VetNet®
VetNet® AIHA discussion forum
VetNet® Forum
Lifelong Learning Network
www.vetnetlln.ac.uk
Veterinary Recruitment
Premier Partner Program
Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - IMHA and detached retina?
| My Shiba Inu Wiley was diagnosed with Evan's Syndrome about 3 months ago. He had two transfusions and seemed to respond well. A couple of weeks later at his blood check, the vet was concerned about one of his eyes. After a visit with a specialist at Tufts, she said that he had a detached retina. I have been reading the boards and haven't seen anyone else with eye issues. I just wonder if this is related to the IMHA/Evan's or something else. The specialist felt that with the doses of medicine he had been taking (Pred, Azo, Cyclosporine) that wouldnt of happened and her thoughts were that it may be a cancer. They wanted to pursue additional testing of bone marrow but we didn't want to put the dog through any more especially since she said that the results may not be accurate because of the prednisone. So fast forward to today, his RBC is about 37 and platelets are normal. He is acting energetic and other than his eye, he seems fine. So I guess my question is has anyone ever had detached retina as a result of the IMHA/Evan's or is it possible that he has something worse brewing? Also, is 37 good for his RBC? It seems to stay right in that range, never going higher but sometimes it drops slightly. thanks for reading! Lisa |
| Lisa CT |
| Lisa, First, 37 is a fine PCV and as long as the hemoglobin remains very near to the normal range (which I suspect it is) there should be no problem with this number. Chance settled in at 37-38-39 after he recovered, never going higher than that. But his hemoglobin and all other values remained within normal limits so I knew this was "his" good number. The only time a PCV of 37 might be a little on the low side would be for certain breeds of sight hounds who require a much higher average PCV of around 55. The drugs you have been using, esp prednisone, alter all kinds of normal things in the body. Muscle tissue is lost because of rapid metabolism wasting them (due to the prednisone), fat moves around and accumulates in odd places and fluid is reshuffled abnormally. Ligaments at joints can become loose and joint injury during this time is a possibility. I'm not a vet, nor do I have a clinical background, so this is a good question for a vet with a solid clinical background. But knowing the kinds of side effects I am referring to, it might not be beyond possibility for the muscles of the eye to have been significantly weakened by high doses of prednisone. This would and could cause an imbalance in the eye socket muscles. A strong jarring, from a fall or stumble, might be enough to jar the eyeball in that loose eye socket. Would this be enough to cause retinal detachment? Hmmm, I wonder if this is just a case of the muscle being so weak that it "appears" that there is something wrong with the retina? What exactly are the symptoms that led your vet to believe that this might be a detached retina? Is it blood shot or is the eye drifting off to one side? Or does Wiley seem truly blind in one eye? Is he stumbling or bumping into things like his stereoscopic vision is impaired? my best patrice |
| Patrice NYS |
| This is a pretty inclusive website on canine retinal damage. http://www.petyak.com/dogs/dog-health/retinal-detachment.aspx It looks like prednisone, which does cause a condition called Iatrogenic Cushing's Disease (Cushings due to high body levels of cortisol due to prednisone use) can lead to increased blood pressure. This can cause a retinal detachment. Checking a dog's blood pressure is pretty tricky, most clinics don't have the equipment to do this due the wide variety of limb sizes. And then, they don't have a good reference as to what normal should be. I was very successful with an inexpensive human wrist cuff I bought at the drug store. But you do need a reference range for dogs. I would say in general, if it comes in on the high side according to a human chart, it is probably too high for a dog. I would also advise testing kidney function at this point if your vet agrees that high blood pressure might be a possibility. This would be critical to treat if there was a problem, sooner rather than later. Dogs can live quite fine with vision in only one eye. They are not alert to the fact they have lost something, only that they have had to adjust how they do things. But you do want to make sure there isn't some organic disease behind this that needs to be treated. my best patrice |
| Patrice NYS |
| Hi, Thanks for your reply. I will try to describe his eye as best as I can, initially it looked like the bottom part was filled with blood and his vet said that she had concerns that he wasn't seeing well. I brought him to Tufts and they did testing there and they said that he had the retinal detachment and a hemmorage. They believe he is blind in this eye. Now, the blood is gone but if you look at his eye it looks totally empty, just kind of dead like. Its very sad and if you look into it with a flashlight, its just hollow and pretty gross. I stopped doing that pretty quick. He gets around find and he doesn't appear to be in any discomfort. Thanks! |
| Lisa CT |
| Hi Lisa, I am so sorry to hear your Wiley is having problems with one of his eyes. Tufts should have the equipment necessary to check his blood pressure. This is very important because high blood pressure can cause blindness, not to mention do major damage to the kidneys. Checking the blood pressure in dogs is different from us humans, as they only check the systolic pressure, which is the "top" number for us humans. Specialist normally have the doppler machine to check blood pressure, while regular vets do not. I would guess it has something to do with cost. They will either check by the foot or foreleg and sometimes at the base of the tail(that is how they checked my boys). 37% is an awesome pcv. Way to go Wiley Boy! Please keep us posted. Teresa |
| Teresa va |
This thread was discussed between 10/06/2010 and 21/06/2010
Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index
This thread is from the Vetnet archive. The live Vetnet forum is active now.
