Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Just bruoght home-what to feed?

Tuesday night I noticed that my 6 year old spayed female cockapoo, Kiki, seemed a little weak. She didn't come up to bed like she usually does. Wed morning she was too weak to get off the loveseat. I carried her outside, then took her into the vet. I actually thought something was wrong with her back or legs, as she seemed wobbly. Anyhow, she had a 104.7 fever. They ran some bloodwork, which came back looking like autoimmune. They did a tick titer, which came back positive 4. (she was vaccinated for everything, including lyme 6 weeks previously). Last weekend I applied advantix to her, usually I use frontline. I have 6 dogs, all who have medical problems. Anyhow--she just came home today on all kinds of meds, I have to take her in tomorrow and Monday for some chemo stuff they inject through this port in her leg. She is very tired. I have tried everything under the sun to feed her. Does anyone have any clue on how to get her to eat? She acts like she wants to eat, but then turns away. I have tried hand feeding her, she did eat just a few bites of boiled chicken, and that was it. Oh, and her Coombs (sp) test came back positive yesterday so my vet says it is autoimmune and she will never get vaccinated again. She is in guarded condition. She was sent home with me today because she's very depressed there and thought that she may be in better spirits and eat for me at home. She seemed happy to be home, but has been sleeping most of the time. I take her out every few hours due to her high pred and other stuff she is so bloated and urinating alot. She also had a very mushy BM in the house, which she never does. I expect this. They sent me home with a box of latex gloves as we are not to touch anything that comes out of her due to the chemo drugs. Sorry so long!!I just wish she'd eat. The vet said if she doesn't eat we are going to lose her. So if anyone has a clue on how to entice her, I'd appreciate it.

Kriss Bethlehem PA

Kriss, I am so sorry about Kiki's diagnosis. You certainly came to the right place for help and support. First I would recommend you to go on Joanne's webpage and learn as much as possible about the condition. Also make sure to read the success stories. http://www.cloudnet.com/~jdickson/newhope.htm What you describe happening with Kiki is pretty normal for being on high doses of prednisone. It will take a few days until she starts eating and then her appetite will become ferocious. Dr. Dodds recommends a diet of no grains and high quality protein. Make sure Kiki is on some sort of stomach protectant. If her AIHA is tick related Patrice will certainly be able to help more, that is really her "specialty". Best wishes to you and Kiki, Brigitte & Kahlu

Brigitte BC Canada

Hi--thank you for that link! I'm off to check that out now. I'm just so worried about her, as I know everyone else here is worried about theirs. It just amazes me at all I've read about this disease, just how fast it hits. One day fine, the next near death. She is on pepcid, along with a bunch of other things and hi-vite. Not sure if it's tick related. She had her heartworm/lyme test done March 22, and everything was negative. Then the tick titer came back high positive, but they said it may be a false reading from the vaccine. I'm just so confused. It could be from so many things. Is there a way to pinpoint what did trigger it? Oh, We did get her to eat some McD burger, probably not the best thing for her but we had to get something into her. Thank you again!

Kriss Bethlehem PA

Kriss, I forgot to mention for food, low fat! So the burger, not so much.... But I am sure you are happy she ate something . Lean Chicken or white fish is probably better. Finding out what triggered it can be a puzzle and most of us can just guess. Take care, Brigitte & Kahlu

Brigitte BC Canada

Hi Kriss, SO sorry to hear about your poor Kiki. We've been in this fight almost a year now. When we brought Tiggs home, the only thing we could get him to eat was Hills A/D canned, and we spoon fed him. It's high calorie, and we found this was easy because it's very soft and we gave it too him via a tongue depressor. Later, we mixed in steamed white rice, then some boiled chicken. Also, you can try steamed sweet potatoes, scambled egg, or some boiled hot dog pieces, but not too much fatty stuff, like Brigitee said, you have to cut out the high fatty stuff because it will upset their tummies and they are at a very high risk of developing pancreatitis. In a way, it's almost better if her IMHA was tick borne triggered. It seems like this has a good prognosis with Doxycycline in the regimine, and again Patrice will probably elaborate, but the dosing must be correct and for the correct length or relapse is likely. My tiggs needed a toddler pull up for many weeks, he just leaked and leaked. We put him on a towel that we changed frequently. Sadly, he was just too exhausted to go outside, and due to ecessive thirst, and the poly uria caused by Pred, there was just managing it and accepting it. The poo will get better, but it takes time, it's just one of those things. If she is very naseous, ask your vet about Cerenia, which can be administered via a shot followed by a five day pill course. Many of these guys just plain feel awful, naseous, etc. I feel for them. Who would want to eat when you are exhausted, naseous, bloated, etc. Our mantra was and will always be: one day at a time! We will be hoping the best for Kiki and your family, they CAN and DO make it to use Joanne's wise words! melissa and tiggs

melissa slc

Thank you guys--I'm so worried about her. Her breathing is really weird. She is so bloated I think fluids are pushing on her lungs or heart. I have to wait 1-1/2 hours yet until they're back in the office today. I'm supposed to take her in at 3 for her cytoxine (sp) in the port, but I'm not waiting that long to call. She is on doxy 50mg 2x's day, she's on pepcid, carafate, imuran, hivite drops, pred 20mg twice a day. She was on a different steroid at first, then they switched her to pred as her count was dropping yet. Her oral chemo med comes in Tuesday, which I think they said she'll start on Thursday or Friday. She gets it in the port today & tomorrow. We have to flush it every 6 hours. Well, off to try to figure out what she'd like for breakfast and give her her meds. Thank you for the thoughts on foods. She just seems so lethargic and not interested. Usually she's my hoover and was never ever picky. I have to worry about my others now, as I read that cockers & poodles are predisposed to this horrible thing. I have 6 dogs, 3 are cockapoos (Kiki and 2 males who seizure), 1 cocker (who is in remission from lymphoma), and 2 bolonkas. If I don't get them vaccinated, then I have to find a new groomer as she can only take dogs who are vaccinated.

Kriss PA

I am so sorry to hear about Kiki, the white rice and chicken is a good thing. chicken baby food has been reocmmend a lot here but with NO onions or garlic. Or maybe a tsp of wet cat food, my dogs go nuts over that. Try mixing a tsp of whole pumpkin in wiht the food to help with her stools. Poor Kiki, you mentioned Kiki starting chemo, what type of cancer does she have? Laurie

Laurie CA

Kriss, The last thing I would add for Kiki, is that you will want to inquire about an ultra low dose of asprin for her, new studies are showing that it is instrumental in preventing blood clots and fluid retention, which unfortunately, can be the leading cause of death in an IMHA dog. I assume Kiki is very, very small? If so, you would probably have this compounded. I know for Tiggs that he was on 1/4 of a baby aspirin, and he weighed about 64 lbs at dx, so you can imagine how small of a dose a toy dog would need. I'm so sorry for all of the challenges your babies have had to face. Clearly, they are lucky to have a mom who is willing to help them get well. good luck, never be afraid to be a pain to your vet daily, that is how it starts out- especially when they are critical like this. Also, don't be afraid to have another opinion, and as always, ask here as much as you need. We'll be thinking of Kiki. melissa and tiggs

melissa slc

Hi Kriss, welcome to the board. This truly is a great place to come and find out information. The help and support can be overwhelming at times. Everyone cares so much and only wants the best for our furkids. Do you know what Kiki's PCV/HCT currently is? That is the main number you'll want to track. It shows the % of red blood cells in her body. When you talk with the doctor maybe you could ask for a copy of the tests that were ran so far. Most of us on here do that and it's good to have so you can answer questions more easily. Have you had any luck with getting her to eat yet? I know that when my Tessy started to not eat (almost 2 days without eating) she was put on an IV drip so she could get the nutrients needed until her meds kicked in....which could take time. You will probably know when the meds start to kick in, especially the prednisone, because you'll have a problem keeping her from eating then. The pred really gives them an appetite. Is she drinking lots of fresh water? We don't want her to get dehydrated. That never helps. I know what it's like to have lots of dogs. If at all possible you should try to keep her calm. At the onset she should probably get lots of rest. The abnormal breathing is normal with this disease. Since her red blood cell count is low, so will the oxygen circulating the body. The rapid or abnormal breathing is the body working overtime to pump more blood around the body to disperse proper amounts of oxygen. There were times Tessy breathed so fast and hard that I thought the house would blow down. They'll get over this as they start to recover. Excessive drinking and peeing is normal. Be prepared for frequent potty breaks during the night. Loose stools are also very common. The drugs are hard on the bodies and will cause this. How much does Kiki weigh? The best thing for you do do now is keep her calm and read read read! The more you become educated about this disease the more capable you'll be to handle and combat it. We're all here to help you if needed. Don't be scared to ask questions regardless how stupid they may sound. It's also good to know if your doctor has lots of experience dealing with this disease. This could be a determining factor for her recovery. If they are inexperienced you could try to consult a specialist. Dr. Dodds is probably the best in there is when dealing with autoimmune diseases and is very helpfull. Give Kiki hugs from Tessy and I. We'll keep our fingers and paws crossed for Kiki and will send a prayer her way. Johnny & Tessy

Johnny

Kriss, I agree with Melissa, and feel that you should ask your vet about low dose aspirin to prevent blood clots. Kiki may not be developing clots, but it's something to be aware of and worth inquiring about. My dog seemed to be improving from IMHA, but died from a blood clot. You and Kiki will be in my thoughts and prayers. Sue

Sue PA

Well--Kiki was admitted again this AM. They did tell me different numbers on her bloodwork, but I don't recall what was what. This morning they did an xray (I took her in cuz her breathing was weird and she was grunting). Her chest/lungs looked ok, but her stomach was full. So they couldn't figure that out since she hasn't eaten. Then the doctor on call did an u/s and it showed fluid leaking into her stomach. She then admitted her and called another doctor in who is really good on the u/s machine. He said pancreatits. So they told me she has a 50/50 chance. I'm going back in to visit her, they are getting her situated and adding more meds. I think they said reglan and flagyl, and also giving her plasma and the IV again. I will come back with her blood readings. Laurie--she doesn't have cancer, sorry to confuse you. They said they are doing the chemo drug for some reason, but I forget what it's supposed to help with. I think it's called cytoxin or something like that. It was added in on Friday because one of her levels kept dropping. She was 19 pounds when she went in, today she weighed 21.7. She's very bloated looking. The vet did say something on the phone today about her having a potbelly something. Her weight gain is from something, I haven't talked to the vet in detail about that yet. Guess when I go in today I should know more. My Skippy, my cocker, had lymphoma and is remission right now. He was diagnosed 1-1/2 years ago and the doctor is amazed at him being in remission yet. We caught it very early, as soon as one lymph node was up he went right into the vet. That's another story. But it's actually the same vet that saved him that is working with Kiki. I feel confident in her, but I just have this horrible feeling. Thank you all for all of your help. I will post the readings when I come back later with her history report. I was driving myself nuts looking at stuff online, and am so grateful to have you all here on this board!!

Kriss PA

Our thoughts and prayers are with KiKi and we hope she is feeling better soon. Please keep up posted on her condition. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Well, Kiki is getting a transfusion right now. I do have some of her numbers from bloodwork: PCV=19% (today's) yesterday was 20% they said it should've went up some since off the fluids when sent home but it came down HCT=15.8 (yesterday) today's not in yet There are a bunch of other things in her chart with stars next to them which indicates out of normal range but I don't have a clue what these indicate. The nurse said Kiki was very mad when I brought her in and left her today. She tore out her port and bandage, and crumbled up all of her blankets. She seemed a little perkier when I visited a little bit ago.

Kriss PA

Kriss, Hang in there, sometimes the numbers will go up and down. It's not uncommon for them to go up immediately following a transfusion, then back down within a couple of days. Tiggs PCV was about 10 at diagnosis he recieved a transfusion at diagnosis. My vet thought there was a good chance we would lose him within a week. That's when my husband and I agreed that we would take it one day at a time. We also learned (though this is the hardest) that the numbers don't always mean everything- that clinical signs are important too, as in, how are they acting. Kiki seems to have the fight in her, she got mad, and did those little things that show she wants to go home and get better. Along with aspirin, some vets opt to try Heparin for the clotting, and I think for the fluid retention too. You might ask. It's a good idea to keep a list of your questions, along with notes about what you learn online and from your vet, and here on this board. It's so hard to keep it all together in your head. I always ask for copies of Tiggs bloodwork now. Alot of people come back and post this info here, and we all try to sort through it and learn what the different numbers mean. You could also consult with an internal specialist. I trust my vet implicitly too, but it didn't stop me from having Tiggs seen at Colorado State University 6 hours away just to be certain (we used to live in Ft. Collins so we made a trip to visit friends and have him evaluated). It was so reassuring to know my vet was totally on top of it, and luckily, she was very supportive of another opinion, and even collaborated with the staff there when we returned to Utah. We'll keep you in our thoughts and prayers, unfortunately, it sounds like you are no novice when it comes to canine health issues, and my heart goes out to you to have another baby with a serious illness. melissa and tiggs

melissa slc

Thank you! I will be sure to ask about the aspirin or the heparin. She had 3 new things added today, but nothing like those--reglan, flagyl, and ampicillin. I think those are for her belly issues.

Kriss PA

Don't overly worry about the numbers Kriss. Easier said than done I know but what Melissa said is true. Watch the clinical signs. Tessy had a transfusion after her HCT dropped below 10. Post transfusion her HCT rose to 23 and then a couple days later dropped back down to 18. That's when her meds started to kick in and her HCT slowly began to rise. As you may have already read on this forum...many dogs go through a transfusion and some multiples. All the transfusion does is buys time for the body to start fighting the disease with the drugs. She's got fight in her so that's a really good thing. Hang in there and let us know how she does. Prayers and best wishes to you and Kiki. Johnny & Tessy

Johnny

Kriss, Be sure to question your Vet about low dose aspirin or heparin. Blood clots are often the killer in AIHA. AIHA is not a disease that is cured overnight. It can take many months to come into remission. Many people on this web site know about being on the roller coaster ride. There are small victories and some set-backs. The most important thing is to inform yourself about this disease and never let a Vet tell you there is nothing that can be done. Our prayers are with you. Sue & Ren

Susie Delaware

Just wanted to thank you all for your advice, support, and prayers!! I haven't heard anything since I left earlier. They were still doing her transfusion so I couldn't stay long. I will update you all tomorrow. And I will plan on asking about the aspirin and the heparin. Thanks again! I appreciate everyone's comments!

Kriss PA

Well, I saw Kiki before I went into work, she's got an ecollar on since her little episode yesterday pulling out her lines, chewing her bandage, etc. She was syringe fed some today, sill no interest in food. She actually looked a little brighter this AM, was right at the front of the cage. At lunch time, she wouldn't even look at me. After work, she wouldn't lift her head. She looked very bad. I was very worried then. I spoke with her doctor, who said I should get her out and take her outside. So I did, without a leash as I figured she wouldn't go far and she stays right with me. Well, the little stinker started trotting down to the parking lot, I called her and she didn't want to stop. I picked her up, belly so tender and bloated yet--and carried her back up to the grass. She tried taking off again, like I'm out of here whether you are coming with me or not. I then went in and got a leash, and she walked around some. Her pcv today was 20%. 1% higher than yesterday, even with the transfusion. The doctor said she may need another one. Just hoping that her meds kick in soon! I did ask about the aspirin and the heparin. The doctor said when she goes home she will be starting one of them. When I saw her so limpy and not even caring if I was there, I was very worried. So it brightened my day when she was set to trot home! Had to share that with you. They did do a liver test of some kind but results aren't in yet. Doctor said she's stable but still touch and go.

Kriss UPDATE

Kriss, Thanks so much for the update on Kiki, that is better news. Remember, just one day at a time. 20% isn't too bad, I think we were around that after Tiggs' transfusion. Actually, his might have been a little higher, then dipped again, but they wouldn't transfuse him again unless he dropped below 15% I think. The second transfusion can be tricker, it's more critical to cross match, as the liklihood of a reaction can increase. Vets can order blood from Hemopet, Dr. Dodd's practice. She uses greyhound blood, which has a good matching potential I guess (?). At least Kiki was showing a little rebellion, that is a great sign. She sounds like a little fighter. We'll be thinking of you. melissa and tiggs

melissa slc

Thanks! I visited her again tonight. Took her out for a slow short walk and took her back in to try to feed her. Doctor wasn't there, so I don't know how the results where for the latest test they did. She did eat for me, off my finger, so that was exciting. Some intensive care stuff, that I at first thought was baby food. I'll have to remember that about the 2nd transfusion. I sure hope she doesn't need one. But she was very perky tonight. My youngest son, 14, went along. I think that cheered her up alot. She even drank some water. I think the transfusion helped, and hopefully the meds will be kicking in soon. Wednesday night will be one week since she's started most of them. She was there all day Wednesday before they actually started treatment, until they got the results in and figured out what was going on. Anyhow--thank you all again! Hope everyone else's babies are doing good. I haven't been home too much to go through the other threads. When things calm down more here I'll hopefully have more time. Have a good night.

Kriss

Good to hear Kiki is drinking and eating a little. Little bits at a time is good. Her being more prerky is also a good thing. The first couple of weeks is always hard. I know I was a basket case the first couple weeks after Tessy was diagnosed. Since she hasn't quite been on the meds a week yet it may still take some time for them to really kick in. You'll know when they take hold cause her appetite will return. I can only imagine how cute it was when she tried to trot home. I got to watch Tessy when she's in the clinic cause she doesn't use a leash. Every so often she gets the urge to boot it for the door when someone comes in. Anyhow.....stay strong and give Kiki some hugs from Tessy and I. I pray and hope for the best for her and your family during these tough times. Best wishes, Johnny & Tessy

Johnny

Kriss, Kiki sounds like my Madison did when she was first diagnosed. Madison had 2 transufsions and it took about 7 days until the meds kicked in then she started to improve. After that she ate like a horse. Madison was only 5.8kgs when all this started - 5 months later she is 8kgs!!! Little fatty i call her. But she is really doing well and nearly off all the drugs. I am hoping you have the same success as we did. Samantha & Madison

Samantha Perth Australia

This thread was discussed between 17/05/2009 and 22/05/2009

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