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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Maggie's modified treatment protocol
| Maggie now has a modified treatment protocol. Her latest numbers can be viewed in this recent thread: http://www.vetnet.co.uk/cgi-bin/gen5?runprog=vetnetbbs&mode=thread&access=&subject=7&source=T&thread=201111110124319602 Due to her elevated liver enzymes: ALT: 477 U/L we will be scaling back her Azathioprine, from every other day to every third day. She is starting 150 mg/day of Zeniquin, an antibiotic that does not have any affect on the immune system, to treat her liver enzyme inbalance. She is starting her first dose of Cyclosporine this evening, 200 mg/day. Further, Maggie's vet says that according to the internal medicine specialist whom she consults, Maggie is on track with the increase reticulocyte released in her blood. The expectation is that we will start to see Maggie's HCT/PCV increase about a month into her treatment. The stated reason for adding the Cyclosporine is that Maggie is not feeling well. I suppose its to attempt to accelerate the rate of immuno-suppression in hopes that we can sooner decrease her Prednisone dosage. Please feel free to corroborate. I asked my Vet about Dr. Dodds. She spoke highly and said that Jean Dodds has moved this field (hematology) forward tremendously. She called Jean Dodds the leading expert in the field and said something about her being in Pennsylvania, which we all know. If Maggie has a poor reaction to the Cyclosporine, we will temporarily cut her dosage in half. If she continues to suffer from side effects, we will add another medication, Ketaconazole. Maggie is really hanging in there. She is much weaker and has a bloated belly. Its as though all the negative effects of Prednisone, apart from urinary incontinence, kicked up a notch at once. She still wags her tail and wants lots of affection which I happily provide to her. To make things easy on her GI while we acclimate her to the Cyclosporine, she will eating chicken and rice the next couple of days. I am really hoping that the next CBC provides good to great news regarding her Hermatocrit/PCV. BTW, for Patrice, Dr. Barlow, Maggie's vet did address the PCV/HCT values and their differences. She seems to put more stock in the HCT, but she also said that the PCV provides similarly useful data. I feel like Maggie and I have sort of taken over the board. Sorry for all the posts but thanks for providing a forum for me to share (and vent). Maggie and Robert |
| RobertN Superior |
| Richard~ Sounds like you have a plan! Tori's first reduction in Prednisone came 2 months into the treatment process. If you can remember that each dog is different then it is somewhat easier to be patient as the meds to their work. For us, this is the second time we have had to fight and understanding the process better this time, I am far more patient and understand Tori's reactions to the meds and disease in general. Don't get me wrong, I still hate to see her so heavy from the Pred and not running and jumping, but she is alive and enjoys her daily activites with a much slower pace! You are all in our prayers. This group has helped me so much, as I'm sure it does for you and others. Blessings, Cindi & Tori (Evans Syndrome) |
| Cindi FL |
| Robert, The liver takes a toll with all the medications these dogs are on. many of us had great results with a milk thistle supplement. My vet had a tincture that was easy to give and I believe was effective in supporting the liver. we also gave Zentonil, an other product is samE. Both have similarin (spelling?) in it that is effective to help the liver. If your vet thinks highly of Dr. Dodds, why not have her consult with her? everybody can learn from her! she is in California, but vets from all over the world consult with her. Best wishes, Brigitte |
| Brigitte BC |
| I know that this process can be a roller coaster, but Maggie appears to be slowly turning a corner after bottoming out. Although not normal, her respiration no longer seems as laboured. Her pallour is much better. She is eating well, wagging her tail and even her bloat has substantially subsided. She is also much more alert. The only current concern is she seems very weak. More than just a few days ago. I am attributing that to the muscle wasting, but it is very marked. Just to think only 4 weeks ago, she was a well-muscled Labrador. But I have a feeling that we have passed a critical point and she is finally on the way to recovery. I only fed her chicken and rice yesterday, plus she started on the antibiotic for her liver (Zeniquin) as well as the Cyclosporine. I know it will at least a few more days for the Cyclo to make a difference, but I just have a feeling her next CBC will bring some strong reason to celebrate. |
| RobertN Superior |
| That is very normal...due to lower oxygen. There is always a weaking, but I believe most of the doggie stories here have said they bounce back. We look for them to be active, but I was told by those who have gone through this that the doggies really need to be calm and resting so the body will heal. Even exercise becomes for most of our furbabies...just going out side for a "pit stop", or going from one room to another to be with you or just barking and going to the door or window to see what sound they just heard. The fact that you shared so many little improvements...that IS great! Praise the LORD! I take each improvement like a cookie crumb, while by itself is not much, but as more are added you finally have a cookie!!!! (Got to stay positive! Smile) You are doing as any concerned caregiver would do that loves their furbaby! You are in good company! Looking for a good report with the next CBC! Blessings, Cindi & Tori (Evans Syndrome) |
| Cindi Fl |
| Robert, I am echoing everyone else to contact Dr Dodds. 400 yes, when you think about it, is high but it is prednizone induced. I have not heard of antibiotic to treat this. My Wylies ALT was at 1000 when she was on her meds, she did go back down to 200 for over a year, but has been in the 400 range now for almost years as she is 14 years old. Can you please elaborate abou this treatment for high ALT? t You also mentioned about a UTI has this been ruled out? This is quite common in AIHA dogs and can hamper the increasing numbers. Laurie |
| Laurie CA |
| Laurie, UTI was tested and found negative. She is on an antibiotic that is supposed to help her liver. My vet told me that she and her internal medicine specialist follow protocols developed from Dr. Dodds' work. Maggie, btw, is much better than last night. All of the sudden, after bottoming out the past few days, she is much perkier, and is breathing much easier. She is back to begging and seeking affection. I took her out for a bio-break, and she trotted for the first time in 5 days. The only negative is her poo looks like chocolate syrup and she has a bit of constipation. A little spoonful of pumpkin was happily gobbled up and hopefully will alleviate some of her GI issues - probably caused by the recent addition of cyclosporine. |
| RobertN Superior |
| Robert, Is Maggie on something that protects her stomach? Sucralfate or Carafate? Pepcid is not strong enough to protect from these harsh drugs. the Sucralfate has to be taken separate from the other medications so it does not interfere with absorption. I just thought of it because of your description of her stools. Keep up your good work! best wishes, Brigitte |
| Brigitte BC |
This thread was discussed between 12/11/2011 and 13/11/2011
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