Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - kahlu update and advice please

Hello everyone, i can't believe, how coming to this board has become such a big part of my daily routine. I check at least 3x per day. And when i see a new diagnosis I get so sad and hope for the best. I thank all the people that come here to help us newbies through this. When I get new results for Kahlu, good or bad,I can't wait to share with you. So here it is:RBC from 4.6 to 4.2 to 4.6 HCT from 37 to 32 to 36. This increases or decreases happened in 2 weeks. This is week 4 on 35mg prednisone 2xpd and week one of 50mg azathioprine 1xpd. He weighs 55 lbs. Of course he is on all the usual stomach protection drugs and just finished a week of metranidazol for bad diarrhea. Now I give him Forti flora. As much as it scares me, I would like to start to reduce the prednisone by maybe 10mg (?)per day, because it is so hard on him. I will talk to the vet on Monday and just wanted to know what you think. Is it to early? I am just worried that I poison his body so much. (even with Milk Thistle)Also his muscles are totally gone. His hip started clicking about 10 days ago. Has anybody experienced this? He is clearly not in pain, since he lifts his leg on both sides. His gums are quite pink now but he is still VERY tired and I was hoping if we reduce the prednisone that would get better. Thank you so much for your input, Brigitte

Brigitte BC Canada

Brigitte, I do understand that you are concerned with the effects of the steroids, it is at the forefront for almost everyone that has had to deal with this disease. The muscle loss is very normal and hopefully will be restored once Kahlu is off the meds. The flucuations you are reporting does show that he is not stable yet.Your Vet will be able to advise you better when you talk to them. Go back and re-read the success stories at Joanne's site and try to see a pattern in what worked for those dogs. The Azath can take up to 6 weeks to even start working. Thinking of you both Penny

Penny Lytle Creek Calif

Since Kahlu is on 70 mg a day at 55 # and its been 4 weeks, I would be inclined to ask the Dr about reducing the pred. I think from what I understand reading your previous post is she dropped to 32 and that was the blood test not the spin one right? and In this reading of 36 the spin one? Because the test they dont do the spin is always lower than the spin one and not as accurate so vets usually go by the spin one, and that means Kahlu is holding. Laurie

Laurie CA

For Kahlu's blood tests, the 37 was done on a LaserCyte, i don't know if you would call it a spin. The last two were sent out to a lab for a full CBC. His HCT at diagnosis was 17 I don't know about the RBC. I can't wait till Monday! Thanks for your input Laurie and Penny, Brigitte

Brigitte BC Canada

Brigitte I just wanted to let you know that Ginger's hip sounded like an old creaking rocking chair while she was on the high dose of pred. If I gave her a little push on her side you could really hear it creaking, it was horrible. But there is good news once the pred was reduced the creaking gradually went away and it is now totally gone. Kahlu is the first dog other then Ginger that I have heard of with the creaking hips. If your vet agrees to lower his dosage make sure it is done very, very gradually. I believe Dr Dodds does have a pred reduction protocol and perhaps someone else on the board can tell you what it is. I know how hard it is to see them on pred with all the side effects but it is a small price to pay when you think of the alternative. Sending tails wags your way!!! Cheryl & Ginger

Cheryl & Ginger Pineville PA

I'm extremely glad to hear that Kahlu is doing well. I'm hoping Tessy will eventually get there and eventually be off the meds all together. My first prayer is for her body to accept the first transfusion she had yesterday. Just keep giving Kahlu love and warm talkings and it'll go a long way. I'll be thinking of him and wish you both the best of luck.

Jonathan Nova Scotia

Brigitte, I know how hard it is thinking about all these potent drugs that our pets are taking. The pred has such terrible side effects. My little Ren has lost most of her muscle. She can not jump up on her chair any more. But she has enough sense to look up at the chair and whimper to be picked up. It is very important that the meds are not withdrawn too soon. Ren was on meds for four months last year and this last relapse, she has been on meds for three months. The blood work number can fluctuate a little. We discussed this in another thread. (Ups & downs). The numbers can be affected by the vet visit itself, feeding, etc. You are in our prayers, SUE

Susie Delaware

Brigitte, Lasercyte is the automated analyzer that many vets use in office. It is very sophisticated but it can have a hematocrit reading that is lower than the packed cell volume. The PCV is a tiny little tube of blood that is spun in a machine for about 3-5 minutes to separate the blood elements. Then they hold the tube up to a chart and read off the PCV %. It is extremely accurate and should be a very inexpensive test. Always ask for this in addition to the full CBC test. The side effects are all related to this very high dose of prednisone you have him on. The azath will take some time to begin suppressing the lymphocytes. If you are taking routine CBCs you will begin to see the numbers of these white blood cells slowly decrease. This will be an indication that the new drug is beginning to work. The body can recover from Iatrogenic Cushing's Disease (or Cushings that is caused by high doses of prednisone) once the dose of prednisone is lowered. The muscle will come back, the liver will recover, the skin and fur will become supple and shiny again. I *know* how very hard it is to watch these awful things happen. They will go away. I promise. Moderate his activity so he will not injure his joints while he has so little muscle. my best patrice

Patrice NYS

Patrice, thank you so much. You just have a great way to explain things! I will talk to the vet tomorrow and see if they could do a spun PCV at the clinic. His Lymphocytes are down from last weeks CBC but I don't know the exact numbers. I will check that tomorrow as well. To be on the safe side, we should probably stay on the 70mg for an other week, to make sure the Azathioprene has kicked in. Thank you so much again for explaining! I also read your post to Jonathan. There is so much that is clearer to me now. I found a picture of your Chance in the old archives. What a handsome boy! It gave me so much hope that we will come out of this with a healthy, happy dog. Thanks for your dedication to explain and educate us! Brigitte

Brigitte BC Canada

This thread was discussed between 21/02/2009 and 22/02/2009

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

This thread is from the Vetnet archive. The live Vetnet forum is active now.