Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - New complication with Milly

If anyone has experienced this please let me know.... Milly, after doing better and improving is having trouble walking - like it hurts her to walk- she's been very quiet all day - unlike her recent behavior - started walking with a limp but not confined to one leg - just walking like it's very difficult to move. No fever, no vomiting or diarrhea. She ate this morning but not since. Just not acting right. Vet said to take her temp but if no fever to wait until tomorrow. I'm not entirely comfortable with this. Anyone have this experience? Thanks.

Judy Medford

Muscle atrophy is common on prednisone. Richard's (he used to post here frequently) dog Dylan had the atrophy so bad that she couldn't walk. I see that she is still on high dose pred. If the weakness worsens, you may consider pushing for a decrease sooner than the 28th.

Monet Sammamish

Milly, Have they told you which tick disease they are treating for? Lameness is so common in dogs with Lyme disease that it is probably the first symptom that shows up, more so than in humans. I want to know how long ago they diagnosed this tick disease. I also would like to know her weight and the exact dosage of doxy they have her on. my best patrice

Patrice NYS

Hi Patrice. Milly does not have Lyme disease. She tested positive for Anaplasmosis. They started her on Doxy on 11/23 - 100 mg - split into 2 doses (every 12 hours). She was 27 pounds at that time and is 29 now though I'm beginning to limit her food since she's hungry all the time due to the Prednisone. I did not take her to the vet last night as she didn't have a fever and had an appetite and seemed otherwise ok except for the lameness - which is still very evident today. Thanks for the help. Judy

judy Medford

Judy Here is an excellent website regarding all things "tick" disease. I trust Gil Ash, she is a consummate researcher. I know her from the Tick-L list. If this is anaplasma phagocytophilum then here is the information and TREATMENT for this particular tick disease. If you have any questions, please ask and I will post on the Tick-l forum to find out for you. **Please note that from our recommendations on Tick-L, your doxy dose is too low, it should be 10mg per pound per day, or around 300 mg, not 100mg. We say that is "just tickling the tick disease."** my best patrice https://sites.google.com/site/tickbornediseaseindogs/ehrlichiosis "Anaplasma phagocytophilum Once known as Ehrlichiosis equi, A. phagocytophilum and Human Granulocytic Erhlichiosis (HGE) now share classification as A. phagocytophilum as they are so closely related. A. phagocytophilum can cause painful arthritis in several joints, lethargy, high fever, loss of appetite, vomiting and diarrhea. Less commonly, a dog may have neck pain or seizures. Lester, Breitschwerdt, et al. report in this abstract from the Canadian Veterinary Journal that: "Canine anaplasmosis caused by A. phagocytophilum varies from a subclinical infection to an acute febrile condition accompanied by anorexia and lethargy. Central nervous system dysfunction and lameness have also been recorded in dogs. Based on reports to date, anaplasmosis appears to cause a less severe disease in dogs than does infection with E. canis, E. chaffeensis, or E. ewingii. Lethargy, accompanied by fever, appears to be documented consistently, and the lethargy is often disproportionately severe in comparison with the general lack of abnormalities documented on physical examination. Although most dogs have a mild thrombocytopenia, anemia is uncommon and changes in the leukocyte numbers are variable. Elevated ALP activities have been reported in dogs with anaplasmosis. Recent serologic assessments in California indicate that many clinically normal dogs have titers to A. phagocytophilum; this suggests that cases may be subclinical or that the disease may be underdiagnosed." (By the way, the dog discussed in that abstract was from Vancouver Island in Canada and had never left the island. Obviously, TBD does exist in Canada.) A. phagocytophilum infects granulocytes, as does E. ewingii, so both may be referred to as canine granulocytic ehrlichiosis or CGE. The pathogenesis (origin and development) of polyarthritis, observed more often with infection by granulocytic ehrlichiae, arises from hemarthrosis (hemorrhage of blood into a joint) and immune complex deposition into the joints. (Immune complexes are formed by bound-together disease antigens and antibodies produced by the dog.)" https://sites.google.com/site/tickbornediseaseindogs/treatment "Doxycycline A semisynthetic tetracycline, doxycycline is the drug of choice for ehrlichiosis (including Anaplasma phagocytophilum and platys), Lyme Disease and Rocky Mountain Spotted Fever. The dosage we recommend on Tick List is an aggressive one: 5 mg. of doxy per pound of body weight given every 12 hours for 8 weeks."

Patrice NYS

Wow! This is scary. It's unclear to me how long she may have had this infection but it seems certain to me now that this is the trigger for the AIHA. I noticed a limp earlier in the summer but it seemed to clear up then come back again a few times. I mentioned to to our vet at the time and we had bloodwork done in July for Lyme and Heartwork. I think this would have shown up there so I'm hoping she hasn't had this for too long and gotten to acute levels. I have made a list of questions for our vet and changed my appointment from Tuesday to Monday. I just don't want to let this go any longer than necessary. Thank you again, Patrice, for this important information. Milly was quite lame today but seemed to improve a bit and even went for a walk and chased down a few squirrels.

Judy Medford

Judy, I always feel awful when I have to post something that seems alarming to an owner. And it is not my intention to frighten you or make you worry excessively. My purpose is to give you the information you need to investigate what seems to be happening and get appropriate help. I have been on Tick-L for nearly 5 years now and I can vouch for the accuracy of their information. We have a vet and several tick experts on the list and we constantly discuss/disagree about all things tick. We also assist many frightened owners help their dogs recover. Please consider joining Tick-L for more expert help than I can give you. I am a casual participant. Many dogs have been saved from the information they provide. You will find the link to join Tick-l on the bottom of every page of Gil's website. my best patrice

Patrice NYS

Thanks, Patrice. I'm grateful for the information. I have just joined Tick-L and already posted regarding Milly.

Judy Medford

even tho our initial test for lyme disease came back clear - we did infact have lyme and that was our trigger for the autoimmune, we had to use the high doses of doxy 8 weeks then again for 12weeks -- and it was the second round that finally kicked it -- lameness was our first symptom as well....good luck!!

charlie

Folks, Judy and JeyT are over at the Tick-L forum and there is a flurry of activity as those people try to help them resolve the issues with treatment. I just wanted to let everyone know they are in good hands and I am sitting back in awe watching it all happen. my best patrice

Patrice NYS

This thread was discussed between 16/12/2011 and 19/12/2011

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