Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Ill Chihuahua - 13 years old

My 13-year-old Chihuahua Ebby had been losing weight for several months earlier this year. After various tests, the vet removed her spleen, which had a benign tumor, and after that she began to gain weight for awhile. Then a few weeks ago she began losing weight again, and tests showed her to be anemic--the vet said she is making red blood cells, but losing them somehow. Before Christmas we began giving her prednisone -- 5 mg twice a day (she weighs about 6 pounds). We took her in 3 days ago for a blood test, and her PCV had gone down to 19. Her regular vet is on holidays, and the vet we saw noted that she was breathing quickly. However, she had gained about 4 ounces. She said to continue the prednisone and bring her back later this week when her regular vet returns. Tonight (New Years Eve) she seems much worse. Her breathing is very laboured. However, she did eat a bit of dinner. I'm wondering if we should try to get in touch with an emergency vet tonight, or tomorrow. Before Christmas her vet mentioned that if her anemia didn't respond to the prednisone, her it might be caused by a tumour.

Lesley Robinson Canada

HI I would take her into the emergency vet asap. I hope she is ok. Lisa

Lisa Greig West Aust

Thanks for responding, Lisa. I think you are probably right. In this town there is always one vet on call, but there is no emergency clinic as such. I was worried that if we took her in on New Years Eve either the vet would tell us to euthanize her, or she would spend the night alone in cage. Anyway, she made it through the night into 2008, and actually seems a bit better this morning. She ate a bit of chicken this morning. However she seems very weak, and she is breathing very quickly. She doesn't look well. I'm trying to decide whether to take her to an emergency vet today (New Years Day) or wait until her regular vet opens tomorrow. I suppose if her PCV has gone down, she would have to breath fast to get oxygen. She really doesn't look good, and I fear she might die suddenly at any time :( Why does this sort of thing have to happen on a holiday when the vet is closed?

Lesley Canada

Lesley sorry to hear about Ebby, my dog Trixie hasn't really responded to her medication (pred) she has been on it since early October 2007, she had a bone marrow biopsy not so long ago, also ultrascan and there were no signs of tumors. I know what you are saying about why do things like this happen on or near a public holiday! I took Trixie to the vet xmas eve as I was a little concerned about her once again. The pred, you will find does have a few side affects. You will find lots of support here Lesley, being on this forum has helped me quite a lot, there is also so much information on AIHA here. Pren will cause rapid breathing, one of the side effects unfortunately. Please keep us posted. Tricia

Tricia UK

Lesley, It does sound like you need an emergency vet visit today someplace that can do a transfusion in case you need one. Your vet may be able to do this if they have experience doing transfusions. If this is your first transfusion, there will be no need for crossmatching it. The first one is "free" for dogs. Patrice

Patrice New York State

We took Ebby to the emergency vet this evening--fortunately it is a vet from her regular clinic who is on call tonight, so they have all her records. They gave her a bit of sedation, and put her on oxygen, and tested her blood. Her PCV has gone down to 15%. They are bringing in a donor dog and will give her a transfusion tonight. The vet also tapped her abdomen, which is distended, to make sure it wasn't distended with blood (it wasn't). The vet looked at her blood sample under the microscope and told us that there seem to be lots of immature blood cells--so she is still producing blood. The vet also gave her some more meds--can't remember the names. (I should have written them down). We are back home now, and Ebby had to stay at the vet. They will put her in an incubator so she can get oxygen, and keep warm. The vet said she would phone us later tonight to let us know how the transfusion goes. Thanks for all the info and advice. I do get the feeling the the vets think perhaps we should just euthanize her, perhaps because of her age. But we told them we want to give her a chance and do everything we can for her, as long as she isn't suffering. She seemed calm and relaxed when we left. I think they will keep her sedated. If she gets anxious she would use up more oxygen, I suppose. I'll keep you posted.

Lesley Canada

Hi Lesley My thoughts and prayers are with you. Hang in there, my original vet gave up on Bertie as he did not respond to the meds and had to have two blood transfusions and he got through, even though is was a tough time. Thinking of your Ebby. Lisa

Lisa West Aust

Lesley, I'm thinking of you and Ebby and hoping for a turn around. My dog, Duck, was down to a PCV of 5 at the crunch and ended up having 2 transfusions. That was 7 months ago and while we are still in the process of weaning him off a lot of meds, he seems like a perfectly healthy dog. Please keep us posted. deb and Duck

Debbie BC Canada

Lesley, Good for you for getting Ebby to the vet on a holiday. From reading your posts I am not sure if Ebby has been diagnosed with AIHA/IMHA for certain or not or if she has some other issue. However if you have not read my Web site on AIHA/IMHA as yet, I would urge you to do so when you can. The URL is http://www.cloudnet.com/~jdickson/ Be sure to follow the links on the first page to many other sites on AIHA/IMHA that will be very useful to you and do read the Success Stories pages. The will show you what has worked for other AIHA/IMHA dogs in terms of treatment options as well as give you a lot of HOPE. I am seeing more and more senior dogs diagnosed with AIHA/IMHA all the time. But they like younger dogs CAN and DO survive and go on to live happy healthy lives. I pray this will be the case for your dear Ebby as well. I know this is so hard so be assured that you and Ebby are in my thoughts and prayers during these most difficult days.

Joanne MN

Lesley, It is good to hear that you had access to such good care, even on a holiday. It sounds like they did all the right things. Our vet specialist was just as discouraging. I think sometimes they are used to having owners balk at the cost of the care. And they perhaps have not seen many successes in their own practice. Here you will find many successes and great hope. I have big dogs so 13 yr old sounds wonderful, but don't Chihuahua's live to be as old as 17 or 18? If it were me, I would not let it deter me in the least. If your vet saw regenerative cells, then already Ebby is preparing to recover to the best of her ability. Keep us up to date on her progress. My best, Patrice

Patrice New York State

The vet phoned us last night after Ebby's transfusion and said she was pinking up nicely. Then she phoned back a few hours later and told us that even after the transfusion, and being on oxygen, Ebby's rapid, distressed breathing continued, so she xrayed her and found that her lungs were filled with fluid. She tapped off fluid from her lungs, which gave her some relief. The vet suspected a blood clot in her lungs might be the problem. This morning the fluid in her lungs had returned, so the vet tapped off more. The vet sounded very discouraging this morning. We asked her to go ahead and do an ultrasound to look for a tumor, but she (the vet) seemed to be very doubtful and discouraging about it. However, she said she would try to do it. She said Ebby will have to lie on her back for the ultra sound, and this might make her difficult for her to breath. We asked her to do what she can, and to continue with the ultra sound if Ebby doesn't become too distressed. My husband is starting to say it might be better to let Ebby be euthanized now. Her other vet will be back on Friday (2 days), and I would prefer to get an opinion from him (but I don't want to say this to the vet who is caring for her now, for fear of giving offense). The vet who is caring for her now seems to be kind and competent, but she is young and perhaps somewhat inexperienced. I'm leery of her because several years ago one of my pugs, Leah, had nose bleeds and needed a biopsy to see if she had a cancer in her nose. The vet who is caring for Ebby now helped with the nose surgery on Leah, and spoke with us afterwards. She was VERY discouraging, and told us that Leah almost certainly had cancer and probably would die -- at least is that is what I remember. I remember being extremely upset. But the biopsy came back showing no cancer. The nose bleeds stopped. That was 3 years ago and Leah hasn't had a nose bleed since. She is lying on my lap as I type this. Anyway, the vet said she will try to do an ultra sound, and gave us instructions to phone her back in a few hours. My daughter (who is a vet tech) told us that a lot of vets aren't very experienced at reading ultra sounds, and she is planning to get her elderly toy poodle an ultra sound from a specialist from Vancouver who will be travelling to her city soon. So I wonder if perhaps the vet is discouraging us from getting an ultra sound because she hasn't much experience reading them. I think this vet is working alone in the clinic today, and the other vets are on holiday. Has anyone else had experience with a dog accumulating a lot of fluid in the lungs concurrent with the anemia problem? Last night the vet said she would send cells from the lung fluid to a pathologist to look for signs of cancer, but this morning she asked us doubtfully whether we still wanted to bother with that. Sorry this is so long and rambling. Thanks so much to anyone who has read through it all, and thank also for the good thoughts and prayers and information you all have provided. I read over most of the info on Joanne's web site, including the success stories. In the success stories, those that had updates telling that the dog had now passed on sometimes, someimes mentioned fluid in the lungs near the end. Is this something that can be recovered from? The vet still doesn't know what is causing any of this. She thinks the fluid is caused either by a tumor or a blood clot. Oh dear--I'm just not sure what to do. I don't want to euthanize her unless she is suffering and has no chance of recovery.

Lesley Canada

Lesley, I am so sorry to hear about your difficulties this morning. You have your hands full. It must be very hard to wait for the other vet to return. Another opinion is really a must in this situation. My initial reaction is that this may be congestive heart failure. These symptoms *could* be indicative of that. There are a number of tests that can be done and many drugs that can bring this under control. Here is a very short brochure that describes this condition: http://www.vet.upenn.edu/departments/csp/cardiology/brochures/Congestive%20Heart%20Failure.pdf It might be possible that a blood clot has caused this. A number of dogs on this list receive some kind of medication (from simple baby aspirin to coumadin) during the initial early stages of AIHA to prevent clots. An xray of the heart would tell a lot... but perhaps more to a specialist than a regular vet. Do you have access near you to any other specialists? A 24 hour hospital? My thoughts are with you, Patrice

Patrice New York State

A more scholarly look: http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00032.htm

Patrice New York State

Lesley, I agree another opinion is a MUST. So many vets know so little about AIHA/IMHA, that they are not willing to treat it as agressively as it should be treated and have too much of an ego problem to recommend another opinion. At the very least have this vet do a consult with a veterinary internal medicine specialist or a veterinary teaching hospital. Clots are indeed a huge problem with AIHA/IMHA so you might want to ask your vet about something for that such as baby asprin or heparin. I been doing this for 16 years now and I have never heard of coumadin used for AIHA/IMHA dogs. The drug of choice for clotting issues used by all the vets I have spoken with is heparin. In fact the Meisha's Hope Fund is sponsoring some studies in regard to heaprin so I have read up on it quite a bit. If this were my dog I would not even think of quitting the fight yet. As long as there is life there is always HOPE. Keeping you both in my thoughts and prayers.

Joanne MN

The vet did an ultrasound of her chest and abdomen, and thinks she sees tumors in both places. We don't know what to do. We discussed bringing her home, but she is on oxygen and intravenous fluid, in an incubator. We don't want to bring her home if that is going to make her breathing very laboured and fast, as it was before we took her in--she seemed to be very distressed when her breathing was like that--it must be horrible to feel as if you can't get enough oxygen--like drowning :{. She is still receiving prednisone and other medication for the AIHI, as well as something for a possible blood clot {Heparin?). After talking it over, we have decided not to bring her home now, but to leave her at the clinic and continue her treatment, at least for a few more days. Her other vet will be back Friday. (We probably have such a huge vet bill already that a few more days isn't going to make much difference.) I will not euthanize her without another opinion. I wish we were in a larger city that had specialists. The vet said if we wanted to investigate the tumours with surgery we would have to take her to Vancouver to a specialist, since she would be unable to survive regular anesthetic. It is four hours away over snowy mountain roads, and we don't have a place to stay there, and I have to go back to work in a few days. :( But there is always hope that the meds will kick in, and she will start to improve. They are keeping her comfortable with sedatives for now. I can't decide whether we should ask to come in and visit her or not. I don't want to get her upset--and it would be so sad for her not to be able to come home with us...

Lesley Canada

Joanne, Absolutely my error. Not coumadin, contraindicated because of bleeding problems. Getting mixed up between dogs and my father, who is congestive heart failure now. Patrice

Patrice New York State

Hi Lesley, So sorry to hear about all you have been going through the past few days. Can you tell us where you live? There have been a few people on the board recently from BC and possibly someone can recommend their vet if you are looking for a second opinion that is a bit closer to home for you than Vancouver. Do you really think Ebby will be upset to see you? Or would it comfort her? I tend to think most of our babes are pretty happy to see us, but if she will get very stressed when you go maybe that's not a great idea. You know her best. Good luck with everything, Christina

Christina Campbell River

Hi Lesley, So sorry. I'm new at all this, but just wanted to add that last week my Nips was in respiratory distress and had swelling (fluid) in her neck. I could hear the rales in her lungs. Doctor treated her with Lasix and she responded wonderfully--breathing became normal and all the swelling went away. Best of luck to you. You will be in my thoughts. Shirley

Shirley

Lesley, I am sorry you are having such a difficult time right now. I hope Ebby turns it around. You never know from day to day things can change so much. I will be keeping you both in my prayers and thoughts. Penny

Penny Lytle Creek Calif

Lesley: Please keep us posted on little Ebby's progress. My terrier mix was diagnosed with AIHA on October 19. After three transfusions, she began to improve steadily and consistently. Shortly after her diagnosis, she accumulated a ton of fluid (not blood) in her abodmen. It resolved itself about two weeks after it appeared. The vets never figured out what caused it - even with an ultrasound. My previous dog (a cocker-corgi mix) suffered congestive heart failure for nine months. I rigged up an oxygen "tent" (covered a regular kennel with plastic sheeting and channeled oxygen from a home health agency into the kennel) for Toby to use at home when his breathing became labored. It kept him going (with a good quality of life) for six months longer than the doctors expected. I'd be happy to share detailed instructions for rigging an oxygen tent for Ebby if you decide to bring her home. Best of luck to you all! Sandy

Sandy Utah

This thread was discussed between 01/01/2008 and 03/01/2008

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

This thread is from the Vetnet archive. The live Vetnet forum is active now.