Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - my 13yr old lhasa has just been diagnosed

hi everyone, feeling slightly overwhelmed right now, our 13yr old lhasa apso, shandy was diagnosed with autoimmune hemolytic anemia on wednesday..yes she was tired and lethargic and had gone off her food but 2 days into the predinsone treatment she is depressed....having probs breathing and now not eating at all. I'm so terrified we may lose her, this is my disabled daughters companion dog and she is not making this easier...she has cerebral palsy and suffers form anxiety and panic attacks....she has told me if I let them put shandy down she will hate me forever...I know she doesn't mean it but its putting added pressure on right now. I don't know what is normal for a dog just starting treatment..what i should expect or if I should be panicing right now!

Linda australia

Linda, Oh dear. This is such a difficult situation for you. Can you tell me where you are having the dog treated? Is it a local vet clinic or are you at a specialty 24 hour clinic? This can sometimes make a large difference in the diagnosis, the treatment and the eventual outcome. The very first days can be uncertain and it is so hard on you because you don't understand what is happening. However, there is a lot of pressure on you to make the right decisions. This would make anyone feel panicky. You have come to the right place. There are plenty of people here that will help you, even just to let you know they are thinking about you. Please let us know if anything else was prescribed besides the prednisone. Describe the tests they used to determine this is AIHA and what the prednisone dosage it. The next time you go to the clinic, ask if they will give you a copy of all tests that have been done and always ask for copies of tests they do. You certainly are doing the very best you know how to do right now. Take a deep breath and we will work through this together. my best patrice

Patrice NYS

hi Patrice, you don't know how much it helps just to talk to someone who understands what we are facing! we only have the option of a local vet here, unfortunately we live in country australia and the nearest large vet hospital is over 3 hours away, and with a daughter in a wheelchair its just not possible to get there. Shandy first had problems about 6 months ago with a rash under her neck which she was scratching until it bled, we were told it was an allergic reaction and to change her food, she got a cortisone injection and it cleared up..oh and a special shampoo to use once a week...she improved out of sight but had become picky with her food, she IS 13 so we figured maybe the current food was doing it for her anymore and tried her on many different ones, she would eat them for a few days then taper off. the lack of interest in food and general lethargy convinced me she was not well....I know shes old but I know her and it was abnormal. the vet did blood work, no I didn't recieve a copy of the results....so I'm not sure what they were...he told us she had this autoimmune disease but that it was th ebest outcome we could have hoped for....he was worried about liver failure apparently but he said her liver enzymes were ok...her gums and tounge are EXTREMELY pale so i knew she was anemic...she is only on the prednisone at the moment..5mg twice a day, she weighs 5kg so thats 1mg per kilo. I'm worried that because of her age she might not respond to treatment so well, and that maybe the vet won't try as hard....I'm going back over there this afternoon to try and get some answers so i need to get my head around what questions i need to ask. first time I've ever wished i lived in the city!

Linda Australia

Linda, As I read what you have written it sounds like Shandy has been having some health problems for a while. Most vets in areas like yours are not able to follow along with the latest treatments and may have limited exposure to certain conditions. However a local vet can have a great deal of clinical experience and an excellent grasp of many diseases. So there is room for some optimism. In order to work through this you will need to do some research and learn more about what is happening so you can make educated decisions. The first place you can go to learn about this condition is the website associated with this forum: MEISHA'S HOPE A GUIDE to CANINE AUTOIMMUNE HEMOLYTIC ANEMIA http://www.cloudnet.com/~jdickson/ Once you have read through this material you will probably have many questions. Please come back and ask all those questions. My very first thought when I read Shandy's history is that she may be hypothyroid. This means that the thyroid gland has become less effective at producing thyroid hormone. That hormone is the body regulator for many things. When it isn't working properly there can be many different symptoms. One symptom can be coat and skin problems. In the most extreme, dogs can develop autoimmune problems. Luckily the function of the thyroid gland can be tested with a blood test. The difficult part is that this test must be done at a specialty lab which may be very difficult to find in your area. If there is a university nearby that is probably the best place. You do not need to go there but the blood would need to be sent there. You can talk with your vet and see if they have tested the thyroid function before and if they could do this for you dog. It's not a cheap test, but it's not terribly expensive either. I would also want to know if this vet tested for anything local, like tick diseases, that may be causing this. Also ask if they did any x-rays of the abdomen or chest. These kinds of tests help rule out causes that may be contributing. If they can be fixed then the anemia may be easily treated. my best patrice

Patrice NYS

Hi Linda, I am so sorry that your little one was diagnosed with this disease. You have come to the right place for information. I wish You and Shandy the Best.

Kathy Calif.

Linda, Some dogs take a while to respond to prednisone and others require additional meds to help suppress the immune system. Cyclosporine and azathioprine are the most common. She should get Pepcid AC to protect her stomach (if you have that in Australia.. the drug name is famotidine) I believe I was told that it takes 3-10 days to see a response. Now, the important thing about this is that after 2 days.. the meds are not working yet.. that means she has been losing blood for 2 days. She should be getting tested again to see how it's going. Get the results from your vet, you should've at least gotten the PCV (or HCT). My guess is, based on how you're describing her behavior, she will be needing a blood transfusion. Cookie was behaving similar and this ended up being the case. Not eating is a bad sign and chances are this means she is getting worse, although it could also just be that she has associated her food with feeling bad. I would offer her different foods that are low in fat (Rice, chicken, fish, I/D, tripe) One last recommendation, you are too far from a vet hospital but that doesn't mean you can't consult with a specialist. Dr Dodds is very famous on this board and she can be reached by email at hemopet@hotmail.com. Also, it would be helpful if *your* vet was willing to contact an internal med specialist from the hospital. This way, if it was absolutely necessary (may be for a transfusion) they would be up-to-date.

Monet Sammamish

Linda, I am so sorry your Shandy has been diagnosed with this awful disease. It is a roller coaster ride in so many respects. Try to keep a journal of every thing you are told by your vet and how Shandy seems to be day by day and what meds she is taking and what times. It is such a scramble to try to remember and also to understand everything so having a reference is handy. When you go to Joanne's site be sure and read the success stories. I am keeping you all in my thoughts and prayers. Penny

Penny Lytle Creek

Shandy just died in my arms moments ago....I am so devestated. I got the blood results from the vet....her hct was 9...he never mentioned transfusions even though I know now she desperately need one, I was angry and we had called in a second vet....he was only at the house for 15 minutes and it was already too late, I was nursing her so he could check her heart rate and she simply died, her poor old body just couldn't take any more. I am grateful for the iformation I recieved here though because without it I would have gone on beliveing this first vet that everything would be fine with just a few tablets....shandy was far far sicker than he led us to believe. Anger is fast replacing grief. thanks for just being there'Linda

Linda Australia

I am so sorry to read of the passing of Sandy. I don't have the right words to say to make you feel better after losing your Sandy but I would like to say I'm so very sorry for your loss. RIP Sandy Cheryl & Ginger

Cheryl & GInger

I am so very sorry for your loss. There are no words to help, I know. This is a devastating illness for our pups. Sally and (angel) Bentley

Sally Louisiana

Oh Linda, I am So Sorry! Words can't describe the Emptiness that fills our Hearts. RIP Shandy.

Kathy Calif.

Linda, I am so very sorry for your loss. It is unfortunate that even in this day and age it is still considered a rare disease and there are a lot of Vets that are just not that familiar with treating it. Even when you have the best resources there is no guarantee that you can beat it. You were a great Doggy Mom and you did everything you knew to do. I hope that the 13 years of good memories with Shandy help you through this awful time. Sharing in your sorrow. Penny

Penny Lytle Creek

Dear Linda, You can't imagine how badly I feel about what has happened. Sometimes I wish I could squeeze through the internet and give a hug. Please believe me when I say that I know you did the best you could do with what you knew at the time. There is NO MORE you could have done. We are often left to rely on others for help, that is the way of the world. I hope in the days and months to come that you will remember the very best things about Shandy and the last few days will diminish in importance. It is the sum of a lifetime that matters the most. In Shandy's memory I hope you will visit here occasionally to give comfort and share friendship with other worried owners. Please accept my sincere condolences. Patrice

Patrice NYS

I just want to thank everyone for their kind wishes and thoughts, I will never ever forget shandy, the house seems so empty and quiet without her and having to tell people shes gone has me bawling every time. my daughters home care lady sat and cried with me this morning, she has been showering my daughter for 3 yrs now and still shandy would bark at her every time. I'm so not ready to get another dog right now, but I do know one thing, this has taught me to ask questions..vets are falliable...they do NOT know everything and I will never accept anything less than the best for my animals. I was too trusting, if i had got her blood work from him straight away i would have been more aware of the gravity of her illness. I will miss her forever and my heart goes out to those who are fighting for their friends against this horrid illness. I will probably hang around in teh shadows here....this group was the only place I got answers and the info I really needed. hugs to everyone.

Linda Australia

Linda, Still thinking about you. I know how you feel. Words can't express the Pain that we are going through. Long Distant Hugs to you.

Kathy Calif.

Our hearts are sad...it is such a dreadful disease and so many of us have lost or nearly lost our beloved furbabies. Anger is understandable. Loss is so hard. May I leave you with this~ "A loved one is not gone, until they are forgotten. And to live in the hearts of those left behind, Is to live forever." 'author unknown You are in our prayers. Blessings, Cindi & Tori

CIndi FL

This thread was discussed between 25/11/2011 and 03/12/2011

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