Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Moose has AIHA: question about prednisone

Hi, our pound special Moose (mostly ridgeback with a bit of whatever else was walking past at the time) was diagnosed with AIHA two weeks ago (after being very sick for a week). This was after he presented with a myriad of symptoms including the classic AIHA ones (lethargy, not eating, jaundiced). He also had a temperature and a high white blood cell count, which threw the vets down different paths (toxic exposure, blood poisoning). He came back negative on the Coombs test, but started responding to prednisone after his PVC hit a low of about 20. The vets have theorised that an infection actually set off his AIHA, meaning he was treated fairly quickly (it was 36 when he was first seen). His PVC has been climbing nicely- it was up to 35 again last week, and he is being slowly eased off the prednisone (currently he's taking 60mg per day, down from 80 when he came home two weeks ago). He's extremely hungry, and we are feeding him probably 3-4 times what he would normally eat. Despite this he has lost a large amount of weight since he's been home! Much of it is muscle wastage, but I'm really surprised that he is so lean given his intake (and the fact he's currently getting very little exercise). The vet did say that prednisone can fire up the metabolism in some cases, but most of what I've read warns that dogs will gain weight with the side effect of increased appetite. He's been through so much in his 4 years- he has hip dysplasia, has had both cruciate ligaments reconstructed and had a really rough start to life before we rescued him as a skinny, scared 4 month old pup. Has anyone else seen this side effect in their AIHA dog? Thanks for your answers. Leonie

Leonie NZ

Leonie, I am so sorry to hear about Moose. Muscle wasting is one of the side effects of high doses of pred. If you look at the thread from 2/22 Kahlu and advice, Brigitte was asking about this and people shared their experiences. Laurie

Laurie CA

Hi Leonie, I am sorry to hear about Moose. I got great advice and lot of encouragement on this board, when i was so worried about the side effects of prednisone on Kahlu our Standard Poodle. He was an incredibly athletic (Agility) dog. Initially he went from 62 lbs to 52 and just looked like a bag of bones. Then when the prednisone started to kick in, he ate 2-3x his normal amount of food, but it took a good three weeks until he started gaining weight, because he had bad diarrhea. Now he is 58 lbs but unfortunately all the weight gain is on his belly. Now he is my bag of bones with a potbelly! It is hard to see them this way, but a lot of people on this board asured me that it would all get better in time. Moose is clearly heading in the right direction. Just make sure the prednisone is reduced VERY gradually. Best wishes and thinking of you, Brigitte

Brigitte BC Canada

Leonie, sorry to hear about Moose. Did he have large amounts of muscle? Maybe he is trading the muscle so to speak and replacing it with fat? My dog had an appetite yesterday but now she seems to have lost it. Not sure what to think of this. As for her muscle mass, I can't see her losing some in a week but she may have. I think she is just more weaker than she was. I'm hoping that over time she doesn't lose too much muscle because she doesn't have much to begin with. I'll keep moose in my thoughts and send a paw his way. Jonathan

Jonathan

Hi Leonie, Moose sounds like a real cutie and a fighter too! I'm sorry he developed IMHA, but it sounds like things are going well. Tiggs was also 4 at dx this past July. He lost nearly 10 lbs, then gained about 25 back in it's place once Pred kicked in. He was 64 lbs at dx, then down, and now he's at 81 lbs! But, we found out that he has developed hypothyroidism through his journey with IMHA. Muscle wasting is very common, and now 7 months later, I still have to lift Tiggs rear end into the car. It's a slow process. We just walk every day to help his stamina and strength build, and he's back to playing more, which I'm hoping will build his strength back. Also, his head became very thin, and the occipital bone sticks wayyyy up. I call it "the Pred Head." He also leaked quite a bit of urine, and required (no joke), toddler pull ups that I wrapped around his waist. It will also make them very, very thirsty. But, as mentioned, all reductions should be done very slowly and very carefully, and not too soon. Best of luck, keep us posted, everyone here is wonderful and at different stages. Someone will always be here to listen, or give advice and encouragement. melissa and tiggs

melissa slc

Hi all, thanks so much for your answers and kind thoughts for Moose. Johnathon- yes he was quite a muscular dog in his front end- his back end has always been a bit thin. It is really noticeable because his head shape has changed (he's getting the pred head as Melissa has aptly coined!) and his collar is hanging off him. His back legs are pretty wobbly now- they've never been that flash with the hip dysplasia, but now he's staggering around like he's a bit drunk. He doesn't have a pot gut to speak of yet, so right now we are just feeding him more. Melissa, Moose has also been leaking urine- because he is drinking so much he doesn't always quite make it off his bed and has a small accident. Not really a problem- his bed has a water-proof cover which we've put towels over. We've been doing lots of towel washing, but we reckon that's just helping prepare us for our first babies arrival in May! The vet wants to reduce the prednisone to 40mg per day later next week - Moose weighs 35kg. Does this sound too fast? He's obviously responded fairly well so far, with his bloods going from 30 to 35 in a week. Thanks again for all your support. This is a fantastic network of dog lovers- I'm glad I found you! Leonie

Leonie NZ

Leonie, I am sorry your Moose has been diagnosed. If you haven't found your way to Joanne's site be sure to take a look. http://www.cloudnet.com/~jdickson/ It will answer a lot of your questions. Pretty much everything you describe is pretty much part of the disease and the side effects of the drugs. Just be careful of reducing the Pred too fast as it can lead to a relapse. You can try things like raw carrots to try to fill him up. Just don't make the mistake I made of offering too much people style food because that and the drugs can lead to a very bad bout of pancreatitus. Are they giving Moose anything to protect his stomach from the drugs? It does sound like he is doing quite well but this can be a real roller coaster ride so you might want to start a journal or diary of some sort just to keep track of things. Thank you for being another pound puppy parent. Moose sure knew how to pick you! Penny

Penny Lytle Creek Calif

Thanks very much Penny. We'll be careful about giving Moose too many human treats! He isn't taking anything for his stomach- what kind of drugs or suppliments are usually perscribed/recommended? We've always thought that Moose would probably not have a long life due to the hip dysplasia, but we've been determined to give him a good life. 4 years is too short though- we want him around for another few years yet! Here's a photo of our handsome boy (before he got sick) http://www.flickr.com/photos/25374437@N00/3307882553/ Leonie

Leonie NZ

Moose is a beautiful dog! At that dose of prednizone I would have him on a stomach protectant, High doses of pred can cause bleeding ulcers. Ask your vet about this many take sulfricate (not sure of spelling) and also ask about denymirin, its a mix of milk thistle and what is know as sam e over the counter, it helps heal the liver and protect it Laurie

Laurie CA

Leonie, What a handsome boy! I am not sure what the equivilant is down under for the stomach meds but it would be like the human Pepcid ac or the sulfracate that Laurie and I can't spell. Ha-Ha! Best to you and yours. Penny

Penny Lytle Creek Calif

Thanks very much Penny and Laurie. I'll talk to the vet about these drugs for Moose. The vet told us they may see one case of AIHA a year come through their clinic, so it's obviously not a disease they are overly familiar with. Having said that, they had another dog come in with AIHA while Moose was under their care. They thought this was so unusual they checked to see if there were any local links between the two dogs, but came to the conclusion that it was a coincidence. Sadly the other dog didn't make it- her PCV was down to 8% when they gave her a blood transfusion, and I think it was just too late for the poor little thing. I'm eternally grateful that Moose has a fighting chance, and am thankful for every day we have with him. It's inspirational hearing the stories of dedication and courage on this board, and the support you all give each other. Leonie

Leonie NZ

Leonie, What a handsome boy!!! Sending prayers your way and for all out there dealing with this insidious disease! Terese

Terese Erie

Hi everyone, Just an update on how Moose is going- he's doing really well. Had a blood test last week and his pcv was up to 45!!! That's from 35 just 2 weeks ago, so he is a wee star. His blood cells are looking good too- the vet said there was a good mix of big healthy looking cells and newly generated ones. Moose is much more energetic, and has even gone for a few short walks. He seems pretty happy (especially when we feed him....) We can drop his pred dose down by 20mg per day now, so his next test is to see if he maintains his progress at a lower dose. Thanks everyone for your thoughts and good wishes. Hoping a bit of Moose's magic rubs off on some other of the sick pooches in this forum. Leonie

Leonie NZ

Fabulous news on Moose, thanks for sharing!

melissa slc

Great news! It's good to see that Moose likes to get out for walks now. The PCV increase is good news also. Hopefully the med reduction isn't too early. I'll keep in in my thoughts and pray he remains stable after the med reduction. Good luck and Tessy sends some wags your way. Johnny & Tessy

Jonathan

Thanks for your thoughts guys. After the research we've done (and the advice we'd been given on here) we decided not to drop Moose's pred from the 40mg per day he was on to the 20mg the vet initially said. We are giving him 30mg instead, as he seems to have been tolerating the pred pretty well, and we really don't want to reduce it to quickly. He's still a happy chap, and seems to be getting better daily. I'll keep you posted on his progress. Leonie

Leonie NZ

reducing the pred dosage too much at once can also have bad side effects so glad to hear you only dropped to 30 mg which is a 25% reduction which is good. Way to go Moose. Laurie

Laurie CA

glad moose is doing well :)

josh california

This thread was discussed between 24/02/2009 and 11/03/2009

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