Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Latest blood results for Riley

Well, Riley's results seem to be standing still. All pretty much the same with the PCV - its the hematocrit here - of 0.29. Red Blood Cells from 3.99 to 4.05. Reticulocytes up from 152 to 478! White Blood Cells up from 36.7 to 43.6. Platelets down from 907 to 779 (given that this is the problem that took us to the vet in the first instance with 9 platelets)! The pathologist is asking whether there is any sign of bleeding internally that could be complicating this case. Spoke to the vet tonight about these results and she is seeking advice as she is frustrated as well. He also says the results are much the same, mild anemia with marked reticulocytosis and no spherocytes noted in the smear. I know compared to some results you guys have had and also from reading Meisha's Hope website, that these numbers are ok, but they do not seem to be moving. Is this the way it goes? I know it could take a long time. My visit to the Melbourne University specialist was moved to another specialist closer to home and they messed me around by giving me a regular vet, not a specialist, so I walked out. Have another appointment Monday with Melb Uni. To top things off, I was made redundant last Wednesday, called at 8.00am to a meeting and given the news at 10.00am. Great timing. :(

Silka Melbourne Australia

Dear Silka, How cruel! I am trying to see the positive, now you can spend more time with Riley? It took Kahlu about 3 months to get his numbers up into the high 30 ies and I know for some dogs it took even longer than that. Riley's numbers don't seem that bad to me, but I admit that I am not able to see a connection between the numbers or remember when his ordeal started. Have you put him on any supplements and has he been tested for hypothyroidism? Just thinking out loud. Thanks for the explanation on the anti nuclear test, i will ask the vet on Monday. I hope that Monday will bring good news to you and Riley! Best wishes, Brigitte & Kahlu

Brigitte BC Canada

Sorry to hear you were made redundant. I guess more time with Riley. At least he is stable which is a good sign. It is so hard when you want an answer and it is so difficult to find. Hope your next appointment bring you good news. Julie.

Julie Australia

Thank you Brigitte and Julie. The due date for the redundancy kicks in on 18 Dec, but it seems they might be making it difficult for me so Ill go sooner and forego the December pay, but I will not be able to do that. Hugely stressful. Anyway, re Riley, my vet phoned tonight after her chat with her consulting specialist. She said that Riley's current medication i.e. 12.5 mg prednisone, Imuran every second day, 1 cyclosporine per day - seems to be controlling the IMHA but not making much difference. It seems there are other immuno-suppressant drugs that can be tried, but only the specialists have them, such as Danazol, and this is mentioned on Joanne's site. Apparently they try this and see if there is improvement and if so, weaning can take place of the other drugs, I guess, just as Brigitte's fears in her other thread, its the fear of the unknown. Kim knows the person I am going to see - the Head Lecturer of Melbourne University and said that if it was her dog, that is who she would take it to see. Fingers crossed.

Silka Melbourne Australia

Silka, I'm a little concerned with the decision to maybe add another immuno-suppressant drug to the mix. With the retics as high as they are it is almost fair to say that there is no destruction in the marrow and with no spherocytes being seen that could almost conclude that the drugs are working. If I were you...and maybe I might have missed this in another thread....I'ld put Riley on some sort of a blood builder...Pet-tinic maybe? The reason I say this is because like Riley Tessy also hovered in the same areas...almost.....for months! Maybe she's missing some of the key blood builders that's needed. Perhaps her body isn't absorbing the nutrients properly. Have you ever had her B vitamins in her system checked? Might be worth while having that and her iron levels checked. Oh...and like Brigitte was saying.....thyroid tests done? I hope and pray you figure this out for Riley. I'll keep her in my thoughts and prayers. Johnny & Tessy

Johnny

Thanks for chiming in Johnny, and yes I do agree with you. Im not comfortable about another drug; I dont like what is happening to Riley now. Interesting what you say about the marrow though. We dont have Pet-Tinic here, tried to follow it up, and I am giving both my dogs a health booster with B vitamins, but I dont know how good it is. I am going to raise the thyroid issue as well as that is on one my pathology reports as a possibility, but the vets seem to think it is a common reaction to the drugs. I will raise everything I can on Monday. Just how many drugs does one poor little dog try at one time? At the moment Im worried about Riley, his tummy is tight and seems swollen, hope its not pancreatitis again.

Silka Melbourne Australia

Silka, I was not able to get pet-tinic here in Canada. Dr. Dodds recommended a bunch of supplements to us that would do the same thing. For my 60 lbs dog it was 5mg folic acid 250 mg B12 and 150 mg iron. You would have to adjust it to Riley's weight. Of course you will have to talk about this to the vet on Monday. Even supplements can be pretty powerful. Our vet talked to Dr. Dodds on the phone and was happy to follow this suggestion. I am glad you will bring up the thyroid issue, I would not be surprised if Riley would be hypothyroid, it is so common with AIHA dogs. It sounds like you will see somebody on Monday that really knows his/her stuff. That is always good to know. Good luck and best wishes, Brigitte & Kahlu

Brigitte BC Canada

I was able to get the Pet-Tinic here in Canada. I had to order it online and it arrived almost a week later. I think it was close to $10 a bottle and $20 for shipping. I ordered several bottles to save on shipping.....shipping was the same. I'm pretty sure they can deliver it anywhere...including Australia. I noticed a huge difference in Tessy's blood results after adding the Pet-Tinic. I added it on Dr. Dodds' recommendation to help with the microcytic anemia Tessy was dealing with. I think the site I ordered it from was "Allivet Animal Health" in case you wanted to check it out. One more thing...Tessy's crit hovered between 26-30% for months and it wasn't until I started to reduce her meds that it finally started to climb over 30%. Then it hovered between 32-35 until I added the pet tinic. Her iron was always a little on the high side so that's why I chose not to use the pet-tinic in the first place. She's been on it for just over two weeks and her crit jumped to 38.8%. Coincidence??? I don't know. Big, swollen, tight tummy eh.....you should see Tessy at times! Just watch out Riley doesn't get bloat. This can be deadly for dogs. I know I've had my scare numerous times with Tessy's tummy....usually after she drank TONNES of water. How often does he eat? Large quantities? There was one time she couldn't even lay down her belly was so big. Maybe you could try a small teaspoon of pepto to see if it might be gas down there. That's what I do for Tessy....but only when she gets bad. I'm always being asked if my dog is pregnant. Too funny. I guess I'ld know what she'ld look like if she was. I'm sure you'll figure out what's best for Riley. Have you ever consulted with Dr. Dodds? Money well spent. I can't even begin to stress how helpfull she's been to Tessy & I. Hugs and prayers to Riley. Johnny & Tessy

Johnny

You guys are fantastic - Im printing this out so I dont miss a thing tomorrow. I have checked up to see where I can get Pet Tinic once before. That is so interesting about the numbers. Patrice has also talked to me about supplements, and I need to follow through. I have communicated with Dr Dodds via email, and I also have her correspondence to take with me, I just hope this person is amenable to all of this information, as I have almost a suitcase of it. Johnny, I dont give Riley large meals anymore after the pancreatitis attack, but he is always asking for food, sitting at the pantry door, scratching, scratching - hard to refuse sometimes, but I just give a little at a time, and Im homecooking, boiled chicken breasts, lots of steamed vegies, low fat yoghurt, cottage cheese - baby food. Sometimes I eat it myself :) I have to say my other dog, Bonnie, a border collie, is looking more streamlined. What is pepto? There is gas, I know that, sometimes its very funny as Riley has his gassy moments and scares himself, running from the room, thinking something terrible is behind him, and of course it is! Thank you again, sincerely. I will let you know how it goes. I hope I can find the place. Silka

Silka Melbourne Australia

I know exactly what you're saying...."he is always asking for food, sitting at the pantry door, scratching, scratching - hard to refuse sometimes"! Tessy will sit in the corner of the kitchen sometimes for hours waiting for food. When I ignor her she'll scratch at the cupboards to get my attention. When I'm sleeping she'll paw at my head to wake me up. Thinking she might need a pee I get up and straight to the kitchen she leads me and in the corner she sits waiting for food. Annoying at times but very cute. Pepto Bismol (did I spell that right?) ...pink stuff. Tessy's doctor told me to give her a tiny bit when I thought she might have been bloated. Helps to get rid of the gas. The absolute first thing you should do is talk to your vet about using this. Apparently there are aspirin derivitives in the newer formulations which can be bad for dogs. ....from a yahoo question board.... "The children's pepto is what's recommended, and NEVER to give to a dog who has a fever. Dose is small, a teaspoon for every 20 lbs of body weight. AND always with a vet's ok only. There was a huge discussion on it on yahoogroups last year, people had lost ferrets to the new formula, and that brought up the feasability with dogs and other animals." ....... www lindamarvet com/pdfs/newsletter_2_supplement.pdf not sure of the age of this article Hope this all helps.... Johnny & Tessy

Johnny

Oh yeah...I almost forgot. If you are giving Riley cyclosporine you should know that there's been discussions concerning the use of dairy products while on the cyclo. Apparently it can inhibit the proper absorption of the cyclo into the system. I make sure that if Tessy gets any dairy (milk/yogurt/cheese/etc) she gets it nowhere close to her cyclo med time. Some don't give it at all. I have yet to find any literature that'll back this up. Why take a chance though with a drug that expensive right. Johnny & Tessy

Johnny

Thanks Johnny, everything is helpful, and some of those things I did not know - the pepto I have not heard of here, wonder what the equivalent is. I did not know about the dairy and cyclosporine either, I will have to be careful, wonder why they dont tell us this stuff. I honestly have no clue what does what, just that Riley is on the whole cocktail. Sometimes I find one of those cyclosporine pills on the floor out of the way, I guess he holds it there and then spits it out.

Silka Melbourne Australia

Took Riley to the Melbourne University Veterinary Hospital today on referral, and the vet I saw is the Head Lecturer there. A chest x-ray was done on Riley, a slightly enlarged heart with some fat around it, but nothing untoward going on there, she could not hear a heart murmur or an abnormal rhythm, no evidence of bleeding and unlikely there is fibrosis - so nothing to worry about there to use her words. Blood Crit/PVC is still 0.29; white cell count is 41.9 which is mainly mature neutrophils at 41.1. Platelets are 738. The bone marrow it seems is working particularly hard, with the reticulocyte count, corrected for anaemia, would normally be 0.1.5 is 14.3! Obviously not staying in circulation. I asked for an iron count which is not back yet and a cyclorsporin count was requested and those results not back yet - will find out tomorrow. The vet felt that the medication has been reduced too rapidly (something we talk about often), and I know she is thinking of increasing the cyclo and also the pred. Boo hoo - she knows Riley is suffering the effects of the pred. She wants to know whether the cyclo is doing what it is supposed to be doing. We shall see. Oh and for Brigitte, she did not know of the ANA test being used as a prognostic indicator as to whether a dog could come off medication - she said she would have to check up on that - so that was interesting, or not. Im not sure I like being led to believe that was the case - dont like false hope. Had to take my other dog, Bonnie, to the vet, with a lameness in her back leg, soft tissue inflammation so I passed on all that news to my regular vet. She did not suspect hypothyroidism due to the size of the red cells. It would seem cortisone is responsible for a lot of things. Because I have had Riley clipped back to cope with the summer heat we have been having and possibly will have, Ive been advised to get him a little t-shirt as the fur will thin and not offer the protection it should. Thats where we are at the moment. Iron levels will be interesting to hear Johnny. Silka, Riley & Bonnie.

Silka Melbourne Australia

Silka ...... "The bone marrow it seems is working particularly hard, with the reticulocyte count, corrected for anaemia, would normally be 0.1.5 is 14.3! Obviously not staying in circulation." You've got me stumped. Not sure what to think here. I know it takes 3-5 days for retics to mature into rbc's so it's interestin to see what happens. 14.3 is a fairly large number though. Perhaps the oxygen content of the blood is low? The high neutrophils could indicate a bacterial infection ir it might be due to stress. Does Riley get stressed easily? What are the other values on the CBC? Specifically the "M" values....mcv, mch, mchc, anmd RDW? Do they do a RBC morphology often? ..."She wants to know whether the cyclo is doing what it is supposed to be doing" .... you want to get the lymphopenia to a certain point so that there's limited activated T-lymphocyte attack on the rbc's. At least that's the understanding I got from discussing it with Dr. Dodds. ..."She did not suspect hypothyroidism due to the size of the red cells. It would seem cortisone is responsible for a lot of things" .... I'ld still have it checked. Better to know it than to have to wonder. Even if it's on the low end of normal sometimes it's good to treat for it. Johnny & Tessy

Johnny

I'ls strongly advise you to contact Dr. Dodds. I'ld even strongly advise you to send blood samples to her for analysis. She totally changed my perpective on Tessy's treatment protocal. Johnny & Tessy

Johnny

Thanks Johnny, I know you have advised me to contact Dr Dodds, and I have done that and she sent me her protocols, I dont know that I will be able to do the blood transfer given that I am in Australia, unaffordable for me at the rate I am going. I do the bloods every 10 days or thereabouts,latest M values are: MCV 71, MCH 22,MCHC 315 - actually those are within the normal range, except the MCHC a little lower. The cyclosporine assay takes about a week, may find out Friday, but I know she feels that will be increased, also the pred increased once again. Im a little exhausted Im afraid. Thank you all.

Silka Melbourne Australia

Silka, take a deep breath, sit back, and relax. I know exactly how you're feeling and how easy it can be to be afraid. There's been times I thought my head would explode. I used to drive myself nuts by worrying and being scared for Tessy. These numbers look to be in a good range. A high MCV usually indicated certain vitamin deficiencies. A low MCV indicated iron deficiency. A high MCH indicates poorly oxygenated blood. A low MCH indicates iron deficiency. A high MCHC indicates that there is too much hemoglobin in the red blood cell, indicating a high iron level since an important component of hemoglobin is iron. Iron excess is just as damaging to the body as iron deficiency. A low MCHC indicates anemia. (I cut and paste this info from petplace dot com). I'm sure that with time Riley's PCV will start to rise. Prayers and thoughts for Riley. Johnny & Tessy

Johnny Nova Scotia

Thanks Johnny, you have a lovely with words, and it is much appreciated. :) That information is very interesting to me. I also had an iron count done at the Hospital, and Riley is within range. In between trying to work at a place that doesnt want me any more, seeing my work being disseminated all over the place, trying to find work, and some medical issues, as well as Riley, its all wearing me out. Wanna swap?

Silka Melbourne Australia

Oh my Silka, there's times I wish I was on the other side of the world. I don't know if my shoes are any better than yours. I'm so financialy strapped now that we won't even be celebrating Christmas this year. Just way too many bills. The best x-mas gift for me would be having my Tessy Babe getting better. That's all that matters for now. I'm sure you'll find work somewhere. Like you I'm also in need of a full time job. A few months before Tessy got sick I left my job to seek other options. Been working part time since. Had many opportunities but none that will accommodate the current situation I'm in with Tessy. Things will get better with time. I consider this just a bump on our journey. The smooth road is just around the bend. Hope and pray for the best for you and Riley. Johnny & Tessy

Johnny

Thanks Johnny, I know, I was having a bad moment, and me too, I would like Riley to be better, like your TessyBabe it just all happened too suddenly. Just spoke to Melbourne University vet and her view is that changing the medication for Riley could be a good move to getting him on the way. Her view is that Riley is doing what dogs do, when he wants to go to the toilet, he goes, when he is thirsty, he gets a drink, and when he is weary, he can lie down and rest, and she felt he was doing ok under the circumstances with a possibility of reducing the meds in time, just not quickly (results still not through). I was feeling sorry for myself and I know there are lots who are worse than I, so forgive me for that moment. I like your philosophy Johnny "a bump on our journey and the smooth road around the bend" Thank you :) Silka

Silka Melbourne Australia

My dog Suddee Lou ( a 110 pound Dobe) was just diagnosed with autoimmune Hemolytic anemia. Its nice to see that others are as attached to thier pets as I am to my Suddee. We have been to 4 different vets and they all seem a little clueless. She is on Presidone and a immune system suppressor. She is eating, but is still sleeping 90% of the time. I don't know what else to do for her..

CeeJay U.S.

I am thinking of you and Riley, always. Stay strong and know that alot of people have you and Riley in their thoughts and prayers.

Mardi Northern Calif

This thread was discussed between 19/11/2009 and 29/11/2009

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