Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - New Med recommended: Cyclosporine

Hello All, I have been browsing this site and really admire all that have taken the time and care to write/share/offer help! You obviously (other than our furry loved ones) are the reason this site exists. I wanted to share my story and at the same time possibly ask for advice or feedback. Our dog Candy (female pitbull of about 54ish pounds normally) was diagnosed with AIHA on Oct 31st this year. Her PCV has been as low as 22 and RBC at 3.1 (at time of diagnosis) and up as high as PCV 39 and RBC 4.8. She has been on the high doses of Prednisone (starting with two 20mg pills, twice a day =80mg) and recently tapering slowly to one 20mg pill twice a day =40mg) Her PCV was hanging in at 38-39 from about mid Nov til early Dec. as we reduced 10mg per week approx. But since we reached the half way mark of cutting back her Pred dosage, the PCV has decreased slightly to about 36-37. Now our vet, who we do respect quite a bit, wants to introduce the Cyclosporine, mainly because the almost 2 months on Preds has has a significant effect of muscle loss to where you even notice it in her head (showing skull bones). Probably the right approach as I hate seeing her skull and bones as they say but just curious what to expect now that this new road has been placed in front of us. Also, her mood and demeanor has been at its most normal, with out the blood counts and the side effects of the preds, you would think she is all but normal. Sorry about the long one here, just wanted all the important info. Thanks and hope everyone is enjoying their holidays and god bless all those that stood by their sweet hearts in time of need, you are the saints of the world. Thanks so much, Steven & Arizbe

Steve & Arizbe Los Angeles

Steve, Welcome to our group! It's nice to read that Candy is doing much better, and really, in a very short time too! It sounds like her pcv never dropped to extremely low levels. Some veterinary textbooks mention that this is a sign of a good prognosis for recovery. Our Chance had his spleen removed and is well on his way to good recovery, but his pcv will probably never get much higher than 36-39. The loss of the spleen has much to do with that. We consider 38% a wonderful number and he is quite healthy at that! He went on an hour and a half walk this morning! We used cyclosporine as our second med for Chance in a veterinary product called Atopica. Cyclosporine is an interesting drug, it is made from a fungus. If you look up the history of it, you will see it was originally discovered and used for humans who were undergoing organ transplants. It has saved many human lives over the years. What they wanted was a cytotoxic drug or one that suppresses the immune system in a different way than glucocorticoids. This helps reduce some of the nasty side effects that come from immunosuppression. There are some potential side effects in humans, but interestingly, the side effects in dogs are considered to be less. Some of the owners on this group have *not* had a good response from it, including severe diarrhea. Read here about the history and action: http://en.wikipedia.org/wiki/Cyclosporine What I noticed, and so have others, is that Chance would be a bit woozy after his high doses. It seemed almost like he was in a trance. I don't know what this side effect means, but it was not harmful. This drug indeed saved his life. In many cases, vets do use a second drug so they can lower the pred dosage. We are currently on 2.5/5 mg alternating pred and m-f 25 mg atopica. It is a very expensive drug, so keep in mind you will be spending somewhere around 2-5 dollars a day in pills. I hope this has helped you decide what to do. Merry Christmas to you! Patrice

Patrice New York State

Steve: My dog, Shadow, had an adverse reaction to cyclosporine, so she is not taking it anymore. I have extra 100 mg pills (atopica, the veterinary formulation of cyclosporine). If you decided to put Arizbe on cyclo, I would be happy to send you Shadow's leftover pills if they are the right dose for Arizbe. (They are a cqpsule, so can't be split.) Sandy

Sandy Utah

Welcome Steve and Arizbe, We have a minischnauz who was diagnosed in February. He was on pred, then we lowered it and he was off, and two months later he relapsed - in November. His levels were coming back about like yours, a little lower maybe, and our vet added imuran about 10 days ago to boost the numbers. Yesterday, our vet talked to us about introducing cyclosporine, so I have been reading alot about that today. I am unsure whether it is better for kent to be on imuran or cyclosporin, but either way he will be on pred, which we are starting to lower. Kent also has had muscle loss from the pred, has blown up like a bowling ball, and is starting to show high levels of lipase (1044) which is related to the pancreas. also his GGTP is 240, normal is 1-12. I would suggest you make sure you have the superchem done with his cbc before and after adding any drug. Kent is also on a liver beneficial diet (Dodd's diet), takes milk thistle 175mg a day, gets pet-tinic 2x3ml a day, and pet tabs. Kent is 35 lbs, used to be 30 lbs. I dont know how much this helps, but AIHA/IMHA is a disease that comes on suddenly and takes a very long time to get over or control of. I'm curious why your vet wants to add cyclosporine now and how they chose that over imuran. Is he concerned Candy is dropping? Like Patrice said, those blood levels are not bad ones to see. Take care, Christine and Kent

Christine Florida

Thank you for all you comments, and I want to apologize for not responding sooner. It has been a wild couple of weeks with Candy's condition. She has had a couple of vomiting episodes where it was very difficult for her to hold food in her stomach. Also, she has some bladder infection that we started treating yesterday. She is doing good w/ the cyclosporine and we are cutting the pred very slowly (today she will get one 20mg pill). Today she seems in a good mood and very hungry. We just have to pray for her and our vet and take it one minute at the time. thank you.

Arizbe California

Hi Steve and Arizbe, Welcome to a very helpful site. I've always found someone who can help shed some light on any questions I might have. Hopefully Candy is doing better. Is she on something for her stomach, such as Pepcid AC? Ask your vet if she isn't, as it is very helpful to give them something to protect their easily irritated stomaches. Good wishes! Nancy

Nancy CO

Our Candy girl passed away yesterday. She was doing so good with her treatment and the last blood panel was excellent. Saturday she was running around and with her normal energy. But Sunday, she woke up w/ no energy, she couldnt go outside, we rushed her to the ER and they discovery that she had a very, very large tumor attach to her heart. We went to a heart specialist and he told us that we had to put her to sleep right there and then. We couldnt do it. We wanted to bring her home and spend one day and night w/ her before we let her go. She passed away in our way back home. We feel so empty and we dont know what to do but cry. There was nothing to do at that point. For what i understood was that a tumor like that pretty much is a death sentence. I miss my Candy girl!! (Sorry for bad spelling it is very difficult to type)

Arizbe California

Dear Arizbe and Steve, I am so sorry to hear this has happened. Sometimes it isn't fair what happens and this was surely one of those times. I know that both of you had such hope that she could survive this and you did your best. We were faced with this possible diagnosis with Chance very early last year. I had a week to think about what would happen and what I would do. These malignant tumors are very aggressive and there is no way to remove them completely. I knew in my heart that if we had a diagnosis like yours we would have had to chose the same thing that you have. The happiness that I feel for you is that Candy had a very good day with you on Saturday.. before you knew. I kept thinking during that week while we waited for surgery was that I wanted *just one more day* with Chance before I knew he had that mass on his spleen. That week remains in my memory as one of my lowest moments in my life. What Candy thought of that last day was pure happiness to be with her family running and happy. She was with you all that time and felt secure in her place in the household. That is such a great gift that she left you. Please accept my deepest sympathy at this great loss. Patrice

Patrice NYS

My heart goes out to you. This is terribly hard. So so sorry. Shirley

Shirley GA

Arizbe and Steve, I am so very sorry to hear of your loss. My thoughts and prayers are with you. Tricia

Tricia UK

Arizbe and Steve, Please accept my deepest and most heartfelt condolences. Know that you Candy a wonderful life and did everything you could for her. She will forever live on in your hearts. Evelyn

Evelyn So Jersey

Steve and Arizbe, I am so very sorry for you loss of Candy. It doesn't ever seem fair to fight so hard and lose. I felt the same way as Patrice I wanted just one more day with my dear Salome. Like you I got it a bit the evening before she crashed for the second time she was fiesty and putting the other dogs in their places. Try to remember that part with Candy. I think she was trying to let you know that everything you did for her was the right thing. I am glad you got to take her home with you. In the coming days it will be so hard but eventually you will be able to remember the dog she was before all this awful stuff came into your lives. Sharing in your sorrow. Penny

Penny Lytle Creek Calif

Steve and Arizbe, This is just so terribly sad. I'm so sorry to hear that Candy died. I am a total stranger to you, yet not really as we share a horrible disease. I really feel and understand your pain and sorrow. Peace to you as you mourn Candy. Gail

Gail SD

Steve and Arizbe...I am so sorry to hear Candy died. We are going thru the grieving process with you. Our Daisy had to be put down last Tuesday the 12th. She had been fighting since July. We both still expect Daisy to be under our table or at the foot of our bed. I expect it is going to take some time for both of us to get over our loss. We both have to realize that we had no choice and our dogs expect us to make the right decision for them... Good luck, Ron

Ron B San Mateo

Ron, I am so sorry about Daisy. We thought we will have more time with our Candy and now there is a big empty space in our hearts. Be strong and God bless our little girls. Arizbe

Arizbe Los Angeles

This thread was discussed between 25/12/2007 and 20/02/2008

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