Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Oliver - Diagnosed 2 days ago

Oliver is my 7 year old Dachshund who has been my best buddy since he was a puppy. He's typically a high-strung, energetic dog that loves to eat, play, and cuddle. I got home from work this past Thursday evening and was baffled that Oliver stayed in his bed instead of greeting me at the door, which is always does. He did eat his dinner that night so I didn't feel too bad about it yet. Friday morning he still seemed completely drained and he refused to eat his morning food. That morning he had an accident in the house-- again, very uncharacteristic of him-- and I noticed the urine was a deep purple. I immediately took him to the emergency vet Friday morning. That morning they did a complete blood count, urinalysis, I-STAT 8, x-rays, and ultrasound. His PCV was at 30 and his platelet count was also a little low, and the ultrasound and x-rays turned up no tumors or other anomalies. He was immediately given injections of Dexamethasone and 100mg of Doxycycline, and the invoice also shows an injection of "Pepcid" although I do not know what that one is. He had a 104.5 fever and was showing signs of dehydration, so they also started some fluids through his IV that morning. His PCV was checked for the second time on Friday night and was at 27. Saturday morning, now 24 hours since I first took him to the vet, his PCV was checked for the third time and was now down to 20. The tests alsi showed heavy autoagglutination, which the vet described as a very foreboding prognostic. At this point the invoice shows he was receiving some combination of Dexamethasone, Doxycycline, Pepcid, Azathioprine, and Prednisone. I'm not sure whether they replaced one medicine with another or whether they used all of them together, but all five of those show up on my invoice around that time period. His PCV was tested for the fourth time late Saturday night and was down to 15. At this point we decided to move forward with a 1-unit blood transfusion over night. This morning, Sunday, after the transfusion his PCV was at 22. The vet advised that I could take him home for the day today. The justification was that he has never vomited, his stool has remained solid (although orangish in color), and he is eating small amounts of food (allowing the use of oral meds). Additionally she does not foresee the need for another transfusion today, and if a clot is going to happen it's not going to matter whether it happens in the hospital or at home, so there's nothing they can do for today that I can't do from home. I was given a bottle of 20mg Prednisone and told to give him 1/2 tablet twice daily, a bottle of 50mg Doxycycline and told to give him 1 tablet twice daily, a bottle of 50mg Azathioprine and told to give him 1/4 table once daily, and I was also advised to give him 1/16 tablet of baby aspirin twice daily. I will be bringing him back to the vet tomorrow morning for another PCV check, and if there is a further drop we will discuss the possibility of a second transfusion then. I know this is a lot of information, but I'm incredibly nervous and I guess I'm hoping to get some advice about whether this seems like the best course of action to be taken. Oliver definitely seems drained now, but he still has a bit of spring in his step. He hops up and down a couple of stairs on his own to get out to the lawn. Upon coming home he drank some water, ate his peanut butter covered meds, then hopped onto the couch by himself for a nap. I know he needs rest, but I'm constantly looking over at him to make sure his diaphragm is moving. =( I realize it's mostly a waiting game at this point while the meds try to stabilize his dropping PCV, but I want to make sure I'm doing absolutely anything I can to help him. Also, if anybody has had a dog that has recovered despite autoaggultination, I'd really love to hear about it. Thanks in advance for any advice, information, or encouragement. -David and Oliver

David Arlington

Hi David -- I'm so sorry to hear about your Oliver. Our dog, Penny, was diagnosed in October -- her PCV got down into the single digits and she had autoagglutination. The situation was so bad that she couldn't get a blood transfusion, they used Oxyglobin instead. She was in the hospital, on oxygen, for 5 days until the drugs kicked in and the autoagglutination stopped. She was then able to have a whole blood transfusion and was able to come home. The months following have been difficult, but she has made steady progress and is stable now -- may actually be in remission, although she is not drug free and may not every achieve that state. By the way, we have found Pill Pockets to be a life saver -- Penny loves them, and with so many pills, they really make the administration of them much easier! I guess my message is that while there is life there is hope. It sounds like you are doing everything you can, please take good care of yourself too -- this can go on a long time. Christine

Christine N.Ca

David, I am sorry you have had to join us but you have come to the right place. If you haven't been to Joanne's site yet please go there. http://www.cloudnet.com/~jdickson/index.html It will answer a lot of your questions as well as offer you a lot of hope. You will probably see all kinds of things you will want to discuss with your Vet. The Pepcid is to help protect his stomach from the meds. The aspirin is to stave off possible blood clots. When you are at Joanne's site be sure to read the sucess stories. I know this is a lot to take in right now but know that there are a lot of people on this board available to answer any questions that you have. You might want to start a journal so you can write things down like a record of drugs/ PCV's things in general that you notice about Oliver. The first few days are so confusing it is really hard to think straight so having a record will be a very valuable tool. Fighting this disease is a real roller coaster ride so hang on tight and don't let it overwhelm you. Keep us posted. Penny

Penny Lytle creek Calif

Hi David, I'm so sorry to hear about Oliver. I also have a dachshund with AIHA. On March 4th, when she was diagnosed, Boogie's PCV count was 13. She had no signs of being sick other than she was lethargic. One week later her count was 10 and she was transfused. In the subsequent month and a half, she received three more transfusions. Her count would go up after the transfusion and within about 10 days, it would be back down to around 10 and need another transfusion. After the last transfusion (April 24th) her count rose to 35 and it has stayed in the 30's ever since. We have been decreasing her prednisone and her count has actually risen since then. Friday her count was 39.7. She is feeling a lot better too. She never had autoagglutination, but she was one very sick little dog. I really thought I would lose her a number of times. I am so grateful she is better. What I'm trying to say is this is an awful, awful disease, but there is hope. Even though this is very serious, a lot of dogs do come back and live normal lives. I am so appreciative for every day with Boogie and consider it a gift. Good luck to Oliver. I hope he is an exception and has a quick recovery. If not, my advice to anyone who is dealing with this is that they have a good supply of anti-depressants on hand and an even larger supply of money. You're in for quite a ride. Sue

Sue Moorpark

Hi David. My dog experienced autoagglutination and at the crisis point his PCV was down to 5. That was just over a year ago and today, if you didn't know his history, you wouldn't know how ill he had been. So please realize that even though things look grim, there is hope. It sounds like your vet has things well under control but I would ask him/her about adding sucralfate to the drug cocktail. Sucralfate, combined with the Pepcid, protects the GI tract from the harsh meds that Oliver will have to take to fight this. Also, azathioprine can take up to six weeks to kick in but the prednisone is much faster acting. My dog needed two transfusions before his PCV started to climb on its own but some dogs need more and some less. Hang in there. I hope for the best for you. deb and Duck (my dog!)

Debbie BC Canada

David,I have a 7 year old dachshund as well There are several dachshund owners on this site. Choe's initial diagnosis sounds close to Oliver's. I have to prepare you for the good news and bad news. As others note, be prepared for a roller coaster. Oliver can survive this condition. But he may need several blood transfusions before he stabilizes. My boy needed four. It has been a very emotionally taxing and expensive experience. It is 22 months later and he is on a low dose of prednisone with other drugs being slowly weaned off. He receives blood tests every few weeks to check his pcv. He has been doing very well with a high energy level for some time and I cross my fingers for him to contnue. I love hm more than anything in the world. If you are close to a homeopathic vet you might want to ask for a consult. Adding Chinese remedies and vitamin supplements I believe were very helpful. Doxies are strong little tykes! I am routing for Oliver. Best, Jan

jan

Hi David, I too am a dachshund owner here on the site. And I am so sorry that Oliver has been diagnosed with this horrible disease. But please know there is hope. Tipsi, who is my 4 year old dachshund was diagnosed in September 2007. She spent 2 weeks in ICU at the NC State Veterinary Teaching hospital here in Raleigh. She had a very poor prognosis after she was diagnosed, but she pulled through. And is now doing very well and has had a stable PCV for months. It will be a roller coaster ride with Oliver so prepare yourself. Patience is the best advice I can give. But there is always hope! Dachshunds are little fighters and I'm sure Oliver will do his best to beat this. I will keep you and Oliver in my prayers. Please let us know if you have any questions. Everyone on this site has been through what you are currently dealing with.

Layla Brantley Raleigh

Thanks for all the encouragement and information. Joanne's site was a great source of additional information. We had Oliver's blood checked this morning for the first time since he came home yesterday morning. His PCV is now 20, which is a 2 point drop from 24 hours ago, but that's the lowest drop we've seen in a 24 hour period since this started on Friday morning. The vet cautioned that it could just be the lingering positive effects of the transfusion that occurred on Saturday night. She also told me that one positive sign is that she saw a lot of huge newly created red blood cells in the smear, so that's a good sign that his body is fighting hard to survive, but there are also still spherocytes. Although it's not great, I was fearing a bigger drop than we saw, so that's a little heartening. However, his platelet count continues to drop and is now at 100k. The vet seemed to think that it wasn't dangerously low yet, but getting there. Because of this, and because they had a difficult time getting blood from him this morning, I was advised to wait 48 hours before the next blood test because they don't want to risk him being poked and bled too much right now. In the meantime, I was told to keep a close watch on him and to bring him back to the emergency vet if he vomits at all, if his breathing or lethargy worsen, or if I notice any bleeding. In the meantime, Oliver has been taking his meds like a champ, nibbling on bits of food here and there, and napping a lot on the couch. -David and Oliver

David Arlington

Hi David, Sorry to read that your Oliver has been diagnosed with this disease. It can be quite a roller coaster for sure, especially in the beginning. It sounds like your vet is experienced with AIHA/IMHA and that is a big plus. A little note on platelets: When there is not overt bleeding, for me, the easiest place to observe potential bleeding problems is the lower abdomen (where there is decidely less fur) - look for bruising or small areas/pinpoints of redness. Also occasionally the eyes can sometimes be affected with visible blood spots (this is not all that common as far as I know, but just another place to look). My dog has both AIHA and ITP (Evan's Syndrome) and what helped her when her platelets were life-threateningly low (and I'm not saying that's going to happen with Oliver) was an injection of vincristine which causes a release of platelets from the bone marrow. It saved my dog from bleeding out when she was down to 16,000 platelets. Just something to keep in the back of your mind. Again, sorry that your Oliver was diagnosed. There are successes with this disorder, my own dog is a 5 year survivor. Good thoughts are heading Oliver's way for a good response and recovery.

Ronda So Cal

Hi David, Another dachshund owner here. Our Holly is 3 years old and was diagnosed March 2007 when her PCV went down to 8 when she was admitted to the hospital, the weekend prior she was having seizures. 15 months later she is still fighting and still on prednisone and azathioprine. Just watch the White Blood Count with the azathioprine because Holly has a problem her counts sometimes go very low almost to the point that we might have to go every other day just to stablize her. She only need one transfusion and also they did a bone marrow aspiration and spent 5 days in the hospital in Atlanta. As others have said it surely can be an emotional rollercoaster, ups and downs and the expense. But just hang in there and we will hope and pray for Oliver to be a hard fighter. Linda

Linda Sapphire

Hi David, And another Dachshund owner here - Matilda (11 years old) was diagnosed this past March - she did not have quite the tough time that a lot here have had (only 1 blood transfusion needed, and she held her pcv at 38 after that), but it is still a very frightening and confusing disease. We are into our 2nd week of reduced prednisone - but she is also still taking the full dose of all the other meds - azathioprine, cyclosporine & omeprazole, & thyroid. This site - and the people on here - and Joanne's site - gave me much hope and lots of knowledge, so you are at the right place. We will keep Oliver and you in our prayers! Take deep breaths and take care of yourself the way your are caring for you pup! jeanne

Jeanne Texas

Hello David -- I am sorry to hear that your sweet dachshund Oliver has been diagnosed with IMHA. It sounds like both of you are fighters, and although the PCV counts can be disturbing, it is good to hear about Oliver's behavior. He is eating and taking his medications, and he is responding to you. Those kinds of behavior are as important as the PCV numbers. I lost my dear beagle Wiley to this disease in May 2005. Her vets at Old Dominion Animal Hospital referred her case to SouthPaws Critical Care facility and the vets there treated her until we had to say goodbye. It sounds like your vet is knowledgeable, and that's a good part of the battle. Good luck to you and to Oliver. I'll keep you in my thoughts and prayers.

Brenda Arlington

Hi Everybody. Thanks again for all of your responses. It's quite sorrowful to read about all of the loved dogs that have been stricken by this awful disease, and I'm grateful that this forums exists to swap information, stories, and suggestions. I have already acted on a few of the suggestions. Oliver had his latest blood test today. I had high hopes because his clinical symptoms have substantially improved over the past 24 hours. He ate nearly a complete meal last night and also this morning, his urine is back to yellow, and he's walking around a bit more at home. His breathing is still labored, but I think it has also improved a bit. Sure enough, his PCV was at 27! That's an increase of 7% over the test that was done 48 hours ago. For some reason related to his auto-agglutination they were unable to get a platelet count with this sample, but the vet says there is other evidence in the sample which suggests his platelet count is probably at least holding steady. Since he is currently on an upswing, and since he has been stuck with a lot of needles over the past several days, the vet suggested that we wait one week until the next blood test (unless I see a decrease in his appetite or energy level, or any other worrying symptoms). In the meantime, he will maintain his current dosage levels of Doxycycline (50mg twice daily for 28 days), Prednisone (10mg twice daily), Azathioprine (12.5mg once daily), and aspirin (1/16 of a 81mg tablet twice daily). Thanks again for all of the well wishes! Your dogs are all in my thoughts. -David and Oliver

David Arlington

MY 4 YEAR OLD GOLDEN RETRIEVER HUNTER PUT UP A FIGHT, BUT HIS WAS BROUGHT ON BY PROHEART6, THE 6 MONTH HEARTWORM PREVENTATIVE INJECTION, AND IT ALSO CAUSED LIVER DAMAGE AND HE JUST COULND'T OVER COME THEM BOTH.BUT MANY DOGS PUT UP THE FIGHT AND MAKE IT. NEVER GIVE UP HOPE. ANOTHER THING i DIDN'T READ IN ANY OF THE POSTS, WAS NEER GET HIM VACCINATED AGAIN. A VAX CAN BRING ON A RELAPSE. i THINK MOST VETS WILL WORK WITH THE PEOPLE ON THAT. I AM SORRY YOU HAD TO FIND US HERE. MY HUNTRWILL HAVE BEEN GONE 5 YEAS COME OCT. 16, AND EVEN THO THE FDA HAD THEM PULL PROHEART6 TEN MONTHS AFTER HIS DEATH, THEY ARE ALLOWING IT BACK, BUT WITH LOTS OF "DON'TS" THIS TIME.

SANDRA TEXAS

So glad to hear that Oliver is on the upswing. My Maggie (a cocker spaniel) became ill around the same time Oliver did last week. She is having her 2nd blood transfusion today. She went from 20rbc to 16rbc in three days (w/meds) so we are going for a 2nd one this week. Trying to give all the med's a few more days to "kick in". It's been one hell of a week...I am completely worn out with this, but I love this little dog too much to give up. Reading Oliver's recovery gives me hope...God Bless you and your sweet puppy. Please keep us posted on his progress.

kimconmom Atlanta

My dog, Clifford is a golden retriever that was taken to our vet a week ago for lethargy. He is prone to seizures and takes pheno twice a day. He is 8. The results were not good. His PVC was down to 12 and there was a mad rush for immediate transfusions. We are still at this time trying to stabilize him with the help of Prednisone (20 mg) and the PVC as of 2 days ago was 23. Yesterday they let Cliff come home to be with his twin brother, Curt. Another test was run for heartworms and unfortunately it came back positive. Our vet in Newnan, GA has never treated a dog with dual life-threatening diseases. She is not sure when to start Cliff on the medication for the heartworms and is hoping to get some input from other vets. What are we dealing with here?? I am taking him back for bloodtests again this morning but feel very uncomfortable due to the lack of experience. Does anyone have any suggestions? Has anyone dealt with these 2 deadly diseases at once? Please help. Janice

Janice Georgia

Hi there, Im glad to hear Oliver is doing better! My thoughts and prayers go out to all of you here. It really did help to read some many inspirational stories here. I didn't even know about the disease till this Sunday. Our best friend, daughter and soulmate... Jessie (retriever/sheltie mix) came down with IMHA last Sunday after she stopped eating and collapsed in our yard. She had 2 transfusions Sunday night when her PCV dropped to 14. The odd thing was it dropped to 9 after the first transfusion so he had to do a second one later that night. He thought we might lose her. It finally went up to 14 and held. The doc asked if she had any tylenol, pennies, excessive onions, or had any vaccines recently bit, by tics, fleas or also bee stings are know to bring it out. The only thing she had was her "heartguard" couple days before which we give her every month. He told us that they are unsure what exactly causes this disease but, they're still doing studies. Not to place blame but, oddly enough I've found a couple people online that say their pets had come down with it shortly after taking "heartguard" some even said frontline was the last thing they put on there dog. In any case, She is now at Oradell in NJ and shes is looking better. She's had 2 more transfusions and her PCV is at 20 and holding. When we saw her Wed she was very tired but fighting, she didn't look good at all and...Just when I began to lose hope we saw her last night and she looked a lot better. They stopped poking her for a day and took a PCV this morning and its up to 23, which is a good sign. She's very aware, eating and her gums and tongue look a little better too. The Vet said her heart rate is actually normal now. Her tail was going and she definitely recognized us and is again all about the food.. which is definitely Jessie :) She loves to eat :) This has definitely been an emotional and financial rollercoaster and I know its just begun but, Jessie is part of out world, our goals, our lives together. Its always been my wife and I and Jessie. She completes us. We're thinking positive. we're going to visit her again tonight and talk with the vet so I will keep you all posted on any new info that may help . The doc said as long as her blood is less sticky and her PCV holds she might be able to come home on Sat. So we're pulling for her with lots of love and prayers. We know she is a strong soul and she can kick this:)

Sean Nieves New Jersey

glad to hear oliver is hanging in there, keep up the good work and know that this can be beat with a lil luck!!

josh california

Yay! Up to 27?? Clifford, Curt & I will keep rooting for Oliver! Janice

Janice Newnan

Yay! Oliver. Well, we picked up Jessie last Sat and she was up to 25 we just brought her back this past Wed for a check up and she's up to 31 which is AWESOME!!!! She is starting to seem a lot more like herself:) The Vet even said she's coming along nicely and she is proof that there is always hope no matter how bad it is. Just thought I would share my results. The doc said as long as it continues to go up they'll start reducing the Steriods which is good news because it makes her breath kind of heavy. I will keep you all updating and keep all in my thoughts and prayers:)

Sean Nieves Lyndhust NJ

This thread was discussed between 15/06/2008 and 04/07/2008

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