Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Maggie

Re posted from "pepsid" tread to get attention, Brigitte Good Evening. We have a 3 year old Yellow Lab Maggie that developed AIHA in June 2010. We had a rough go off it during the summer but she survived with the help of our great Vet and many sleepless nights. She was on a combination of Prednisone, Imuran, Losec, & Sulcrate. We finally weened her off her Prednisone & Imuran in December. Her hematocrit went from a low of 15 back up to 48. Now we have had a major setback. 5 days ago she seemed a little lethargic and we discovered her hematocrit had dropped to 27 and by two days ago 19 despite the introduction of Prednisone & Imuran. She weighs 36 kg and is on Prednisone 75mg twice per day and Imuran 75mg per day. We are also giving her Sulcrate 1g twice per day and Losec 20mg per day. She has marked diarrhea with flecks of blood. I have a couple of questions; does anyone have experience with Losec 20mg twice per day, or the introduction of cyclosporine? We are keeping our fingers crossed that she will survive this relapse. We are off to the Vet again in the morning. Any comments appreciated. If you would like to print this thread please click here to get a copy of the page without all of the superfluous information (and then use the print option on your browser). Please report abuse immediately. Add your comment to this thread

Charles& Kelly Newfoundland

Charles and Kelly, I hope you are ok with me reposting in a new thread. This way it will get more attention and the threads don't get too long. I am so sorry you had to find us because you are going through this for a second time. At least you know what you are up to and if Maggie has beat it once already, she can do it again. Please go to Joanne Dicksons website, Meisha's Hope, you will learn lots about the disease there. Make sure to visit the success stories, they will give you lots of hope. Maggie is certainly not the only one that has beat the disease twice: http://www.cloudnet.com/~jdickson/index.html I have no experience with Losec, but I know that many dogs here had great results with cyclosporin. It does take some time to kick in so it is good to start it as soon as possible. Unfortunately it is very expensive, especially for a big dog like Maggie. It seems your vet knows what he/she is doing, I would still urge you to ask him to consult with either Dr. Dodds or the vet college in PEI. AIHA is not very common and there is so much to know. Our vet was very exited to talk with Dr. Dodds in California (she has studied in Canada and as far as I know is Canadian!) because she was able to learn a lot. Dr. Dodds website is: http://www.hemopet.org/ The blood in Maggie's stool concerns me. It could be that her bowels are irritated from all the heavy duty drugs or it could be that she has developed ITP, Immune-mediated thrombocytopenia. This condition would result in bruising and bleeding. The medications are basically the same as far as I know. I am glad Maggie is going in to see the vet tomorrow, hopefully the medications will have kicked in by then. How is she acting, is she eating? Best wishes, we will be thinking of you and Maggie, Brigitte & the poodle boys

Brigitte BC Canada

Charles and Kelly, I am so sorry to read of Maggie's relapse. I hope that having caught it early it is just a matter of time before she is stable again. Sometimes dogs have to be kept on low doses of the drugs to maintain. Keeping you in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Any news about Maggie? How did the vet visit go today? Brigitte

Brigitte BC Canada

Brigitte & Penny Thank you for your advise and good wishes. Maggie visited the Vet this am. Her hematocrit has remained at 19. We are hopeful that the hemolysis has been halted. We will have more blood work undertaken on Wednesday. Maggie like most Labs has a great appetite but has been picky the past 24 hours but eating sufficiently and drinking lots of water. It looks like we might be able to avoid cyclosporin. Losec (omeprazole) is similar to pepcid in that it reduces acid secretion in the stomach. Kind regards. Charles & Kelly

Charles & Kelly Newfoundland

Charles and Kelly, I am so glad to hear Maggie is holding her own. I looked up Locec and realized that it is something like pepcid. I am glad she is also on sucralfate, these high doses of pred and imuran are so harsh on the digestive tract. I agree with Penny, that Maggie should probably stay on a maintenance dosage of prednisone for the rest of her life once she has been SLOWLY weaned from the meds. But that should not occupy your mind now, main thing is to get Maggie back to be a healthy hapy pup. Did you get a chance to ask your vet about getting Dr. Dodds into the picture? I know you would not regret it. Her consultation fee is something like $45 which is a steal. She is up on the latest studies and developments of the disease. You could also send blood to her which of course is costing you more, but it is still very reasonable. I would also urge you to have Maggie's thyroid tested. Ideally you should get a full thyroid panel T4, free T4, T3, free T3 and TgAA. Most likely Maggie will be hypothyroid and a thyroid supplement could make a big difference in her recovery. I am sure Maggie feels pretty lousy and tired, that is why she has no big appetite. What are you feeding her? Make sure it is grain, soy and fat free. Steamed white fish with potatoes, kale, green beans and squash would be great. Lean chicken and turkey is good too. You might also want to give her some vitamines and suplements. In the US they get a great product called petinic. It is available on line. Dr. Dodds recomended I could give just the ingredients of petinc, vitamin b (250mg I think), folic acid (5mg) and iron (100mg) dosage for my 60 lbs dog. Make sure you read the success stories fom the Meisha's Hope website, they are so uplifting and will give you hope. Best wishes and keep in touch, Brigitte & the poodle boys

Brigitte BC Canada

How is Maggie today? Any results from the blood tests? keep us posted, Best wishes, Brigitte & the poodle boys

Brigitte BC Canada

Charles and Kelly....fellow newfies (although I've lived in Nova Scotia my whole life). Sorry you are dealing with this evil disease! Like Brigitte, I'm also wondering how Maggie is doing. Oh...omeprazole is a GREAT drug to be using! This is what I used for Tessy and it's supposed to be better than pepcid! Keep us posted. Lots of thoughts and prayers, Johnny & Tessy

Johnny

Good News. Maggie seems to be on upswing. She was doing her best to run around the garden yesterday with the shovel as I was cleaning up from the recent storm. We were at the vet again this morning. Thankfully her hematocrit has risen to 22.9. She will remain on Prednisone 75mg twice per day and Imuran 75 mg per day until Monday when the Imuran will be reduced to every second day. The Sulcrate & Losec are protecting her stomach but she still has frequent diarrhea. Our vet suggested canned pumpkin may help with the diarrhea. We will give this a try tomorrow. Thank you for everyone's support. C & K

Charles & Kelly Newfoundland

Charles & Kelly, I am so glad Maggie is doing better. Your vets advice to give canned pumpkin for the diarrhea is great. Just make sure you get plain pumpkin, not pie filling. I am however a bit concerned about reducing the imuran already. A 50% reduction seems pretty severe. I could be wrong (please anybody correct me if I am) but I would tend to go down to 50mg every day. I think I would even wait for a bit longer than Monday. I agree with Penny that Maggie will probably be safer to stay on a maintenance dose of prednisone. At almost 80 lbs, Maggie is at the high end of the prednisone dose, maybe you could lower the prednisone by 25%? The rule of thumb is to reduce only one of the medications once the disease is in remission. Only 25% to 33% every 3-4 weeks. You might remember that from last time. Also remember, I am not a vet, just throwing out ideas. Thinking of you, best wishes, Brigitte & the poodle boys

Brigitte BC Canada

Glad to hear Maggie feels up to helping you in the yard. I agree with Brigitte that maybe a smaller reduction might be in order? The canned pumpkin works both for diarrhea and constipation (go figure) Keeping you all in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Any news on Maggie? Thinking of you, Brigitte

Brigitte BC Canada

Good Evening. A short update on Maggie. She is continuing to improve. We have had her at the Vet very second day. Her hematocrit today is up to 30 and hemoglobin > 90. She is improving much quicker this time around. I think the cool weather is also helping. Last summer she wanted to sleep outside and was always panting but now she enjoys the warm inside with frequent trots around in the snow. We will be keeping her on the high dose prednisone and alternate day Imuran until her hematocrit is back in the normal range. The diarrhea stopped a few days ago. Hopefully she will not have as much muscle wasting this time around. I am bringing her for a short walk each night. Beat regards.

Charles & Kelly St. John's

So glad to hear Maggie is doing good! Keep it up Maggie girl!!! It looks like you and your vet have a good handle on things. Best wishes from Vancouver Island, Brigitte & the poodle boys

Brigitte BC Canada

Great to hear Maggies good news!!! Looks like things are heading in the right direction. Lots of thoughts and prayers. Johnny & Tessy

Johnny

Glad to hear Maggie is getting back on track. I think you are very wise to take it slow this time around. Keeping you in my thoughts and prayers. Penny

Penny Lytle Creek Calif

This thread was discussed between 31/01/2011 and 11/02/2011

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