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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - peppy, then lethargic
| Toby was diagnosed with AIDA about 2 months ago. He as been on prednisone. Our vet the amount in half and then was happy about the blood count and cut it in half again. A couple of weeks ago the dose was increased. It didn't seem to have an adverse affect. But just this weekend Toby got very lethargic and absolutely refused to go for walks. (very out of character for a Jack Russell!) Anyway, I almost have to carry him out to relieve himself. We took him in today to have more blood work done. Our vet doesn't think there is water retention and thinks he is just getting fat. Any ideas? |
| Mary Indiana |
| Mary, How experienced is your Vet at treating this? The 50% cuts at a time is a bit worrisome. It can lead to a relapse. We all want our dogs off the drugs as soon as possible but not at the cost of starting over or worse losing them. Was your Vet doing regular blood work at each cut and doing at least weekly re-checks? What was Toby's PCV today? You mentioned that the dose was increased a few weeks ago? Did your Vet say why? What is Toby's weight and what dosage of Pred is he on? I Pred the only drug? Post some more info and I am sure you will get a lot of responses. Have you read Joanne's site? http://www.cloudnet.com/~jdickson/treatment.htm If not please do as you will find a lot of info as well as it might help you ask your Vet about the chosen course of treatment. Remember you have to be Toby's voice. Best to you and Toby Penny |
| Penny Lytle Creek Calif |
| Toby was 17 pounds before he was hospitalized on April 10 and started treatment for AIHA. He was in hospital for 5 days. He then was put on 10 mg pred 2 times a day, amoxycillin and doxycycline. He went in for a recheck 4-24 and continued on the same dosage. On his 5-1 recheck his CBC was in the normal range and he was put on 10 mg pred once a day. On his 5-08 recheck his CBC values were close to normal and was put on half tablet daily. A week later his values were lower than he wanted and was put on a full pill again.(10 mg) I'm sorry I do not know the numbers concerning his blood work. We then noticed a few days later that Toby was lethargic. We thought it may have been constipation, as his demeanor picked up after his system unplugged, so to speak. He still eats and his digestive tract seems ok now. He just acts tired and depressed. He went in today to get a complete blood workup done as was done at the beginning. We should be hearing about the results on Thursday. |
| Mary Indiana |
| I forgot to mention that I have seen Joanne's site. In fact it was my vet that put me on to it, giving me a printout concerning AIDA from it. I also told him today about this forum, because he wanted to know how I was becoming informed on the subject and he wanted to check it out also. I will say this about him: He is a good caring vet who is experienced and knowledgeable. And what he doesn't know, he makes every effort to learn about. |
| Mary Indiana |
| Mary, Well that is a definate plus that your Vet is aware of Joanne's site and that he is open to learning more. You might want to do like I and others have done by starting a daily diary so you can log everything. It helps to be able to look back and know what doses/blood counts etc. were over a given period. With this being such an emotional roller coaster it is hard to keep things in your head. Hopefully it was just too quick of a withdrawal from the meds and Toby can get back on track soon. Keep us posted. Penny |
| Penny Lytle Creek calif |
| Mary, Sounds like the prednisone was reduced to much and too quickly.I do have some information that might be helpful to you in regard to the prednisone reduction. This information is from a Magazine called “Veterinary Medicine” subtitled clinical solutions for practicing veterinarians. This is the June 1999 issue. In the article called “Managing immune-mediated hemolytic anemia in dogs” by Stephanie J, Lifton, DVM, Dipl. ACVIM which was peer reviewed before publication we find the following information and I am quoting here: “The level of medication should be kept constant until the PCV is normal for at least three to four weeks. If the dog is having severe side effects from the prednisone (e.g. polyuria or polydipsia, panting, exercise intolerance) the dose can be lowered slightly after two weeks or another medication such as Azathioprine can be added to the treatment regimen. Remember this medication needs to be given two to three weeks to take effect before the dose of prednisone can be decreased. “Once the disease is in remission, the dose of prednisone can be lowered by 25% to 35% every three to four weeks until the lowest dose that keeps the disease under control is reached. This can be accomplished by either decreasing the dose or the frequency of administration (e.g. twice a day to once a day then every other day then every three days and so on.) If the dog is receiving more then one immunosuppressive drug, change the dosage or frequency of only one drug at a time.” End of quote. Even though this is a from a source that is several years old, this is the prednisone reduction schedule that many of the veterinary teaching hospitals follow in regard to AIHA/IMHA |
| Joanne MN |
| Thank you for the article quote. I am going to the vet tomorrow. He said that Toby needs to go back on 10 mg pred 2x a day again and to pick up antibiotics. I take a copy of your information with me. Toby will go for short walks and eat a little. Do you think we should have him hospitalized again? The vet hopes this pill regimen will work but I hate to have to go through a weekend without the vet open. (Though he is open Saturday morning.) |
| Mary Indiana |
| Just a reminder to anyone having to purchase lots of meds. Search the internet for prices. The vet can write a prescription for you to purchase at Walmart, Sam's, Costco or any other place. Some of the antibiotics our pets are taking are on the $4.00 list at Walmart. An antibiotic my dog is currently taking is 'free' at one of my FL grocery store pharmacies. Just a way to save a pennies or quarters. Ann Marie |
| Ann Marie FL |
This thread was discussed between 28/05/2008 and 29/05/2008
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