Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Macy has infection--I need your help

I don't even know where to begin....Macy wouldn't eat all day and she was really lethargic. She couldn't even make it out to urinate so I knew something was wrong. I took her back to All Care in Fountain Valley and while in there, a big absess (sp?) burst and she bled all over the floor. Apparently she has a bad infection near her rear end. I was told this happens frequently with AIHA dogs as their immune systems are so suppressed due to all the drugs. I was also told this is potentially fatal and that I needed to take it one day at a time to see how she responds. The vet recommended a 4 night stay and they took a culture?? to see how to best treat the infection. I guess the culture takes 3 days at a minimum to best see how to treat the infection. Thousands of more dollars, more restless nights, and more tearful days. What am I to do? Macy is a member of our family and I am not a rich man but I cannot and will not give up on her if I have one dollar left. With that being said, am I just fooling myself here? Has anyone else's dog had an infection following the AIHA problem? How was it treated? What was the outcome? The trick according to the vet is to reduce the AIHA drugs enough so that the immune system can work well enough again to fight off the infection. The good news is that her AIHA numbers are pretty solid (RBC in 30's, no spherocytes, bilirubin has dropped from 40 to 2) so that lowering the drugs is a feasible option. The vet was going to consult with many experts before deciding what to drugs to lower first. Any suggestions? I am also going to get in touch with Dr. Dodds to see what she recommends. I could really use your knowledge, support, and prayers. Can't believe she is back in this precarious position again. Please pray...... Thank you, Darren

Darren Long Beach

Hi Darren, First of all, lots of good thoughts going out to you and Macy that she can overcome this. My IMHA dog Benson also developed abscesses about a month after the IMHA nightmare began (Benson is the Feb 2006 success story at Joanne Dickson's Meisha's Hope site). He had three (two on his hind paws and a large abscess on his shoulder). He was hospitalized for a week as the vets treated the abscesses and changed his meds. Benson also developed edema and cellulitis. Until that point, Benson was on pred only plus stomach protectants. The vets reduced the pred (his liver numbers were quite high) and added imuran. This combination of drugs was more successful with him. After Benson came home, the abscess wounds were very slow to heal (because of the pred). I cleaned his wounds with saline daily to keep them from becoming infected. I also put on a topical antibiotic The wounds did not really close up until several months later after we stopped the pred entirely. I hope that the vets will find the right antibiotic for Macy and that she will get through this okay. And I hope that the financial aspect is not too great to bear. Please keep us posted. Good thoughts, Aden

Aden Jerusalem

Darren I am so sorry to hear that Macy has this infection and you have all this worry again. I am tending to agree with you that maybe your vets need to look at reducing her meds. After reading Kathleen and Nollaig's experience, I wonder if the Leflunomide should be the one to go down first? It is common for immune suppressed dogs to get infections, a catch 22 with treating IMHA. Please keep us posted on Macy's progress. Thinking of you Samantha and Millie

Samantha Geelong Australia

Hi Darren Im sorry to hear this news, and I hope that it can be sorted out, its such a journey as we all know, with a task to get the medications right. I will certainly pray for you both. As you say, Macy's numbers are good and that can only help. Best wishes to you. Silka

Silka Melbourne Australia

Darren Have they checked Macy's white cell count to see if it's way too low as she needs these in order to fight this infection. Is it an anal gland absess she has,as two of my beagles have had this and blood and pus burst out of their skin, and they don't have AIHA/IMHA, they just needed an antibiotic? Please look back on the thread Leflunomide (Arava) for IMAH??? started by Jaime and read my post about Nollaig's experience with leflunomide and a fatal infection which she recovered from,but they immediately stopped the leflunomide as it had put her white cells down to a dangerously low level,that's why you need to check what her white cells are doing. I will keep Macy in my prayers and know that she can get through this although I know how worried you are-I've been there,but at least Macy's pcv is at a decent number, Nollaig's was at 10% when she took the infection and she still came through it-they put her on iv fluids and antibiotics and she was put into isolation due to her white cell count. Take care Kathleen and Nollaig Take care Kathleen and Nollaig

Kathleen North Ayrshire

Darren I am sorry to read about Macy setback and I just wanted to let you know that she is in my prayers. Please keep us updated on how she is doing. Cheryl & Ginger

Cheryl & Ginger Pinevile pa

Darren - I'm so sorry to read about Macy. We had a similar experience about four months into my dog's IMHA treatment - he was on pred, aza, and we had just added cyclosporin recently. He became acutely ill, literally overnight. He had become septic due to his immune system becoming too suppressed to fight an infection. He had a very high fever, a dangerously low white count and severe gastro issues as a result of the infection. The internist stopped all his IMHA meds excepts a maintainence dose of pred (as you probably know, it can be dangerous to stop that cold turkey) and started him on an army of antibiotics. In our case, she didn't feel he had time to wait for a culture. It was touch and go for 3 - 4 days but we were ultimately able to bring him home and he did well. For us, it was a matter of whether or not his white count could respond once the IMHA meds were stopped - which it did. And, ultimately, his red count came around as well (he was diagnosed as non-regenerative at the level of the marrow). I've been where you are and know how frightening it is. Just take it a few hours at a time - your love for Macy is very clear and from all your posts it sounds like she is in very good hands to give her every chance to fight this. Take care and let us know how she is doing when you have a chance. Bonnie

Bonnie Chicago

Did they "not" put her on an antibiotic while they wait for the culture? It would surprise me if they didn't. You did the right thing in getting Macy to the clinic. She's in good hands now and they "should" be able to treat the problem. Many dogs get abscess's while on immune supressing treatment. Tessy had a retrobulbar abscess 10 months in and antibiotics cleared it up. We didn't do a culture for it either. The fact they are doing a culture is a good thing indeed but I do think they should have her on something while they are waiting for the results. Just make sure they don't prescribe and of the Sulfa drugs to Macy. It could be likely they might decrease both the pred and arava at the same time. Just try to take them relatively slow IF you can. The antibiotics will help to prevent infections while she's on them. Hope to hear an update soon. My thoughts and prayers are with you and Macy. Be strong for her and have faith. Sending some strong Canadian healing vibes Macy's way. Johnny & Tessy

Johnny

Darren, Bless your heart! You are a wonderful "daddy". No, you are NOT fooling yourself. You are doing everything you can for your girl. When my Jacob was diagnosed, it broke me and my hubby (also named Daren:)) very quickly. My hubby sold his prize possession-- an old antique jeep cherokee without thinking twice. I remember we were eating sandwiches and hotdogs while Jacob had steak, as it was very hard to get him to eat anything in the beginning. As I said earlier, with this disease sometimes it is one step forward, two steps back, etc. I think, with the immune system suppression any kind of infection can develop. From my years of dealing with the disease, Jacob developed an eye infection and a urinary tract infection. The goal is catching it quickly and having them on the correct antibiotic. While waiting for the culture results, the internal med dr. would start Jacob on a powerful antibiotic and then change it once the results came in. We were lucky though because he was already on the correct antibiotic while waiting for the results. You know your girl better than anyone, including the vet so just listen to what she is telling you. She sounds like a real fighter and I believe she will kick this infection. Best wishes to you and your wonderful Macy! Sending hugs to both of you! Teresa

Teresa va

Darren, I to feel the pain that you are going through. We are now at the 11 month mark and almost drug free at this time. However, just after diagnosis Cooper developed an absess in his front paw that eventually took over 5 months with antibiotics to clear up. As others have said it wasn't until the prednizone was reduced before the infection finally deminished. The infection truly adds to the frustration and anguish that you are going through. I hope that you can utilize the services of Dr. dodd's she is one extra special person and has helped so many of us here at the forum. Stay tough, stay the course, and we wish you the very best. Ron & Cooper

Ron Florida

Darren, I am so soarry to hear of Macy's infection, as many have stated, dogs are prone to these types of infections and have had success in treating them "The vet was going to consult with many experts before deciding what to drugs to lower first. Any suggestions? I am also going to get in touch with Dr. Dodds to see what she recommends" Darrin, please do not hesitate in contacting Dr dodds. prayers to Macy Laurie

Laurie CA

Thank you all for your knowledge, experience, and well wishes. The vet is not waiting for the culture to start her on the antibiotics. From her last CBC, I was told her white cell count was good. I will get exact numbers this morning when I go in. They have her going in a hyperbaric chamber twice per day to clear this up as well. I will keep you posted and you are all wonderful people who I appreciate very, very much.

Darren Long Beach

Darren, I am so sorry that Macy and you have to deal with this on top of everything else but it is part of the fight. Hopefully they can get the infection knocked down soon. Keeping you both in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Darren, I am really sorry to hear about Macy. Please look on Jaimes last post concerning Ruger as I posted Cocos meds that I no longer need and would be more than willing to ship them to you if needed. You can also contact me at princessmullenix@yahoo.com.I wish you the best of luck with this latest setback, although it does seem like you(as always)are doing what all amazing doggie dads do. take care..Kelly

Kelly Redding

This thread was discussed on 26/01/2010

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