Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - My Boxer Tia

Hi all My 18 month old Boxer Tia was diagnosed with Auto-immune Hemolytic Anemia on the 30th August 2008. She had been poorly for about a month previous to this and we had no idea what was happening to her until the vets first said she was slightly anemic. Since this things have deteroited. Her first blood count was 17, then it went to 15, then 14, at which point she was put on Preds then her blood count went to 11 and eventually to 10 so the vet took her spleen away and put her on Azathioprine, aka Imuran. She has been on these for 3 days now and is now back home with us. She will be going to the vets on Monday 9th Sept for a blood transfusion to buy time for the Imuran to hopefully start working. Tia is eating and drinking well but has all the signs of AIHA being lathargic, etc. She has no jaundice. The vet has basically told us if she does respond to the Imuran then we need to consider euthanasia. I can't imagine life without her and the family are traumatised. God knows how Tia is feeling. As anyone had a similar experience and does her chances sound realistic or should we get our heads around losing her? Can she recover from this and lead somekind of normal life? Thanks in advance for any advice? Andybwfc

Andybwfc UK

Hi Andy Good to meet someone else from the UK who is living with AIHA. My first piece of advice is take one day at a time and treat everyday with Tia as a gift. Enjoy your time with her. Each dog is different, and some go onto lead a reasonably normal life. You do have to remember that unfortunately there may come a time when you have to make the right decision for your girl. Be observant, and any changes in Tia, no matter how small, notify your vet. Become a pain in the bum, ask questions, write down what you want to ask and write down the answers. Someone on here will always try to answer any queries you might have. This is my second time with this disease, my girl, Lily, had to be pts three days after diagosis aged 22 months in 2006. She was the first puppy I had ever bred myself and it was like losing a child. BillyBob was diagnosed on 29 May 2008, he is now 2 and a half. He is on Pred and Azathioprine as well. He now takes his Azathioprine every other day, but by the look of him that will be going back to every day pretty soon. I have asked my vet about transfusions but as Billy is still destroying his own cells, he said he would just destroy new ones. At the moment he is holding his own. Good luck with Tia, and hope all goes well on Tuesday.

Steph UK

We are heartbroken over our dog too... Jeter was diagnosed almost 2 weeks ago with IMHA... after seeming like a normal dog the day before, he woke up peeing blood and not eating... AFter taking him to our local vet, they told us to take him to the dog hospital where after being in the hospital for a week and 3 blood transfusions, sent him home... We thought we could feed him and nurse him back to health... but today he is not looking as good as he did a few days ago... he is on 4 different medications. I'm not sure I could send him back to the hospital.... this is a horrible disease and the doctors' have all been wonderful, but say there is no cure and a 50/50 chance of survival. We love our dog, but am unsure as to what the right thing to do is anymore....

Barbara Tobin North East

Andy and Barbara, If you haven't already found your way to Joanne's site http://www.cloudnet.com/~jdickson/ Please take a look and be sure to read the success stories. It is indeed a difficult journey but it is also something that can be beat. We all have faced that question of what to do, what is right for our beloved family members. I believe that they let us know whether they are up to the fight or not. The one thing to know is this is not a painful disease in itself. They are just really tired from the low oxygen levels in thier blood. Having a Vet that is well experienced in treating it is a must as well as having one that believes it is not an automatic death sentence. Learn as much as you can and be your dogs voice. Any and all questions will be answered by the wonderful peope on this board so know that you are not alone in this fight. Penny

Penny Lytle Creek Calif

Andybwfc, i am sorry your boxer has been diagnosed with this. most important thing i want to say to you is this... please see a specialist that has experience in treating this disease. for your vet to recommend euthanasia is just rediculous, especially this soon into the process. i have a dog that has been dealing with AIHA for 16 months now and she didnt even start making her own blood until well after 6 months into the process. some dogs respond very fast, other dogs have scenarios that take months and months before anything turns around. this is a very serious disease but it absolutely is not a death sentence and people here can testify to that. for your vet to mention putting tia down after 7 days??!??!?! that is the height of lazyness and irresponsibilty in my opinion and it shows that your vet doesnt know much about how to effectively treat this disease. prednisone takes weeks, imuran can take over a month to kick in. time needs to be given I wish you luck with TIA

josh california

My prayers for you and for Tia. Our experience has been an emotional rollar coaster. It is devastating especially for dogs so young to be stricken. My 3 yr old Std poodle Alex was diagnosed in May 2008. I noticed a mild decrease in energy as far back as February. After diagnosis he initially had a round of doxycycline, and has been on pred and pepcid Ac. My vet said to be optimistic as there are dogs that survive and eventually can go off the meds. His PCV was initially 20 then climbed to mid 40's on pred but has been hovering around 35 or so since. His energy level went from a 10 to a 1. He's gained 20 lbs. I kept thinking there must be an underlying condition as the vet said he should have more energy with that blood count. He's now being treated by an Internal medicine specialist. He's not handling the pred well and has developed liver disease. I am awaiting test results Monday. It has been a battle but there are success stories!! I have heard of dogs having a rough time for awhile but pulling through. I am counting on Alex being one of them. My thoughts are with you. Tia may be one of the ones that turns around quickly and goes on to lead a normal life. Good luck to you both!

Chris apr39@comcast.net

Andybwfc, I totally agree with Josh, you need to find a specialist who knows about this disease! Especially after just 7 days and having her speen removed and now talking about putting to sleep, WOW! Why did they not try a transfusion first before removing her spleen? I know how scary this disease is and also for the owners, but you really do need to find a specialist. Our Holly, 3 year old dachshund, has been fighting for 17 months now and is on the road to recovery, it has been a long and expensive road, but lots of times it can be done and they do recover. ALso wishing you the best with Tia, but please do try and find another vet more experienced. Linda

Linda Sapphire

Andy, It is very important to find a vet who has experience with this terrible disease. Our dog Brandy is a 7 year old Shepherd mix who was diagnosed Aug. 15 2008. We go to a vet office that has several doctors servicing patients. Brandy has been seen by several different doctors since many of her visits have been last minute due to an immediate need for medical attention. Within the first 48 hours of the diagnosis, she was put on Prednisone, but her numbers continued to fall. They immediately did 2 transfusions over the course of two days in order to give the drugs time to work.(cyclosporine had also been added). She came home from the hospital and did well for 2 weeks and then her abdomine filled up with fluid. Her original doctor was not available, and after doing several tests, the second doctor said he was stumped and backed into a corner. Didn't know why she was reacting as she was. He told us we might have to make some "difficult" decissions. We brought Brandy back the next day for a scheduled ultrasound to look at her liver, and she was seen by a different doctor.....someone with more experience with IMHA. She explained her new problems were due to the drugs she was taking....causing her to retain liquid and also causing her liver to be less efficient. She has given us some different things to help her liver and slightly reduced her prednisone. Brandy is like a new dog. It sure was a tough night after the first doctor told us we might have to make a difficult decision. Bottom line is that this is going to be a long hall. You need a doctor who has enough experience with various different cases of IMHA. There seems to be so many different scenarios and combinations of drugs. I have heard that the chances of making a recovery are better if the cause of the IMHA was due to vaccinations. Not sure if that is true. From reading the posts, it seems each dog seems to respond differently. You also need a doctor who is open to the idea of reaching out to other doctors with experience. It sounds to me like this is going to be a long roller coaster ride full of ups and downs. One of the posts mentioned the importance of enjoying every moment you can with your pet - every day is a gift. That is the philosophy I have taken. I understand this could have a bad ending and I have prepared myself, but I am also giving Brandy every chance I can since she does have a chance of living a long life. My thoughts and prayers are with you and Tia. Deb, Grand Rapids MI

Deb Grand Rapids MI

Andy & Tia, Barbara & Jeter, PLEASE, PLEASE read and re-read the posts by Penny, Josh , Linda and Deb...and RUN, don't walk to a vet with more experience and to the Meisha's Hope website done by Joanne. Time is of the essence in fighting this disease and time spent with a vet that does not have the necessary knowledge and experience will not only impact your dog's well-being but also the well-being of your finances...and you will need to spend your money wisely to fight for your dog rather than fight to save your dog from both the disease and an inexperienced vet who doesn't believe your dog can recover! Spleen removal is usually the last desperate step, not the first! We're all here to back you up so get ready to RUN and fight for your dogs! Cheryl (and always Barkley)

Cheryl Medford

Hi everyone Thanks for all the replies. Tia's spleen was removed because it was excessively large and looked abnormal and on examination looked that of a 6 years old dog and not a 18 month old dog. To be honest shes eating well and drinking well. Tia's in today for a blood transfusion. What is the lowest the RBC can go before it takes adverse affects? I have looked in Bolton UK to find an experienced vet who deals with AIHA but to no avail! My heads messed up and I don't know what to do? Already the insurance has cost 4K and we now have to start paying our own monies. Tia used 3 bags of oxyglobin whilst having her operation. Is medication expensive if we keep trying the Imuran and Preds? My stomach is knotted with all this and I don't know what to do for the best! Andy

Andybwfc Bolton UK

Andy & Tia, Is there a University within driving distance of your residence with a veterinary hospital? Some extra funds spent on petrol could save you some money spent on questionable care and some nights spent on worry. I feel minimally better about your vet's choice in light of the additional information but he/she still seems to be looking at possible euthanasia far too soon. At the same time it is far too true that trying to save the life of a dog with IMHA can be a very costly fight. It is certainly up to each individual owner in each individual circumstance to be able to determine what they can afford. Do they have such things as clinical trials in the UK? If so your Tia might be able to access care by being part of a trial and that could be far less costly, depending upon the nature of the trial. You might also investigate organizations which assist pet owners with the costs of more expensive treatments, either with grants or financing or ?. It is also exceedingly difficult to have to be trying to get this information while your time and your mind are filled just with trying to save your Tia. We have all been where you now stand and know the incredibly hard pain and anxiety and uncertainty. No one here will judge whatever choices you must make since we have walked your path and know its challenges. My Barkley's RBC/PCV at one point went down to 7 and with a transfusion he rallied...for a week or so until the next transfusion. But each dog is unique in the form their version of this disease takes. Your best bet and the best hope for Tia is doing the best you can to have an experienced vet. You might even be able to find a vet out of your area and have them consult with your vet by phone or email to provide direction for Tia, instead of you both having to travel. With warm thoughts of support and hope for you both, Cheryl (and always Barkley)

Cheryl Medford

Hi Cheryl, Josh and everyone The blood transfusion went well today! She now has a RBC of 22! She was 8 this morning. No ill side effects as yet. The vet said that the rate of the red blood cells being killed off had slowed down but they were still being killed off by her immune system. Her spleen was healthy although enlarged and the bone marrow results showed that she is producing red blood cells so no cancers or tumours. What they have found is that Tia has Toxin attached to her healthy red blood cells which are being attacked by her immune system. Because these reb blood cells are attached to these toxin cells they are mistaking them for bad blood cells. It looks as though Tia has most possibly picked something up with a metallic based toxin which has got into her blood and caused havoc and devastation. They are still treating her with Preds and Imuran combined and she currently has a 30% survival chance. She is back in for blood tests on Weds and we need to see either the blood count staying the same or an increase in the RBC. The medication of Imuran does take 7/8 days to work and she has had 4 days of these! We need this to kick in and start working for her to stand any chance of survival. The tranfusion will last 4/5 days and this will buy her time. Does anyone on here know about these toxins and how they work? I will be ringing around and looking on the net for other specialists. She's obviously more perkier but still tired but at least you get a responce and she walks to you for a cuddle! While theres a 30% chance we have hope! Keep praying! We certainly believe in miracles! Andy

Andybwfc Bolton UK

Give the meds a chance. There are many vets who are not familiar with the leaps there have been with regards to treating this disease. It is very scary to them. Just remember, that removing the spleen is not necesarily taking away the problem. You still have the liver to contend with and it too can kill rbc's.

Courtney SLO

Andy, It may be that Tia does not have AIHA it could be and I know I do not have the correct spelling something that sounds like Babliosis. I know it has been mentioned on this board before and I was just watching the National geographics show Dogtown that has been dealing with it at Best Friends Animal rescue with the Michael Vicks pitbulls. It is as you describe a toxin that binds to the red blood cells. Also dogs have gotten anemia from eating copper pennies. I know that some of the meds are the same but there also might be a different treatment involved. It would be worth mentioning to your Vet. I hope someone will post the proper name for you to research. Penny

Penny Lytle Crfeek Calif

Babesia ?

Courtney SLO

That is probably it. I know initially the dog was being diagnosed as anemic and they never mentioned ticks being the source but they did say it can be transmitted to other dogs if they were to bite each other. They were treating the dog with Pred and other steroids and he did seem to have a good prognosis. Penny

Penny Lytle Creek Calif

give the meds time to work.... again, my dog didnt produce her own cells again until after 6 months... that is almost 200 days!!!!!!!!!!!!!!!!! it sounds like ur vet is sticking you with these 7, 8 day plans and then suggesting you make a decision if something doesnt turn around. that is the wrong approach! i am being blunt as possible because i want your dog to live. i dont know how else to be besides blunt, i apologize if i am coming off as negative

josh california

Andy Try Liverpool University Hospital on the Wirral. They are fantastic and know a lot about AIHI. Their phone number is 0151 795 6100. Steph

Steph Wales UK

Hi all Thanks for the responces and I will contact Liverpool University Hospital! (Thanks Steph) We took Tia for her blood test today after the blood transfusion and on Monday after the transfusion it read 22.....after todays RBC it now reads 24 after 2 days! I am happy about this but I have also read other peoples stories about AIHA and things can take 2 steps forward 20 back.....but is this proof that the Preds and Azathioprine are working? Its a start! Andy

Andybwfc Bolton UK

This thread was discussed between 07/09/2008 and 10/09/2008

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