Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Millie relapse fears

Hello all, Firstly, I hope everyone has had a wonderful Christmas. After all the worry about Tiggs and Kahlu, I am sorry to have to burden you with my news about Millie. Brigitte - I am so relieved that Kahlu is not relapsing. We are 11 months into fighting IMHA, and on Christmas Eve, we received the not so good news. Millie is currently on 1/4 Imuran tablet twice a week, a reduction 2 weeks ago from every second day. No Prednisone for about 2 months. Thursday we had the full haemogram to check all was OK following this reduction, and I had a voicemail from the vet saying 'Millie's blood results are pretty good. The PCV has dropped, but it's still in normal range. Concerned this might be downwards trend, so want to retest PCV next week. Merry Christmas'. Needless to say, I phoned her back, and spoke to her. Millie's PCV before the reduction was 44, and Thursday's test showed PCV at 40(which is still a good number, I know). Leonie (the vet) said that she wanted to retest her given this drop to make sure it wasn't a trend. Next Tuesday we are going in for the PCV test. A long wait, and anxious holiday period! Tuesday just gone, Millie refused to eat and drink. I think maybe a tummy upset as I gave her some canned food due to being in a hurry the night before. She wasn't interested in food, though she walked OK that night. Her appetite returned on Wednesday night and all seemed OK. Could this perhaps cause a lower PCV on Thursday, not necessarily a relapse? I was so shocked by the vet's news that I forgot to ask her on the phone if any of the other results concerned her, or if it was just the PCV. Maybe just the PCV because that's all she wants to retest on Tuesday. I'm hoping. Like Brigitte was, I'm over the shock and the tears and ready to fight this horrible disease again. Millie seems good, but I'm watching her like a hawk and analysing every move. It's doing my head in. She seems less energetic, but then again, that could be all in my head!! She walked well last night, get's excited about her walk and is eating and drinking well. All the signs look good, but she could be slowly relapsing I guess. Gums are pink! At least this time I am armed with experience, knowledge and there would still be some Azathioprine in her system, so hopefully not waiting for drugs to take so long to kick in. Obviously we will not start fighting this when her PCV is 14, like last time. If we are facing a relapse, should she go up to the same high doses as last time, even if the PCV was much higher? I figure yes because we want to suppress the immune system, but want to make sure the vet does the correct thing with her medication. Thanks to everyone for letting me vent. I haven't posted much lately, but have been following everyone's progress closely. Samantha & Millie.

Samantha Geelong Australia

Samantha, I know how you feel and that your fear is real. I think a small drop in PCV is quite normal, especially since Millie is acting normal. I am sure healthy dogs have these drops in PCV all the time, they are just not tested constantly like our dogs are. I think I would insist on a full CBC, just to be on the safe side though. The PCV is just one side of the story and with a full CBC the vet or pathologist sees so much more. In Kahlu's case we had a small drop and sent the blood to an outside lab where a pathologist looked at a smear. Although the results were very scary, we found out that we have to reduce the pred (that is all Kahlu is on now) even slower than we did until now. As per Dr. Dodds we don't have to increase. I still have not talked to our vet (she is on holidays until Monday)and don't quite understand if the whole thing with the spherocytes was a fluke or the beginning of a relapse that we caught early. Millie not eating and especially not drinking can for sure influence her PCV. If she was dehydrated it could be lower than what it shows. That is why i would do a full CBC. At 40, this is clearly not life threatening. I am sure you would recognize right away if she gets to a very low number. I am sure it is just a little dip, but your vet wants to be on the safe side, which is clearly a good thing. Best wishes, Brigitte & Kahlu

Brigitte BC Canada

Samantha, did you ask the vet/doc to look at the blood under the microscope? They'ld at least be able to see if there were any spherocytes present. I get Tessy's doctor to do this everytime I get worried. Most techs can even do this. I wouldn't be too concerned with that small of a drop in PCV. Like Brigitte was saying...dehydration can play a role in PCV #'s. I think she had it backwards (or maybe I'm wrong) but isn't it the opposite...when the dog is dehydrated the PCV will be lower? Hopefully someone can clarify this for me. If this were me I wouldn't go up to the same high doses as last time......if it is a relapse. Millie still has the azathioprine in her system and the reason for the higher doses in the first place is to hit the immune system hard and fast to stop the destruction. Changing the food can definitely affect the moods in Millie. Since she went back to eating alright that would make me question any sort of relapse. You know....every once in a while I'll get really worried about Tessy for no apparent reason what so ever. Then I start to question things. Is she eating the right way? Is she sleeping more than norm? Is she drinking the same? And the list goes on. I think alot of it is in our heads. Good htings to keep an eye on though. I find that Tessy is the same way as far as energy goes. Somedays she'll be crazy running around and then a few days later she doesn't want to do anything but sleep. LOL This happens quite often actually. I wouldn't worry about the small drop in PCV. This happens all the time. I would get the blood checked on Tuesday however becuase as we all know we can NEVER rule out possible relapses. It's something we're all going to be worrying about for a long time probably. Try to relax for Millie. Dogs can pick up on these things and it can affect them negatively. I'll keep Millie in my thoughts and prayers. Hope Tuesdays vet visit is a good one. Hugs, Johnny & Tessy

Johnny

Thanks so much for your reassuring replies Johnny and Brigitte. Johnny, I am kicking myself for not asking more questions of the vet! When she phoned me back, I took the call because I was anxious to speak to her, but had people in my office at work and was shocked by the news of a potential relapse. Millie had a full CBC done and the only thing I discussed with the vet was the PCV! I will find out more about there results on Tuesday. I will ask about spherocytes then. On Brigitte's advice, I will ask for another full CBC. Millie was great last night. She went crazy excited when my husband and I returned home from a night at the movies. You would have thought someone wound her up and let her go! Here's to staying positive! Samantha and Millie.

Samantha Geelong Australia

Hi Samantha, I know how hard it is, especially over the holidays, the wait can be agonizing. But, I do believe Millie will be OK, especially since her coloring and energy are so good. Perhaps she had a bug or a little infection. Sometimes it can be a little thing, but of course, after everything we all go through, it feels like the world is crashing down again. We will have our paws crossed that little Millie is just fine and will be feeling better in no time! I'm sure with all the relapse fears, we are all extra nervous. I know all of our kiddos will pull through! Keep us posted come Tuesday! melissa and tiggs

melissa slc

Thanks Melissa. I appreciate the positive message! I hope that Tiggs is feeling better. I think the vet has me worried and not Millie. I remember thinking on Tuesday night when she was off her food that whatever was wrong would affect her results. Maybe it has. I guess i will deal with a relapse if that is what is happening the same way we got through the last 11 months. It is frustrating because we just got Millie back to her ideal weight and she has been going so well. I will let you know what Tuesday afternoon brings. Samantha and Millie

Samantha Geelong Australia

Hi Samantha I got a shock to see your post - I just think no news is good news. Seems to me your vet is being extra careful given Millie's history, but it would not hurt to get a full CBC, as its probably a while that you have done that? I suppose when our dogs have had these serious illnesses, we would worry about every little thing, and maybe Millie was just having an "off" day. Great numbers though and given Millie's behaviour, which sounds fantastic, I would like to bet she is doing A-OK. Hope Tuesday alleviates your concerns, and please let us know how you go. Best wishes, Silka from up the road

Silka Melbourne Australia

Samantha, It is terrible that we have to think the worst every time we notice a change in our dogs behavior. Perhaps it was just the canned food that put Millie off. A lot of our dogs do get spoiled during the fight and maybe she was just letting you know that she wasn't pleased with the food as well as you said you were in a hurry. She may have felt she wasn't being the center of attention at the moment? We had an Aussie that had hurt his paw and we of course lavished attention on him, unfortunately after a while he forgot what paw he was supposed to be favoring and the game was over. The drop in PCV was not a significant drop and could be related to a lot of things. Hopefully the next draw will reassure you. Her behavior sounds like she is doing quite well s I would concentrate on that. Penny

Penny Lytle Creek Calif

Samanta, I would not worry, but to jest watch her. I posted 2 weeks ago about Wylie being sick and freaked out, I think she had some bacterial infection bcause after a day of antibiotics , A hug improvement, so I was told take a deep breath and I am sure Millie will be fine. Take care Laurie

Laurie CA

Thanks again for everyone's support. We are going to the vet in about 4 hours to test Millie's blood. I'm going to ask for a PCV (so I know the count there and then), and then for the full CBC (of which I'll have to wait for the results). Silka - We are testing Millie's blood about every 6 weeks (full CBC) following the med reduction. She had a full CBC done on Thursday morning, but in my shock on Thursday, I forgot to ask about any of the other results other than the PCV! I'll ask Leonie today when we go in. Millie has been somewhat subdued over the weekend, but that could just be because it's a little warmer. She has had some amazing bursts of energy too! Penny - You make a good point! Maybe she was annoyed at getting yucky canned food! She has become fussy in her old age, and our other dog has had a knee reco recently, so he's been getting a lot of attention. Maybe Millie is jealous! :) Laurie - Yes, I read back on your post again. That was very reassuring and hopefully this is all that is wrong with Millie. I will post later today with Millie's PCV number. Fingers, toes and paws crossed. Samantha & Millie.

Samantha Geelong

This thread was discussed between 26/12/2009 and 28/12/2009

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