Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Olivers recent blood results :(

I just spoke with the vet and the news isn't good. Oliver's PCV have remained stable at 14-15, but now his red blood cells have dropped significantly and are non-regenerative. He was at 80,260 and now is at 45, 000. He is still active, eating, drinking, etc. The vet is concerned, as I am, obviously. This is not the news I was hoping for. We are going to do a transfusion next week to buy some time, hopefully, and hope the meds will kick in, but it's a month now and I just don't know. I know it can take a very long time, but if he is non-regenerative now, I am just so worried. He is going to get cross matched on Monday, as the vet said cross matching at this point is a safer way to go with the transfusion. Does anyone have any thoughts suggestions, words of advice. I so value all of your opinions. Oliver, in case no one remembers, is currently on 50mg pred 2 X day and azatioprine 50mg 1 time a day. We discussed Cyclosporine, but are concerned that he might have more problems taking so many medications. It's always a risk. I told the vet I will do all I can, but don't want to see Ollie suffer. Like I indicated, so far he is doing great, but the blood isn't doing so hot! Thanks everyone.

Mardi Northern Cali

One more thing, the vet mentioned that this situation may not be a true AIHA, so I don't know. Please keep us in your thoughts and prayers as we do for all of you. I don't know how I would have handled all of this without you folks! I have a wonderful vet now because you all suggested getting a 2nd opinion. Bless you all....

Mardi Northern Cali

Hi Mardi I am sorry to hear Oliver's blood test are not that encouraging. I was wondering if you could contact Dr Dodds and see what type of treatment she recommends based on his latest blood work. I believe Dr Dodds is located in Calf. but not sure if she is located near you. If you contact her have his blood work handy. Here is her email address hemopet@hotmail.com I am a fan of the cyclosporine as I feel it did help my dog when the other drugs did not. It is a good sign that Oliver is eating and drinking and not letting this get him down. I hope and pray that Oliver can turn this around soon. Cheryl & Ginger

Cheryl & Ginger Pineville PA

I will contact Dr. Dodd when I get a copy of the blood work on Monday. He had his test yesterday and results came in today. My vet called me at home to let me know results, so don't have hard copy. Said the white blood cells are a little low, but that it typical for the heavy medication he's on. I had a brief crying jag, then bucked up and got into positive mode! There are still options to try and if I start stressing and fretting, Oliver will certainly pick up on it and thats not good for him. thank you for responding so quickly. I feel like we are all a big family supporting each other. What an awesome feeling. Again, thank you!

Mardi Northern Cali

Mardi, I am sorry to hear about Ollie's set-back. I too am a strong believer in Cyclosporine. It was nearly a month before the meds kicked in for Ren. So I know this is a difficult time for you and Oliver. It is good that he is still eating and drinking. That means he does not feel really sick. I wonder what your Vet means by "not true AIHA"? Also, is Ollie taking any type of medication to protect his digestive tract? It is so important when taking Pred and Aza. My prayers are with you and Oliver. Sue & Ren

Susie delaware

I can't get off this site! Thank you. Yes, he is taking sucralfate 1grm 2X day and an over the counter "Pepcid" acid reducer 30 minutes to 60 minutes after the sucralfate. He is getting 1 1/2 tabs of the 10 mg acid reducer. If given the Cyclosporine, would he normally still be getting the same dosage of Prednisone and Azathioprine? I've said before, in my numerous threads, that if I didn't know Ollie was sick because of his blood tests, he would seem like a normal pup, albeit the pale gums, etc. I am grateful for this for him....My vet wants to see how the transfusion goes before starting the cyclo, because of the increase for more problems. I'm not sure about the "not true AIHA stuff either. Maybe because he went from a regenerative form to non-regenerative form in a months span. I really don't know. I will speak to her in person on Monday. Phone conversations are kind of hard. She is really good with explaining everything though, pros and cons. My first vet, bless him, told me almost a month ago that there was nothing he could do. He just doesn't know enough about the disease. You folks are the ones that got me to go for a 2nd opinion. Because of that, Oliver is sitting next to me right now while I'm pounding on the keyboard. thanks again Susie. I'll keep posting info and keep reading all the feedback.

Mardi Northern Cali

When Ginger was started on the cyclo the vet did begin to reduce the pred, not sure if that is what they all do. Give Oliver a BIG hug from Ginger and I.

Cheryl & Ginger Pineville PA

Mardi, I am sorry the tests don't look as good as you had hoped. It is still a good sign though that Oliver is behaving as if he is not sick. I don't have much to add to what everyone else has said. Just wanted you to know I am thinking of you guys. Penny

Penny Lytle Creek Calif

Mardi, Good for you to stay positive! You are so right, Oliver would pick up on you being down and he doe s not need the stress. I would highly recommend for you or your vet to contact Dr. Dodds. I preferred that my vet contact her, because English is my second language and i felt kind of intimidated to call such a famous and busy specialist. My vet was totally impressed with her and has continued to work with her, in other cases as well. I have no experience with Cyclosporin, we never had to go that route. I must say though I have mainly heard good things about it on this board. Just in case you have not read this post from 2003, I will post it again, because I think it is so well written. I have posted it a couple of times by now and I hope you (and Sheila ) will forgive me. Sheila, VA, sheila@rileynet.com *We spend so much time and energy focusing on our beloved canines with AIHA, I thought I would throw out some survival tips for their human family* AIHA is a marathon, not a sprint, so pace yourself physically -- eat properly, exercise, try to get enough sleep. AIHA is an emotional rollercoaster complete with hopeful highs and crushing lows -- seek support, acknowledge and talk about your feelings. AIHA is random and unfair, it can test your spirit and faith -- now is the time to lean on your beliefs, to find strength and peace in them. AIHA is life altering, but it is only one part of your dogs life -- it doesn't take away 'who' your dog was/is or erase the 'before' time and memories, try to call on thoses positives and allow that joy to bolster and fill your heart. AIHA requires us to be an advocate for our dogs, with almost no warning or prior training we must become a doctor, scientist, researcher, financier, counselor, and cheerleader. Even the most confident person can begin to question past choices and actions, and that can shake your confidence badly. Do not give into fear and doubt, separate facts from feelings and try to stay focused on the future. ~*~*~*~*~ Bless each of you for being such a wonderful friend to your dog, it takes such a loving strong person to fight this disease. We each talk about how special our furbabies are, and they are, but I think their 'owners' are just as special. I believe that our dogs know just what we are giving and doing, and I think that that means more to them than whatever the outcome of this evil disease may be. Your dog thinks you are the greatest, so please take care of YOU today!! ~Sheila, lucky mom to Dakota, Nuggett, Harley and Radar (my current gang) I will be thinking of you and Oliver and send some positive thoughts while I am at it! Best wishes, Brigitte & Kahlu

Brigitte BC Canada

mardi, I just read your post in Nollaig's thread about the low thyroid. this would be an other reason to involve Dr. Dodds. This is her specialty. There is clearly a connection between AIHA and low thyroid. many of our dogs have hypothyroidism. Maybe you can ask Patrice to explain it to you. She did it so well for me. Best wishes, Brigitte

Brigitte BC Canada

mardi, please do talk your vet into sending blood to www.hemopet.org next week for a complete thyroid panel. there are complete instructions on the website how to pack and ship the sample. try to get it done early in the week. she will turn around the results and notify you and the vet with 24 hours if she considers it a clinical emergency. i considered the thyroid supplementation for chance to be extremely important. prednisone will need to be decreased sooner than later. one month is long enough to be at high doses without any positive immune suppression. the aza is recommended in difficult cases by dr. dodds but in conjunction with or concurrent with cyclosporine. aza is also a possible bone marrow suppressant and the reduced white blood cells may indicate this. you do want to decrease a certain type of wbc, but not all lines of different wbc. this leaves oliver open to all kinds of opportunistic infections. the prednisone is also doing this. i don't like the way the reticulocyte numbers have dropped. i would not hesitate to add cyclosporine in the veterinary formulation of Atopica immediately. please email me privately for a complete protocol you can give your vet. the side effects of cyclosporine are far fewer than the other two drugs. the worst is usually gastrointestinal; nausea, vomiting and diarrhea, but not in all cases, and it tends to be limited to a few days. a few dogs develop odd skin problems but they are not life threatening. cyclosporine is well tolerated by dogs and is now marketed by Novartis as Atopica for canine allergies. i like your vet's approach to another transfusion. get it matched now and then be ready for a quiet time next week in the early morning or quiet afternoon to have it done. transfusions are time and labor intensive, you want several people fully involved in making it happen and monitoring oliver. doing it as an emergency in the middle of the night is stressful on everyone. ask for packed red cells if they can find them. avoid oxyglobin at this point. it took chance 4 months to become regenerative again. don't give up hope, please. tonight chance is right here next to me sleeping more than 2 years later. i had a quick pcv drawn this morning and he came right in where he usually does: 38%. What a lovely number. i will be thinking about oliver tonight patrice

Patrice NYS

Mardi, You are so strong and you are a rock for Oliver. I know how frustrating it can be (we all do!) when the numbers come back low when we are certain our dogs must be doing a little better. That's where the clinical signs can give us so much hope. I always think of little Darcy, Karen's 'Wonder Beagle' as I call her. She has been non regenerative for so long, but even with a low PCV, she has adapted and lived a full life with much joy. Our dogs are so resilient, even when their darn blood isn't. Please know you are in our thoughts and we are hoping and praying for good results in the coming days. You are an awesome doggy mom! melissa and tiggs

melissa slc

Just wanted to let you know I'll be keeping you and Oliver in my thoughts and prayers. Like everyone else here was saying, be strong and I'ld also advise getting Dr. Dodds on board. Keep us posted. Johnny & Tessy

Johnny

Mardi: I agree that you should talk to your vet about cyclosporine - I am convinced it's what made the difference for Sheba. I also think you should contact Dr. Dodds - she is very knowledgeable and very helpful and many here have found her to be a great resource. In the meantime - try not to let the numbers become your main focus. If Oliver is eating well and still acitve - that's what matters. He's obviously willing to fight this thing so you need to concentrate on that. He sounds like a wonderful little guy - just spend the day living in the moment and enjoying his company. Sometimes that's the best medicine! Rita, Mike and Sheba

Rita IA

Thank you all. I will take your advice and words and put it to good use. Oliver is a trooper. We are in it for the long haul. Keep the ideas/thoughts/prayers coming. It gives me strength. Believe me!!! Love to all of you and thanks....

Mardi Northern Cali

This thread was discussed on 15/08/2009

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