maturation process. Thus supplementation with a vitamin mineral supplement might be helpful. Dr. Dodds likes Pet Tinic. It's most likely on the vet's shelf and is relatively inexpensive. Your lab report: "The leukogram is typical of the so-called leukemoid response seen in some cases of IMHA and is due to a mix of the regenerative bone marrow, antigenic (antibody) stimulation and anoxic damage due to anaemia." From my reading the leukemoid response is generally considered benign. It indicates that there is an increase in the number of white blood cells. What this lab report is saying is that when the body stimulates the bone marrow to produce more red blood cells, it will also, in some cases, stimulate the production of more white blood cells. Both of these cells begin with the same precursor cell and so it stands to reason that they would increase too. Antibody stimulation means that the body is responding to some kind of infection and the immune system is being called to react to fight the infection. Anoxic damage means that the cells could be damaged due to the low level of oxygen in the blood. Your lab report: "high "band forms" up from 2.1 to 6.1 and normal is less than 0.4." This is a type of white blood cell that looks a certain way when examined under a microscope. When the technician examining the smear sees these WBC (neutrophils) with the granular contents shifted to one side, creating the look of a band, they will note this as a "band forms." There seems to be great inconsistency from one lab to the next on how these are counted and evaluated. Thus there is some question about diagnosing when there is uncertainty about the actual number of these. A high number of right shifted "band forms" may be an indicator of some kind of infection, megoblastic anemia (anemia due to poor B12/folic acid or as a response to "poisoning" by azathioprine, iron deficiency, or some kind of bone marrow disease. Whoa, lots of stuff. So the task of the diagnostician is to sort out all these things and figure out which one is the most likely cause. If this were me, I would begin addressing some of the easier to treat things, the nutritional causes. You can test the blood for B12, folic acid and iron. It's a pricey test. Supplementing for these nutrients is more complex. If there is low B12 and the cause is a small intestine malabsorption, then supplementing orally won't work. In this case, giving B12 shots is inexpensive and safe. You can learn to do this yourself easily. Folic acid is another B vitamin that can be low and supplemented. I would recommend, though, using a combined balanced B-50 supplement as trying to supplement one B vitamin without balancing it with others is not a good idea. Human vitamins are more stringently tested and would be an inexpensive source, this is what I use for Chance. I would not recommend supplementing with iron pills in large quantities unless your vet specifically advises this. You can, however, easily give fresh liver at about 1 ounce per 10 pounds of dog per week. If there is a borderline iron deficiency, this might be enough to help. Liver at higher amounts can lead to diarrhea so be cautious in your enthusiasm. If there is infection, your vet will want to treat with antibiotics. This remains to be seen if this is a cause. I know you are discouraged right now and the science is getting in the way. You want to help Riley but you feel trapped by the lack of explanation by your vet. I wish I could be in these examining rooms all the time to help interpret but that's not possible. Some vets may feel overwhelmed by these complex cases and have little experience treating them. This might be a reason for being "snappy." It's not an excuse for poor bedside manner. Try to avoid burning your bridges with this vet however. Thank them for their help and move on to another vet. I hope this has helped somewhat and not confused. my best patrice

Patrice NYS

Dear Patrice Thank you for your post, it is amazing. As it is Sunday here and the vet is only open for a short time,with my regular vet on duty, I am going to print this off and discuss with her. Now waiting for a call back, she has already spoken with me. Riley was not a well dog last night, vomiting and looking distressed. I took him to the emergency clinic and he has tested positive for pancreatitis, and they are concerned that he is still on all this medication, the full dose, and while the platelets are up the red blood cells are not, with the possble explanation being continued destruction - they want to keep him there and talk to a specialist today - she suspects it is Imuran causing this, but my vet says its is the pred that causes pancreatitis. I am stunned by the possibility of B12 deficiency as I did ask about B12 shots after something I read the other day but my vet said no - she is focused on the pred. There is indeed "lots of stuff" and Patrice, thank you for your contribution, I have printed out many of your posts as they are so clear and make sense. Silka

Silka Melbourne Australia

Silka, This answers the puzzle for me. Pancreatitis is one cause of this inflammation. Prednisone can indeed be involved in this. Pancreatitis can lead to poorly digested food (as the pancreas is responsible for making digestive enzymes as well as insulin) and even inflammation of the small intestine, so it is possible that there is malabsorption of B12. Immediate treatment is to rest the digestive system 24-48 hours (no solid food) and give intravenous fluids. I am not sure if they can withdraw all his meds or not, this would be their call and I would take their advice one way or the other. We can hope that this was a moderate attack and that Riley will recover from this. You will be getting dietary recommendations from the emergency clinic before they will release him. While this is serious, there is a good chance he can recover with good veterinary care. You did the right thing taking him to an emergency clinic. This is a painful condition. By the way, the test they most likely used to test for pancreatitis, cPL, is one of the most accurate tests available and is manufactured by Idexx. Here is a specific treatment protocol recommended by Idexx: http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/reference-laboratories/spec-cpl-treatment-for-canine-pancreatitis.pdf If you would like to read more about canine pancreatitis you can go to this link. Look at the right lower screen for more links to articles about this. http://www.idexx.com/view/xhtml/en_us/smallanimal/inhouse/snap/cpl.jsf?selectedTab=Accuracy I will be thinking about Riley tonight. my best patrice

Patrice NYS

Dear Patrice You bring me to tears with the time you take with your posts and your knowledge is amazing. Your posts are leading me to other things I have printed with focus on this - the treatment you have indicated is exactly what is happening at present, on fluids and no food. I think the emergency clinic will be taking advice from specialists in regard to medication - there is a specialist centre across the road from them and they are indicating that they would like me to see them with Riley. My vet also said that he is in the right place with being able to be closely monitored. It is hard when your dog cannot tell you what is what, but Riley somehow seemed to be telling me he needed help - kept pushing his way into my room and sitting beside the bed staring at me. I thought he wanted to get up to sleep, but very restless, moving around, no doubt the pain. We stared at each other and I realised he needed something I couldnt give him and when I went into the lounge, there was the evidence. (The vet problem I had is now the least of my problems). I will now follow those links you provided to learn more. Thank you again! Silka

Silka Melbourne Austrralia

Hi again Patrice - do you think that this ongoing "possible inflammation" which has been appearing on the pathology reports and subsequently treated with a 2 lots of ten days of Baytril antibiotics, has actually been the start of pancreatitis? The site that one of your links led me to is indicating that azathioprine whould be withdrawn. Ill visit Riley today and see what the emergency staff have to say. Silka

Silka Melbourne Australia

I am so sorry Riley is having such a difficult time right now. You must be frantic. I will keep you and Riley in my thoughts and prayers. He is a little fighter and I'm sure he'll bring himself out of this. Stay strong.

Mardi Northern Calif

Silka, Both prednisone and Imuran (azathiprine) seem to contribute to pancreatitis, among many things. Though there is some evidence that prednisone may not be as guilty as it once was thought to be. Withdrawing the prednisone suddenly would be somewhat dangerous depending on the current dosage. (Is it at a high, immunosuppressive dose or a much smaller maintenance dose.) I am not as clear about withdrawal of the Imuran and would defer to your vet's experience with this. But it is known to be sometimes suppressive of the bone marrow. Pancreatitis is a condition of inflammation. The strong digestive enzymes that it produces (which are normally channeled to the small intestine along special ducts) manage to instead attack the tissues of the pancreas. This causes inflammation, destruction and pain. It can be quite painful and this can, in and of itself, increase stress and thus increase stress hormones creating a cycle of pain and inflammation. The cPL test measures exactly this, the level of inflammation systemically, or throughout the body. So yes, I think that Riley may have been borderline with some level of pancreatitis for some bit of time. There are two different categories of pancreatitis, acute (happening suddenly) and chronic (over a period of time). The skill of the nurses that are attending to Riley are critical right now. They are managing his fluids carefully and monitoring his body systems closely to ensure that he stay STABLE. He should be feeling much better in a day or two. my best patrice

Patrice NYS

Thank you Mardi, your words mean a lot to me. Riley is having a tough time right now, and he keeps on in there, I dont know how - if I was him I would possibly have given up. They are confused about the hemolysis and why it is continuing - for the moment they are cautious about the medication, but have gone to every other day for the azathioprine (Imuran) - the vet at the emergency clinic spoke to a specialist and it is hard to know which drug causes what. They brought Riley in to me and he is struggling somewhat, some whimpering with his rapid breathing, very hard to watch, as Im sure many of you would know. I may be able to bring him home tomorrow morning (Monday). Patrice not sure that they did use that test, when I asked about the biochemistry results, the red blood cells have dropped a little from 3.6 to 3.3, but the PCV holding steady at 29 - she said he is not anaemic enough for a blood transfusion - I didnt even think he would need that! From what I understood they used the amylase number, and for the life of me I cannot recall what that was - I need to get a copy of that. On the funny side, I have a typed document with all the blood tests in a table and they asked if they could have it and they have been using it, saying it was the most amazing thing they have seen! I think that was a compliment, but its the best way I know to see the the grid of all the results. Thanks again everyone.

Silka Melbourne Australia

HI again Patrice, I thought you may have gone to bed! We must have been posting at the same time. The prednisone Riley is on are 5 mg tablets and he started on these on 3 September at 2.5 tablets twice a day - as his results improved, he was dropped to 2.5 tablets once a day - and last week, dropped to 2 tablets once a day, but when things didnt continue to improve and went down, he was increased that half tablet again to 2.5 tablets once per day. The Imuran is a half tablet once per day (I just went to check the dosage but the medications have been left with the emergency clinic) - and today I was told they have decreased it to half every other day. I dont know how to measure the skills of the vets at the clinic, I just know that I like the idea of Riley being monitored 24 hours a day, and the vet I spoke to today remembered me, and when I saw her face I remembered her as well - I also noticed she had the most letters after her name on the "staff on duty board" if that means anything. Patrice? I really do not wish to take advantage of your knowledge and your good nature, but would you look at the results if I email them to you? I asked about the diet when Riley comes home and they said they would give me some food - low in fat and highly digestible, much like you said Patrice. PS. I dont think we have Pet Tinic here, I will have to check.

Silka Australia

Silka hang in there i am sending you and Riley loads of prayers.

Effie Melbourne Australia

Remembering Riley in my prayers,he can get through this thanks to his attentive and observant Mummy getting him the emergency treatment he needed. Great idea of yours to have a spreadsheet with all blood results. Nollaig had to be taken off imuran(azathioprine) with immediate effect as it was lowering her white cell count to a dangerously low level,it was not helping her red cell count to rise anyway,but even if it had been, the specialist vet told me,there's just no way we would keep her on a drug that could kill her in other ways.It turned out trying to stop destruction with immunosuppressants was not the answer for Nollaig anyway(she has prca non regenerative anaemia in the marrow)but a combination of other things. So don't worry Silka, if it turns out these drugs are making him sick, there are alternatives the vets can try. All the best Kathleen and Nollaig

Kathleen North Ayrshire

Sending our thoughts and prayers for Riley, we hope he can home soon. Cheryl & Ginger

Cheryl & Ginger Pinevile pa

Hi all, thank you for the encouragement, as always. I should thank Brigitte for inviting me over here, again! Well I called the clinic at 5.30am as requested, and they had good reports that Riley is bright and doing well and eating and I can collect him at 7.00am and put him on a bland diet etc. Imuran has been tapered back to every other day - none today - so lets see how that goes. Kathleen, Riley's white cells are high, always with suspected infection, so perhaps this was the pancreatitis brewing, I dont know. I would love to see him come off this drug cocktail that he is on. Yesterday when I visited Riley, he seemed uncomfortable and I told them that - apparently poor little tacker had a full bladder - no wonder he was staring at the door constantly, I guess he though if anyone would let him out, it would be me! I love the way you talk about us in terms of being the "mommy" - I smiled when I was called out of the waiting room yesterday as "Riley's mum". Again, thank you all. Its nice to know Im not alone with this. Silka

Silka Melbourne Australia

Brilliant news Riley, going home where you belong! Again Silka, pat yourself on the back for acting fast,and getting Riley over,hopefully,his only hurdle on the way to recovery. Do what I do with Nollaig a lot, take Riley's face in your hands look him in the eyes and say 'Riley's body is healing itself' and talk and sing to him,he will then pick up on your positive energy and vibes. Enjoy bringing him home. Take care Kathleen and Nollaig

Kathleen North Ayrshire

Hi Silka, how good to hear Riley going home where he belongs. How great to have Pratrice "decipher" the lab reports. Vets always seem reluctant to discuss them with you, like you don't count. In my case I don't think the vet had any idea what it read either. I always remember studying Scruffy's lab report but not understanding it at all and no vet explanation for it either, when you are going through so much and just need to know what is happening. I hope he recovers quickly from his stay at the vet. regards Julie.

Julie Australia

Riley is home and very lethargic, sleeping a lot but coming to life when there is food around. I tested something to see if he did respond to me opening the side gate as he loves going out the front - and that worked, he magically appeared. I hope he will be ok, of course he is still anaemic. Im now looking for supplements recommended on here and also by Patrice, but not available in Australia - very disappointing. I did what you said Kathleen. :) I know Julie, I dont understand - have to ask lots of questions, but the biochemistry area has me baffled, and though some of the results are high, they dont alert you to them.

Silka Melbourne Australia

Silka Were you not thinking of starting bioprep? The reason I ask is it has a whole combination of essential vitamins and minerals and enzymes required (so no need to have a whole bunch of other supplements too) including Vit B12 but I also started the vet giving Nollaig vit. B12 injection every 3 weeks at the same time of starting bioprep so she's had 3 in total now(I just said I wanted that and so he agreed to do it).If you read the info on bioprep you'll see it says the dog's body breaks down bioprep easier at it is a whole food rather than having to process individual oral supplements.This website is very informative www.bioage.com Again just a suggestion and if you've any questions or worries about bioprep and it's vit enzyme contents etc I would contact both Russell Louie at Optimum Choices but even better the Kiriac's directly (who are the ones who did years and years of research and had to prove to the Canadian government on the safety and efficacy of it's use both in humans and animals) just go to their website www.bionutrition.ca and contact them there. I also feed Nollaig a well balanced diet( she gets orijen grain free kibble(grain free recommended by Dr Dodds)http://www.orijen.ca/orijen/about/ mixed in with a premium holistic wet dog food called nature diet http://www.naturediet.co.uk/ I also add in little cooked organic chicken or very small amounts of liver or oily fish(every lunchtime she gets a sardine in spring water as no salt added to that) and I give her plenty of steamed veg -sweet potatoes/button sprouts/peas/carrots/broccoli/very small amounts of spinach.I just vary all of the above day to day to make sure she's getting a well balanced diet. I know atmoment you have to stick to the special diet the vets gave you until he recovers from this bout of pancreatitis but I presumeonce he's recovered you can get him back on a normal well balanced diet. Just thoughtI'd let you know how I got Nollaig back on road to recovery. I truly believe in the power of positivity so keep encouraging Riley by your words and actions. Take care Kathleen and Nollaig

Kathleen North Ayrshire

Silka Noticed that orijen foods are no longer available in Australia as due to your countries strict import laws,the government were actually irradiating the food prior to distribution(as it contains fresh fish/chicken etc) and that caused a lot of illness namely leukaemia among cats from these high levels of radiation, that's very scary actually and something I'll certainly be telling my sister(who emigrated to Sydney 5 years ago)that they possibly do this to other fresh foods that are imported there?! This only applies to Australia as the other 49 countries that orijen is supplied to from Canada do not irradiate the food. Kathleen and Nollaig

Kathleen North Ayrshire

Silka, I certainly feel for you and Riley. Darcy developed pancreatitis right after having a transfusion. The internal specialist was never clear on exactly what brought it on, but she did lower her dose of Prednisone dramatically and stopped the Aziathioprine completely. I was never convinced that there wasn't something wrong with the blood, especially since, after her last transfusion with Dr. Dodds' greyhound blood, she had fantastic results. When she had the pancreatitis she was a very, very sick little girl and had to stay in the hospital on IVs for a few nights. It is so hard to be parted from them, but you have to do what's best for them to get them well. I'm so glad that Riley is back home with you. It is important not to feed him a high fat diet while he is recuperating, but I'm sure you know that by now. They sent us home with a special, low fat, canned food, which she was on for a week or two. My best wishes and prayers for you and Riley. Karen

Karen NC

Silka, so very happy your boy is home with his family. Always a great sign that he is interested in his food and the side gate! Sending you lots of positive thoughts and prayers. Effie

Effie Melbourne Australia

Kathleen, I am looking at BioPrep and following the other thread quite intently, but have not pursued it at this stage. Thank you for all the other advice as Im going to go down the "home cooking" path, which I have pretty much done most of the time, but probably not as properly as I should. Karen, Riley did have a transfusion in the early days of September when he had the large bleed, and I would have to go back and check the blood readings re the white cells, but there always seemed to have been an inflammation somewhere, I just wonder what what you have said. The reports said the blood he had was a good match with no reaction. I too have the low fat canned food for Riley, but I do worry about all the medication he is on. Im a little depressed right now as to what Im putting Riley through, though I know many of you have had worse and somehow persevered to come out the other end. I have been reading the success stories - I just feel despondent right now. Again, I really appreciate your kind words of encouragement.

Silka Melbourne Australia

I know how you feel. I was torn on doing all I can to save Oliver and putting him through such a barrage of medication to do so. Ultimately, the choice was basically made for me. I still think that maybe I didn't do enough, maybe we could have kept trying and doing other things/medications. I will always live with the guilt and doubt and sorrow of Oliver not being here anymore and maybe it's my fault. I shouldn't, because I did do everything thing I could, but that's human nature I guess. My point is. Riley is home, he is fighting and hanging in there the best he can. Your his mom and you know what is best for Riley. You heart will lead you no matter how difficult the road may be. This disease puts not only the pets but the moms and dads through so much also. Keep your spirits up. Allow yourself to feel all the emotions, then bring yourself up and keep fighting along with Riley. I'll be thinking of you two.....

Mardi Northern Calif

Silka, I understand exactly how you are feeling because I was once there myself, not knowing what to do and if the meds were helping or hurting. I haven't been following the forum for a while, so please forgive me for not knowing Riley's history. I will tell you that it was Doxycycline that ultimately helped turn Darcy around and start regenerating. She was initially diagnosed with non-regenerative anemia and that was the only diagnosis I was ever given. She went through all the expensive immune suppressants like Cyclosporine and was on the Azathiroprine and Prednisone. When she was at her very worse, PCV below 8%, I quit having her PCV checked and took her off of everything except the low dose of Pred, low dose of Soloxine, and added in the Doxycycline. We were also doing the anabiolic steroid injections and Vitamin B12 injections. It took a few weeks, but she finally started turning around. At last check, her PCV was 37%. She is on 100 mg. of Doxy once daily and .2 mg Soloxine once daily. Aside from the supplements and a healthy diet, that is all she is getting. I hope that Darcy's story helps to encourage you. I pray that Riley will be feeling better soon. Karen

Karen NC

Thank you Mardi and Karen, your posts mean a great deal to me right now. I believe my heart will lead me down the right path, and there is all those things, guilt etc, but somehow Riley is hanging in there. Your posts are from different angles, but both so helpful to me. Im sad about Oliver, and all the dogs that are going through this, and hopeful when I read about Darcy. I think Mardi you posted that Riley's numbers were still pretty good, and I dont think his PCV has ever been below double numbers, so yes I am encouraged. Thank you!

Silka Melbourne Australia

Yes, indeed. I believe that Riley's numbers are still VERY good. You should be encouraged! Like I said hang in there. Riley is a tough little cookie, it sounds like. That is a very good thing. You both take very good care of yourselves.

Mardi Northern Calif

This thread was discussed between 16/10/2009 and 21/10/2009

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