Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - I'm losing my mind (Kiki)

THings were looking better for Kiki. Lastnight I went to see her, she was so happy. But somehow she developed like cherry eye. They were talking about possibly sending her home today. Last Wed AM she went in, she's been there since, but for one night home with me before going back in the following AM for her heavy breathing. Today her wbc is down from 26000 yesterday to 20000. I am going in to see her this AM and to talk to the vet, as the nurse isn't sure now that she's coming home today as planned. Ugh!! This poor dog, one thing after the other! Her oral chemo drug came in yesterday so she started that. She'll do that 4 days on, 3 days off. She has had 2 transfusions. Not sure if she'll need another. The pancreatitis is what got her last.

Kriss PA

Hi Kriss...I know what you mean about losing your mind. The first couple of weeks really does number on the ole nerves. Just remember that at least if she has to stay another night or so with the doctors she will get professional monitoring and care. You don't really want to rush to get her home unless she is stabilizing and starting to turn around. Do you know what her HCT is? When you go in to see her you should ask for copies of her tests. As far as the WBC dropping down to 20,000.....that just means that it is getting down to within normal range. Higher numbers here could be a sogn if infection or inflammation. Tessy had high WBC's at first and just recently dropped to normal levels. Her reference range is 6 - 17 so 20,000 would still be a bit high. I hope the best for you and Kiki and she'll be in my prayers today. Keep us posted on any updates you get. Johnny & Tessy

Johnny

Hi Johnny & Tessy! I just got her home. She's very tired. Yes, the doctor explained that the WBC going down is good! The nurse explained it wrong. Looks like her HCT is 18.2, PCV 18%. I have her printed history in front of me. She's very sleepy, doesn't even act excited to be home. She has what they think now is cherry eye, too. She's still dehydrated some, so we have to make sure she's drinking. Monday I take her back in for bloodwork again.

Kriss--Kiki's Home! PA

Hello Kriss, we have been there to, with almost loosing the mind. It is such a roller coaster ride and a long one at that. This being said, you have Kikki in good hands. Try to learn as much as you can about the disease and you will be better off in the long run. Keep reading the success stories and stay positive. Like Johnny said, it is a good thing to get copies of the bloodwork. It first sounds Greek, but after a while you start to know what is what and seeing trends. Don't hesitate to ask the vet lots of questions. Make a list before you go. A good vet will not mind to take the time. there is a lot of information on the internet too. Try and stay with the positive stuff, Joanne's website is perfect. When you go and see Kikki today, stroke her with intention and tell her you love her and do all that is in your power to get her healthy again. But ultimately she has to do it herself. If she is ready to do it she will. Try to get some rest now whyle Kikki is at the vet. You will be up a lot at night once she comes home. I will be thinking of you, Best wishes, Brigitte & Kahlu

Brigitte BC Canada

Kriss, great you got to take her home! That means the vet is confident she is getting better. For fluids, try to boil some chicken breast (it has to be lean chicken) Then let her drink the chicken broth. The chicken breast will be good in her food or to hide her pills. Best wishes, Brigitte & Kahlu

Brigitte BC Canada

Good to here Kiki is home. Tessy's HCT was also 18% when I brought her home. The main thing for now is to keep her as calm and rested as posible. Excitement and exercise should be avoided for now. Keep a bowl of clean fresh water down for her. Is she eating yet? You may want to start planning some meals for her. Eggs and chicken were big hits with Tessy at first as well as roast beef and liver. I used icecream also to put her meds in and she loved this. Might help you if she isn't eating much yet. Like Brigitte was saying....be prepared for some sleepless nights. There will most likely be accidents in the house....remember...this is the meds doing this and she really can't help it. Is she up and around or does she just rest? If you want to and you have the time you can post her blood results on here and we can help you to figure them out. Do you know if she is regenerative or not? Take care and give her hugs from Tessy & I. Johnny & Tessy

Johnny

well, not even an hour of having her home, I had to run her back in. Her breathing got very heavy again. Apparently the lasix was stopped, and she had more fluid buildup again, and some in her lungs. So they gave her a shot of lasix, and some pills. I have to run back again because they forgot to give me one of the meds for her that she needs tonight. She's had I don't know how many accidents already. I have to be careful cuz we have to clean it with bleach and gloves cuz of the chemo drugs they have her on. Her bloodresults this AM were: PCV CL 124 NA 154 CAL 8.2 K+ 3.5 TP 4.6 Album 2.2 total wbc 20760 WBC 20.76 HCT 18.2 RBC 2.00 HB 5.7 MCV 91.2 MCH 28.5 MCH 31.3 RDW 30.3 RSD 27.6 RET 201.4 Ret 10.07 PLA 287000 PCV 18% TS 5.4 I have no clue what any of it means. Have to find a puppy play yard or larger crate to keep her in when I'm not here and at night cuz of the other animals. I do have her in the kitchen and computer room with me, but the cat already jumped through her urine as she was going. No notice of when she's going to go--she just squats and goes.

Kriss PA

Hi Kriss, Hang in there. Try some pull ups to wrap around her waist. It must be so weird for them too, it was like tiggs was filled with 10 gallons of water, he peed so much. We also just laid a towel on his bed. I guess I'm still stumped about the need/use of the oral chemo drug. I don't know that I've ever read of anyone else hear using a chemo drug, but I'm no expert. She doesn't have a cancer right? I'll leave her bloodwork analysis to someone like Patrice, I hope she can help you sort through it. we are hoping and praying for the best for Kiki. I would still encourage you and your vet to consult an intenral med vet, or a teaching hospital, just to be sure you are on the right track, it's very reassuring. Thinking of you guys, hugs to kiki. melissa and tiggs

melissa slc

Hi Kriss I am glad to hear that Kiki is home and it sounds like you are taking great care of her and making sure she has everything she needs. Don't forget to try to make some time for yourself as you can become run down with all that's going on. Do you have a family member that can help you with the other dogs and you can just focus on Kiki. I know it is harder when you have multiple dogs as many of us on this thread do. Do you know why they have Kiki on a chemo drug and what is the name of the drug? Also when you have time can you please post a list of all the med's they have Kiki on and how many mg's and how much Kiki weighs. I know Dr Dodds recommends Pet Tinic and my vet has Ginger on it too, it is a vitamin supplement. Is Kiki eating for you at home? I had to buy one of those pill boxes with the days of the week on the to help me keep the medicine straight for Ginger and I still use one for her, it really does help.. Don't hesitant to ask your vet questions and if you don't feel comfortable with something you can contact Dr Dodds. Phone: (714) 891-2022 Fax: (714) 891-2123 e mail: hemopet@hotmail.com Just remember any improvement will come in baby steps and sometimes it is two steps forward and one step backward. Hang in there and as others have said take one day at a time and know that we are here to support you and Kiki. Sending our prayers your way, Cheryl & Ginger

Cheryl & Ginger Pineville PA

Kris...from what I can tell from the numbers above Kiki is highly regenerative. The most important numbers you'll want to keep an eye on is the RET's ...these stand for reticulocytes. Retics are the immature red blood cells created in the bone marrow. Higher numbers will show that the body is trying to combat the disease. The "M" values (mcv, mch, mchc) also backs this up by showing larger than normal red blood cells. Immature blood cells are larger than the older mature blood cells. This is good! PLA 287000....this is Kiki's platelet numbers and they are where they should be. This is also very good. Platelets serve a vital function in the formation of clots (cut repairers...stops bleeding, etc). Heavy breathing! I remember when I brought Tessy home there were times I thought she'ld blow the house down. It does ease up as she becomes better. She breathes heavy because the body is working overtime trying to pump oxygen around the body. The number above HB 5.7 (hemoglobin) represents the oxygen in the red blood. The reference range we use is 12-18. Once this number as well as the RBC and HCT climbs the breathing will get lighter. You think the breathing sounds weird...wait till she starts snoring (is she does). I had many sleepless nights from Tessy snoring. I do not really know a whole lot concerning fluid buildup. Fluid in the lungs would have me a bit concerned. Hopefully someone else can chime in on this one. For the time being, keep a good eye on her and get sleep when you can. Try to keep her well rested and keep her well hydrated. If you get overly worried then you should call her doctor...that's what they get payed the good money for! It's VERY important that she gets all her meds on time also. What does she take for meds? I'll send a prayer out to Kiki tonight. Hope you both the best. Johnny & Tessy

Johnny

Hi--I am not sure why the chemo drug, I think vet said until other stuff kicks in? She's not really eating. Once in awhile she'll nibble out of my hand. Here's what's happened so far (long!)--5/13--AM she had a 104.7 fever and was very lethargic. Took her in, they ran bloodwork and she was 19 pounds, about her normal weight. TBILI was 1.3, IN PH 2.1, AST 98, TRIG 124, GGT 25, ALK P 173, ALT G 218, serum sample hemolyzed +3, clean stick. CBC total count 12740, PCV 26%, platelet count 180,000, moderate anisocystosis, moderate polychromasia, many RBC's well filled, agglutination, few retic. Started on doxy 50mg, 1 capsule twice day, Imuran 50mg, 1/2 tablet once day, started on IV dexameth. Ultrasound showed some parenchymal change to spleen. 5/14-- added pepcid 10mg 1/2 tablet twice day, 30 minutes after carafate. PCV 26% TS 6.0 Tick serology came back lyme titer high but was vaccinated in March. Immune mediated panel partial indicative of likely autoimmune hemolytic anemia. 5/15--PCV down to 20%, started on pred 10mg twice day, cyclophosphamide and hivite 1/2 dropper, weighed 21 pounds filling with fluid, WBC total 23280. TS 4.4 some toxic neutrophils and bands, moderate polychromasia, rare large platelets. Vitemin B added to IV. Cytoxan dosing was 1.9ML slow IV for 4 days, off 3 days. Ordered 20mg capsules for next round of 4 days on. Changed to 20mg pepcid twice daily. 5/16--PCV 20%, TP 5.6, TWBC 31600, HCT 15.8, RDW 44.9, Ret 148.6, MCH High, Hb 6.7, MCV 121.3, MCH 42.4, RSD (-) 54.5, Ret 11.43, RBC 1.30. Then was sent home with the flush for the port that was kept in. She ended up back there in the AM on 5/17 due to her heavy breathing. I have to run for my son, but will post the rest of her history when I get back.

Kriss PA

Ok-- 5/17 AM she went back in. They did an xray of her, showed some fluid in/around her lungs. They did an ultrasound which showed fluid leaking into her stomach, with a full belly and thought that may be why she didn't have an appetite. PCV = 19% TS = 5.4 Got first transfusion-- Universal frozen plasma. Added ampicillin and flagyl, reglan 10mg 1/2 tablet 3 times day. Chewed extension, got ecollar. Perked up. Resting more comfortably during transfusion than prior. 5/18--IMCP (ana) negative, Coombs: 1:16> positive, High correlation with immunohemolytic anemia. Rheumatoid factor negative. PCV 22%, TS 5.6 Blood still agglutinating in tube. Hb 6.1, MCH 48.4 RDW 44.3, Ret 144.4 WBC 37, 740, RBC 1.26, MCV 105.2, MCH 45.9, RSD (-) 46.6 Ret 11.46, Alt (g 69, TBILI 0.8, Alk P 739, TP 4.1. Added Cerenia injfection. Gave the cytoxin. Large amount of fluid accumulation/swelling in abdomen, leg/paw slightly swollen. 5/19-- Gave cyclophosphamide, weight 22.6. Breathing heavier, weight increased from yesterday. Pitting edema in front legs. Serum Electorlytes (Na+, K+) TP 4.0, Album 1.8, WBC 34500, RBC 1.45, MCV 112.7, MCH 40.5, RSD (-) 53.4, Ret 13.27, NEU 31050, HCT 16.3, Hb 6.6, MCH 45.5, RDW 47.4, Ret 192.4, PLA 477,000, Mon 2760. PCV 20% slight anisocytosis, many macrocytes, moderate polychromasia, few howell jolly bodies, many spherocytes, serum icteric +1. Got cytosinx, Vitamin B, Potassium chloride, Burpen IV. Got anotehr transfustion hetastarch per internal specialist, and added vitamin E 200iu 1 time day and Denamarin 225mg 1 tablet once day. 5/20--PCV 18%, TS 5.6. Weight 22.1 Added lasix injectible. Ampicillin. WBC 36580 HCT 12.0, Hb 5.8 MCH HIGH, RDW High, Ret 119.1, PLA 495,000 RBC 0.91, MCV 132.3, MCH 48.3 RSD (-) 110.2, Ret 13.09 serum icteric +1 5/21--weight 21.5 got lasix injectible, serum electrolytes (Na+, K+), WBC 31740, HCT 14.8 Hb 5.7, MCH 42.5, RDW 43.8, Ret 192.8, PLA 472,000, RBC 1.34, MCV 110.2, MCH 38.5, RSD (-) 48.3, Ret 14.39 5/22-weight 20.6, got cytoxin, doxy, denamarin, pred, hivite, caraf slurry, ampicillin, flagyl. PCV 18%, wbc 26,100, HCT 13.2, Hb 6.0 MCH High, RDW 51.2, Ret 158.7, PLA 405,000, RBC 1.06, MCV 124.5, MCH 45.5, RSD (-) 63.7, Ret 14.97 Album 2.3, TP 4.7 Chewed IV so pulled. Eye slightly red/pink gland sticking up and eye verrs slightly up and outwards. 5/23--weight 21.4, PCV 18%, breathing mod hard, 60rr, mildlly increased lung sounds, groaning when picked up. Pink bulge at medial canthus, looks like cherry eye thought not inflammed. CL 124., NA+ 154., CAL 8.2, TP 4.6, Album 2.2, TWBC 20760, RBC 2.00, MCV 91.2, MCH 31.3, RSD (-) 27.6, Ret 10.07, HCT 18.2, Hb 5.7, MCH 28.5, RDW 30.3, Ret 201.4, PLA 287000, TS 5.4 this AM. Got discharge instructions and meds together to send home.

Kriss PA

Cheryl and Ginger--Hi! No, I don't know why they have her on a chemo drug. I haven't been told she has cancer. From what I think the vet said was to get a hold of the autoimmune since the meds took some time to kick in. Here is what I was sent home with: This AM she weighed 21.4 when I brought her home. She usually weighs about 19. This is all fluid. You can see it everywhere on her. The other day the vet told me that all of her cavities are filling with fluids from the low protein. I am trying everything under the sun to get her to eat. Somewhere along the line they thought she has pancreatitis also. But the vet said just get her to eat. Some days she will pick something and only want that all day. Then the next day it's something else. She's keeping me on my toes. I came home today with 3 plastic bags of foods that I took in for her to the hospital. Felt like I was leaving the grocery store instead of the hospital! Her meds are: Lasix 12.5mg 1 tablet once a day Flagyl 2ml twice a day Hi-Vite drops 1/2 dropper twice a day Pepcid 10mg 1/2 tablet twice a day, 30 min after carafate Carafate 1gr 5ml's 3 times a day (I do have to call on this tomorrow, as carafate 3 times a day, the pepcid says twice a day after carafate) Pred 20mg 1 tablet twice a day doxycycline 50mg 1 twice a day denamarin 225mg 1 tablet once day on empty stomach cyclophosphamide 20mg once a day (cytoxin) vitamin E 200IU at bedtime Imuran 50mg 1/2 tablet once a day

Kriss PA

Hi Kriss, don't painc about the Imuran my girl Belle who was diagnosed with this AIHA 4 weeks ago has just strated taking it 4 days ago. Check out Joanne's site it has info on this medication. My vet told me Belle has had the "big guns" added to her other meds of sulcralfate,Zantac syrup,Macrolone(cortisone)Misoprostal,Cyclosporin and now Imuran. Being in Australia the names maybe a little different but they are the same. I have found the last few days she has vomited a little after taking Imuran but it's there to help the immune system and do something to the T cells. Your vet will carefully monitor your baby this medication is to push her into remission. I have stumbled over this site a few weeks ago when our world started to fall apart i take comfort from all you lovely people and the love we all have for a babies. All our Love Effie and Belle.

effie Australia

Kriss here is the link for the Azathioprine (Imuran) sending you lots of prayers http://www.cloudnet.com/~jdickson/treatment.htm

effie Australia

Well, we made it overnight with her home. Hubby had to sleep on the kitchen floor with her as she kept barking. The other 5 are trying to figure out why she is being so spoiled, offered all kinds of foods, given meds (they think they are missing out on something!), and having someone sleep on the floor with her. I slept about 4-1/2 hours. Her breathing and noises are much worse when she's laying down, guess the fluids push on her belly/chest. Cheryl--I found this on Meisha's page, about the chemo drug cytoxan, that she is on: Some veterinarians advocate giving corticosteroids at least one week to work before adding other drugs to the treatment regimen while other veterinarians prefer to add cytotoxic drugs at presentation. Another potent drug used in the treatment of autoimmune hemolytic anemia is cyclophosphamide sold under the brand name Cytoxan. Cytoxan may be used in cases with severe hemolysis and agglutination. The usual manner in which Cytoxan is given is daily for 4 consecutive days per week, stop for 3 days and then repeat. Because of the potential for development of serious adverse effects, Cytoxan should only be used in patients who can be adequately and regularly monitored. Primary adverse effects in animals associated with Cytoxan are bone marrow suppression, gastroenterocolotis (nausea, vomiting, diarrhea) alopecia (hair loss) and hemorrhagic cystitis. Effie--thanks for the link! So you're a newbie too, here. It's a very confusing disease. I thought I was a mess when my cocker had to go through chemo. I think this is way worse!!

Kriss PA

Kriss, yes i'm a newbie it's an awful disease. Belle isn't 7 yet, she is a white maltese sh*tzu and the centre of our world. I feel so blessed my Vet and her specialist are holding my hand every step of the way.I have cried endless tears and haven't slept for over 5 weeks or left the house without someone being home to watch over Belle. Things are ok at the moment although she is a nightmare to feed. My vet helps by giving her all her meds twice a day (at no charge). She has been hospitalised twice and has had a blood transfusion. slow and steady is the way for us to go. Will be thinking of you. P.S don't let all those side effects freak you out as long as she is being monitered they can always pull back on the meds before any problems set in.

Effie Australia

Hi Kriss If you want to you might want to cut and paste all Kiki's information that you posted and send it to Dr Dodds and just get her take on things. Ginger and a few others were also put on cyclosporine (Atopica) and I truley believe it was what saved her. Have you tried baby food, a few have had some success with that, just make sure no onions. What part of Pa are you from? The medicines do take a few weeks to kick in and some even took abe cyclosporine took about a 4 weeks. Wishing Kiki a better day today. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Kris, I see Effie posted the link to the treatment page at my Web site where you can learn more about the drugs used to treat AIHA/IMHA: http://www.cloudnet.com/~jdickson/treatment.htm There are links at the bottom of this page to other sites that contain more info on these drugs. Many years ago, I saw lots of dog on Cytoxan for the treatment of AIHA/IMHA. However these days I see few dogs on that drug. If another drug is needed besides prednsione most vets will now prescribe either Azathioprine (Imuran) or Cyclosporine. Since you are already using Imuran, you might to ask you vet what his/her experience is with the use of Cyclosporine in the treatment of Canine AIHA/IMHA. I have seen many who dogs do very well on this drug. I know this is so hard but remember dogs CAN and DO recover from AIHA/IMHA and go on to live happy healthy lives. My own Meisha was proof of this as are all the dogs on the Success Stories at my Web site: http://www.cloudnet.com/~jdickson/successstories.htm If you have not read these Success Stories as yet, you might want to do so when you can. They will show you what has worked for other dogs in terms of treatment options and give you a lot of HOPE. Be assured you and your dear Kiki are in my thouggts and prayers during these most difficult days.

Joanne MN

Just a thought.... When my mother went into the hospital and almost underwent heart surgery, she was quickly diagnosed with a deathly case of anemia. She believes more is better and would take aspirin for any onset of pain throughout the day.... Well, she was bleeding internally. She lost half of her blood supply and almost died. The aspirin was tearing up her GI so she had blood in her tummy and stool (could kiki's tummy fluid be blood?).Up to that point, I did notice she was of course very pale, but her limbs became very swollen. She showed signs of edema in her legs and arms. The Dr informed us that due to the lack of blood supporting her organ function caused her kidney to slow causing fluid to build. My grandmother has congestive heart failure. The Dr looks for fluid on the lungs as a sign that the chs is active. Not saying this is what kiki has but she was strictly advised that while she is required to take daily lasix she must keep an eye on her water intake. If you drink too much water the lasix will not be able to get the excess off, but if you don't drink enough, you could become dehydrated... Hopefully, Kiki will continue to get better. I just started chemo with my dog this week. Does Kiki really have to take chemo although shes cancer free? That would scare me.... Good luck

shannon florida

Hi guys--no luck getting kiki to eat anything so far today. I tried all kinds of stuff. Yes, we are getting the beechnut baby food as that doesn't have onions. I have tried so many things with her. She's breathing very heavy, and walking very slow. I think she's more swollen than yesterday. I do need to call over at the vet's office as I just remembered they never started her on aspirin, plus I only have enough pred for tonight yet. Is Dr Dodd's an internal specialist? Sorry, I keep hearing her name. Does she mind when someone just emails her out of the blue? I know some Dr's won't diagnose without seeing a pet. Maybe I'll copy/paste her results and send them and see what happens. Kiki's regular vet is on vacation now for a week, so they are taking turns at the vet's office as being alternates. Shannon--I will mention that to the vet when I call this AM. That's really what I thought last Saturday night--congestive heart failure. I know they xrayed and said the heart looked fine. They just said that from her low protein, all her cavities were filling with fluids. I know the vet yesterday who released her said she still strikes him as being dehydrated. She drinks, but not alot. I still don't know where pancreatitis came in at as she hasn't been vomiting or any diarrhea. They said her proteins were low from pancreatitis.

Kriss PA

Kris, you can email Dr. Dodds with a brief but detailed history of Kiki. I've been always told to keep it as brief as possible but also don't leave anyhting out. She is a very smart woman and she usually responds fairly quickly. Here's the contact info Cheryl posted earlier.... Phone: (714) 891-2022 Fax: (714) 891-2123 e mail: hemopet@hotmail.com If it were me I'ld email her today. It can only help your situation. If Kiki isn't eating much try waiting 2-3 hours and then offer her something she really likes. I did this with Tessy at first because she was doing the same thing and then I offered her some cooked lean roast beef. She gobbled it right up! Hope she gets better. She'll be in my thoughts and prayers today. Johnny & Tessy

Johnny

Johnny--thanks. I did email her, however it wasn't brief, lol. I emailed her right after posting my previous message, and just copied/pasted everything I typed up above. I do have a call in to my vet, waiting to hear from them. I just don't want her to be uncomfortable and suffering if there's no chance for her. I mean, I have read the success stories, but with her being in the hospital 10-11 days, and her seeming worse now than when she was in....... I'm just so confused. I don't want to keep prolonging it if she is suffering. If the fluid is going into the lungs, then they told me there's no turning back. The other vet said on Tuesday with her 2nd transfusion, that the internal specialist said to do one every other day, she didn't have another one since. I just don't understand. And I don't get where they said her proteins are low from pancreatitis, when she hasn't vomited or had diarrhea. Maybe her whole diagnosis is wrong. I should probably take her for a 2nd opinion somewhere, but now it's the holiday weekend. Where she goes, there are 12 doctors there, very good doctors. And they do put their heads together and since she's so sick and been in there, they are all aware of her and everything about her has been discussed with them all. So I would think I wouldn't need a 2nd opinion. I'm just a mess right now. Sorry!! I should really make a list and tell this one when he calls back everything. But I know I'm going to lose it on the phone. I was in tears with the receptionist when I placed the call. I've been hoping to get to the store to get different things for her to try, but hate leaving her alone. Nobody else is here right now. I want to get some roast beef for her, that sounds good and I haven't tried that yet with her.

Kriss PA

Do you know what kind of doctor Dr Dodds is? Does she mind phone calls, like from me or my vet? I don't know anything about her and would hate to have the alternate doctor call her if she doesn't like that.

Kriss PA

Kriss: So sorry to hear about Kiki. We know how hard these first days and weeks are but hang in there. It takes time to get this disease under control and there can be some very scary moments in the meantime but we've all been there and are rooting for you. Dr. Dodds is an expert on AIHA/IMHA. And a wonderful human being. She will answer emails, phone calls, you name it. I emailed her about our own dog once and she replied within a matter of hours (after her work day should have been over). As for a second opinion - are you anywhere near a veterinary teaching hospital? They can be very helpful and have 24 hour emergency services. Sheba spent 6 days in their ICU and it most likely is what saved her life. I also agree with those who have mentioned the use of cyclosporine (Atopica). I really think this drug made a huge difference in Sheba's treatment and recovery. We also were giving her a low dose of aspirin for some time (12 mg - had to be specially compounded by ISU's pharmacy). Something to consider if you are worried about blood clots. As for food - Sheba (who will eat almost anything but her own food generally) was VERY picky for a while after coming home. Some of it because of all the meds and some because she was just feeling lousy. Give it a little time and just keep trying anything and everything. We tried boiled hamburger, Iams I/D canned food, treats from Three Dog Bakery, etc. (We knew she had turned a corner at ISU when she ate the treat from Three Dog Bakery!) Eventually Kiki will eat something. In the meantime - celebrate the little things and remember that dogs do get better and go on to lead full lives. Our own dog Sheba is now in remission, meds free and enjoying a quiet, spoiled life - something I could only dream about when she was first diagnosed in April 2008. Just know that we are all here for you and will be keeping you in our thoughts and prayers. Rita, Mike and Sheba

Rita IA

I just found an interesting article at petplace.com on lymphangiectia. You should ask your vet about this possibility. It has the same symptoms as Kiki's.

shannon florida

Hi Shannon--interesting! Thank you. I just called the vets office again and told them to run that by the vet on call. I actually just got back from there with her. She's paler than yesterday, but---and he's stumped by this...... her pcv is up to 22% and TP is up to 5. He did an xray and u/s --the xray shows some fluid in the belly yet, but he said not a whole lot. The lungs have a little bit, but he said not as much as yesterday. He did hear the coughing, and the heavy breathing, but not sure what it's from. She's so uncomfortable, I can't stand it. I havent' gotten her to eat anything today. She acts like she wants to eat, then changes her mind. I've offered her a whole buffet. He is stopping the doxy, he said maybe that is causing trachea discomfort and fluid (her belly still looks big, and he said he was surprised that the ultrasound looked better). He's increasing her lasix to twice a day and cutting her pred to 10mg's twice a day, instead of 20 twice a day. That kinda scares me. I'm just at a loss. I cried, and asked if I was doing the right thing. He said definitely, that he wouldn't let it go on this far if he didn't think we'd see some improvement. As far as the breathing, the coughing, and the paleness, he's at a loss cuz her blood work looks better. I'll let you know if he calls me back on the Lymphangiectasia. There's a different doctor on call tonight. Thank you so much!

Kriss PA

Kriss, I am no vet and still don't understand half of it, but when you wrote that you are reducing the prednisone by 50% I gasped. All I have read and heard is, no more than 25 to 35% and then only if the dog is stable. you might want to revisit this with your vet. I had a thought about the coughing, that it might be that there is some aglunitation (clotting). Has that been tested. Many dogs are put on a small dose of aspirin, this might be indicated with Kiki. I know that a lot of vets that are not experienced with AIHA don't want to give it, but it has saved many dogs. Bring it up with the vet. I am very grateful to my vet, that she was very open minded and wanted to learn as much as she could about this disease. She only sees about 2-3 dogs per year. She consulted many times with a specialist and called Dr. Dodds twice and went to one of her lectures. Best wishes, Brigitte & Kahlu

Brigitte BC Canada

Kriss hang in there Belle and i were exactly where you are now as she wasn't a straight forward case and hard to diagnose. This nightmare will settle down things get worse before they get better. Belle is nightmare to feed as well she wants to eat but also turns her nose up at everything. Last night i dipped my finger in peanut butter and she liked that it gave her a little bit of an appetite so she ate a little cooked liver. (my vet okayed it). Your in our thoughts constantly Effie, Belle and family

Effie Belle

Kriss, if Kiki is still not eating anything perhaps you could talk to her doctor about bringing her in to be put on an IV drip. Tessy had this done to her after she wouldn't eat for the first couple of days. They kept her overnight and the next day she was way better. This is a last resort I think to get nutrients into her body. How long has it been since she ate anything? If you have steak you could boil that and try her with it (no fat though). You could also try scrambled eggs, boiled chicken (no skin), liver, etc. Try what you can for her to get her to eat. She should be getting some nutrients to her body in order to help her fight this. A PCV of 22% is a good climb. She may be drousy and discomforted by all the drugs she's on. I'ld be a little concerned also with regards to reducing her pred by half. With a PCV that high they don't usually consider transfusions. If I were you I'ld have them do another pathological report when they do the next blood test. Ask them about spherocytes....above you wrote that they say many spherocytes when they looked on 5/19. That was 5 days ago and these may have went down by now. This number will tell you if the body is still destroying it's own red blood cells. Try to relax and rest with Kiki. I used to lay on the floor with blankets all day long with Tessy and watch movies. Keep us posted with any news you get. Again, she'll be in our thoughts and prayers. Johnny & Tessy

Johnny

Hi Bridgette, I did tell the doctor on call today that Kiki was supposed to be sent home with instructions on aspirin, but he didn't mention anything before I left, and I totally forgot about it. I haven't heard from him since I called there about 2 hours ago to ask about the Lymphangiectasia. Even when she drinks she starts coughing. I just don't get it. She wasn't coughing like this yesterday. She hasn't eaten, when she goes to even smell or taste something, she starts coughing. I don't understand why she seems to be going downhill when her blood looks better than yesterday's. She's more pale today than yesterday. I don't know how the heck I'm going to even give her her meds tonight. I was surprised, too, when he said about reducing the pred. Her regular vet is away for a week, and left me confused. This one today said she was on mega dose of pred, 20mg's twice a day. I gave her one this AM. He said to skip it tonight, and tomorrow just give her 1/2 tablet in the AM and 1/2 in the PM.

Kriss PA

Kriss....do you have icecream in the house? Try her with a teaspoon to see if she'll eat it. If she does you could hide her pills in it tonight for her. If not you'll have to open her mouth and put it down her throut. It's hard to do, trust me. Johnny & Tessy

Johnny

Hi Johnny--Thanks for the idea! No, no ice cream, everything else but that! I did finger/force feed her some baby food. Probably got about 4 tsps into her by prying her mouth open and rubbing it on the roof of her mouth. I did just give her most of her meds. I decided to not cut that pred in 1/2 like the doctor today said, but only gave her a 10mg tonight, she had a 20mg this AM. I'm too afraid and will call the doctor that is on call tomorrow and run it by her. It's just scarey how pale her tongue even is. Yesterday it was at least a faint pink, now it's white. She hasn't urinated in a few hours, since coming home from the vet and that's got me thinking she is dehydrating. She does try to drink some, but then coughs and changes her mind. If she's sitting in the upright position, she doesn't cough. But if she lays down, drinks, etc then she coughs. Though she didn't cough at all when I finger/force fed her. I'm going to try again in a little. I didn't want to overdue it.

Kriss PA

If I were you I would take her in tomorrow to have her blood work run again just incase the reading was off earlier. Especially if her tongues turning more white. Usually one should not go by the color of the tongue. The gums are more accurate and the mucous membranes around her eyes. Either way....I can see where you are stressed and worried.....I'ld probably be losing it by now. Hopefully someone else might be able to chime in on if it's the drugs she is on that's doing this or not. Alot of the drugs Kiki takes I'm not at all familiar with. Try holding the water bowl up for her next time. Might be easier for her to drink it as opposed to bending over for it. Hoping and praying for Kiki and you. Johnny & Tessy

Johnny

I'm going to be driving the doctors nuts. I have a call placed in now, with the doctor on call tonight (different one that was on during the day today). I cannot sit here and watch her like this. She's gotta be in respitory distress----will be back--doctor is calling now!!

Kriss PA

Kriss, Please ask your Doctor about adding aspirin or heparin to Kiki's medications. The agglutination your vet says is on the collection tube shows that her cells are still clumping together. This is a prelude to blood clots. That delicate balance of thinning the blood and at the same time preventing hemorrhage must be carefully considered. Most of us here have been where you are at now. The disease is terrible but so are the secondary complications that come with it. Shutting down of the circulatory system causes serious problems. One being that the vital organs is not receiving the necessary amount of oxygen to function properly. Hence the swelling of her abdomen and edema. When the medications start suppressing her immune response, Kiki will slowly respond and generally begin to feel better. I had to force feed my dog, Ren for several days while she was so ill. I did not give her huge portions but rather small syringes full of pulverized food. I would need a full page to explain all of the complications that Ren has suffered. But have hope, your beloved pet can recover from this disease. Although it is a long term care scenario with many, many ups and downs. My prayers are with you, Kiki and your family. Sue & Ren

Susie Delaware

Hi Susie--thanks for reminding me that again! I just called in and spoke with the nurse staying overnight with Kiki (See my thread Kiki bad news). I told him about the heparin or aspirin, and he's going to call the vet. He said there's actually a bottle of heparin sitting there, so he needs her ok and dosage. thanks again Kriss

Kriss PA

This thread was discussed between 23/05/2009 and 25/05/2009

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