Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Macy- possible pancreatitis

Hi guys. Just got back from the vet. Macy's absess is looking a lot better. We are continuing to treat that with antibiotics and of course, still waiting for the culture to come back. That is the good news. The bad news is that she may have pancreatitis. The vet says that if so, we will have to stop all steroids (Aza was stopped already) so that means stopping the Pred in order for the pancreatitis to go away. Of course, stopping the pred will lead to a greater chance of her anemia returning and of course, this would not be good. Should the vet stop the pred altogether or just reduce it? Now, fighting the infection, IMHA, and pancreatitis...not sure how much fight she has left in her and I certainly do not want her to suffer. Please let me know what you would do in terms of stopping the pred altogether and taking our chances that way.....Thank you.

Darren Long Beach

Darren, I am very sorry to hear about this turn of events. They have given you a tough decision without giving you enough of the information you need to do that. Pancreatitis can be either acute or chronic. Dogs seem to be very sensitive to this condition and it can contribute to other problems because of system wide inflammation. Yes, prednisone can contribute to the development of pancreatitis. How pancreatitis is treated depends on whether it is acute or chronic. Acute can be a medical emergency and is sometimes treated by withholding food for a period of time to rest the pancreas. Chronic can be addressed more often by dietary changes and also adjusting the causative agent if possible. However, suddenly removing prednisone (unless it is currently at *very* low doses) can be potentially dangerous. The adrenal glands "go to sleep" when high dose prednisone is used because they feel they are not needed. They provide the body with cortisol for stimulation of vital needs like heart and breathing rate, blood sugar control and many other things. If you suddenly remove the artificial source of cortisol (prednisone) and the adrenal glands are too sleepy to provide the needed cortisol for stimulation, your dog can have an Addison's Crisis. Every doctor and vet understands this relationship and knows the importance of reducing prednisone slowly so as to wake up the adrenal glands properly. They may have neglected to explain this to you well. But yes, it should be withdrawn when possible to assist in healing the pancreas. If it is not allowed to heal properly there might be some other resultant health problems. So do ask your vet what their plan is for treating Macy's anemia. Do they feel that treating the pancreatitis will improve her overall health and then they can consider adding another immunosuppressive drug? Do not be afraid to express your concern to the vet and ask for some education about the choice you have to make. This is an important decision you need help with. my best patrice

Patrice NYS

Darren, I do not have much more to add that Patrice hasnt already said. But, please know I have been on this forum since 2002 and I have seen many dogs that have developed pancreatitis, infections, absesses, etc. and they went on to be success stories. I know how scary this is for you and I am sure you are exhausted. If you havent already done so, please read some of the success stories. I think they will help you understand that you and Macy are not alone and you will find that a lot of the stories are very similar to what you and your girl are going through. Hugs and prayers being sent your way, Teresa

Teresa va

Hi Darren, Again I am sad to hear this latest turn of events for Macy. As always, Patrice's advice is sound. It is a big worry stopping the Prednisone altogether, and I'm not sure what I would do if this had happened to Millie, but you need to be guided by your vets and what you feel is right given the information you've got on Macy's condition. Would they withhold food and keep Macy on intravenous fluids to see how Macy goes as a first option to treat the pancreatitis before stopping the Pred altoghether? Please keep us posted on Macy's progress. Samantha & Millie.

Samantha Geelong Australia

Darren, I'm sorry to hear this news. Yeah, when it rains it pours right! I'm confused. Are you saying that the vet doesn't know for sure if it is pancreatitis? Is she showing any of hte symptoms? I know you were saying that she wasn't eating and was lethargic but could that have been from the infection (abscess)? The other symptoms to look for would be vomiting, signs of pain (this can be very painfull for a dog), diarrhea, depression, or swelling of the abdomin. The easiest way for them to tell for sure would be to do an ultrasound of the abdomin to look for inflammation. In most cases the WBC will also be elevated but this is the case with lots of our dogs battling IMHA. Did they do any of this? How is Macy acting or feeling now? Until you get this figured out keep her diet bland and fat free and if you can you should fast her for a short period of time. Just feed her enough for her meds. If this were me I'd want to know FOR SURE if indeed she does have pancreatitis BEFORE we decide to lower any meds. I'll keep Macy in my thoughts and prayers. Sending her some strong get better vibes as well. Johnny & Tessy

Johnny

Well...when it rains, it pours. The vet now thinks she is septic due to her really low blood pressure. Her situation is dire and I believe we need a miracle at this point. They took her off all the drugs to attempt to control the septicimia. They are giving her plasma in case Ecoli is the bacteria causing the bad sitaution. She can't even test for pancreatitis at this point due to her situation. I guess they are just going to try and stabilize her and address the most critical needs first. Please pray.......

Darren Long Beach

Oh Darren Again I am devastated for you. I am hoping that Macy is not septic and she will be ok. Please take heart from Kathleen and Nollaig in that Nollaig was also in the same situation and pulled through. Thinking of Macy and you. Samantha

Samantha Geelong Australia

I'm so sorry to hear this news Darren. We're all here for you with thoughts and positive vibes. I'm sending all my prayers to Macy right now. Hang in there sweetheart. Johnny & Tessy

Johnny

Hi Darren My Riley had pancreatitis - had to take him to the emergency in the middle of the night after finding he had opened his bowels and vomited everywhere - he was acting strangely, kept coming into my room as if he wanted to tell me something. The emergency diagnosed pancreatitis - put him on fluids and withheld food, keeping him there for 24 hours - they consulted with a specialist regarding his medication and the specialist said it was six of one and half a dozen of the other as to whether it was best to reduce pred or aza, so the emergency elected to reduce the aza from every day to every other day. I had to give him low fat food in small serves, often during the day, and then I home cooked myself. I had not at any time heard that the medication should be ceased altogether. I wish you well over the next few days with Macy - it is heartbreaking to see all of this happening with your loved pet - Macy may just surprise you with her fighting spirit, which she seems to have. Thinking of you Darren, and praying for Macy. Silka

Silka Melbourne Australia

Darren, I am really sorry to hear this latest news. Know though that we are all sending many healing prayers Macys way and take comfort in the fact that many have overcome this very thing. I know how hard it is to hear such bad news but just know that we are all here for you.May God watch over you and Macy....Kelly

Kelly Redding

Darren, I'm sorry to hear that Macy might have pancreatitis. My little Darcy developed pancreatitis after she had a blood transfusion and was in the hospital on IVs for two nights. She was taken completely off the Aza. and the Pred was lowered. She was on a special low fat canned food after she came home and stayed on that for a few days. Darcy was initially diagnosed with nonregenerative anemia. I must tell you that, after having been on lots of expensive immune suppressant drugs, like Cyclosporine, she didn't improve. I mean her anemia didn't improve --- she did, of course, get over the pancreatitst. She remained on a low dose of Pred, Cyclosporine, and Soloxine after her bout with pancreatitist. It was only after we stopped the Cyclosporine and started her on 100 mg. of Doxycycline twice a day that she actually started to regenerate. If you haven't had Macy tested for flea/tick disease, I would urge you to do so. However, keep in mind that those tests are notorious for producing false negatives. Darcy's tests were negative; however, her response to Doxycycline was great. It did take a long time --- six months --- before her PCV made it to 38. According to our holistic vet, there are a variety of flea/tick borne diseases that require long periods of treatment with Doxycycline. Most vets will only give a round of about seven days, which is not enough. Also, this disease can lay dormant, which means you have to be vigilantly checking for any recurrence. Although Darcy is now off the Doxy, the vet gave me a bottle to have on hand just in case she relapses. I hope some of this information helps and gives you hope. I had a vet and a "specialist" who were both giving me a grime diagnosis and I am so glad that I did not listen to their negative comments and suggestions. I found a holistic vet who was willing to give the Doxy a try even though Darcy's medical history records with the other vets said she had not responded to the one week of Doxycycline. Sorry this post is so long, but I feel it's important that I pass along my Darcy's success story. Best Wishes, Karen

Karen NC

Darren - I am really sorry that you are going through all this right now. It sounds like Macy is facing the same thing as my dog - the septicimia, the plasma transfusion - it's all too familiar. I know how frightening it all is but don't give up hope - just take it a few hours at a time. And, just focus on fighting the infection right now. Dogs can get through this and it sounds as if Macy is getting great care which is definitely a plus at this time. And, also, hang onto the fact that her white count is good and she has come through this so far. You and Macy will be in my thoughts and prayers tonight. Bonnie

Bonnie Chicago

This thread was discussed between 26/01/2010 and 27/01/2010

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