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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Kahlu update 9/4
| I just got a call from the vet, Kahluhs RBC and HTC went up after our reduction from 50 to 40 mg prednisone 10 days ago! RBC 4.1 - 4.6 Hematocrit 0.33 - 0.36 So there is clearly regenerration. Unfortunately his liver enzymes went up even further, they are skyrocketing. ALP 500 ALT 448 GGT506 They climbed since the last time we tested. Should there not be a reduction now, since we have reduced the prednisone? I am wondering if I can do more for his liver than Sam-e and Milk thistle. Should I put him on Dr. Dodds liver cleansing diet? Right now I feed him half his food in high quality kibbles with duck, turkey and salmon, no grain. 16% fat 26% protein. The other half I add either fish or chicken, and potatoes, beets and pumpkin. He is back to his normal weight, so I was wondering if the 16% fat in the kibble is to high for his liver. When I talked to the vet she mentioned going to every other day with the azathioprine fairly soon. She was wondering what everybody on this board is doing or did with that. I know you usually only reduce one medication and I thought the pred would have to be down to at least 5mg before reducing the aza. Just last week my vet informed me that she has an other dog with IMHA! She asked for websites and this board,and of course I was able to help! The dogs Hematocrit was down to 8, but after a transfusion he could go back home a few days later. I hope they will find the information they need... I wish everybody a wonderful Easter, Passover or what ever you are celebrating! Best wishes to all the dogs and their parents, Brigitte & Kahlu |
| Brigitte BC Canada |
| Hi Brigitte, We are so happy to hear that Kahlu is doing so well. I'm sure there are some nutrition things that could help with his diet, but I'm no expert there. That liver cleansing diet always sounded like a very good idea for dogs whose levels are elevated. We never really tried it because thankfully, Tiggs' levels were usually ok there. I've heard a few things regarding med reductions, here is what we did regarding Pred and Aza. We reduced Pred slowly, until Tiggs was on 5 mg per day, then about a month later, we went to 5mg every other day and Aza every other day, alternating the days, so Pred one day, Aza the other day, checking the PCV every week or two. After about another 3 or 4 weeks, we dropped the Pred entirely, keeping the Aza every other day, at 30 mg. After he was still maintaining, we lowered the Aza to 15 mg every other day(we have it compounded), and that's where he'll stay indefinitely, until I decide to try no meds- a scary thought. My vet thinks we can d/c everything, but I'm not there yet. I want to get through the summer. Good luck! melissa and tiggs |
| melissa slc |
| Great to hear that Kahlu is responding well to the med reduction. I was always under the impression that as the meds were reduced the chem numbers usually start to level off slowly. You are in the right boat as far as using the thistle and SamE. These numbers are quite high. Have they been rising on every test or only after you reduced the Pred? Have you had a chance to talk to Dr. Dodds about this? Perhaps a liver cleansing diet is needed. I know if it were me I'ld be freaked out. Even the tiny things get me upset at times. Keep us posted on what you find out. I'll keep you both in my thoughts and prayers. Johnny & Tessy |
| Jonathan |
| Brigitte, I would try the liver cleansing diet, it probably wont make the ALT ALK come down but will help with the liver processing foods, here is a good synopsis of why http://www.b-naturals.com/newsletter/liver/ Its most likely the prednizone, you didnt say what Kahlus values were at the test before this. Wylis ALT shot up to 1000 with this relapse, it was prednizone induced and being off pred now for 3 weeks, her ALT is down to 338. We never tested her ALP since it has to be sent out except when her relapse was diagnosed, my vet felt it wasnt needed since it would most likely show high from the pred. Are you getting the PCV done with Kahlu? I know you asked about it before because your vet was doing the blood test which always is lower and not as accurate as the PCV. Laurie |
| Laurie CA |
| Melissa, thanks for your input, that really helps. Could you tell me how much Tiggs weighs? I know every dog is different, but since Kahlu is on pred and aza as well, your reduction schedule seems appropriate for us. I know how you feel about the fear.....as much as I want to reduce it is also very scary. Jonathan, yes freaking out happens a lot these days! My vet talked to Dr. Dodds and she did not seem too concerned about the Chem numbers. They have been constantly rising and I thought for sure after reducing they should have come down, but I guess it takes a while. Thanks for thinking of us! Laurie, thanks for that link, that was very helpful. I have started to leave out the kibble and feed from the recipes from that website and Dr. Dodds diet. He went from ALP 462 to 500 ALT 393 to 448 GGT 378 to 506 in 10 days. Now that I type these numbers out it worries me even more..... We haven't done a PVC in a long time. The blood is always sent out. I think next week I will ask if they can do it at the clinic. There really is no point sending it out. But then it will vary because it is a different machine. So I don't know... Thanks for your help! Brigitte & Kahlu |
| Brigitte BC Canada |
This thread was discussed between 09/04/2009 and 11/04/2009
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