Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Lincoln has AIHA

We took Lincoln into the vets on Sunday because he was "off" and they ran blood work that was sent out. When the results came back on Monday they called and ask if we could bring him in Tuesday for them to recheck his blood in-house because his PVC was so low but he wasn't showing any clinical signs of it being that low. We took him back in and his PVC was even lower at 13. Lincoln is a greyhound and their normal PVC starts at 55. They did x-rays to rule out a mass and since there was none we are treating him for AIHA. He had a blood transfusion on Tuesday evening. Fortunately we have other greyhounds and one of them was the donor. He came home last night on 60 mg pred 2xday, Azathioptine 1xday and clavamox 2xday (I think 375 mg). His gums are still very pale, he's tired and not wanting to eat. This is not the Lincoln I'm used to. He's only 5 (we've had him since he was 4 months old) and, unlike your normal retired racer, has always been high energy and eats EVERYTHING. He'll eat his treats and PB with his pills hidden in it and if I hand feed him I can get his meals in him over time. I'm so glad I found this forum. I can find info on the net but no everyday experiences of what to expect. For those who's dog has had a transfusion, how long did it take for their gums to return to something close to normal? They are rechecking his blood this weekend, How soon do they go back to wanting to eat? Any tricks for getting them to eat? When will MY stomach stop bing tied in knows with worry? Guess you really can't answer that one. How long before we know if the treatment is working? Thanks for any info. Trish (Lincoln's worried mom)

Trish Ellciott City

Hi Trish. Sorry you had to seek out the forum for help but you found a great place for advise and support. How much does Lincoln weigh? Do you mean he gets 30mg pred in the morn and 30mg in the evening OR do you mean a total of 120mg daily? If it is 120 then it's way too much! What's the dosage of azathioprine? Are you using something to protect the stomach? Sucralfate/carafate, pepcid or prilosec? If not GET ONE! Very important to prevent stomach ulcers from these hard drugs. Get some milk thistle also and start adding it daily to the food. This will protect the liver from the damaging effects of the drugs. These drugs will cause some fairly serious side effects but it's what's needed right now. Ask for copies of all the bloodwork done to date (and in the future). They shouldn't have a problem doing this as you're the one paying the bill remember. This is important because then you can look stuff up and answer our questions easier! Do you know a trigger for the disease? What started it? This can be a number of things from previous drugs, vaccines, flea/tick preventatives, poisons/toxic reactions, etc. Thyroid problems have been linked to this disease so that makes it VERY IMPORTANT to have a full thyroid panel run. In fact it would likely be wise to add a low dose of thyroxine regardless cause this will help stimulate the bone marrow to produce more new blood. You could contact Dr. Dodds and have blood sent there cause she's the expert on this disease and actually she's the one who teaches the specialists AND she deals with Greyhounds on a daily basis so would be very familiar with the breed. Many of us here send blood to her for analysis...I'm in Canada and have sent blood to her! (around $200 from Canada). Pet Tinic....if you can find this then get it. This is a mineral/vitamin supplement that supplies the body with the needed micronutrients (iron, Bvitamins, folic acid) for hematopoiesis (blood making). You may have to order it online. Diet is super important in fighting this disease. I fed my TEssy a liver cleansing diet per Dr. Dodds' advise and TEssy did really well off it. If you are interested here's a link to the diet... www.canine-epilepsy-guardian-angels.com/liver_diet.htm I gave Tessy loads of different foods to keep her eating...scrambled eggs, roast beef, steak, green beans, hummus, sweet potatoes, brocolli, etc. Just avoid wheat, corn and soy products. I think the trick with eating is to make it tasty for them...hence the home cooking! If still no luck with eating we can discuss med options to stimulate appetite. Try not to stress too much. They can pick up on it very easily! I know...easier said than done! Keep him well rested, stress free, and drinking lots of fresh water. ALWAYS make sure the meds are given on time. I'll keep Lincoln in my thoughts and prayers. Johnny & Tessy

Johnny

Trish, buckle up, this is indeed a bumpy ride!! I am glad you found us, sorry you needed to. When this damned disease strikes, our buddies are super healthy one day and then the next, they are not who we remember. I first want you to know, you are doing the right thing by asking questions. There are lots of folks here who know quite a bit about this disease. The drugs can take some time to kick in, but the transfusion should make him feel better right away. What was the PCV after the transfusion? Summer was 6% before transfusion, and 22, right after. I would suggest you get some Pet-Tinic right away as well as milk thistle. Make sure Lincoln is taking something to protect his tummy too, like Zantac. Feed him whatever he will eat, if he will eat a cooked piece of white fish fantastic it is great for the liver. Just feed him what you can get down him though. You will see in a short while you will have many answers, more than I can possibly give. Carrie and Summer

Carrie DFW

Yeah, what Johnny said!!

Carrie DFW

Hi Trish, Lincoln is included in our prayers. Listen to Johnny, he was brilliant along with others when we went through this last year. My little dog is doing well now so have faith. Hope things improve. Sue and Archie

Sue Cambs UK

Ok, some things to add to my shopping list. Lincoln is about 65 lbs and yes that's 60 mg 2x/day for a total of 120mg of the pred. I think this is just a starting dose but I'll ask when I call the vet in the morning. I think the Azathiopne is 50 mg but not sure and I'm at work right now. He loves pasta so I was going to try that tonight. He'll even eat kibble as long as I hand feed it to him. I was going to ask about something to help his stomach. I'm used to the roller coaster ride with pets. We have a cat with CRF and I know there are good days and bad. This is just all so new and until he's stabilized very stressful. But I guess I'm preaching to the choir on that one. But it's nice to know there are other going through the same thing and there are "success" stories.

Trish Ellicott City

120mg of pred for a dog that weighs 65 pounds isn't that bad actually. It's a bit high but I've seen higher! All the more reason to be using milk thistle and stomach protectors! Forgot to mention....by PB do you mean peanut butter??? Peanut Butter IS NOT healthy for dogs! IMO not even small amounts! It's extremely hard on the kidneys! I'm sure you can find something much better for putting meds in. If you haven't already then check out Joannes site... http://www.cloudnet.com/~jdickson/index.html There's a wealth of knowledge here and the success stories will give you all the hope you need!!! Joanne has done a marvelous job with this site!!! Sorry to hear about the kitty. Johnny & Tessy

Johnny

Trish, I am so sorry you had the need to find this board, but at the same time glad you did. I can second every thing Johnny said and recommended. What came to my mind right away is Dr. Dodds rescues Grayhounds. She would be an excellent source of advice and does consultations with you or your vet for $45. Like johnny said you could also send blood to her labs at hemopet.com for testing. Keep reading the success stories on Joanne's website, they are very uplifitng and will give you hope! Best wishes, Brigitte & the poodle boys

Brigitte BC Canada

There are too many dogs coming down with this awful disease, but you are fortunate to have found this board. I lost my Juliet last week after a valiant fight to save her. If there is anything I would have done differently, it would have been to get a consultation with Dr. Dodds earlier...before it was too late. My Juliet was just over 7 and similarly she had no signs but for the pale gums...There is a lot of great information on this board....scan through all the threads and you will pick up the information that may be lifesaving. Above all consult Dr.Dodds first...my vet found her to be very helpful too. She has a greyhound kennel since they are universal donors...visit the website www.hemopet.org and you will learn more about it. Also Meisha's Hope website. Many of the people here are very knowledgeable...and a source of consolation as well as good advice. Best of Luck Pat

Pat Vermont

hi trish you have found the very best site for lincoln's disease, i hope they told you that the transfusion is a temp. fix until the drugs start to work. i do not comment very often as our aiha cocker has long since passed (not of aiha,) our pooch developed this terrible disease when she was 2, i found joanne while reading a doggie mag. while waiting in the vet's waiting room, one of many, many visits, i read an add in very small print, asking the question, has anybody ever heard of this disease, and that is how it started with joanne, the founder of this wonderful site. her meisha had just been diagnosed and she was looking for info.in those days the info was very scarce, and it was a tad scarry, but people started to respond and friendships and info started to flow, including the vets, it was hard to find a vet who had treated the disease, i would say in those days the diagnosis was fatal for the dog and emotionally trying for the owners. things have changed since joanne got to work, and now she is working with the morris animal foundation to try and find better treatments and of course a cure for this terrible thing. it will be a long journey for you especially, because the dogs don't have thinking abilities, thank goodnes, so it falls on your shoulder, they become very broad, very fast. take care, there is lots of hope out their.

Bev

Dear Trish, This is a loving caring forum with many wonderful, kind and caring people helping each other and lending support. Everyone on here loves dogs and we are all so upset that any puppy dog has to go through this. It is so unfair. Thank goodness there is help and treatment.(although costly) Unfortunately it is becoming more prevalent but we can only hope that more research will go into this disease. Spot on flea treatments and vaccinations can be a trigger. My Gracie will never get another vaccination or flea treatment. She is such a lovey. Johnny has been through this twice and has a lot of understanding of this disease. Many others know a lot as well. We are all routing for you and Lincoln. Many hugs, Gwen and Gracie

Gwen Rhinebeck

Lincoln had to have another transfusion over the weekend :( His PVC had dropped to 11. He's still at the vets. They are rechecking his blood today. It was up to 19 after teh transfusion. One thing that has us all worried is that even on the pred he doesn't want to eat vet much. Any ideas onn what can cause this? He's on pepcid before meals to help his stomach. I'm going over at lunch with some chicken to try to get him to eat. Keep thinking good thought for Lincoln Please.

Trish Ellicott City

Maybe the Pepcid isn't doing enough. We had a Rx for Juliet called Gastri-soothe. It was a vetinary product, but not very expensive. Might ask the vets about it. Rx was twice a day ahead of the Prednisone. Juliet was very hungry and was on 40mg of Prednisone twice a day.

Pat Vermont

Trish, Most likely Lincoln feels pretty nauseous from the disease and all the medications. It will take a couple of days until the prednisone sets in and he will become ravenous. As Pat said, the pepcid might not be strong enough. We used a product called sucralfed that had to be given 1-2 hrs. before the prednisone and azathioprene. Ideally it was given over night. It lines the stomach and could interfere with absorption if given to close to the immune suppressing drugs. Trying to feed him lean chicken is a good idea. You could mix it with some pumpkin or sweet potatoes. At this point a bit of rice would be ok too, but in general you want to stay away from all grains. Go over Johnny's post again, you have some good information there. You might also want to ask the vet to check for aglunitation (clotting) and add a small dose of aspirin to Lincoln's meds. Please keep us posted. Thinking of you and Lincoln, best wishes, Brigitte & the poodle boys

Brigitte BC Canada

Lincoln's coming home tonight. His PVC dropped a little yesterday but they expected that since he was on fluids. This morning it was up to 20. Not normal but he made up the ground he lost yesterday and climbed a little. Long way from 55 (low end of norm for a greyhound), but at least he's starting to make red blood cells faster then he's killing them off. He gobbled up the chicken I took him. I started feeding him little bites one at a time but that wasn't fast enough so he stuck his head in the bowl and ate everything I brought him. :) We go back Friday for blood work but if he starts slipping backwards we're to take him in immediately. Crossing fingers that Friday will be even higher.

Trish Ellicott City

Yea for Lincoln!!! I am so happy he is going home where he belongs. Now it will be up to you Trish to take good care of him. Make sure he has clean water available all the time. He will drink lots and unfortunately pee a lot too. Be prepared to get up lots even at night. Try and keep him calm and rested. No walks, just go outside with him to do his business. Keep a close eye on the color of his pee, you want it on the light side. Be ready for some diarrhea, adding caned pumpkin (pure pumpkin not the pie filling) can help with that. If Lincoln is getting his appetite back, please stay away from fatty foods, you don't want the complications of pancriatitis. Scroll back to check in Johnny's post about the liver cleansing diet. I must say I would feel a bit nervous about waiting until Friday for Lincoln's next CBC. You could go in in two days and just have them do a RBC. That should be fairly inexpensive, something like $20, since they should be able to do it right there. The RBC should be about the same as the hematocrit in the CBC. What medications and dosages is Lincoln on now? Have you added any supplements like petinic? And then my standard question has he had a full Thyroid panel? Even if his thyroid is on the low end of normal he could benefit from a thyroid supplement. Run it by your vet, check the success stories and don't loose hope! Best wishes, thinking of you and Lincoln, Brigitte & the poodle boys

Brigitte BC Canada

Just to clarify...total dose of Prednisone for Juliet was 80mg a day...in two doses. Juliet weighed 75lbs/34Kilos. Thinking of you and Lincoln. Best. Pat

Pat Vermont

Is Lincoln home yet??? Continued thoughts and prayers, Johnny & Tessy

Johnny

Yes, Lincoln's home. He ate breakfast this morning without any real encouraging. First time in over a week we haven't had to do at least a little encouraging. He also is more alert and "with it". Not as glassy eyed and quiet. Now it my Pet-tinic would jest get here so I can start him on that. Couldn't find it locally so had to order on line.

Trish Ellicott City

I am very happy that Lincoln is showing some signs of improvement. Keeping our fingers and paws crossed for him. Please keep us updated. Cheryl & Ginger

Cheryl & Ginger Pinevile PA

YAY for Lincoln eating!!! That's always a great sign! I bet he's just so happy to be home right now. Keep him eating and make sure he gets all his meds on time. Don't miss any doses. Lots of rest and clean water is a must, as is milk thistle! You haven't answered our question concerning whether they tested the thyroid yet!!! I consider this to be one of the more important tests to have done! If you can afford to do so perhaps you can send blood to hemopet for analysis by Dr. Dodds. You can get a big HUGE blood panel done by her for a fraction the cost your vet charges likely. You also get the breed/age/sex specific thyroid done by her...which is the best canine thyroid test on Earth! Her included morphology and suggestions are priceless! Keep us posted. I'll keep Lincoln in my thoughts and prayers. Johnny & Tessy

Johnny

We did test his thyroid and it's only slightly low for a greyhound. One of our other greys was at the same level and we never treated it and he was fine. Greyhound normally are a lot lower then other breeds. I'll talk to the vet but it's so close to normal for a greyhound that I normally wouldn't want to treat it.

Trish ellicott city md

Trish, the keyword is normally.... this disease tends to give the dogs hypothyroidism. many have had an improvements once they were given a thyroid supplement. Just as Jonny said, I would recommend to get Dr. Dodds involved. I have yet to hear from somebody that regretted that step. I am so glad Lincoln is home and eating. Make sure you keep it as lean as possible, you don't want to deal with pancriatitis. Best wishes, Brigitte & the poodle boys

Brigitte BC Canada

Hi Trish: I am writing to say you have been blessed to find this forum. Not only for all the valueable information many have to share with you but also for all the kind words and support. These are wonderful people who like us have had our most beloved animals contract this AIHA (IMHA). My prayers go out to Lincoln for a full recovery. He,too is so blessed to have you. I'll keep looking for your updates on Lincoln and even though you and he don't know me please give him a hug and kiss from someone who cares. Take Care and God Bless you both, Barb

Barb Ohio

Trish, Glad to read that Lincoln is home with you. I know how hard it is to see them in such an awful state and what a thrill it is when you start seeing them behave in anyway normal. Hopefully things will start looking up more and more as the meds kick in. Penny

Penny Lytle Creek Calif

Trish, how's Lincoln been doing? You're right about the thyroid! Many sighthounds have lower than normal thyroid function (low end of normals for T3 & T4) and very often are diagnosed as hypothyroid without further testing. It's important to note the levels of TSH and TGaa's in these cases. An increase in TSH (thyroid stimulating hormone) along with low T3's & T4's would pretty well almost guaranteed the dog is hypothyroid...regardless the current sickness. It's also really important to be checking the thyroglobulin autoantibodies (TGaa) to make sure it isn't a case of autoimmune thyroiditis...which is very frequent in these aiha/imha cases. This is another reason most of us here will always try to talk people into sending blood to Dr. Dodds for analysis. Most regular vets usually just run a simple T4 which really doesn't say much at all without the rest of the numbers. Dr. Dodds does a breed/age/sex specific thyroid which is one of a kind...noone else does this! Anywho, i'd love to hear an update on Lincoln. I'll keep him in my thoughts and prayers. Johnny & Tessy

Johnny

This thread was discussed between 20/01/2011 and 03/02/2011

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