Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Mitch

Hi I have had such good support here and thought I should update you all - don't hold out for good news though. Over the first few weeks of Mitch's illness I was totally taken over by the shock of what was happening to my little man and unfortunately work got pushed aside which meant the last few weeks I have really had to get my head down and work hard so I apologise for my abscence. My husband has been a saint taking lots of time off his work to take Mitch back and forth to the vet hospital. I don't even remember how things were when I last posted but despite all sorts of treatment Mitch has remained around pcv 24-28 and platelets of about 12- so dangerously low. WBC variable- sometimes below reference.He is currently on prednisolone and cellcept plus protectants, antibiotics and bioprep. He has had so many different drugs tried (with little if any improvement shown) including atopica, epogen, human immunoglobulin, vincristine, granulocyte colony stimulating factor, doxycycline possibly others I have forgotton. Nothing has produced results. He has been ill for over 2 months now. Mitch's bloods last week showed his pcv better at 28, his wbc at low reference range and his platelets at only 2!- the lowest yet. Alongside this his body is not coping with the meds and he is very bloated now but still very much a terrier at heart and mentally bright. The only hope of saving him (the meds) is now making him ill. I noticed there are a lot of new people and their dogs on the forum which is a shame - for all the right reasons but I know they will get great help and support here. If Mitch's case sounds relevant to you do a search for 'Mitch' and you will find posts since early August. He primarily has thrombocytopenia but also milder symptoms of IMHA (Evans). We continue on and as long as Mitch battles on we will do the same. Best wishes to everyone and thanks again.

Kath Scotland

Poor Mitch. He is such a fighter. He can still turn around. PCV's are still pretty darn good, it's all the other stuff thats slowing him down. I know you and Mitch aren't giving up and thats a good thing. I will keep you guys in my thoughts and prayers.

Mardi Northern Calif

Our thoughts and prayers are still with you and Mitch, there is always hope, one day at a time. For some of these guys, it just takes a long time, but as long as there is that little gleam in their eye, it's worth it to keep fighting. Mitch is a fighter! melissa and tiggs

melissa slc

Kath: Sorry to hear some of Mitch's numbers are low. It sounds like he's willing to fight this thing though which is good. Hang in there - we're all thinking positive thoughts for you and praying for a full recovery for Mitch. Rita, Mike and Sheba

Rita IA

Kath and Mitch When they were thinking of using micophenolate for Nollaig they told me it can take up to six weeks to show any results. What about the danazol or nandrolone injection-the danazol didn't work for Nollaig but the nandrolone is maybe the one helping her now, it stimulates the marrow instead of concentrating on stopping destruction-the way I saw it with Nollaig was the amount of drugs they'd already tried why not try everything possible then you know you gave it everything to get them through it. Also keep going with the bioprep,might be better for absorption to open and sprinkle them on his food rather than eating capsule whole.It took Nollaig 4 weeks of being on bioprep and 6 weeks of soloxine and ronaxan(doxycycline) before she turned it around she went down to about 8% pcv and then went up to 19% but she continued to go down before she went up even on these drugs/bioprep. What meds is it that are causing bloatedness is it pred because if they're not helping him he might as well be weaned off it? I know that I stopped danazol and atopica as I felt they weren't working anyway and sometimes the less they're on the better. I do so wish Mitch's bone marrow would spring back into action and he can have the body that matches the mind and spirit of this little man. I continue to pray for him. Kathleen and Nollaig

Kathleen North Ayrshire

Kath, Sorry Mitch is not responding as fast as you would hope. It is not unusal with the thrombocytopenia and the Evans to take longer. Hopefully you will be able to figure out what combo of drugs will best help your "little man" Keeping you in thoughts and prayers. Penny

Penny Lytle Creek Calif

Aren't danazol and nandrolone the same? This is the only drug we haven't tried yet. The mycophenolate mofetil has been used with sucess in a very similar case to Mitch so fingers crossed we will see a differece. With a platelet count of only 2 we are lucky he is still here at all I guess. I think it is the pred causing the side effects and will enquire about weaning him off it if possible. Thanks for your ongoing support

kath scotland

Kath No danazol and nandrolone are different drugs but supposedly of similar type,however danazol didn''t work for Nollaig but the nandrolone did(along with help of soloxine and bioprep and ronaxan) Nollaig was put on danazol tablets as they had worked for another dog with similar case to Nollaig but unfortunately they didn't work for her-she was on danazol about 6-8 weeks. The vet at Glasgow Vet Hospital was not going to try nandrolone injections for Nollaig as he said if the danazol hadn't worked the nandrolone wouldn't as they are similar type but Dr Dodds told me that nandrolone stimulates the bone marrow.Well I asked him if he would do it for me as I needed to know in ny heart I'd tried everything so he allowed me to try it.Nollaig gets the nandrolone injection once every 3 weeks as that is the type Glasgow Vet School use, some use the weekly injection nandrolone it just depends what it is licensed for,the one Nollaig gets lasts 3 weeks in Nollaig's system. Well 3 weeks to the day after the first nandrolone injection was when Nollaig's pcv was tested and it went from 8% to 19% the first rise in 7 months,now whether it's the nandrolone or the bioprep or the soloxine or the ronaxan(doxy)or a combination of all of them we might never know. Mitch is very similar to Nollaig in that a number of the normal conventional drugs haven't worked and they both have a 'stubborn' form of auto immune disease in the bone marrow and it takes a lot more time and hard work to find the winning treatment but I do believe Mitch can defy the odds just as Nollaig did,he seems to have the same fighting spirit as her many other dogs with Nollaig's extremely low pcv of 8 or Mitch's platelets of 2 would have certainly succumbed. I hope the micophenolate works but if not please get them to try the danazol and nandrolone injection(the nandrolone would work quickly if it's going to)but please persevere with the bioprep too and if they think the pred is not helping him at all then he would be better weaned off it as it could cause him problems which he certainly doesn't need-he's got enough. I really hope this wee fighter man can do it,the terrier nature must be similar to the beagle, as my vet said 'Nollaig doesn't want anything to get in the way of her plans, including her own illness, she's stubborn and determined and thank God for it. Take care Kathleen and Nollaig

Kathleen North Ayrshire

Kath, just keep fighting it and your little man will fight along with you that's all you both can do. One day at a time. Many hugs and strength coming your way. Effie.

Effie Melbourne Australia

Mitch is not well today. He was a bit loose last night and he has been sick 3 times in the night. He is feeling very poorly today and doesn't want to eat or drink at all. My poor wee man. He will be going back to the vets today.

Kath Scotland

Kath, I will be thinking of you and Mitch today, hoping he is just under the weather and it is nothing serious. Take care, best wishes, Brigitte

Brigitte BC Canada

Kath and Mitch Thinking of you both today,I really hope and pray Mitch can get through this. The symptoms he has sound like Nollaig had when the drug leflunomide had reduced her white cells too much and she caught a gut infection and developed sepsis and that's why they wouldn't try micophenolate on her as it tends to do the same, but they stopped the leflunomide immediately and thankfully she recovered.Nollaig had to stay in hospital for 2 weeks and was in isolation also and she was feeling very very poorly and wouldn't eat or drink so she was supported with IV fluids and IV antibiotics.Know that she did get through it though Kath and it wasn't the illness making her feel ill but the drug which had suppressed her marrow too much. Like I said before I felt they were concentrating too much on stopping destruction and not concentrating on stimulating the marrow,maybe that's why nandrolone helped as it stimulates marrow.Sometimes the drugs do more harm than good, and remember you could still try nandrolone or danazol, they do not suppress white cells. Please God help Mitch today. Kathleen and Nollaig

Kathleen North Ayrshire

Kath & Mitch Please know that we continue to pray for you and Mitch. Cheryl & Ginger

Cheryl & Ginger Pinevile pa

Kath, So sorry to hear that Mitch is not feeling well today. You are both in our thoughts and prayers. Chris

Chris Pa

Hi Kath, Stay strong and don't give up.Mitch seems to have alot of fight in him and I'm sorry to say this but it's early days yet.I believe you posted to Joey's threads and you know how long we've been going through this.Just hang on in there. Love and special thoughts to you and Mitch. Best wishes, Corrie & Joey.

corrie Dagenham Essex UK

Have just got back with Mitch from the Dick Vet. He has a reduction in all cell lines but is still fighting on.Stomach settled. The consensus seems to be that Mitch's bone marrow may well be damaged beyond repair. His liver is not coping too well with the meds either. To be honest we have accepted that Mitch is probably on borrowed time and in reality and hindsight I now realise this probably all started last August/Sept time not long after his vaccines, being a typical terrier he showed little evidence till nearly a year on by which time too much damage has probably been done. Although he is still quite bright he is not the Mitch we once had and with platelets so low he is not allowed to have the life he deserves and desires. He is not really living only existing at the moment - we have not given up on him but need to face the reality of how grave the situation really is. I cannot praise the vets at the Dick Vet hospital enough they have been fantastic throughout.

Kath Scotland

I'm so sorry Mitch isn't getting better. It's heartbreaking, I know. I am thinking of you and Mitch and hope that things can turn around. Be strong.

Mardi Northern Calif

Kath, my heart goes out to you and your litle man. Sending you both endless prayers for what ever lies ahead. Effie.

Effie Melbourne Australia

I truly appreciate your good wishes and I know we havent been fighting this long - 2 months that we know of but in reality maybe actually over a year. Unfortunately time is our enemy. His pcv (27 ish)is not really an issue but his low Wbc leaves him open to overwhelming infection and his platelet count of 2 makes severe heamorage at any time a very real problem. Also his body is not coping with the meds well.

Kath Scotland

Kath, My heart goes out to you and your little Mitch. Where there is life, there is hope. I know you have not given up. I had my moments of being close to throwing in the towel, thankfully my vet was not ready for that. Mitch will tell you when he had enough, but until then keep fighting! Best wishes, Brigitte

Brigitte BC Canada

Kath, Perhaps you could try reducing some of the meds and see if that kick starts his system? Stranger things have happened. I believe that is what Bonnie did with her Murray. Perhaps she will see this post or I will look in the Archives and see if I can refresh my memory. Keeping you and your little man in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Kath, my heart goes out to you and your little terrier Mitch. Your vets have done everything they can and no matter what happens you can live with knowing you have done everything you possible can for him. My thoughts are with you. Julie.

Julie Australia

Kath We continue to pray for Mitch and hope things turn around for him soon. Cheryl & Ginger

Cheryl & Ginger Pine

Hi Kath - I have been following Mitch's story and I'm so sorry to read he hasn't responded yet. Murray's situation sounds similar but not exactly the same - his white blood count was dangerously low but his platelets were not as low as you are dealing with. He became septic and the internist immediately stopped his IMHA meds (except a maintenance dose of pred) and began aggressive IV antibiotic therapy. He had been non-regenerative for months with a PCV in the low 20s - the biopsy indicated the destruction was happening at the level of his bone marrow. So, stopping the meds "cold turkey" certainly did not sound good but they didn't feel there was a choice if he was to have a chance. The infection was so pervasive we honestly did not think he would survive but after five days of this protocol his white blood count came up a bit and we were able to take him home with a very guarded prognosis, an army of antibiotics and no IMHA meds. His white count responded in about a week and then several weeks later, his red count began to make very slow improvement and we saw our first signs of regeneration. We don't know what triggered the anemia and no one has offered a definitive explanation of why his marrow responded when it seemed unlikely it would. I just know I was lucky and got a break that time. It certainly reinforced to me that while doctors do the best they can, no one really has all the answers, it truly is the PRACTICE of medicine and, sometimes, all we can do is take things day by day, even hour by hour. It's clear that you are putting Mitch's best interests first and I sincerely hope he gets a second chance this time - it can happen when it seems the least likely and the terrier spirit is strong. My thoughts and prayers will be with you. Bonnie

Bonnie Chicago

Kath, I'm so sorry to hear Mitch isn't responding as well as hoped. He sure is a lucky doggy to have you there for him. I'm sure that everytime he wakes to see you he keeps the fight going. I'll keep him in my thoughts and prayers. Give him some hugs from Tessy & I. Johnny & Tessy

Johnny

Hi Kath I do hope that Mitch is able to overcome his obstacles, and wish you all the very best. I know what you mean about Mitch not being his usual self. Silka

Silka Melbourne Australia

Kath, My thoughts and my Prayers are with Mitch and your family. I do hope that things turn around for Mitch very soon. Sue

Sue Kingston Ontario Canada

This thread was discussed between 03/10/2009 and 13/10/2009

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