Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Maggie's post-setback update

Please see this thread for reference. http://www.vetnet.co.uk/cgi-bin/gen5?runprog=vetnetbbs&mode=thread&access=&subject=7&source=T&thread=2011111720181521571 Maggie is stable from yesterday which is good news as they just started her on a modified, enhanced treatment. The critical care specialist spoke to me and discussed her reason for being optimistic. A brief history: Monday 5PM - Maggie admitted in critical condition and transfused. It is not known if she clotted before or after her transfusion. Her PCV quickly rises from 17 to 20. She is placed in oxygen and started on two doses of Lovenox (low-dose heparin) every 12 hours. She immediately stabilizes. Tuesday - Maggie shows improved energy and breathing. Her PCV rises to 27 (3AM). Outlook improves. Wednesday - Maggie continues to improve and shows increased tolerance outside the oxygen chamber. She is not quite ready to be released. Her afternoon PCV is 25. Somewhere during Wednesday night, Maggie throws more clots. She is stabilized by being placed back in oxygen. Thursday morning PCV is 24. Reticulocytes have jumped to 233,000. Her treatment protocol is changed. From two to three doses Lovenox (heparin) and continued aspirin. Reduces Prednisone dose from 80 to 20 mg to ward against tendency towards aggluatination. Crit doctor says there is reason for optimism because Maggie did improve over the first two days. Her clot was being resolved, just felt we did not do enough to contain further clotting. Maggie's extra dose of heparin was added overnight (Thursday) and this morning they also added Plavex. She says Maggie's respiration is very good in oxygen, the best she's seen it since early this morning. Guarded optimism.

RobertN Superior

Here is an article on a University of Georgia study on the use of Plavix for dogs. They caution that the study only provides data on the use of the drug in healthy dogs, not those critically ill or receiving other drugs. http://www.physorg.com/news198345749.html Gives me hope. Maggie's platelets since September have looked extra large and clumped together.

RobertN Superior

Maggie's IMHA indicators seem to be improving. Her reticulocytes are up (around 240,000) and her PCV is up as well (25) from yesterday. We just have to beat this scary development. Maggie was more active this morning than late last night. The are encouraging precursor indicators and the vet agrees but says not to take too much stock in yet. What matters is the next 24-48 hours if we can see signs of her clot resolving and no clots reforming. The Plavix (new) More dosing of Lovenox (low dose heparin) Aspirin reduced dosage of Prednisone which has a coagulative effect These all just need to stop clots from coagulating and then Maggie has a really good shot.

RobertN Superior

Here is more info on the plavix study Robert mentioned: http://webcanine.com/2010/plavix-for-dogs/ The Meisha's Hope AIHA/IMHA Fund #338 at Morris Animal Foundation http://www.morrisanimalfoundation.org/meisha was a co sponsor of this study.

Joanne MN

Latest update on Maggie (Sat. 11/19) Since her setback Thursday, there have been slow but steady improvements. Thursday, outside of the oxygen chamber, Maggie's O2 absorption rate was 84. The measurement was by a more accurate system that measured gases in her lungs. A less scientific measurement today showed Maggie absorbing at 92%. I was told to take this with a grain of salt because it has a margin of error, but its somewhat corroborated by the fact that Maggie has more tolerance in general outside the oxygen chamber. Her absorption rate in the oxygen chamber is around 99% which is optimal as she can breath and sleep comfortably. Sleep is important as that's when she'll heal the most. On Thursday, it was just too tiring and she needed to be carried back after going out to eliminate. Today she can slowly make it back on her on. The disease we are treating is hopefully acute, but related to the heart. While she is still guarded, the clots are very scary but we are treating them aggressively based on the latest research and fortunately they are under control. She is now getting a higher than human dose of Plavix, based on a Purdue study. Vets are cautiously optimistic. Maggie is hanging in there. She is strong. She eats, drinks, loves affection and unlike Thursday is now strong enough to slowly go outside and do her business with acceptable tolerance to her system. She does still develop abdominal fluid but its not a lot and they think they can manage it with Lasix. This is related to her (hopefully acute) congestive heart failure, aggravated by the initial embolism. Her PCV is holding steady bouncing around between 24-27 (high on Tuesday, 25 on Thursday afternoon). It will take many months to recover from this crisis but first we are getting through the current crisis. Your prayers and support have been appreciated Once again, the vets are guardedly optimistic.

RobertN Superior

Yes, Robert we deal with each crisis and pray that it will pass quickly. Your vet may be cautious, but I wouldn't have it any other way. "Slow and steady" is my motto! Sometimes, agressive treatment is the best. It's just so hard our our pets. If our vet had'nt been so agressive both times, we would not have had this extra time with our little girl. Like Maggie, she is a fighter! Dr Dodds' protocol really helped us get the platelets to start producing. She is one great vet in this field. Blessings, Cindi & Tori

Cindi FL

Saturday, another night has passed and Maggie once again shows further "mild to moderate improvement". They are still using the term "cautiously optimistic", but more optimistic than before. Three nights since she started her modified approach and she continues to heal. Please send prayers of gratitude to the vets, techs and meds who are providing for her so that she has everything she needs to heal and continue her treatment comfortably and safely at home.

RobertN Superior

RobertN, Prayers are Definitely Continuing for You and your Maggie. Your Vet., Techs and yes, different Medicines will be included. Get some rest if you can. We, from Experience know that's hard to do. Please keep us posted as we care. Take care and know that Maggie is in good hands.

Kathy Calif.

Robert Please know that we are continuing to keep Maggie and her medical team in our prays, please let us know how she is doing after you next visit. Cheryl & Ginger

Cheryl & Ginger

chance lights on in the kitchen tonight for maggie. patrice

Patrice NYS

Robert, any news on Maggie today? I'll be keeping you both in my thoughts and prayers! Johnny & angels Tessy & Sadie

Johnny

This thread was discussed between 18/11/2011 and 21/11/2011

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