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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - IMHA/Blood Clots
| I have an 18 month old Chesapeake who was diagnosed with IMHA on July 20th. He is on the meds prednisone and azathioprine. All was looking good until last thursday when his penis became so swelled and fully exposed. It would not go back in. I took him to the ER and they did utrasound hoping to see a clot. They could see nothing. They gave him a cold laser treatment and worked for over an hour getting it back in. Suspecting a clot from from the IMHA they put a pirse string stich in and told me to ice it and give him 20mg of low dose aspirin.I am curious about the heprin to give at home as that is what they had him on the night he spent in the ER. Has anyone had this problem and what can you tell me about the Heperin. This is a brand new, very overwhelming disease as this guy means everything to me. |
| Robyn Idaho |
| Hi Robyn, So sorry to hear of your situation with your dog (?). Yes, IMHA/IAHA is truly a complicated and overwhelming disease to fight. Heparin is simply an anti-caugulant used to prevent clotting. I don't know a lot of specifics pof it's use, but it has been used for years in treating clots. Clots are common in some attacks and not in others. Also redcucing stress for your dog is important, so some calm reassurance will help. It would help you to try to stay calm, although we all know how difficult that is not knowing much other than how difficult IMHA is. Many dogs survive this fight and many of us stay here knowing how difficult it is for you and how important it is for you to have good help. I know I speak for hte rest when I say, we will do our best to help you and answer your questions. There may be other things too that this might be, or be caused by, as I am pretty new to this fight I am not aware of anything other than the fact that nothing surprsises me anymore. There are others here who are much more experienced, but more detail will help them. Dog's name (helps me), and weight and doses of all meds/frequency. Health before diagnosis might be important, any vet visits or problems before IMHA? HAS he been checked for Ticks? Is your dog taking Pepcid AC, or other stomach protectant? This may be a long fight and doing everything you can to protect the stomach and liver is important. There are other stronger protectants too like Sucralfate that coat the stomach. Milk Thistls is used to help the liver in this process and others can provide other recommendations later. Has there been any noticeable change over time since you left the hospital? It may take a bit of time to break up the clot if it is one. Any other signs of clotting, or bleeding? Knowing the bloodwork here may provide you more help from those here who understand it better. RBC, PCV/hematocrit, hemoglobing, WBC's adnd types, platelet counts etc. If o can, get a copy of the blood work and post the numbers. Everyone here will try to help you undersnadnd them and this disease. Hoping for he best for you, try to stay calm and supportive, I am sure more people will help too soon. Richard and Dog Dylan (AIHA Mar 19/11) |
| Richard Burnaby |
| Hi Robyn So sorry to hear you are going through this. Yes, clots are a real danger for dogs with IMHA, and my vet made this very clear to us. In many cases it is actually the clots that kill so avoiding them is critical. He put our cocker bitch (Mo, diagnosed in March) on Aspirin (a tiny amount once a day) and Heparin - we have had to inject her 3 times daily. The amount is determined by the dosage of prednisolone - we started at 0.7ml, dropped to 0.4ml and then to 0.2ml as her prednisolone has been decreased. It is a fine balance, though, between avoiding blood clots and promoting internal bleeding - too much Heparin can lead to bleeding in the stomach. It isn't cheap (what is?) but we would pay anything and it worked - the initial test showed that Mo was at a high risk of clots, but by the second test her risk was near normal. It is all a huge balancing act with the meds - it seems the one with the most adverse side effects is prednisolone but it is critical to fighting the anaemia. I would also urge you to ask them for drugs to support the liver - Denamarin and Destolit - as Prednisolone enlarges the liver. The other drugs we use are Atopica (Cyclosporin) and Cellcept (mysothenolate I think the actual drug is called). Both are immuno-suppressants and do something slightly different from the Prednisolone which is a steroid. They do upset their stomachs (diarrhea) and so need to be managed, eg. every other day perhaps. On the advice of everyone in the forum, we also put Mo on a diet that is easy for her liver - potato, green beans and courgette and chicken/fish only and no red meat - which seems to have helped. It is low fat so you need to watch they are not losing weight. And in addition, you need a stomach protectant due to the harsh effects of all of the drugs - we give Mo Sucrulfate 3 times daily. It is low cost and is a white fluid that we give her via a syringe into her mouth but it coats the stomach and helps to prevent bleeding. I hope that helps - please do ask your vet about the drugs. It is a complicated regime each day (we have a spreadsheet with boxes that we tick off when the drug is administered) but worth it. Mo was really bad - a pcv count of 9 when diagnosed and had to be transfused - and I didn't think she would make it, but she seems to be on the road to recovery. It is a long haul - you are looking at 4 months perhaps, may be longer, but worth it of course! Take care Di (and Mo, AIHA, March 2011) |
| Diane Milton Keynes |
| Hi Robyn- Sorry to hear that your Chessie is so sick. My Golden retriever Chloe has been fighting IMHA since April 2010. She was on aspirin and still threw a clot in her lung 3months into treatment. You are lucky that the docs could treat your boy. I had to take Chloe home and watch her struggle to breathe as there was no treatment. She fought through it though and is still hanging in there. Be absolutely compliant with all the meds! I use a 7 day tray with four compartments a day for Chloe's drugs. The aspirin is really important as it helps to prevent clotting. I am also really careful with the timing of doses. The half-life of some of the drugs is really important. Chloe is still on cyclosporine 15 months later and gets it 12 hours apart Monday-Friday (and off on Saturday and Sunday). What is your baby's name? I know you are really struggling with this awful illness and I hope your Chessie continues to fight. The best thing I ever did was to consult with Dr. Dodds. I believe Chloe is alive today because of Dr. Dodds and Chloe has had a really rocky course including two relapses. Every day she greets me with a smile and wagging tail to say "I am alive! Look at me!" We can hardly believe it almost 16 months later. Wishing your boy a strong recovery and you the strength to keep him going. Cheri and Chloe |
| Cheri Maryland |
This thread was discussed between 02/08/2011 and 04/08/2011
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