Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Lola the Lab/ can we survive without the transfusi

My beautiful girl, Lola, is a 73 pound white lab mix. She was diagnosed on Monday with IMHA. Her blood count was donwn to 23 and they put her on Prednisone and Cyclosporine. I cannot afford a blood transfusion so we are keeping our fingers crossed that the medicine will begin working before she continues to drop. I took her back on Tuesday and she dropped another 6% to 18. Yesterday she was at 16 so it seems that it could be working a bit. Has anyone not had the blood transfusion and only used the medicine? Has this worked before? I love her so much and she has many people and doggie friends that are in love with her as well. She is my best friend and I don't want her to suffer. Thank you for any response you can give.

Leah Austin

Leah, I am so sorry to hear about Lola, I do not have persnal experience with a transfusion, but do know some have not had transfusions and the drugs started to kick in. The good thing is your vet has her on cyclosporine which helps a lot to jump start the treatment right up front. I would get her in today or tomorrrow before the week-end for another test if you dont already have one planned. I see you live in Texas, Have they tested her for Tick diseases? This is always done in tick areas as its one of the major causes of AIHA and treatment is very specific with an antibiotic called doxycyclene Please check out Joannes sitek on AIHA http://www.cloudnet.com/~jdickson/ There is something called care credit you should look into that helps financially. Sending prayers to you and Lola Laurie

Laurie CA

My dog Riley has not had a transfusion yet.*fingers crossed* He presented with HCT at 18% but after a few days it rose to 21% a few days later, then to 28% about a week after that. So it is possible based on what I've seen so far.

Jennifer

Leah, so sorry to hear about Lola's diagnosis. This truly is a terrible disease but dogs can and do survived from it and go on to live happy normal lives! Have you asked the vet about pet care credit? Perhaps this could enable you to get a transfusion for Lola if needed. It can take upwards of a week for the drugs to start working "effectively" ...sometimes longer, sometimes shorter. Every dog is different in how the body responds. **IF** you can't get a transfusion then there are other options that could help in your favor but time is an issue for these and you'd have to get them before the weekend...if the PCV continues to drop. These options are injectable immune suppressors. You should call and ask the vet for either injectable prednisone or injectable dexamethasone. Dexa is said to be 5-7 times more potent than prednisone and by injecting it it works MUCH quicker! SO...if I were you I would bring LOLA in for a blood check either today or first thing in the morning and if the numbers are still declining then get one of these injections. You should call ahead because they may not have this option here and you might have to get it somewhere else. CALL first to find out if these are an option. I WOULD NOT GO LONGER THAN TOMORROW MORNING WITHOUT ANOTHER CHECK!!!!! OH...and you should remember that this is a disease that doesn't really inflict pain on the dog. Rather it makes them lethargic and tired feeling more than anything. Don't give up hope and keep on fighting. Keep us posted. I'll keep Lola in my thoughts and prayers. Johnny & Tessy

Johnny

Leah, I am so sorry to hear about Lola. And I completely understand your angst about funds to do what you want to with her. What you are asking about is transfusions and specifically something that is referred to as a *transfusion trigger.* There have been many discussions in human medicine in the past 10-15 years about how to define this. There has been no sure consensus about this. Some studies in human medicine have shown that transfusing too early leads to a poorer outcome in humans. This has to do with the body's signaling the bone marrow for a need for more oxygen (as in: please make more red blood cells, NOW). If you provide that oxygen artificially (via a transfusion) it might just satisfy the emergency needs for oxygen and that just might tell the body, "hey don't bother with all those new blood cells, we're doing ok here." When the blood supply for humans was challenged by the risk of AIDS transmission, blood supplies became trickier to obtain and hospitals began to look at lower and lower levels of acceptable hemoglobin as a transfusion trigger. What they discovered, as I have mentioned, is that some of these patients actually improved by not being transfused "earlier." What I have seen, anecdotally, on this forum is that there seems to be a wide range of acceptable levels of PCV packed cell volume in dogs. Some of them have been able to survive for a very long time (month, years) with PCV's as low as 20%. That is approximately half of what the level should be (at 37-55 normally.) However, while we always talk about PCV here and focus on that number, most clinicians tend to look at the hemoglobin numbers. In fact, that is really the critical number when people are donating blood to blood banks. In dogs that normal number is 120-180 g/L. So the HgB or Hb on a CBC complete blood count is the critical number when thinking about a transfusion. In your case, it is very possible that Lola can adjust (with restricted life style in the short term) to a lower hemoglobin count provided your vet can get the red blood cell destruction to stop AND Lola's body is responding by making new blood cells. It certainly is not ideal to get lower than, say, a PVC of 10. At numbers like that, other body systems begin to have real trouble. Heart, kidneys, brain. I know that much of this is not understandable to you. I just want to reassure you that there is no finite number to follow and that your great desire to help Lola is far more important than the money in your pocket. You can explain to your vet exactly what is going on in your mind and heart and I would be surprised if they did not offer to help you in some way. Please stay here on this forum for help and support in the coming days. The experience of other owners will guide you in what to do at each step of the way. my best patrice

Patrice NYS

Leah, I am so very sorry to hear of your Lola's illness. While AIHA/IMHA is a very diffcult disease, dogs who have been diganosed with it CAN and DO recover and go on to live happy healthy lives. Many vets recommend a blood transfusion when the PCV is in the low to mid teens. So if Lola's PCV stays at 16 or goes higher a transfusion may not be necessary. Blood transfusions buy time until the medications used for AIHA/IMHA "kick in". Prednsione takes 5-7 days to start to work and Cyclosporine may take a bit longer. Hopefully the prednsione should start to work within the next day or two and you could then see an upward movement in PCV. If you have not read my Web site on Canine AIHA/IMHA you might want to do so when you can. The URL is: http://www.cloudnet.com/~jdickson/ Be sure to follow the links on the first page to many other sites on AIHA/IMHA that will be very helpful to you and do read the SUCCESS STORIES pages. They will show you what has worked for other dogs in terms of treatment options as well as give you a lot of HOPE. I truly do know this is so hard so be assured you and your dear Lola are in my thoughts and prayers during these most very difficult days.

Joanne MN

My vet quoted a blood transfusion to cost anywhere from $1,000.00- $5,000.00 is this right?

Leah Austin

Leah, I had responded to your post but somehow it got deleted.

Johnny

Johnny, The original one that I posted was deleted as well. Do you know the cost of a blood transfusion?

Leah Austin

Long story short....I was recommending you contact Texas A & M University if you were close enough. Here's some info for ya... Texas A&M University College of Veterinary Medicine College Station TX 77843-4461 Telephone: (409) 845-5038 Fax: (409) 845-5088 Web: cvm . tamu . edu .....remove the spaces VMCAS participant Here's some other places with hospitals/colleges that practice vet medicine in Texas.... Are any of these closer to you... -Lancaster -Midland -San Antonio -Alpine -Tomball -Labbock These are all schools but the Texas A&M would probably be best. I'd recommend you call and get some info from them on prices. $1000 to $5000 is pretty steep and VERY often the teaching schools are much cheaper and offer better service. They have cutting edge technology also and are usually up to date on all protocols. Let me know if these are options for you. I'd still, however, explore the injections of pred or dexamethasone if I were you and would do so before the weekend. The unfortunate thing about this disease is that time is usually against us so it's important to get these things done ASAP. Keep us posted. I'll keep Lola in my thoughts and prayers. Johnny & Tessy

Johnny

I'm from Canada and up here it cost around $500 but that didn't include all hte other costs. This is where the bill adds up quickly. I'd call the university to ask them. They'd be the cheapest by far most likely.

Johnny

Leah....I should probably say that this is even if you need a transfusion. It may be a good idea to find this info out just so you know and have other options. I'ld have blood work done tonight or tomorrow morning to see where you stand.

Johnny

It makes me sick about these vets. Why can't they work out a payment plan or something if she really needs it. if i were a vet i would because it would break my heart knowing that i didn't do all i can to save a precious dogs life because of money. my prayers are with you and i hope she makes a full recovery. lucy

lucy ny

I wanted to update you all. Lola had a vet visit today and she is stabilized! :) This is good news. Her eyes aren't as jaundiced and her blood serum? color is normal again. Her vet is very optimistic. SO I am glad and I thought that you would be glad to hear it too. Thank you for all of your support and I will continue to keep you posted. I will send pictures soon too.

Leah Austin

Great news Leah! Keep them coming!!! Best wishes, Brigitte

Brigitte BC Canada

Leah, Great to read that Lola has stabilized! Looking forward to seeing her pictures. Penny

Penny Lytle Creek Calif

Also, I forgot to mention that she finally ate a can of tuna and a piece of turkey. She also barked at a squirrel last night after napping on the patio a while. Even though I know she is so sick she is the biggest trooper and I get my strength from her. I told her that she was eating like a cat after she ate the tuna and I got "a look" :)

leah Austin

I'll bet Lola would like sardines. Darcy gets one every day at lunchtime. Rich in Omega 3s.

Karen NC

Good to know. I will try that!

leah Austin

So glad to hear Lola is feeing a little better, maybe the meds are begining to kick in. Please keep us updated on how she is doing. Cheryl & Ginger

Cheryl & Ginger Pinevile Pa

Just make sure the sardines are salt free and in water. No added stuff.

Karen NC

Leah....thank doG for the crit stabilizing! This is great to hear. You shuold still keep a really good eye on LOLA cause she's still not in the clear yet and this disease is known for rearing its ugly head. I don't want to scare you but it's important to be aware of this. Keep her well rested and stress free if you can. Lots and lots of fresh clean water is also a must. The pred makes them sooo thirsty! Might be benificial to add milk thistle to the daily meal plan. This will help to protect the liver. Have you been creative with the food options for her? I had big success with boiled liver or beef heart with Tessy when she was first sick but you can only give small portions cause it's so rich. Scrambled eggs, lean roast beef, boiled sweet potatoes, chicken, turkey, spinach, brocolli, etc. Just avoid soy and wheat products ..and corn. hehehehehe....you do realize we'll be holding you on the pictures idea!!! :) Keep us posted. Johnny & Tessy

Johnny

Leah - I'm so glad to hear Lola's doing better - You didn't say what the most recent PCV was in your most recent update. Have you been taking her to Central Texas Specialty Hospital? That's where my Winston has been going for the last 9 months. I've checked out what his vet recommended with the great people here but have been very happy with the care Winston has received there. Keep posting -

Lisa TX

Hello All, I wanted to update you on the last appointment Lola had today. her PVC is at 20! This is great news as Friday it was still at 16. I know that we are still not in the clear, but I am becoming more and more optimistic. She is waggin her tail and sitting up. She has more life in her each day and I hope that this continues. I will keep working on the pictures. I am not very computer savvy, but will keep trying. :)Thank you all for your support and prayers. Leah and Lola

Leah Austin

How does one upload a picutre?

Leah Austin

Hi Leah, Unfortuately, you cannot upload pictures to this site. What you would need to do is post it as a link to another site where we can be re-routed. Some people have their own personal webpage and I know there are others sites out there as well, such as dogster.com. There are many others, I am just drawing a blank at the moment. A white lab mix??Wow! I bet your Sweet Lola is a beauty. Hope you can post a link as I am really looking forward to seeing her sweet face. :) Teresa

Teresa va

YAY for a crit of 20%! That is great to hear Leah! That takes a lot of burden off your shoulders! Now you shouldn't have to worry about transfusions and the sort. Do you ask for copies of the bloodwork? If not perhaps you can do this. Pet tinic is also recommended. Just get the grounded natural powdered seed and add it right in with the food. This is great for protecting the liver. You could also look into getting some pet tinic for Lola. This provides the proper nutrients for hematopoiesis (blood building) in the bone marrow. Having the tail wagging and showing a zest for life is a VERY POSITIVE sign. Don't get ahead of yourself though because although the crit is climbing, 20% is still fairly low. Keep her well rested and stress free. A proper diet probably wouldn't hurt either. Avoid fatty foods if you can. If you are interested in home cooking for her let me know and most of us here can help you with this. Lots of us feed a liver cleansing diet to our furkids who are sick! Now's the time to start looking ahead with the other factors that can help! PICTURES!!!! YAY...can't wait to see Lola! I use photobucket often to post pictures. It's fairly easy to use. I'll keep Lola in my thoughts and prayers. Johnny & Tessy

Johnny

This thread was discussed between 25/03/2010 and 29/03/2010

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