Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Low Platlett count

Wonder if anyone has an input. Alex was diagnosed with IMHA end of last May. He spent all last summer very weak from high does of prednisone and Atopica. His blood count has been good in the 40's and he has been off prednisone for about 3 months now. We were down to a 25mg dose of Atopica twice daily. He's been getting stronger and has been happy again. For some of you that may remember Alex, back in October he was near death and it was only after I started weaning him off the meds that I saw an improvement. We were thrown for a loop again today. He has been feeling good but developed what looked like round circles on his belly. We were up at our cabin and I thought he must have developed a reaction to something in the grass. They got worse and I took him to the vet this afternoon. His red blood cell count is still good but his platlett count is 30,000 ( I think they said normal was 175,000 to 400,000). He's back on 60 mg of pred a day and 500 mg Atopica a day, in addition to Doxycycline. He was so sick the last time from these high doses that I don't know if its fair to him to put him thru that again. Has anyone had a problem with low platlett count and if so what was your experience? Any input is greatly appreciated. It's devastating to me to give him these meds as I feel like I will be making him deathy ill again. Such a long bumpy road....... Chris & Alex

Chris Pa

Chris, The round circles are most likely petechiae, small pinprick like bruisings in the skin. This is a sign of platelet deficiency. This is called thrombocytopenia. Or a deficiency of thrombocytes (platelets). Platelets are the agents that stop bleeding when it occurs. This can be very serious. I would consider this an emergency and is different than anemia. Since you are in PA and you were just at a cabin I am going to take a leap and guess that Alex has contracted a tick disease called ehrlichiosis or more currently called anaplasma. This will cause platelet deficiency like this. The fact that your vet has prescribed doxycycline indicates that they think this too. Be sure that you are on a high and prolonged dose of this drug. See this webpage for information: http://blackgsd.googlepages.com/ehrlichiosis Here is a website where you can read about thrombocytopenia: http://www.marvistavet.com/html/body_immune_mediated_thrombocytopen.html I will be thinking about Alex tonight. Patrice

Patrice NYS

Chris, Alex may have ITP (immune mediated thrombocytopenia). I have seen a number of dogs who have developed ITP after their AIHA/IMHA diagnosis. Some dogs have ITP at the same time they have AIHA/IMHA. When that is the case the dog is said to be suffering from a condition known as Evans Syndrome. The treatment for ITP is the same as that for AIHA/IMHA except that sometimes vet will add another drug called Vincristine: http://www.marvistavet.com/html/vincristine.html From the cases I have seen it seems that ITP may be easier to treat then AIHA/IMHA. That is dogs may recover faster. You might want to go to this page http://www.cloudnet.com/~jdickson/midnight.htm and read about Midnight the Miracle ITP dog who had ZERO platlets when she was diagnosed with ITP. At the bottom of the page are a couple of links that will supply you with more info on this disease. This is a set back but one that can be OVERCOME. Be assured you and your dear Alex are in my thoughts and prayers.

Joanne MN

Patrice and Joanne, Thanks for your input. I started him on his meds last night. I really needed to hear that this could be overcome. I am trying to be optimistic. He was just getting so strong and was happy again I can't believe we are back in this situation. And, my other concern this time is a strong financial one. Not that it wasn't the last time as I have two kids in college but I know this is so unfair to him but I can't go through it financially like I did the last time. My husband and I just recently refinanced our house to pay off the medical bills from the last time. I am so in the middle as Alex is such a good boy and want to give him a chance but it's not fair to the people in my family either. My daughter is graduating with her master degree from New Mexico in two weeks. I had planned on attending and driving with the dogs. I can't leave Alex behind as I know he wont' do well. Last year when I kenneled him that's when he came down with IMHA. And now I don't know if I can take him as I know what he went through with the pred last time and he physically won't tolerate a drive that long. I'm sorry I know everyone on this board is facing big problems. There is no easy answer for any of it. I am in the process of going thru the web sites you sent and really appreciate the info. We are scheduled for a platlett check tomorrow with the Internal Medicine doc and we'll just take it from there I guess. Thanks for your thoughts. Chris & Alex

Chris Pa

Chris, I'm sorry to hear of Alex's potential setback, this disease makes it impossible to ever relax again. I hope that you get to the bottom of this, I know money sucks, it's terrible that it has to factor into treating our babies that we love so much, especially in these tough times. But, Alex is a strong doggie, he did so well the first time, I know he can do it again! Maybe discuss a long term payment plan with your vet office, that's what we had to do. We are sending love and hugs your way, please hang in there, you'll get to the bottom of it, one day at a time as always. hugs, melissa and tiggs

melissa slc

Hi Chris, sorry to hear of this setback for Alex. I hope you can find a way around the finances to benifit Alex. Like Melissa said...maybe you could work out a payment plan with your vet. Look at the positive side of this...Alex's red blood count is still good. Like Joanne said, this setback may be easier to fix than the original sickness. Are there any close friends or family that could look after him if you went out of town. I don't think it would be a good idea to kennel him...especially if that's what caused the AMHA the last time. You are right...there is no easy way around this thing. It's a long nerve racking battle THAT CAN BE BEATEN! Hang in there....there's lots of people praying for a positive outcome for Alex. Give him hugs from Tessy & I. Keep us posted on his condition. Johnny & Tessy

Johnny

Hi Chris, I am so sorry you have to go through this again. On the bright side, I am sure Joanne is right that Alex will recover from the ITP quicker and at least this time you know what you are facing. I have learned that worrying is very exhausting. You are torn into all directions right now. Please don't forget to look after yourself and attend to YOUR needs. If you explain to your daughter, she will understand. I even believe that if you explain to Alex what needs to happen, he will sense what your needs are. Take care and best wishes. You are in our thoughts, Brigitte & Kahlu

Brigitte BC Canada

Thanks guys for your support and thanks for your thoughts and prayers. I guess where there is a will there is a way. I'm sorry to be so discouraging about finances. I know everyone here is in the same boat. I shouldn't have even mentioned the finance thing but I think I had a meltdown last night. I just want to do whats right for everyone around me. You have all given me some good ideas to talk to the vet about tomorrow. I am holding on to the thought that ITP may be easier to treat. Even though I haven't responded to anyone elses posts lately I still do check the board daily to see how everyone is doing. I keep all of your furbabies in my prayers when I pray for my little guy. Chris & Alex

Chris Pa

Chris, I am sorry to read that Alex is having further problems. I think we all reach a melt down point at some time while dealing with this. Regardless of what decisions you have to make whether they are finances or other reasons there is no doubt about your love for your boy. Alex knows you will do everything that you realistically can for him. Penny

Penny Lytle Creek Calif

Just wanted to give you an update on Alex. His platelet count is 25-35,000 (They call this low average?) They said the CBC will tell them more and they did a tick panel. He is already showing the side effects of the prednisone. They lowered his Atopica to 300 Mg a day instead of the 500 Mg the other vet said. (I got the feeling the first vet calculated wrong ) I am plugging along with the financial thing at this point and we'll see. They have no long term payment plan - those stinkers! It's strange that he came down with IMHA end of May last year(after I kenneled him, and gave him frontine and Heartworm medicine right before). Now he's sick again the same time this year? Very strange. He's had no frontline or heartworm this year. They said it will be better if it turns out he's sick by a tick than if its his immune system attacking platelets now. We are taking it one day at a time - again - I guess it worked the last time around! Thanks for all your kind thoughts and wishes Chris & Alex

Chris Pa

Hang in there Chris, at least the news was slightly more positive. I have to admit, that it's not the first time I've heard of dogs relasping at or near their original dx time...It makes me very anxious for Tiggs this summer. Our best, hugs to Alex, melissa and tiggs

melissa slc

Thanks for your positive thoughts Melissa. Thanks to you Joanne for the success stories! It is all very strange. If the tick panel comes back positive that will answer alot of questions. Our third vet visit this week was to the eye doctor. He has night blindness now and they feared he was bleedling behind the eye due to the low platelett count. All turned up well though however he does have cataracts in both eyes now and they think the poodle eye disease PRA starting. I went out and got some night lights so he could at least find his way to the water bowl at night. There is an blindness that people can get from taking cyclosporine (Atopica) that is a neurotoxicity. I was really worried about that since he's been on it since last summer but the eye doctor said in people the blindness comes on anytime of the day and is a complete blindness. Alex is definitely a fighter and I'm right there with him for as long as we can. Chris & Alex

Chris Pa

This thread was discussed between 29/04/2009 and 03/05/2009

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