Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Nikka - Miracle Girl...as of right now at least!

My 7-yr old female German Shepherd, Nikka, was diagnosed with IMT last Wednesday & then IMHA on Friday. Was put on 160mg/day prednisone Wed - then added Imuran Fri. Thought she wouldn't make it through the night Friday & vet said if she made it through weekend he'd have hope. She did! Monday she was awful. Bloodwork showed platelets back to normal level but RBC's still dangerously low, very jaundice and WBC count over 100,000! He's never seen WBC count that high in a case like this. We all but gave up hope Monday, then yesterday, went in and she stood up & licked us! She ate for 1st time in 6 days yesterday & today she seemed even better. Not as jaundice, brighter eyes, more energy. Doing bloodwork again tomorrow & very anxious for results. After reading stuff on here and Facebook, will make sure to get actual printouts of her bloodwork from start to now, as I don't know any of those numbers. Right now she is considered a miracle dog - I hope the angels continue to watch over her!¢¾

Christine Kansas City

Christine, I am so sorry Nikka is so sick and you are separated from her. I am so glad, that there seems to be at least some improvement. Like you say she is a miracle dog and I think she is a fighter! Don't give up hope, there are many dogs that have recovered and live a happy and healthy life after IMT/IMHA. For more information please go to the Meisha's Hope website, created by Joanne Dickson: http://www.cloudnet.com/~jdickson/index.html If you go to the success stories, you will see all the dogs that survived. I am sure these stories will give you lots of hope. Please post the numbers from the latest blood work,there are people here that are awesome in explaining what is happening with your dog. It is a long an rocky road, but there is definitely light at the end of the tunnel. It is very important that you have a knowledgeable and experienced vet on board. You might want to consider a consultation with an internal medicine specialist or Dr. Dodds from hemopet. She charges $45 for phone consultations. Once you get Nikka home, we have lots of suggestions about food and supplements. Please keep us posted. Best wishes, Brigitte & the poodle boys

Brigitte BC Canada

I have the WORLD'S BEST VET!! He has gone SO above & beyond the call of duty - that's why I've been using him for the past 23 years! He has consulted with a specialist & they concurred that he's doing exactly what he should be. I guess I just didn't realize that if she pulls through this, she's still got such a LONG road ahead of her & she's not 'out of the woods' it sounds like for quite some time (SIGH....). At this point, I'm going to try and keep my optimism high that she's even ALIVE - as we all but gave up hope Monday night. Nikka is one of those dogs that has a HUGE personality. We have two German Shepherds and our male, Titan, is nine. Not related, but came from the same breeder. Nikka has acted like a 6-month old puppy since Day 1. She's ornery, obnoxious (in a good way!), barks at EVERYTHING that comes within a 1-mile radius of this house (good ol' German Shepherds!), prances in front of us with a shoe in her mouth whenever she's happy about something, licks our faces & hands with such vigor we're SOAKED when she's done, inhales her food, slurps her water & drips it all over the floor when she's done...just one of those dogs who makes her presence known for SURE! So when this happened last week, we were just blown away. To see that non-stop bundle of energy not MOVE for almost a week has been just heartwrenching. Our home has an undeniable silence that can't be replaced. Titan is doing ok - but I'm sure he's wondering what in the heck is going on when his companion of 7 yrs. is just GONE. Nikka has got a HUGE fan club!! The vet told us there is ALWAYS someone who works there taking turns sitting with her in her kennel when he goes back there! :) He said "she's SUCH a sweet dog and everyone in here is pulling for her SO much!" She also has quite the following on Facebook now ... thanks to me! Can't tell you how many thoughts & prayers she's been getting as I've been posting her journey and pics each day. I believe her SPUNK and all those thoughts & prayers are what's gotten her through so far!! I just hope & pray we get to add her to the Meisha's Hope Success Stories!! (yes, I had already visited that site - sounds like THE place everyone goes who is fighting this disease). This is a club I truly wish I didn't belong to - but I do - and I look forward to empowering myself moving forward - if we are lucky enough to do so. Thanks!

Christine Kansas City

Christine, I am sorry you have had to join this "club" but glad you found this board and have read up at Joanne's site. It is indeed a roller coaster ride but with all the support here you are never alone in the battle. I will keep your sweet Nikka in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Christine, I am so glad to hear your vet is on top of things and by the sounds of it everybody at the clinic is in her corner! i just had to mention the specialist, because your average vet is usually not up on the latest treatments. The fact that your vet has already consulted shows he is going the extra mile. Good for you to stay positive! When Nikka is coming home, hopefully pretty soon, she needs you to be confident and positive so she can relax and heal. You are so right, it is a long road back to a healthy dog. But it is usually these first few days, sometimes weeks, that are the worst. Once her RBC levels rise and you don't have to worry about Nikka so much, the condition becomes a new kind of normal. I don't need to tell you all the work and money is worth it:) Hoping for good results today and best wishes, Brigitte & the poodle boys

Brigitte BC Canada

YAY!! Just took my 21-yr. old son with me for the 1st time - she JUMPED up when we got there, started pawing at him to 'shake' & tried to come out of the kennel! She was SO happy to see him! She sloppy kissed us both like CRAZY (a Nikka trait!) & we even put a leash on her to take her for a lap around the kennel! We also heard she ate an entire bowl of food this morning! Doc had the day off yesterday but came back to see us & said he was THRILLED to see her progress! Said everyone there in the office is wanting him to do bloodwork today (her fan club!) but he wants to wait until tomorrow - the 1-week mark - to run those results. He said he wants them to come back as good as they possibly can and that even one day can make a huge difference. I told him about this discussion board and that I joined. He asked me if I told you guys her white blood cell count was over 100,000 yet - because that's going to put her in the rarest of rare - only 2% or so of dogs that have this rare disease have THAT! Bottom line - she is a MIRACLE right now!! And the best news of all? If the bloodwork comes back like he thinks it should - and she keeps improving - WE GET TO BRING HER HOME TOMORROW NIGHT!! Thank you, God!!!¢¾¢¾¢¾ Now....for the bloodwork..... I asked them to run me copies, so I'm not sure exactly what #'s you guys would like to see, but I'll take a shot. 3/9 was when we first took her in & they said she had IMT. 3/11 was when we took her back in & they determined she also had IMHA. That's when she was 'admitted'. Her prognosis wasn't good to make it through the weekend, but she did, and 3/14 were her results on Monday. Tell me what you think, how dire her situation was, etc. Can't wait to post new results tomorrow! 3/9/11............. AST (SGOT) 72 (HIGH) Total Bilirubin 0.6 (HIGH) Calcium 8.6 (LOW) Na/K Ratio 39 (HIGH) Amylase 1243 (HIGH) WBC - 18.5 (HIGH) RBC - 2.5 (LOW) HGB - 5.9 (LOW) HCT - 18 (LOW) MCV - 67 MCH - 23.4 MCHC - 35 NRBC - 2 (HIGH) Platelet Count 21 (LOW) Neutrophils 13,505 (HIGH) Lymphocytes - 2,960 Monocytes 1,480 (HIGH) T4 0.5 (LOW) 3/11/11............. Reticulocyte Total - 24.1 (HIGH) Absolute Reticulocytes 337,400 (HIGH) WBC - 51.2 (HIGH) RBC - 1.4 (LOW) HGB - 4.1 (LOW) HCT - 10 (LOW) MCV - 74 MCH - 30.2 (HIGH) MCHC - 41 (HIGH) NRBC - 14 (HIGH) Platelet Count 98 (LOW) Neutrophils - 37,888 (HIGH) Bands - 1,536 (HIGH) Lymphocytes - 7,680 (HIGH) Monocytes 3,584 (HIGH) 3/14/11............... Reticulocyte Total - 18.6 (HIGH) Absolute Reticulocytes - 241,800 (HIGH) WBC - 98.7 RBC - 1.3 (LOW) HGB - 3.6 (LOW) HCT - 15 (LOW) MCV - 105 (HIGH) MCH - 27.5 MCHC - 27 (LOW) NRBC - 19 (HIGH) Platelet Count - 278 Neutrophils - 75,999 (HIGH) Bands - 1,974 (HIGH) Lymphocytes - 11,844 (HIGH) Monocytes - 7,896 (HIGH)

Christine Kansas City

Christine, I am so glad to hear that Nikka feels better and is happy to see you! That is a good sign that she is feeling better. There is a high increase of reticulocytes. These are baby blood cells and this is a good thing right now to recover from anemia. It takes a few days for these cells in circulation to mature into proper red blood cells. So over time you will see the number of reticulocytes decrease and the number of RBC increase. Along with that you will see increases in hemoglobin HGB that carries oxygen to the cells. And of course the HCT hematocrit (also PCV) will increase as well. Many things on her chem screens are pointing to pancreatitis, an inflammation of the pancreas. High white blood cell count, AST, bilirubin, bands (left shift white blood cells), amylase, and sodium/potassium ratio. Plus decreased calcium levels and thromobocytopenia (low number of platelets). This may be a direct cause of the prednisone. In any case, it does need to be addressed. It can be very painful for the dog and has some negative impact on her health. I hope that they have discussed this with you? She should have been fasted for a day or so when they did the first chemical screen and saw these numbers. After that, she should be receiving a low/no fat diet that is easily digestible (mostly carbohydrates and high quality proteins) for a period of time. When you receive the results of the next chem screen I would like to see them. The vet should be attempting to adjust the electrolytes to their proper balance. The body is very good at this but sometimes needs a little help to get started in the right direction. Most dogs that have a single acute case of pancreatitis and are treated properly right away can recover well enough to have a relatively normal diet the rest of their life, with some restrictions. Dogs that continue to have acute attacks or tend to have chronic pancreatitis can possibly have continuing health issues. My girl Cassie had a single acute attack of pancreatitis. Daddy was a little too "liberal" with a package of bologna and she had immediate trouble. I treated her as I described above for about 4 weeks and then re-tested her with a special test. The most accurate blood test for canine pancreatitis is the canine pancreatic lipase immunoreactivity (cPLI) test. Her results returned normal and so I returned her to a modified, slightly lower fat, diet. We also took a shopping trip to find appropriate treats that she can have that are lower in fat but still fun. She has no troubles now. my best patrice

Patrice NYS

Wow....thanks for all the great info, Patrice!! Are you a vet? We visited her tonight and she was even better than this morning! Jumped right up in her kennel and for the first time - cried and barked!! Wanted out of that thing SO bad that they let us take her into their grooming waiting room where she could move around. She was sniffing, wagging, licking, playing with her squeak toy - I literally could not believe my eyes!! It's like literally watching her come back from the dead! I'm VERY anxious to get that bloodwork back late tomorrow afternoon, too. Hopefully I'll be posting the good news that we've brought her home! :)

Christine Kansas City

Patrice - one more thing. Are you suggesting pancreatitis may have caused her IMHA? No, that has not been brought up by my vet. We very well may be bringing Nikka home tomorrow afternoon. Should I bring this up to him - or post the results of tomorrow's bloodwork for you first? Thanks!

Christine Kansas City

Hi Christine, so sorry you are having to deal with this disease! Having a case of pancreatitis associated with it only makes matters more difficult. Sounds like things are improving for the better for Nikka and hopefully continue to do so. Having a highly regenerative anemia is such a good thing! This'll mean the numbers should rebound much quicker than normal. Also, I'm wondering if this is even a case of an autoimmune reaction to the red blood cells OR just a simple anemia due to blood loss caused by the IMT??? Just wondering what you're using for an antibiotic? My thoughts and prayers are with you both. Johnny & Tessy

Johnny

Christine, In dogs that are on high dose prednisone, they can be prone to having some degree of pancreatitis. If they were already sensitive to fatty foods and had some digestive problems, they might be more likely to develop pancreatitis. But in just a few days on prednisone? I am not sure about that? And, as I read your history, Nikka has not been on prednisone for a long time. In fact, as I read more carefully, it sounds like she was very very sick when she was brought it and did not eat for 6 days? It may be possible she had a very severe acute case of pancreatitis. This can have accompanying symptoms such as low platelets and very high white blood cell count. The pancreas is often referred to as the "angry organ." It does not like to be disturbed and when it is challenged can become very painful. Of course, it is very serious in humans, but dogs just seem to have a rougher time of it. The pancreas has two jobs. It's first job is to make insulin for the body to use to control blood sugar. It has islet cells that do that. Our lives depend on the pancreas to do this job properly. Without it, we are diabetic. It's second job is to manufacture and release digestive enzymes into the small intestine. These enzymes help the body digest food into molecules that the body can use. Carbohydrates become simple sugars, fats become fatty acids (with help from the gall bladder) and protein becomes amino acids. There is a direct connection from the pancreas to the small intestine so it can drop off these enzymes when needed. If this function fails, we cannot absorb nutrition into the body. In pancreatitis, the organ becomes inflamed and those digestive enzymes can leak into the surrounding tissue. The enzymes begin to irritate and "digest" local tissues. It can be extremely painful. It can begin to have systemic effects as well as these enzymes hitch a ride in the blood stream, or in other words can begin to bother many of the bodies organs and tissues. And of course the body will prepare to fight the inflammation and damage. This is where the white blood cells come in. The immune system will jump in and become involved as well. Is this what happened to Nikka? Your attending vet is the person to answer this for you. They have clinically examined her and viewed all her lab work. You should ask them about this if you have the opportunity. If you approach them in a calm way and explain that you have been reading about this on the internet and have some questions, I am sure they will sit down and help you understand this. From your description of her behavior now, it is clear she feels better. So this may have very well been the case. But you need to know so you can prevent this from happening again. I am not a big fan of the prepared special veterinary food that is developed for dogs prone to pancreatitis. It will do the job, but from my perspective they are bland and low in good nutrition. There are simple-to-make home diets. I'll bet your clinic has a prepared sheet of diets. my best patrice

Patrice NYS

Hi Patrice...and Johnny! Pancreatitis hasn't even come up. Here's our story. As mentioned, Nikka lives life at 110% - boundless energy and noise, has wolfed her food down every day of her life, etc. Last Tuesday morning, she wouldn't eat. After 1/2 hour - she DID eat (understanding she ALWAYS snarfs her food down same time every day). That day, we noticed she was wobbly when she walked & she just was lethargic. We always give her a 5pm snack & she didn't take it. BIG red flag! I e-mailed my vet that night cuz' I wasn't TOO concerned yet. He said since she ate & drank that day & went to the bathroom - keep an eye on her & bring her in tomorrow if she doesn't get any better. Wednesday morning she wouldn't eat at all. Still wobbly & lethargic, so I took her in. They immediately looked at her gums and eyes and said "She is SO pale". Looked at her blood & then said she either has an autoimmune disease - or possibly something worse, like cancer. They kept her, put her on IV fluids and did an x-ray (no tumors showed up) and sent her bloodwork off. Later that afternoon they called me with the IMT diagnosis. Said her platelet level was dangerously low and that night gave her 1st does of prednisone (80 mg). The next morning (last Thursday) she popped right up, snarfed her food down, drank a bunch of water then they took her on a short walk & they noticed she wasn't as wobbly. They said they've never seen a dog have such a quick response to the prednisone - but they were very pleased! Said I could come get her that day, but that she was VERY 'fragile' and that we could only allow her to sleep and go outside to go to the bathroom. They said if she accidentally got bumped hard by our other GSD or hurt in any way - she could bleed to death internally. When I got there to pick her up, she definitely seemed better than the day before, but not as good as they made her sound that morning. We got her home, she seemed fine, but very, very tired and weak still. It was like her body wouldn't do what her brain wanted it to do because she was SO weak. Very wobbly again, too. On Friday morning (one week ago) she seemed just as weak. I tried to feed her dry dog food - no. Tried to then wet it down - no. Made her some hamburger and rice - got a couple of large handfuls down her but that was it. It was ok, at least she ate! Then, I got her meds and covered them in spray cheese (how we always give meds to her). She turned her nose up. So then I went to what I KNEW she would eat - I wrapped her pills in a slice of deli turkey. Turned her nose up at that, too. That was HUGE. I had to stick her 80mg prednisone pills down her throat. She drank TONS of water, but I knew this would be the case cuz' of the meds. I took her out & her poop was red. Then when we came back in, she threw up the small amount of food she ate, the pills (plus the TONS of water!) She was so weak she could barely lift her head. I called the doc & he said to get her back in right away. He was VERY concerned when he saw her (this was his 1st time - his partner saw her 2 days prior as it was his day off). He took blood and noticed how thin it looked in the vial. He then told us how low her RBC count was and how she had severe anemia. So she had IMT and IMHA. He sent the bloodwork off to the lab for the more in-depth analysis, but told us this was pretty bad. Said that now since she had BOTH things, he felt there was a better chance she may have cancer - or secondary IMT/IMHA. He did get her prednisone pills down - but then he took out his 'big gun' as he called it - the Imuran. He called later that afternoon and gave us the results of the bloodwork you saw above. He said her platelet count had come up some, but the red blood cell count was horrible. He told us how dire her situation was, how in his honest opinion she had a 30% chance of making it through the night and that if she made it through the weekend he'd give her a 30%-40% long-term chance of making it. So that is where our journey began!! She seemed to go way downhill Saturday & Saturday night, and Monday seemed to be the worst day of all. The thing that absolutely blew him and the specialists' that he called out of the water was her white blood cell count. Said in all the years he's been in practice, he's never seen a dog in her situation with a WBC that high! (I'm still trying to figure out if that's a good thing or bad thing?) On Tuesday, we started having hope. Long story short, each day she got a little better. She was too weak to even lift her head Monday & Tuesday she got a little bit of strength back. She wasn't interested in eating still but he said that was the least of his worries. Wednesday he got 2 cat food sized cans of wet food down her for seriously ill dogs - but he did it with a syringe. Yesterday, they let her take a lap around the kennel and she was bending down eating the dry dog food that had spilled out of other dogs cages - so they gave her some of that. She ate it all! She had great energy yesterday morning and even MORE last night. I just left her an hour ago and she was barking, wagging, eating - they let me take her outside and she was able to walk down the stairs, she went #1 and #2, she played with her toy - I'm just shaking my head in disbelief!! So we should find out the results of the bloodwork in the next 2 hours - and HOPEFULLY she'll be coming home tonight! I'll be anxious to post them for you. She has never once acted like she was in any pain at all during any part of this. Don't know if pancreatitis doesn't always have pain accompanying it - but her only symptoms have been EXTREME lethargy and weakness. The appetite seems to be back in full force! Hope all of this helps you!!

Christine Kansas City

Patrice - As I re-read your post, I want to be sure I mentioned, she didn't eat for 6 days AFTER all this began. She was just too weak (which the vet said was to be expected). The last full meal she ate was last Thursday morning the 10th, I got a little ground turkey/rice down her Friday morning the 11th - but she threw most of that up an hour later. The first time they got food down her was Wednesday the 16th through a syringe and then yesterday she started eating dry dog food on her own! Johnny - She's not on any antibiotics - only the 160 mg of Prednisone/day and Imuran (not sure what this dosage is - I'll find out). She weighed 71 lbs. when we took her in last Wednesday, but she's obviously lost weight since then - just not sure how much yet.

Christine Kansas City

Sorry - one more thing I thought I should make you aware of. Nikka eats 3 to 3 1/4 cups of Nutro Natural Choice Large Breed Weight Management food each day. We measure her portions every day and we rarely give any kind of table scraps. Also, Johnny, I forgot to ask...you said having a highly regenerative form of anemia is a good thing. Does she have that? And if so, how can you tell? Thanks...I promise that will be it until I hear from the vet!!

Christine Kansas City

Christine, I am not your vet so it's hard to say what they feel about this diagnosis. However, these signs lead me to suspect pancreatitis. A dog that refuses food and vomits should be evaluated for this condition. Here is an excellent guide to read. I value Mary Straus's research very much. Read this carefully, several times and see how it fits to your situation. Talk it over with your vet. http://www.dogaware.com/articles/wdjpancreatitis.html my best patrice

Patrice NYS

NIKKA IS HOME!!! I feel like we have a VERY fragile baby here - but she is HERE - and I am THRILLED! I talked to my vet about the pancreatitis, he is POSITIVE she does not have it. He did tell me she's on a dangerously high dose of Azathioprine & that it can end up causing the exact thing to happen that it just helped save her life on. However, he said he had to do it or she would've died. He said she's on as high a dose of that and Prednisone that he's ever put a dog on. Starting tomorrow, he's going to go down a bit on both. He feels good that she will be ok doing this - he said we pretty much HAVE to do this, as it would be horrible to have the exact med that saved her life end up killing her. Tomorrow, we go from 160mg/day of Prednisone down to 120mg/day. I don't know what her Azathioprine dose was at, but we're going down to 75mg every other day. She's also on 800mg/day of Amoxicillin. She's eating her regular dry dog food perfectly!! Here are the results of todays bloodwork: Reticulocyte Total - 13.3 Absolute Reticulocytes - 292,600 WBC - 56.1 RBC - 2.2 HGB - 6.2 HCT - 22 MCV - 100 MCH - 28.9 MCHC - 29 NRBC - 18 Platelet Count - 259 Neutrophils - 43,758 Lymphocytes - 6,732 Monocytes - 5,049 Eosinophils - 0 Basophils 561 Let me know what you think of those #'s as compared to Monday's. Thanks so much!

Christine Kansas City

Looks like things are heading in the right direction for Nikki!!! The high reticulocyte counts are an indictation of regeneration as seen by the high numbers above. In a normal healthy dog these numbers would be between 1-1.5% or around 60,000!! Having high numbers means the bone marrow is responding properly to the anemia! Good to see the WBC going down! Perhaps the antibiotics are healping? Please please do talk to the vet about adding a stomach protectant. Lots of thoughts, prayers and hugs. Johnny & Tessy

Johnny

I just heard from another guy on a Facebook group dedicated to IMHA about adding the stomach protectant, too. I did bring it up to my vet yesterday before bringing her home and he just didn't want to add another thing to all the drugs she's taking right now. He's been my vet for 25 years and even though I know there is a WEALTH of knowledge on this board - I just want to follow all his instructions to the "T". I trust you guys completely - and I trust him, too. He's keeping a VERY close eye on her & is having me call him every day for an update and call me WHENEVER I see anything change. Can you tell me, what would be the first sign that she might be having stomach problems?

Christine Kansas City

I heard about that Jonathan guy!!! Might have to meet him some day!!! :) hehe Stomach problem signs....unwillingness to eat...loss of appetite, vomiting/puking..with or without blood/even on an empty stomach, darker than normal stool/tarry looking stool/bloody stool, anemia, lethargy, etc. These are the symptoms but it's important to protect and prevent these symptoms. This is somehting that can be easily prevented!!! Check out the post Patrice made regarding stomach protectants! IMO this is a must! Johnny & Tessy

Johnny

When did you start the antibiotic???

Johnny

Oh, I am CRACKING up!!! It's YOU!!!!! Is Patrice a vet, by the way??? Have you ever seen a WBC as high as hers in an IMHA dog? My vet said she's the rarest of the rare. Can you tell me - what did that MEAN exactly? Was it a good thing or a bad thing?

Christine Kansas City

They started the antibiotic 5 days ago - and there are 5 days left.

Christine Kansas City

Patrice, IMO, is better than a vet!!! She's like our own resident specialist!!! High WBC counts can be caused be several things. First thing I'd consider is ...was the dog stressed or excited when the blod was drawn? This can cause abnormally high WBC counts. Certain cancers, toxic reactions, kidney or liver problems, PANCREATITIS, etc. The most common reason though would be some type of infection or inflammation in the body. Usually they'll use antinbiotics to see if the numbers drop. Perhaps it's a combo of stress/excitement and an infection somewhere??? Tessy's WBC was always high during treatment (but not that high). Hers was usually in the 40-60 range. Being on these drugs opens them up the the vulnerability of infections due ot the weakened imune state so we always gotta keep an eye out for things that can cause infections. Keeping them away from other dogs or dog parks is a wise choice while immune systems are weak. Johnny & Tessy

Johnny

If I were you I'd pick up a probiotic to give AFTER the antibiotic. Make sure to give it AT LEAST 2 hrs AFTER the antibiotic if not the antibiotic will kill the probiotic. I'd suually recommend something simple like yogurt but you might want to avoid this due to the pancreatic numbers. You can get a very good product from the vet called Forti-Flora. I used this quite often with Tessy when she was on antibiotics! Johnny & Tessy

Johnny

Christine, I am so glad Nikka is home!!! You will see she will improve now that she is where she belongs. Johnny is so right, Patrice is more than a vet! She has the knowledge and then some of a vet or GP and best of all she can explain things to people that don't speak the medical lingo. I hope you have gone back to her post about protecting the stomach. Of course it means 2-3 more (big) pills for Nikka, but believe me, she will thank you. It is a small price to pay. if your vet does not want to do it, maybe you could ask if you could try the slippery elm? maybe he is worried about absorption? You can tell him that your "new friends" from the internet just won't leave you alone :) We have used Forti-Flora. I don't know for sure if it made a difference, but it certainly won't hurt. you could also add a bit of plain no fat yogurt to Nikka's food. make sure you feed her high quality (home cooked is probably best) no grains, soy, corn and as lean as possible. Have a can of plain pumpkin on hand in case she gets diarrhea again. You can give her a good table spoon per meal and it will help. I am so happy things are looking up! Best wishes, Brigitte & the poodle boys

Brigitte BC Canada

Christine, Get that stomach protection NOW! I'm sitting at the animal hospital now with my Beau whom I may lose as a result of the prednisone - not IMHA. Internal bleed highly suspected, liver enzymes extremely high, now peeing blood. And he's been on sucralfate and pepcid since diagnosed! No evidence of the damage appeared until this past week - unexplained dropping PCV. The bleeding is causing compounded anemia. Beau is a cocker spaniel. I also have a German Shepherd at home who sounds alot like yours! My experience has been that GSDs have sensitive GI systems. PLEASE protect it now! Best wishes, and hang in there! Sharon

Sharon PA

Hi Christene, I don' post much anymiore, I have a 14 year old AIHA survivor, Wylie going on three years. I have read hudnreds of threads and see so many dogs suffer needlessly by not having a stomach protectant when they are on such high dose of meds. Regarding Nikkas, IMT, Wylie has had IMT twice since her inital bout of AIHA and we think it was caused by diseases that ticks carry I am surprised no-one has mentioned this that I saw. and it looks like you are live in a tick area. Has she been tested? The only treatment for that is an antibiotic called Doxycyclene. Amoxicillen will not do it. It can slow the disease but not kill it. We think this was what initally happened to Wylie. She had a low platelet count, they put her on amoxxilcin in December. in March she had IMT again, this time they put her on a month of doxy and she has been fine since. They thinkt he amoxycilline suppressed for those 2 1/2 months. Good luck Laurei

Laurie CA

Christine, I just saw Nikka's picture on Facebook. Poor baby! She is a beautiful girl. It is very hard to see just such a strong pup so weak from this disease. But please know it is just that--she is tired and not painful. She will continue to build her strength back. Right now, rest and the meds are the "best medicine". Please give your special girl a gentle hug for me. She looks like such a doll baby and I just wanna get down there on the floor and lay beside her. :( Teresa

Teresa va

Hi Everyone! Just realized I haven't posted on here in several days - have been trying to play 'catch up' with my business this week after missing so much time with Nikka in the hospital. She is doing GREAT!! Every day she seems to get a little bit stronger. I know she's not back 100% - but it FEELS like it since she was on the brink of dying. To see that personality come back that we were starting to accept we would never have again around our house (because we thought she would not make it) is the most AMAZING thing to feel! Tomorrow we get bloodwork done again. It has been a week - so I can't WAIT to see the results! Will post them on here as soon as I get them. Oh, and by the way....thanks for the advice on the stomach protectants. It wasn't comfortable asking my vet because I adore him so much and don't want him to think I'm questioning his care (I've already asked TONS of other questions, too!) But, he agreed that it could happen - so Sunday we started her on 1 1/2 tablets of Pepcid AC twice a day!! Thanks for EVERYTHING, everyone!!!!

Christine Kansas City

Hi Christine, My journey with Dylan began last Friday, she is 10. She has just started what I hope is her turnaround. She went from first symptom to death row in 24 hours. It has been 5 days of prednisone and she is gratefully decided to stay. Glad to hear Nikka is doing better. Sounds like lot's of great advice here. I am trying to get something for Dylan's stomach today, a friend has to go as I won't leave her side. 24 hours ago she was as close to death as I would like to ever see and could not stand or walk. I see the desired effects of the prednisone and her behavior is improving. I won't be able to take her for a blood test for another day or so, as I am still concerned excess trauma from physical stress and anxiety will influence her recovery more. Although Dylan was back eating within the next 12 hours, I am going to be very careful with her diet. I do feed raw though and not dog food and perpare everything myself. I am trying to adjust according to the advice above and keep fats as low as possible. She is eating really well and her stool is pretty good (not orange anymore either). I will also have to look into other potential complications of this diet. I truly wish you the best and I am so happy for the help provided here. Even knowing the other stories, like Nikka's and how they progressed is so valuable for me to be prepared for the difficult road ahead. Sincerely and Good Luck! Richard and Dylan (survivor)

Richard Burnaby

:( Just left the vet's office. She's not as "pink" as she was when she left last week, not as pink as she should be by now and to add to it - she's got some fluid on her belly. Doing in-depth bloodwork & should have results back late this afternoon. He doesn't know for sure - but says many times fluid like this is caused from a tumor - which is what we've dreaded from the beginning - but thought we had avoided since she responded to the meds. His words "I'm very worried about her".

Christine Kansas City

Christine, Try not to worry too much until you have her latest results. ( easier said than done) I know a lot of people that get through the initial stages have posted about fluid related problems with their dogs so I wouldn't be thinking tumor yet. Prayers and thoughts going out to you and your dear Nikka' Penny

Penny Lytle Creek Calif

Christine I agree with Penny as there have been many dogs that have retained fluid in their stomachs and I think it was due to the medicine. Perhaps others will post on more exact causes. How is Nikka acting and eating to me they are the important signs. If possible try not to get down about her visit to the vets as I think our dogs can sense when we are upset or worried. Just take it day by day just like Nikka does. Keep us posted with her results Cheryl & Ginger

Cheryl & Ginger Pineville PA

She's eating fine - but definitely a marked difference in her energy level the last 48 hours. It seemed to be going up a little each day from when we brought her home last Friday through Wednesday. Any minute now I'm expecting that call - so I'll update when I get it. Thanks!!

Christine Kansas City

Talk about feeling like you just got kicked in the GUT. Vet called, bloodwork is back and it is SO much better than a week ago. She's got so much more blood - but guess where it's going...her abdomen. He talked to 3 other vets, 1 specialist & all agree - this is most likely cancer. It's not 100%, but you can tell by his voice he's pretty convinced. He still said ‎"Today's not the day we give up" - but he also gave us our options. It seems that we're right back to where we were 2 weeks ago. We're going to know something, and we'll know it quick. If her belly is bigger tomorrow than it is today, and even bigger Sunday - then it's almost a guarantee that's what it is and she will be gone within a matter of days - or we will have to put her to sleep. If she remains steady - still eating, drinking, etc. and it DOESN'T get any bigger - there's still some hope that this might be something else. And then there's that rare chance that she just starts getting better each day and it IS something besides cancer that may be 'fixable'. Bottom line - by Monday or Tuesday he says we're going to know a LOT. To know that we brought her back from the dead - just to have her die after all is just heartbreaking to think about. It's just killing our vet, too. He said we've treated the IMHA and our treatment is working. It just may be that we're now seeing what caused that IMHA to begin with. So we are going to spend another weekend stressing but also drinking in every minute with her because it sounds like the odds are better than worse that it may be our last. The only thing that makes things better than they were 2 weeks ago is at least she's with us - and not at the animal hospital. Let's hope that she has another miracle ... cuz' we sure have liked having her around again.♥

Christine Kansas City

Christine, I am so sorry to hear what you're dealing with this weekend. I am holding out hope for a good outcome for Nikka. Hang in there! Sharon

Sharon PA

Christine, I will keep sending positive thoughts and prayers for all of you. Try not to stress as your girl will feel it. Just love every minute you have with her.

Penny Lytle Creek Calif

So Nikka continues to baffle veterinary medicine. The bloodwork did NOT come back good. Last week she looked bad but the results were good - this week she looked good but the results came back bad. The past 24 hrs. she's been acting the bes...t she has since this all started! Everything has gone down except her WBC count. This is good because it means her bone marrow is doing what it DIDN'T do at the onset of her disease - it's working on overdrive to make red blood cells. He doesn't think her #'s are low because her body is attacking them again - he thinks ...it's because blood is leaking into her abdomen. This still very much leaves the "C" word as a distinct possibility. :( As I've mentioned, he's NEVER had a dog on the amt. of Prednisone she's on. He was hoping her results would come back good today so he could cut that Pred. dose in 1/2. That would put her at the HIGHEST safe level he's ever put a dog of her size on. Believe it or not - he's STILL going to cut her dose down by 1/4. Reason being - he doesn't think her body is attacking - he thinks the blood has been leaking. The unexplained fluid on her belly, falling when she walks & now atrophied muscles in her face/head he thinks may be side effects he's never seen before of such a high dose of Pred. THAT is why he wants to get her down to a normal level - yet we still have to worry about her immune system kicking in too! UGH!!!!!!! Forgot to post last week's bloodwork. I'm going to post both last week's and today's now.... Last Friday 3/26: PCV = 28 RBC = 3.1 HGB = 8.7 PLATELETS = 197 WBC = 30.1 Today: PCV = 19 RBC = 2.3 HGB = 6.2 PLATELETS = 279 WBC = 60.9

Christine Kansas City

You might want to add a couple supplements to the diet to help things a bit. Knox Nutrijoint (a geletin) is great to add as would glucosamine and chondroitin (in smaller levels). Reduced exercise also...the more exercise the more muscle atrophy! I've been talking with you on facebook so won't attempt to repeat myself at the moment! :) Give the beautiful *girl* a big hug for me! Johnny & Tessy

Johnny

Nikka passed away this morning. My sweet vet at no charge very delicately opened her up to take a look at her as so much was throwing him and our whole family for a loop. Turns out her IMHA was secondary - just as my vet expected. She had a tumor on her spleen and that's where the fluid was coming from. The cancer was also in the lymph nodes in her chest. Our hearts are absolutely broken right now as she fought SO hard the past month to get back to her ornery self and was making great strides. We had a beautiful weekend with her and she was acting better than she had since this whole thing began. She had quite a "big" personality and her presence will be sorely missed. Thank you all very much for all of your help and support. It really meant a lot.

Christine Kansas City

Christine, I am so sorry to hear of the loss of your most beloved Nikka. Please accept my deepest sympathies on your loss. When you feel up to it, I urge you to visit the Loss & Grief page at the Meisha's Hope AIHA/IMHA web site: http://www.cloudnet.com/~jdickson/loss.htm This page contains many resources that will be very helpful to you during these most very difficult days.

Joanne MN

Christine, I am so sorry to hear of your loss. And what a loss it is. As I told you before, my "other" (non-IMHA) dog is a German Shepherd (Chloe) who sounds alot like Nikka --very feisty with a huge personality. I got her from a rescue as a one-year old after losing my 14 year old German Shepherd the year before. That was a very long year -- and it got to the point where I mourned Betsy as well as the loss of a "presence" in the house. Don't get me wrong -- I love my Beau (cocker spaniel) dearly -- but our house just wasn't the same without the antics of a German Shepherd. I will keep you and your family -- and Titan -- in my thoughts and prayers. Again, my deepest sympathies. Sharon

Sharon Abington

Sharon - You said that so perfectly. You sound like most German Shepherd owners. Once you've experienced one - it's hard to live without one. I've still got Titan here and he just turned 9 on Friday. I had a long talk with him today and told him it's imperative that even though he's 9 - he HAS to stay around for awhile!! A 14-year old GSD - wow - that's almost unheard of. I hope our boy stays around that long. It's awfully hard to look at him right now though (even though he has been nuzzling me, licking my tears, etc. all day) He and her were a pair - and it's hard to know that pair has broken up forever. :(

Christine Kansas City

Please accept my deepest condolences in the loss of your beloved dog Nikki. She is free from pain now and will forever be in your heart. RIP Nikki you were truly a miracle girl. Cheryl & Ginger

Cheryl & Ginger Pinevile PA

Dear Christine, I am so sorry for your loss. You did all you could for Nikka and she payed you back in unconditional love. She is running free, waiting for you at the rainbow bridge. With sincere condolences, Brigitte

Brigitte BC Canada

Christine, I am so sorry for your loss. Nikka will always be with you in your heart and i hope the memories of better times help you through this awful time. Hugs Penny

Penny Lytle Creek Calif

(((CHRISTINE))) You got my deepest sympathies and condolences for your loss. Nikka is running and playing with some very special new friends while she waits for you! Johnny & Tessy

Johnny

I am so sorry. I had been gone and did not know. Nikki and you were very blessed to share this world together. Take care.

Maureen MI

Christine, I am so sorry to read about Nikka. This is such sad news for your family. But I am glad you had some very good times near the end. That probably was more important to her than you can possibly imagine. When my dog Chance was only 7 I was told he had a very large growth on his spleen. For nearly a week I thought it might be this dreadful tumor that affects the spleen and heart. It was a very sad time for me. I will never forget that. Please accept my deepest condolences. Patrice

Patrice NYS

This thread was discussed between 17/03/2011 and 10/04/2011

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