Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Immune Mediated Thrombocytopenia

Five days ago my 3 year old schnauzer Smith, lost use of his back legs and I rushed him to the vet. They administered anti inflammatories ( Robuxen and a Mammital Drip) overnight and by the next morning he could walk again but his blood tests showed low platelet levels of 106. In response the vet started Prednisone and Doxycyclene. In the five days since then his Platelet levels have dropped each day and are now 16. On the third day of dropping platelet levels the vet discontinued the Doxy and put him on Imuran. They only did the Imuran therapy for one day and switched to Cytoxin because the PLT levels continued to decline, the RBC started to decline and the WBC started to climb. They are going to start Vincristine tomorrow in addition to the Pred, and Cytoxin. The diagnosis seems to be Primary Immune mediated thromboytopenia. I guess I am just wondering if there is anything else we should be doing and does all of this sound right. I have no kids, so Smith is my baby and I just want to make sure I am doing everything possible. He is not presenting any bleeding anywhere or some of the symptoms I have read about, just mildly lethargic and the bloodwork problems. His CBC numbers were and are as follows: On admittance: 11/5 Currently: WBC 8.6 K/ul 20.49 LYM .92 .74 MONO .47 2.73 NEU 7.06 16.58 EOS .11 .31 BASO .05 .13 %LYM 10.7% 3.6 %NEU 82.0% 80.9 %EOS 1.3% 1.5 %BASO .05 .6 HCT 39% 27.3 RBC 4.9M/ul 3.46 HGB 14.0g/dl 15.6 RETIC .2% .3% MCV 79.6 fL 78.9 RDW 15.1% 15.9 MCHC 35.8 g/dl out of reportable range MCH 28.51 pg 45.04 PLT 103K/ul 16 MPV 21.15 fL PCT .2% PDW 23.9% Thanks, Dione

Dione Amirkhan Louisville KY

Dione, I am so sorry to hear about Smith. He is just a baby at 3. I love Schnauzers and it is very upsetting to hear about him being ill. Please find out if your vet did a tick panel. You live where there are ticks and this could be one of the symptoms of a tick disease, low platelets. The doxycycline would have been dispensed for this. I am concerned that they discontinued this. These tests can be simple in-house tests called SNAP 4DX. These are yes/no tests for 3 tick diseases and heartworm. However, since you live in an area where there many be more tick diseases the vet should send out a blood sample to a specialty lab for testing. I recommend Protatek labs for this. Dr. Holland will consult with your vet on the test results. Primary immune mediated thrombocytopenia means that the body is attacking platelets with the immune system and that there is no apparent trigger (primary). Secondary immune mediated thrombocytopenia would be nearly the same thing, but there is some outside element that causes the body to trigger the immune system to start the destruction. Tick diseases can be this outside element. Be very sure your vet explains this situation to you and why they believe it is Primary and not secondary. my best patrice

Patrice NYS

We think primary because with all the testing so far there hasn't been any outside element that suggests secondary. Smith is primarily a house dog in the city and I haven't ever seen a tick on him, I think that she tested for that first and gave him doxy as a precaution while waiting for tests results but I will double check and have her run a panel if that isn't the case. His platelet levels dropped drastically while he was on the doxy, so it didn't seem to me like it helped anything. Thank you so much for the advice though, I will try anything to keep him with me. :)

Dione KY

Dione, I am so very sorry to hear that your most beloved Smith has recently been diagnosed with immune mediated thrombocytopenia. When you have time, please read about "Midnight the Miracle ITP Dog" who had ZERO platelets when she was diagnosed with ITP over 10 years ago: http://www.cloudnet.com/~jdickson/midnight.htm Midnight went on to recover and live a happy healthy life. She is still doing well in spite of her age. Be assured that both you and Smith are in my thoughts and prayers during these very difficult days.

Joanne MN

Thank you for your kind words and thoughts, I actually read the Midnight story, printed it out yesterday before I posted and showed it to my Vet because it was encouraging. I figured my Vet needed the inspiration from it as much as I did, because things kept going from bad to worse. We both needed some hope that he could pull through this. My wonderful Vet started him on Cytoxan yesterday along with Vincristine. Today for the first time in six days , his platelets rose to 69 and his white blood cell count went back to normal ranges. We are cautiously hopeful that he will continue to improve. I think I have half the world saying prayers and Im having faith that they are working. He isn't out of the woods, but at least it's the first day something positive has happened. My Vet was so excited to call and tell me about it this morning. I have to say that I have learned a ton through this so far. I am blessed enough to have a Vet that has answered every question, looked at every bit of the 50 pages of information on IMT that I have brought her, and wasn't afraid to consult with some Internal Medicine specialists to try different testing and treatment options. She has really earned my full respect and gratitude. I think it is a real blessing also that web forums like this exist to share medical knowledge and moral support. Collaboration in health care whether it be human or animals is key. I will advise everyone I know to be proactive in their dogs healthcare and learn about anything that they are facing. It has truly helped in this situation. I saw a quote that reminds me of this that I will share: He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true, to the last beat of his heart. You owe it to him to be worthy of such devotion." - Unknown

Dione Louisville

Dione I am sorry to read that Smith been diagnosed with ITP and please know that we are sending our prayers for Smith and hoping he is heading in the right direction now. Sounds like you have found a fantastic vet, who is willing to do whatever it takes to help Smith. Please keep us updated on how Smith is doing. Thanks for sharing that quote it is so very true. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Dione, How great for you and Smith to have such a fantastic Vet. It is so hard to deal with things if your Vet is not on board with you being so involved. I will be keeping you both in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Thank you everyone for your prayers. Smith's levels dropped a little to 41 the day following the Vinchristine, but they rose the following day. As of yesterday they were 64. My vet allowed me to bring him home for the weekend and so gratefully he is sitting next to me right now. We are hopeful that the Cytoxan is working and that his levels will continue to improve. I am so glad that we found the research that says give the Vincristine early and don't wait. It seemingly has started the turn around. Now he is on the Prednisone, Doxycyclene and Pepcid daily. He is supposed to start a second round of Cytoxan on Monday. I'm curious if anyone has had experience with the Cytoxan.. I'm wondering how long he will have to take it? On another note, I just wanted to say how this experience has shown me that there are so many kind and caring people in the world. Having people from all over take time out of their day to pray for me and my dog, whom you have never met, is so appreciated and valued. It restores much of my faith in the compassion that exists in humanity. Thank each of you from the bottom of my heart. Please keep the prayers coming, I really want Smith to feel better and be able to live out a happy long life. Heartfelt regards, Dione Amirkhan PS. If anyone in Louisville ever needs a Vet, don't hesitate to contact me. Dr. Joyce is the absolute best!

Dione Louisville

Hi Dione glad to read that Smith's count is starting to stabalize, our little cocker Torie, had the same drug, cytoxan, it gets the job done, she suffered from aiha and imt, she lived for 12 yrs, with many a relapse, but just kept chugging along. take care Bev

Bev canada

Yay!! We got platelet counts of 202 today! Hope we are turning the corner now. He is acting like he feels better now and I am thankful!

Dione Louisville

Dione - It's so nice to see your post and read some good news - congratulations - I hope this is the beginning of the turning the corner. Smith is so young to be fighting something so scary but is very, very lucky to have someone as commited as you are in his corner. Separately, I really loved the quote you posted and passed it along to my boyfriend - we are at a really scary point with our dog right now and at somewhat different perspectives with respect to priorities and I thought the quote you posted summed up my feelings better than I could say - thank you for sharing it. I hope things continue to turnaround for Smith - my family has had six mini schnauzers and my first two dogs were minis and I have a huge soft spot for them - they are so very special. Wishing you the best, Bonnie

Bonnie Chicago

Thank you so much Bonnie, I will keep you and your dog in my prayers. I hope we are headed in a positive direction,and my heart goes out to all of you who have been fighting these disorders for a long period of time. It is a difficult battle and I've only done it a couple of weeks. :( I'm glad the quote helped. I found so much relevance in those words. Kindest regards, Dione

Dione Louisville

We got a 394!! Yay! Smith's bloodcounts are almost back to normal. The vet is going to slowly wean him off the drug regimen and see how we do. So thankful to everyone for their prayers! My baby is back home with me!

Dione Louisville

Dione So very happy to read the Smith is doing much better and home with you. I share in your joy!!!!! Tell Smith to keep up the good work and I will continue to keep him in my prayers. Cheryl & Ginger

Cheryl & Ginger Pineville PA

This thread was discussed between 10/11/2010 and 19/11/2010

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