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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Med Reduction Question
| Hi everyone. Tessy goes to get her blood checked again this week. If her HCT remains the same at or above 25 we will probably lower her azathioprine from 37mg to 25mg. I've got a couple of questions regarding this possible reduction. 1. Are there specific signs or factors that should be considered first? Ex. If spherocytes are present should there still be a reduction? Ex. If her HCT climbed some but lets say only a point or two...should we still reduce the azath? Ex. Should the retic numbers play a role? OR how about neutrophil #'s...if they are low then it might mean excessive bone marrow suppression? etc. etc. etc. 2. I'm kinda wondering if the Azathioprine SHOULD be the one reduced. What about the prednisone? I've always been under the understanding that the azath suppresses the marrow the most....which might circle my thoughts back around to the neutrophil numbers. Then again isn't the pred the hardest on the body! I don't know if I'm just overly concerned or paranoid. I'm trying to cover everything I can so I can fully understand what I'll be dealing with when I consult with her doctor. I just do not want to do a reduction if there might be reason not to....that I might not know about. On a side note, Tessy seems to be doing really well as of late. I still try to get her to rest as much as possible but sometimes she has other things on her mind. She loves her balls and toys! Seems to be the only thing she thinks of when she's awake...other than food. Hope everyone is doing good. I pray daily for full recoveries of all sick furkids. Hugs from Tessy & I. Johnny & Tessy |
| Johnny |
| Hi Johnny, I am just as confused as you about med reduction, so I am probably not much help. I can only tell you a few things that we did. The question is, are they also right for Tessy? It seems every vet does it different and every dog needs a different regime. Kahlu was in the mid 30ies until we started reducing the prednisone by 10mg (from 70mg) We went down by 10 mg about every 2-3 weeks. Now we are at 20mg and have cut the Azathioprene in half. Some people go to every other day, which of course is a 50% reduction as well. At the time of the first reduction there were still rare spherocytes noted. Before we did the first reduction my vet talked to Dr. Dodds. that made me more comfortable that we were on the right track. I think in 2 weeks we will go down further with the prednisone (25%) and leave the Aza. But usually I don't even think that far, just take it one day at the time. Today was a very good day! We went for a walk, Kahlu's gums are pink and he is barking at the doorbell! Best wishes to you and Tessy, Brigitte and Kahlu |
| Brigitte BC Canada |
This thread was discussed between 04/05/2009 and 05/05/2009
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