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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Keeli/Down to 29
| Patrice, (and anyone her has advice please let me know) We got back from the vet late last night and Keeli's pvc had dropped to 29. Was 32 last week. He said the area on her rt shoulder blade was a mineralization and would be permanent as well as the small areas on her chest. Called them plaques. Does this sound right to you? Just wanted to update on the meds. I had decreased the azathioprine to 12.mg daily, decreased the sucralfate to 500mg daily. Still on the pred at 10mg 2 x daily, pet tinic, and denamarine. Just finished the ketaconazole yesterday with very little improvment in the thrush on the bottom of her tongue. I had the vet do a ua. Here are the results. ph 6 LEU 25 leu/ul PRO TR GLU neg KET neg UBG norm BIL neg BLD neg S>G>=1.012 Very few WBC LAB: BUN high at 51mg/dl ALT high at 386 U/L ALK high at 391 (not sure if this is true or not was initially still too high to read. I am concerned that he tried to take her off the azathioprine and did take her off the cyclosporine before he tried weaning her off the prednisone. He stands firm when I ask but its really bothering me. Let me know what you make of it all. I trust yoiur judgement and have through all of this. I increased her back up to 25mg 1 x daily on the azathioprine and increased sucralfate to 500mg 3 x daily. i just don't want her dropping anymore than 29. Thanks Keeli and Joann |
| Joann Binger Ok |
| So sorry to hear about your Keeli. Know that we are praying for you. Blessings, Cindi & Tori |
| Cindi FL |
| Cindi, Thank you so much for your prayers. Joann and Keeli |
| Joann Binger Ok |
| Joann, Some of your lab workup is missing, like RBC HCT RETIC PLT WBC. These hematology tests are called a CBC complete blood count and are the most important values used to determine what meds you should be using and what dosages you should be using. It looks like your vet only did a chemical screen and a simple PCV. In order to decide what you do next it would be necessary to see these results from several tests to get a look at the overall picture. Your vet is firm in what they are doing and can see the results of all the testing. Do you have a long standing relationship of trust with them? The ALT and ALK are liver enzymes that show the liver is processing prednisone. This damages liver cells and the body is responding by making new ones. You can expect them to be higher than normal when administering prednisone. These values are high, but not the highest I have seen. The liver is very regenerative (and in fact is doing that all the time) and, unless there was any form of liver disease prior to this illness, it will recover once the dose of prednisone is decreased. The Denamarin is very important to help it recover. The BUN is a kidney value and it is showing the amount of wastes that have not been successfully removed by the kidneys and are still in the blood. Without the accompanying Creatinine value it isn't as easy to figure out what is happening. A high BUN value with a normal Creatinine value can occur as a result of a high protein meal prior to the test or even dehydration can influence this number. It can also be high due to prednisone use. Seeing the result of both of the values over several tests is the best way to determine what is happening with the kidneys. You do want to monitor these kidney values closely, they are very important. I am taking a guess that Keeli was dehydrated when this test was taken and that may account for the high BUN and the decreased PCV. That value is a percentage of the combined "red stuff" and "white stuff" that make up blood. Since a large portion of blood is simply water dehydration will mess up the ratio of those percentages. However, it is like being caught between a rock and hard place. The best results are always after an 8-10 hour fast and prednisone is notorious in causing dehydration. So it is inevitable that most dogs here will be dehydrated to some extent. The plaques are not dangerous, just unsightly. Chance had several too. When he had surgery on his knee I had the most obvious ones removed. I am sorry, I know how they look. my best patrice |
| Patrice NYS |
| Patrice, Thank you. Will make sure a CBC is one next week. I hope her pvc is back up then. I believe you're right about it being dehydration because she had diarrhea for several days prior to the test. She has been drinking lots of water and the diarrhea has gone away also. Will keep an eye on the kidney function. Thanks again for addressing this. Joann and Keeli |
| Joann Binger Ok |
This thread was discussed between 01/10/2011 and 02/10/2011
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