Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Kent - Liver and Kidney problems

Hi everyone, Our Vet called last night and the news is not good. It seems that Kent is headed for imminent Kidney failure. His BUN levels are up to 70, his AST is 70 from 59, his ALT is 494, his ALK Phos is 740 and GGT is up to 228 from 138. These suggest his Kidneys are beginning to fail. His thyroid levels are low also, and he is going on a supplement. His liver is also seriously compromised, and our vet has suggested actigall for this. His hemotcrit is stable at 36. We reduced his pred from 20mg to 15mg yesterday, and he is taking 25mg imuran daily also. In addition, he takes 1g sucralfate a day, milk thistle 175mg, pepcid ac 20mg a day (divided by two), and pet-tinic and a pet tab a day. We recently reduced his metronidizole from 500 to 250 to 0 a day (he had taken 500mg for several weeks to control diarhea and bloody stool). Reduced to zero when we got clavamox (125 + 62.5 x 2 a day) to give him for his persistent slimy and dark poo. He started the clavamox Thursday night, and his poo seems to be improving but its hard to tell so soon. His appetite is very low, though he will eat some of his dry food if hand fed piece by piece. He is always happy to eat a hot dog, which we use for his medicine. He will nibble on a carrot here and there, and a bite of apple. But in general, he would just rather sleep. He does not play with his ball or his bear, just lays a lot, perking up only when there is a possibility of a hot dog - which makes it hard to put him on a low protein kidney diet. He rejected the liver diet weeks ag0 - will eat fish, or chicken but leaves the veggies. Our vet has also suggested we can learn how to give him liquid under his scruff and inject him up to 3x a week, to clean his blood since his kidneys are not doing it. We dont know if kent will accept this, and we are worried about his quality of life. He will go on actigall and thyroid supplements on monday and we will see if these help at all. Also suggested is some sort of binder, but our vet is reluctant to put him on a third new drug right now. We are very very dissapointed. It seems that in this fight to get the disease under control, we have seriously damaged his organs. The latest blood report says that serious cholestasis is present as well, meaning liver damage. This poor dog has been through so much, and now this?? I am just sick to think that we are going to lose him now to kidney failure due to the treatment of the imha. I am so frustrated and feel like we have run out of options or other avenues to try. If anyone has had a similar result or problems or knows of anything to try, please let me know. Thanks, Christine and Kent

Christine Florida

Christine, I am so sorry to hear about Kent,you must be so worried. OMG I hate this disease! There are so many side affects, it's like one thing leads to so many other things. My thoughts are with you both. I decided a while ago that if Trixie reached the point that her quality of life was totally going down hill and if she had other major problems going on internally along with AIHA, I really think I would have to make a decison. God, it's heart wrenching! Please keep us posted Christine. Tricia

Tricia UK

i am so sorry to hear this. This is such a horrible disease and people who have n4ever faced it doesn't understand the up, down, up down, and so many times heart breaking end--i lot my 4 year old godlen retriever 8 days after diagnosis. I h ope the new meds will ork.

Sandra Texas

Christine, I was so saddened to read your post. It does not seem fair that you do everything you can to save your dog while trying not to harm them more in the process. I am keeping both you and Kent in my thoughts and prayers. Penny

Penny Lytle Creek Calif

dear christine and kent i am sorry and saddened to hear your story. five weeks ago our girl gismo was diagnosed with aiha and was put on 2 steroid meds.she picked up,her blood levels climbed and then about 3 days ago she seemed to almost be slipping back again. today march 1 we took her to the vet who did a blood test and told us all this medical jargon, that in the end was basically telling us that there was something wrong with her kidneys,something was elevated. it does seem that you take 2 steps forward and 5 steps back. we dont know what to make of it. -delena and gismo

delena winnipeg

Dear Christine, It sounds as though you and I are facing the same sort of dilemma. My dog is also holding her hematocrit but her WBC is way high showing some kind of infection or other unknown problem. She is on intravenous double antibiotics but has not shown any results that are promising. She sounds kind of like your dog - just laying around and not eating. My dog, though, has hardly any mobility in her legs. They just give out on her. It's the same situation here - I think the drugs that we had to give her to save her from the aiha really did a job on her. I just don't want her to suffer but I don't want to play God either. Please know that i am thinking of you and hoping for the best for you and your wonderful pet. Gail

Gail SD

Hi Christine, Many of us still on the list have had to make that dreadful decision. You will tie yourself in knots with "if onlys". It is a terrible time but know you are doing all you can. We had to take the decision with Georgie. We knew it was the right decision for her but it didn't make it any easier. On a more positive note, we had to inject Georgie twice a day in the scruff of the neck and like you I was sure she would not like it. She never bothered once; it was like she knew it would help her. The vet can show you how and believe me once the initial nerves have gone it is very simple. I wish you all the best at this difficult time. Remember each dog is different and you will get so much support here. Steph

Steph Wales

Christine, So sorry to hear about Kent and know how hard it is after all he has been through to now have kidney failure. We had a dachshund that we had to put down about 6 years ago from kidney failure, and the entire time we lived in Florida, because she was an itchy dog and allergic to everything she was kept on prednisone most of her life. If I would have known then what I now know about all the damage prednisone does we would have probably tried to do things different. Unfortunately when our Becky's kidneys started shutting down, it was very quick within one week she was gone. So just tell him how much you love him and spend as much time with him as you can and we will pray that the new meds start working for him. But just know that if it doesn't work you have done as much as you could for him and he knows this. When he has had enough he will tell you. Take care, Linda

Linda Sapphire

Hi Everyone, I havent posted in a while, but have been following up. The good news is that kent's bloody stool has been taken care of. A urine culture showed three bacteria, one of which is extremely rare, but all three responsive to baytril. He started the baytril on the 2nd of February, and now his poop is normal. Yippee! We are having ups and downs since then. We were able to reduce his preds when his hematocrit went to 35, and he was taken twice to the vet for fluids in the last two weeks. Tomorrow he gets tested for addison's disease, and i am then also requesting a pancreatis test - the spec test at texas, and also scheduling an ultrasound. The kidney thing is weird - does he, doesnt he.... his bun is up to 84 and the creatinine at 1.7. He rallied for a while and i was able to take him to the beach (!)for a short swim which he enjoyed. If anyone wants to see some pictures, i'll be creating a flickr site for him soon. But the last two days he has just been lying in his spot. His energy is very very low, and his appetite non-existant. He used to eat so much, now wants almost nothing, and when he wants something its a piece of apple or most often meat. Fish, beef, chicken, kielbasa, anything. I accomodate him. Whatever he wants right now, he gets. His thirst has also decreased, which is weird when on pred. Just now i took him for a walk, and he has diarrhea, but very little as there is not much food in his system, and its not bloody, just brown and a little green probably from teh pet-tinic. We went to the park this afternoon, where he has been going almost everyday, and today was the first time when i would toss his ball and after he caught it, he would lie down for a few minutes. His spirit is there, his personality is full on, but his energy level is zip. I've been frustrated the last few weeks, and do my best to keep that energy out of my house though it is hard to do lately. I would be happy to mail his blood tests etc to anyone who wants them. On a more positive note, i wouldnt trade him in for anything, sick or healthy. He is not in pain, for which i am immensely grateful. His quality of life is slightly diminished but not to the point where he would have to leave us. He reminds me often throughout the day that he remains himself, just a little older and grayer. I'll post his results as I get them, Thank you everyone for your messages. Thank you! Christine and Kent

Christine Florida

Update: Kents hematocrit is 33% inhouse, a slight improvement. He is currently on 10mg pred and 25mg imuran a day, and we have decided to reduce the imuran to everyother day. His poop was good today, and we will have results from addisons testing in a few days. He received fluids and vitamins at the vets, and was more energetic today when we got home and had an appetite, not much, but better than in the last three days. Things are looking a little bit up, and thats all good. Christine and Kent

Christine Florida

hang in there, my dog had a major spike in kidney values and i was told by one of my vets that she would have full renal failure within 6 months... this turned out to be not true at all and instead was a result of a very bad health stretch she had during the prior week (she had a heat stroke) anyways, the levels returned to basically normal over an extended period of time...

josh california

Christine, I agree every moment we have with these very courageous dogs is a moment to be cherished. Hopefully like Josh said this is just a bump in the road for Kent. Thinking of you both. Penny

Penny Lytle Creek Calif

Hi All, The good news: Kent does not have Addison's Disease. The Bad news: Our vet is sure he has Kidney Disease. We do not know how bad, but his UPC ratios were 31 (!!) then 21. New results next week - sent them to hemopet. His Bun is high - 84 - and his creatine at 1.7. In talking with others, there is a possibility of kidney or bladder or gall stones, as well as of pancreatitis. There is a current enrollment for mini-schnauzers at UofTexas Vet College, I will see if he can be enrolled in their pancreatitis study. I also discovered a condition last night called HUS which is mostly in humans but they are finding it in dogs now. It causes AIHA, IMT, and Chronic Kidney Disease. A paper I read out of Japan showed strong evidence it was related to infection with E. Coli - which people and dogs get. It reminded me of a news story of the 19 yr old girl who had got the Jack in the Box EColi years ago, then just last year developed acute kidney failure that they tied to her exposure. Anyway, Kent received fluids two days ago when he was being tested for Addisons, and up until this morning was very much alive and bouncy and up! This morning back to low/no appetite, low energy. Josh - is there any explanation for these values? Curious - we are in florida but kent has 24/7 A/C except its hotter in the car when he rides 5 min to the park. What do you feed your pup? What kinds of supplements? Thanks everyone, Christine and Kent

Christine Florida

Hi Christine, How are the other levels- like phos, potassium, calcium? The bun will always rise faster than the creatinine but the creatinine is kidney specific. If you would like you can email me the results and I can give you some feedback. My email address is: birdshag@hotmail.com

Teresa va

Christine, Just a thought since you mention the E-coli. I don't think you were on the board when Ruth was posting about her dog Maddie. Maddie was initially being treated for a diagnosis of AIHA and was going downhill pretty fast no matter what they did. It was finally diagnosed as being e-coli and she got on the right drugs and was in full recovery the last time we heard from Ruth. You can look in the archives for her posts or I am sure she would not mind you emailing her at tddynewf@cruzio.com Perhaps it is a long shot but I think we all grasp at those straws when in the fight. Good Luck Penny

Penny Lytle Creek Calif

This thread was discussed between 02/02/2008 and 07/03/2008

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