Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - My 3 cockers, same litter - all AIHA

My 9 year old cocker, William, was diagnosed with AIHA on Thursday morning. He is the third of the three out of the same litter to be diagnosed within the past three months. 15 months ago, Holly was diagnosed. She was given less than a 2% chance of recovery due to the severe onset of Evans syndrome and her PCV being 6%. I brought her home, gave her high does steroids at the recommendation of Dr. Dodds and fed her the meds and food with a syringe. Several times in the first three days I thought we lost her, but each time she rallied. For whatever reason, Holly survived. Her only effect was complete and permanent deafness from the steroids. She as also had back surgery due to a ruptured disc from a congenital abnormality and ACL surgery due to the weakening effect of the steroids. 2 months ago, Buckwheat, William and Holly's sibling, was diagnosed. I knew he warning signs of lethargy, and pale gums. We brought him to the vet quickly, but this time the disease was insidious, taking Buckwheat within 24 hours. He died at home, in our arms, surrounded by his family. It was such a rapid onset that we were shocked. Never did we believe lightening would strike twice such as it had. We were completely unprepared for the disease to also take over on William. William was the only one of the three that was purchased from a breeder. Buck and Holly were rescue dogs that were on the website of our breeder. When we found out they were available seven years ago we immediately made plans to adopt them from Kentucky. Here we are now, in the same AIHA fight. William is pale, lethargic and asleep in the bathroom. So far we are heartened by the fact that he as yet, has no fever and his PCV is not dropping as rapidly as Buck and Holly. This might change, we don't know, but we hang on to every possibility of recovery. High dose steroids, pepcid, B vitamins, iron... I can't believe we are starting over again. The breeder we purchased William from won't return my calls or emails asking if there are any other known AIHA cases in her cockers. I don't want anything from her but information, but she won't help, or can't. Maybe someone told her not to so as to not hinder her business. But if you've ever held a dying cocker in your arms, suffering from AIHA and lack of oxygen you know there is nothing anyone can do to take away the horror and misery that follows after they pass. First Holly, then Buck and now William. All within 15 months. How cruel is that? thanks for listening. I am going to go hug up William and do the 700th gum check of the day to see if he is any paler. Liz

Liz Ohio

Dear Liz, I got goosebumps just reading The heading of your post..... I can not imagine going through what happened to you. there is not really anything I can say to help you, I will just write what went through my mind. There must be an environmental connection. Did your dogs get immunized at the same time? Were they all treated with flea control, got in contact with ticks? Since they are all related there must be a connection there too? Although when I got a pup from the same breeder as my AIHA dog, Dr. Dodds reassured me that I don't take a bigger risk that taking any other dog. The why must drive you up the wall. How sad that the breeder is not interested in a cause. I would just keep informing her how your dogs are doing, be non confrontational and maybe she realizes that all you want is info. I am so glad that you have excellent care for your dogs. You must be an expert by now! Please stay here and keep posting. We all still learn every day and I am sure you can give excellent advice! If you post some of William's numbers, I am sure some people here will have some input as well. There are Cocker lovers on here that will certainly want to know more about your story. (Right Johnny?:)) Best wishes, thinking of your and your family, Brigitte & the poodle boys

Brigitte BC Canada

Oh my Gosh!!!!!!! Your story is absolutely heart breaking. I don't know what to say. I'll be praying for you and for William and Holly. Hang in there.

Ronda Illinois

I am so sorry you are going through this. I really thought I was the only one unlucky enough to see it twice in my dogs (unrelated, different breeds), I lost them both within 20 months to the same horrible disease. My thoughts are with you, please continue to come here for support. Sending tons of positive healing thoughts and energy to you and William. blessings, Julie

Julie IL

Liz, How devastating and sad. There are tears in my eyes for you as I can't even begin to imagine how difficult this must be for you. I would wonder as Brigitte said about a common exposure. When my dog was diagnosed with AIHA in 2008, my other dog developed an epulis a month later and needed part of her bottom jaw removed. Although they both had heartworm and frontline at the same time, I still wonder if refinishing the hardwood floors early that spring had something to do with triggering it. Maybe not but I'll never know. With your experience William will be in good hands. I know what you mean about the breeder - when I contacted mine she said she had never heard of it and was not helpful. She was to call me back and I'm still waiting.... Lots of hugs to you both! Hang in there. Chris & Alex

Chris Pa

Oh Liz, how dreadful for you, I lost my Springer Holly to this awful disease in September 08 and was truly devestated and shocked at how quickly it takes hold of otherwise apparently healthy dogs. Sending all my best wishes for William and hope you get some answers from the breeder soon. xxxxx

Keri Lynn Wales

Oh my goodness, I also got goosebumps, and Im so so sorry - what are the chances of this happening! I guess we are all here for similar reasons, and we have all done our certain amounts of research which we have shared with each other, some have survived, like your Holly, others not so lucky, either lose their battle quickly, or the treatment fails. I certainly am no expert, but it is plain to see there is a connection somewhere; I do know that cocker spaniels are one of the breeds that are predisposed to anaemia from what I have found. I would imagine your breeder contact is not responding because there is probably a family line she needs to protect, or does not wish to know. I have a border collie with an undershot jaw - she is a delightful dog, but there is something I should not do, and that is breed from her, which was not the plan anyway. I do hope you get some information eventually, and I dont know what to say, other than say how sorry I am, but also am glad your dogs have you as their owner. Lets know how you go - there is some good information here from some wonderfully sensitive souls, as I personally have found, with my Riley who I lost earlier this year after a few months battle. Take care Silka

Silka Melbourne Australia

Liz, I am so terribly sorry you have had to deal with so much. What an irresponsible breeder that doesn't seem to care what heartbreak she may be opening people up to. I am glad that Holly survived and sad that Buckwheat was lost so quickly. I am hoping that William turns it around soon. You are all in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Liz, I'm so sorry you are having to go through this not once or twice but THREE times!!! WOW...I'm speachless! Hereditary??? Hmmm, this is a tough one! If i had to guess I'd have to say that this is very likely something triggered within or around your own home or atmosphere. Usually with hereditary causes (von willabrand disease, spherocytosis, etc.) the immune response happens much earlier in their lives ...likely before they are even 3 or 4 years old....IMO...I may be wrong but I thnk i remember reading this before. There is one thing that would have me wondering.... genetic thyroid dysfunction. This would have me wondering if the breeder ever had their bitches or studs pre-screened prior to breeding. Usually they'll check for circulating antithyroid autoantibodies and if they are found I beleive most reputable breeders won't breed the affected animals. Thyroid dysfunction is the MOST common endocrine disorder found in dogs. I'd almost put money on their thyroid levels being low....do you know if they were ever checked? The thyroid glands regulate the metabolism of all the bodies cellular functions and can cause a whole array of problems when levels are low. What can this mean? Well, if the thyroid levels are low(er) (hypothyroid or autoimmune thyroiditis) this causes a generalized metabolic imbalance and will also have an associated immunological dysfunction associated with it. This in itself makes it advisable to minimize any exposure to unnecessary drugs, chemicals, toxins, stress, etc, and feed a wholesome healthy balanced diet. Yeah...alot to absorb all at once but what I'm saying is that if the thyroid levels are low due to genetics then it is very likely that somehting within your house/environment triggered the aiha. I'd be wracking my brain trying to figure out the cause. Then again....at the age of 9 perhaps it isn't genetic or hereditary. Perhaps they are all getting into a chemical/toxin or something at different times that might be causing/triggering the autoimmune disease. Just the whole age issue and the fact that they all got sick AFTER you adopted them would have me questioning the trigger. Let us know what you find out and if you have any questions what so ever don't hesitate to ask. Even if you have to vent go ahead. My thoughts and prayers are with you. Johnny & Tessy p.s. ...I have 8 cockers so I LOVE LOVE LOVE LOVE LOVE LOVE LOVE LOVE (is that 8?) my cocker spaniels. Would love to see pics some time.

Johnny

Thank you everyone. Such kind words over and over and you don't even know me. William made it through the weekend. He is still weak and pale, but hanging on. For now we love on him and hope for the best. My vet sent me volumes of information that he found on AIHA. Most of it says that the most common onset for cockers is 7-9 years of age. All three of my babies were right in there for age. We've had Will checked in the past for thyroid dysfunction because he seemed to be listless and gaining weight, but everything checked out "in range" then. It was low, but in range so my doctor didn't treat. This time with Will we are supplementing thyroxin with the pred, pepcid, and b vitamins. Will is now eating boiled chicken and rice and alternating with beef and goat milk. All of my dogs have alway eaten Bil-Jac dog food, all meat, no grains, no preservatives, no colors or additional "stuff". We don't use chemical cleaning products at home, no pesticides, no weed killers, no air fresheners, nothing but dilute bleach and vinegar for cleaning. We only use low VOC latex paint and all my floors are hard surface (tile or wood). My daughter was a preemie and because of that was left with chronic, persistent, severe asthma. No other dog, cat, rabbit or gerbil in our house has ever been ill. I work for the chemical industry in regulatory affairs so I get to see all the environmental studies, tox studies and information on exposure and dose of animals and humans to chemicals. I wish it was as simple as a single exposure to a chemical or consumer product bringing on the AIHA. I simply don't have any answers. I wish I could point to a vaccine, or an exposure or some other experience that would give me an "ah ha" moment. AIHA is not that easy. I am free to treat based on symptoms. I've become exceptionally good at predicting PCV from the color of gums. I won't transfuse or add additional drugs to boost the effect of the pred. Too many studies out there saying there is no great effect with these other drugs vs the standard pred alone. I believe Will will either respond to the pred and his immune system will calm down or he won't. The fact that he made it through the weekend is great news. I do know that we have to get past three weeks, then six weeks, then 3 months... all common relapse points. Thanks again for listening everyone. I wish none of us had to go through this. Liz

Liz Ohio

Liz, did you send blood out for a full analysis? I'd be interested in hearing the results if so. From all the studies I've read I thought the average age for dogs that get this disease is between 3 & 6 years! I wouldn't mind hearing the source from your doctor if he has it. Also, with regards to adding another immunosuppresant I don't blame you for not wanting to...why mess with what's working for you. Keep an eye on the numbers and you'll be able to tell if the system is suppressed enough. This will likely take a few weeks to fully suppress the system to where you want it. I've seen studies on here numerous times that states that animals being treated with a combo of pred, aza and aspirin actually had the greatest chances of survival. Then again every dog is different. I'm on my laptop cause my desktop is messed up at the moment so I can't find the link but if someone here has it perhaps they can post it for you. LOTS of us here thank the *other* drugs for their dogs being alive today. I have YET to see a study that says there is no good results with the use of other drugs. Cyclosporine is slowly becoming the benchmark drug of choice by many specialists along with pred. I wouldn't doubt you'll see it used alone sooner or later. Usually other drugs are added for refractory cases...ones that don't respond to traditional treatment. If you've got Dr. Dodds on board then you're in good hands. Is there any chance the dogs get into anything when on walks or outings? Something that might trigger this? Still no word from the breeder? You should get a friend to call the breeder and ask questions just to see what they say about screening. Johnny & Tessy

Johnny

I forgot to ask...when you had Will's thyroid checked was it while he was on immune suppressing drugs?

Johnny

Here is the link to the study Jonathan mentioned: http://www.ncbi.nlm.nih.gov/pubmed/15934255?dopt=Abstract I have this link on the Treatment page at the Meisha's Hope Web site http://www.cloudnet.com/~jdickson/treatment.htm in case any one needs to find it again.

Joanne MN

Liz, I am so sorry to read about William. This must be so frightening for you. No matter how strong we may be, or educated or environmentally conscious we are, it is a shock when it is OUR dog that suddenly develops an autoimmune disease. I remember feeling like crumbling at the mind numbing complexity of what I faced with Chance. He had a very serious version of this, a non-regenerative anemia, that meant that the red blood cell precursors in his bone marrow were being auto-destroyed in situ. These cases often become refractory. Too often attending vets become stymied and feel that there is little to be gained by continuing treatment and they advise their clients of that. I realized at one point that Chance was succumbing to the serious side effects of prednisone alone. I have a medical background so I sought out veterinary texts to understand what I needed to do for him. I sat up until all hours reading it from cover to cover until I knew what was happening. The next thing I needed was someone who had great clinical knowledge to advise me what protocol to use. And that is when I found Dr. Dodds. She assisted me, for free, by email for almost a whole year until Chance had recovered. It was the addition of cyclosporine and the decreasing of prednisone that finally did the trick for him. You are so very correct about how complex this/these diseases are. There is a very interesting paper, that I often reference here, that Jean Dodds wrote called, "The Canine Immune System and Disease Resistance" Once you read this you will probably understand more of why this is happening to William. http://www.canine-epilepsy-guardian-angels.com/ImmuneSystem.htm In addition, the unfortunate fact is that there are certain breeds that have a pre-disposition to AIHA/IMHA and Cocker Spaniels are one of those breeds. How did this happen? Probably it was due to breeding practices that allowed certain genetic traits to continue in lines and those lines were crossbred. This continues the susceptibility to AIHA. In Dalmatians, for instance, the genetic coding that causes more white spots than black spots to develop is paired with the genetic coding for developmental deafness and possibly an inferior temperament. The coloring is, oddly enough, related to the amount of melanin in the "skin" and in the ears melanin is related to some of the parts that develop into the ear parts. So more white in a Dalmatian means a tendency to deafness. But because it was probably, at some time in the past, more attractive to breeders to have Dalmatians that have coloring that has more white than black, they kept breeding for that coloring, and unknowingly passing down deafness into future generations. If you would like to read some of the textbook that I read, you can go into http://books.google.com/ and type in "Schalm's Veterinary Hematology" This will allow you to read this on line. I didn't have this ability when Chance was sick, google had not developed their online reader yet, so I bought the textbook outright. I believe there is a new 6th addition that probably has updated protocols and the results of any new studies that have been done since the previous edition (that I have) was written. You may find some of this difficult reading. The best way to approach this is to sort of plow through the tough parts. If you have enough medical terminology background you can figure out the gist of what is being said. Some good friends on this forum have given you excellent advice. I can only offer you the academics of this and the sincere wish that William will survive these tough first few weeks. It is very possible but takes having all your wits about you and absorbing information as fast as possible. my best patrice

Patrice NYS

This thread was discussed between 25/06/2010 and 29/06/2010

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