Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - New Case

Just starting a new thread for Rikke....Johnny Rikke, Australia, rikke.boucher@mail.com Our 12 year old Sarahbear has been diagnosed with this awful disease. Her platlets are under 9 so we are on borrowed time. I would like to know what the end stage symptoms are and how much will she suffer. If anyone can tell me the details of their final journey of man's bestest friend I would greatly appreciate it. I need to know what to look for and how to make her passing as loving and gentle as possible. She is not responding much to treatment, however the bleeding gums and urine has stopped - for now.

Rikke

I'm so sorry to hear your beloved Sarahbear has this terrible disease. Is it only the platelets that are low or is it the red blood cells as well? Give us as much information as you can or have....any other blood numbers....drugs and dosages being used....weight/breed/sex....is she home or in the hospital? It's a very good sign that the bleeding gums and urine has stopped! How's the eating and drinking been? If she's home you should keep her well rested and try really hard not to bump her or let anything bump her. Hope to hear from you soon. My thoughts and prayers are with Sarahbear. Johnny & Tessy

Johnny

Rikke, I am so very sorry to hear of your dear SugarBear's illness. If Sugarbear has low platelets you most likely are dealing with immune-mediated thrombocytopenia (ITP) rather then AIHA/IMHA (immune mediated hemolytic anemia/autoimmune hemolytic anemia). ITP is a disease of the platelets while AIHA/IMHA is a disease of the red blood cells. You might want to go to this Web page: http://www.cloudnet.com/~jdickson/midnight.htm at the Meisha's Hope AIHA/IMHA Web site and read about "Midnight the Miracle ITP dog". Midnight had ZERO platlets when she was diagnosed with ITP over 10 years ago. She recovered and has had NO relapses. Michelle's (Midnight's owner/caregiver's) email address is at the end of Midnight's story. You might want to email her. She is very good about answering emails. I know this is so hard but please do NOT give up. Many seem to beleive that ITP is easier to recover from then AIHA/IMHA and I personally have seen lots of dogs with ITP recover. Please be assured you and your dear Sugarbear are in my thoughts and prayers during these most very difficult days.

Joanne MN

Please excuse me that I called your dog Sugarbear instead of Sarahbear.

Joanne MN

Rikke, I am so sorry to hear about Sarahbear. This is sudden and serious condition that you are faced with. Please stay here on this list for support and knowledge. There have been great successes and there is reason for hope. My personal recommendation with any dog that is presenting with platelets this low would be to have a tick panel done immediately. Low platelets are one very serious symptom of full blown tick disease. Your vet should know what tick diseases are prevalent in your area, but be sure to let them know if you have traveled anywhere in the past year. This might indicate the need to test for other tick diseases as well. my best patrice

Patrice NYS

I am so sorry that you have had to come to this board. Please don't think that you have to give up the fight too soon. What part of Australia are you in we have a number of posters on here that may be able to recommend some Vets that are more experienced in treating this. Keepping you and your Sarahbear in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Hi Rikke, I am sorry to hear Sarahbear has been diagnosed with this awful disease. What part of Australia are you in? As Penny said, there are a few of us on this board from Australia, we might be able to help.... Please don't give up hope, this disease can be beaten. Please keep us updated on Sarahbear's progress. Samantha & Millie.

Samantha Geelong

Dear Rikke, I lost my darling girl 4 weeks ago because of this dreadful disease, as much as my heart is aching she to had extremely low platelets which is what we were presented with initially, I would like to give you hope but as you are asking for advice re symptoms, my baby I would hope did not suffer, initially there was blood in her urine from then on the symptoms were lethargy and her appetite altered, she did pick up with medication however we were also fighting with an underlying cause a tumour on her spleen, the purpose of the medication was to get her fit for an operation to investigate the mass, we were told by the vet that she was bleeding internally on that final night and the decision not to go ahead with the op was because of her low platelet count and so the battle began. I want to send you so much hope and good wishes and to say take each day as it comes, the love you have for her will give you strenghth in the coming days. Take care

Diane Luton

Dear Rikke Im so sorry to hear about your beloved Sarahbear, but I would like to add my words and ask you not to give up on her just yet. I know I have lost Riley a few weeks ago, and he started with low platelets and he also only had 9, does Sarahbear have marks on her body? It is Thrombocytopenia and can be treated with cortisone and other immune suppressants. The level of platelets which lessens the danger of bleeding is 50 - that is not too far away from 9 really - it is what they see when they look at a blood smear - called a "field". They are seeing about 9 per field. Riley also had spots on his gums, but honestly, it was the easiest part to treat, except that Riley had a large spontaneous bleed which threw him into anaemia, as well, giving him the diagnosis of Evans Syndrome (both together) and as I was told, the prognosis is guarded, but of course there are the survivors. A bleed is the biggest danger for you with low platelets. Where are you? I would think that a vet would put your baby onto a drip and start the suppressant medication right away, to give her a fighting chance. Of course, Riley was only 6, whereas Sarahbear is 12 - it is such a difficult situation as we all know, and I want to wish you all the best, from one grieving Australian to another. If you have a good vet ask for their advice - I begged my vet to promise me to be honest with me and let me know when the "time" had come, as I would not be able to recognise it. You will know how far you want to go with it. All the best Rikke, my heart goes out to you. Silka

Silka Melbourne Australia

Greetings, Firstly, let me express my heartfelt appreciation at the kind words, the encouragement and the knowledge that has been evident in this forum. It is indeed uplifting to know that others are more thatn willing to share their knowledge in this area or relay stories of their experiences. My heart goes out to those that have recently lost loved pets, and I greatly appreciate the sentiments and experiences you have shared here. We live in Brisbane, and have been here for just over 14 months, having relocated from Melbourne. In the previous 3 months to moving to Brisbane Sarahbear was on a rural propoerty with 2 large standard poodles just north of Newcastle. She has been (generally) very healthy up until last week. She likes company and we have 'doggy day-carers' that look after her for 3 days a week while I work. They have a cat (Bella) that we discovered Sarahbear developed a liking for her droppings left in the gravel garden outside. Some of her droppings a couple of weeks ago contained gravel, but that seemed to have passed (pardon the pun). She was noticed passing urine last Tuesday and she was taken that day to the local vet (we live south of Brisbane) where he conducted a number of tests and found the low platelet count. Sarahbear is a small medium size dog: Weighing 19kg. Medication: Macrolone Tabs 20mg twice a day; Noroclav 250mg twice a day and Carafate tax 1g twice a day, these are to help line the stomach so the cortisone tablets don’t eat a hole in the stomach. The antibiotics Noroclav are finished tonight. Her blood works: UREA 5.8mmol/L CREA 68 umol/L CA 2.64 mmol/L TP 74 g/L ALB 35 g/L GLOB 39g/L ALT 51 U/L ALKP 1304 U/L normal range should be 23-212 so very high GGT 0 U/L normal range should be 0-7 so OK TBIL <2 umol/L AMYL 761 U/L LIPA 1841 U/L normal range should be 200-1800 so high GLU 6.12 mmol/L HCT 40.4% HGB 14.6 g/dl MCHC 36.1 g/dl % RETIC -1.3% WBC # 22.60 X 10 ̂9/L normal range should be 6.00-16.90 so high NEU -18.76 x 10 ̂9/L normal range should be 2.80-10.50 so HIGH EOS -1.84 x 10 ̂9/L normal range should be 0.50-1.50 so high GRANS #20.60 x 10 ̂9/L normal range should be 3.30-12.00 so HIGH %GRANS 91.2% L/M 2.0 X 10 ̂9/L normal range should be 1.1-6.3 so OK %L/M 9% PLT 9 K/ìL normal range should be 175-500 so VERY LOW - the machine can only measure to 9 so could be less than 9!! Granolocytes (1) Red cells have not separed cleanly from granulocytes. To confirm results, verify proper location fo RBC/granulocyte boundary on buffy coat profile, or examine a blood smear. A lot of these facts and figures don’t make much sense to us as lay persons. However, what I can understand is that it shows there is some sort of infection or similar which the body is fighting and the platelets are nearly non existent, hence the bleeding under the skin, in gums and in urine. The gum and urine bleeding has stopped for now, that could be a result of the antibiotics I guess. I would be very grateful if someone could explain these results to me in a language I could understand. At present Sarahbears appetite is very good, but she has started drinking far greataer quantities of water than she previously did. She also pants quite a lot (as though she is hot), even if the weather is not overly warm. Not sure what else I can add at this stage, so if anyone has any specific questions please let me know and I will attempt to answer them as best I can. Once again, we appreciate your assitance more than we can express. Our Sarahbear has been a treasure and my bestest friend since I rescued her from the RSPCA 12 years ago. Kindest regards Rikke (& Reece) – Sarahbear’s worried parents.

Rikke Brisbane

Good to see you back Rikke. How's Sarahbear been doing lately? Have the platelets gone up any? Sounds like immune-mediated thrombocytopenia (ITP)...like Joanne was saying above. Check out the link she left you about the miracle dog Midnight! AMAZING isn't it! Patrice also gave some good information for you on ticks. Did they give her doxycycline? Might be worthwhile adding if htey aren't going to do a tick panel. I'd highly recommend they do so though. I'd also recommend using milk thistle and samE to help protect the liver. OR you could get something called denamarin. I'm not sure what is causing the high alkp but if it is libver related this will help. Keep an eye on the Alkaline Phosphatase (alkp) to see if this value decreases. If it's liver related the milk thistle shuold help as well as the SamE....or denamarin. If you are going to use denamarin then there would be no need to use samE or milk thistle. All the other numbers look pretty good except for the platelets. Have htey been checked recently? I'd also keep her on a low fat diet just in case the high lipase might be pointing towards future pancreas problems. What do you give her for food?

Johnny

Rikke and Reece, I can't help you with the layman's lingo for your blood work but hopefully Patrice will translate it for you. The increased drinking and the panting is usually a common side effect to some of the drugs. In most cases you will never know for sure what the trigger was for SarahBear's health problems if it is indeed AIHA or ITP. Keeping you all in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Rikke & Reece I just wanted to let you know that I am keeping Sarahbear in my prayers. Cheryl & Ginger

Cheryl & Ginger Pinevile Pa

Hello all again, Sarahbear was retested on Friday and her platelets had not improved at all but that was only 3 days between testing and medications. Her "infection" levels, whatever, had improved a little bit. I don't have a copy of that testing. We feed Sarahbear low fat foods as she has always had problems with the lipase levels since young; and developed fat tumours on her body and probably inside it too since about 6 years old. She sometimes gets a bit of our foods too, but only the good ones. Thank you again for all your prayers and great suggestions. We will contact the Vet to ask about the ITP further and perhaps suggest some changes in her medication as suggested by Johnny. Last night just before going to bed, Sarahbear's breathing sounded different (laboured and a slight rattle) and she was uncomfortable, but this morning she seemed better. We take each day with her as it comes - and hope for the best. Kind regards Rikke & Reece Sarahbear's worried parents.

Rikke Brisbane Australia

This thread was discussed between 21/03/2010 and 24/03/2010

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