Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Phoebe re-admitted to Royal Dick as emergency

Hello everyone At 3.00 a.m. this morning Phoebe woke me by putting her head on my leg in bed and I realised that she wasn't breathing correctly. She was very hot and her tummy was distended. Initially I thought she needed to toilet so took her outside - did toilet but when I carried her back indoors her breathing became very laboured. Rang Royal Dick out of hours and local VetsNow clinic. (our vet does not do out of hours calls - I hate this about vets!!!!!) and so we had to go to an unknown vet in an unknown practice but with the Royal Dick number clutched to my breast we rushed Phoebe in. The attending vet checked her out and initially thought she was bleeding internally. She took x-rays, bloods (believe it or not her PCV was 34 and other bloods ok). She thought it might be colic - our hopes were raised - and just as quickly dashed. When the x-ray results came back they showed kidney stones in both kidneys, very enlarged liver, test results showed one kidney not functioning and if all this was not enough the next x-ray showed Phoebe's heart enlarged and raised from her ribcage and her windpipe straight rather than bent. The vet suggested a chest-drain to relieve some of the pressure. I asked if she was well enough to go to Royal Dick she said (which was very good of her) if Phoebe was her pet she would get her there sooner rather than later - she phoned through to RD and Phoebe was on her way 15 mins later. As I cannot travel due to back injury my husband and my mum have taken her to Edinburgh. My husband has just called to say she is now in the very capable hands of Alisdair (Claire - did you get to see him?) Stuart. Alisdair is going to run more tests and we should get to know the results (sorry had to pause to wipe away tears), this afternoon/evening. As I put her into the car I had to say a long goodbye to my beautiful girl in case she does not return home!! I spent yesterday crying over Josh's U-tube video and here I am again crying - don't know how many tears I have left. I hate this disease!! I know she is now in the best place but she is not home with me where she belongs and it is so hard. I know that others have their loved ones at Royal Dick and so I hope they are keeping each other company, just like their Mum's on this site. Please pray for my beautiful Phoebe - I don't know what I would do if anything happens to her - our hearts are breaking!! Has anyone else had this happen where there are so many things going on but the outcome has been "ok". Patrice - I know you always give sound advice - what do you think is causing this enlargement of her heart? liver (drugs I think on this one) and is there anything I can do????? Keep you up to date Gill minus Phoebe xx

gill uk

Gill, I am so very sorry to hear this news. Be assured both you and your beloved gal are in my thoughts and prayers.

Joanne MN

Gill So sorry this has happened,this is what's frightening about this disease,first you have the worry of whether or not you'll get the pcv ok(this is stage I'm still at with Nollaig, even after 6 months) then you worry about a relapse, then you worry about the side effects of all the drugs!! I will keep Phoebe in my prayers and you also,stay strong. Hopefully Patrice will see your thread very soon or anyone else whose dog has had these symptoms. Take care Kathleen and Nollaig

Kathleen North Ayrshire

Gill Please know that we are thinking and praying for your Phoebe today. If you get a chance later let us know how she is doing. Sending our prayers, Cheryl & Ginger

Cheryl & Ginger Pineville PA

Phoebe's dad just returned from Royal Dick in Edinburgh - Alistair is going to keep her there and do tests - (my goodness the house is empty!!) and will call me later today with the prognosis - thanks everyone for keeping Phoebe in your prayers! Will give an update when I speak to Alistair. Your so right Kathleen - it's a wonder we get any sleep at night going over and over what problems the next day will bring - the only thing I can say is that I have to stay positive for Phoebe's sake, positive for Phoebe's sake and strong for Phoebe's sake. She is my everything!! thanks again gill & phoebe Joanne - don't worry about contacting me - I need the distraction to help me through the long hours!! thank you for your thoughts and kind words.

gill uk

Gill, Tiggs and I are sending many thoughts and prayers your way, IMHA has so many complications, but we are confident that Phoebe will be ok, she is in great hands with her vet and with her parents who take amazing care of her. Please let us know how she is doing and remember to take care of yourself! melissa and tiggs

melissa slc

Gill, we are sending our thoughts and prayers. It must be so hard to be separated from your girl but she is in good hands and will be with you again soon. don't forget to look after yourself. Best wishes, Brigitte & Kahlu

Brigitte BC Canada

Gill- Im thinking of you and Phoebe, and praying for the best, things are going to turn out okay...

Josh California

Gill, I am sorry that Phoebe has had to return to Royal Dick but hopefully they can address the problems and she will be back home with you soon. Keeping you all in my thoughts and prayers Penny

Penny Lytle Creek Calif

gill, oh dear, you have had a morning. i am so sorry you are not even able to go with Pheobe to the vet's office. first glance it looks like two things. the kidneys are not functioning properly so fluid is building up in the body, unable to be processed properly. the kidney stone is blocking output. whether phoebe is stable enough for a surgery to remove this is something the vets will determine. one issue with the kidneys not working properly is a build up of toxins in the blood stream. this is damaging to the body so there must be something done immediately to resolve this issue. here is a good explanation of bladder and kidney stones; http://www.2ndchance.info/calculi.htm second, the round heart is a possible sign of a heart condition. i have seen this on xrays before. some of the problem can be caused by the fluid buildup in the body. as it gets surrounded by too much fluid, it tries harder to expand to contract and move blood. without the proper room in the cavity, it has a harder time doing that. this can overwork heart muscles and damage them. an enlarged heart is a sign of this. one drug that is commonly used is lasix to help the body eliminate excess fluids. but can this be used in the face of kidney problems? this is where your vet's clinical experience comes into play. lasix, used to treat heart conditions can also increase the chances of stones forming. i would say that of the two, the kidney problem is the more pressing issue and should be addressed as soon as possible. today, dogs can live long lives with heart problems, there are several very effective drugs on the market for that. if this were me i would want to know how serious the stones are and if immediate surgery is a possibility. this would resolve some of the issue immediately. then there would be follow up with a changed diet to reduce the risk of these stones forming again. some dogs are very prone to these and it's a hard job keeping them from forming again. please keep us up to date about what his happening my best patrice

Patrice NYS

Just want to send some positive vibes your way. Hoping all the best for little Phoebe. Glad you ended up taking her where you did. Probably the best place for her. Thoughts and prayers go out to Phoebe during this tough time. Johnny & Tessy

Johnny

Your in my thoughts and prayers Gil and Phoebe. Stay strong.....

Mardi Northern Cali

Gill, I'm saying prayers for you and Phoebe. Hope you'll receive good news soon and it won't be long until your little girl is back home, healthy and happy, where she belongs. Karen

Karen NC

Hi everyone thank you so much for the positive messages - really need them right now. Alisdair (royal dick vet) phoned about 8.30 p.u. uk time and this is what he has reported: Phoebe is dehydrated due to drugs given this a.m. PCV 40 but he says this is a false reading due to the dehydration. Her liver results are higher than normal but that is to be expected due to the drugs she has been taking. She has had a chest x-ray and her right lung is not filling with air but there is no sign obvious signs of pleuresy. An arterial sample has been taken to see how much oxygen is in her blood and she is being given oxygen to help her. seems like the oxygen is not getting into her system. He seems to think that this could be a case of (and I have heard you guys mention this lots of times) thromboembolism - so she is being given aspirin and other meds but must be closely monitored on these medications. She is also having her prednisolone reduced. She will be monitored for blood clotting. Her heart is enlarged but he does not see any signs (so far) of heart disease - she will have an ultrasound on her heart but he wants to stabilise other matters initially. As I know you all mention thyroid regularly I asked him if she had been tested for this, he said she was not showing any clinical signs of symptoms due to hydrothyrodism. Taking all this in I totally forgot to mention the kidney stones and could kick myself - will speak to Alisdair tomorrow and mention all you said Patrice. Thank you so much - you really are a fountain of knowledge - I don't know how you do it. Josh - thanks for the message - I really know you are going through the mill so even more poignant that you took time to post! And again, thanks everyone for the kind words and especially the prayers - I do believe in the power of prayer and I know with everyone sending Phoebe their thoughts she has a fighting chance - she is so tiny, so beautiful, so strong! This really has been a gut-wrenching day - my husband Tony - began his annual vacation yesterday (so lucky he was at home today) and we can hardly look at each other without crying!! Ah well another sleepless night - you may find posts from me thru the early hours!! Kindest regards to you all Gill, Tony and Phoebe

gill uk

Hi I hope Phoebe will be ok.My thoughts are with you.I

corrie dagenham essex

Just when you are mentioning the thyroid Gill,this is what Dr Dodds wrote back to Nollaig's vet after he said she had no clinical signs of hypothyroidism... " She has no clinical evidence of hypothyroidism" . That could well be the case, because classical signs of hypothyroidism do not appear until more than 70% of the thyroid gland is destroyed by this gradual progressive lymphocytic infiltration. I think in Phoebe's case at the moment there's more to be concerned about than her thyroid, but if I were you I would get her thyroid tested(it's a simple blood test) as I did for Nollaig and you need to get free T4 levels checked otherwise sometimes they just check T4 basal and TSH levels.I had to just ask them to do test at my request as my vet was reluctant but Nollaig's free T4 level came back lower end of normal and she's now on soloxine(thyroxine).Dr Dodds told me that if the thyroid's not working properly,it can affect bone marrow and kidneys and I can't remember what the 3rd thing was? Why don't you email Jean Dodds with an update on Phoebe and see what she has to say and whether you should still pursue the thyroid route?? It really is a rollercoaster ride you're on after being so glad about her pcv increase and now this. I will be praying for you all tonight. Kathleen and Nollaig Kathleen and Nollaig x

Kathleen North Ayrshire

Thanks corrie thanks kathleen I think I am quite afraid to mention Dr Dodds to Royal Dick for fear of upsetting them - they are doing so well treating her and so when I mention things I have read on the forum I always tell them it's from research on the internet. I once mentioned Dr Dodds to one of the vets at RD (not alisdair I hasten to add) when Phoebe was first diagnosed and was met with a less than favourable response - I really need them to be on board with Phoebe's treatment so maybe when and if we get through this next chapter I will consider raising the matter again. Also when things are settled down I will ask if I can have a thyroid test - maybe now I have planted the seed in Alisdair's head he might test for it anyway? Will keep you all up to date thanks guys gill & phoebe Claire - how's shaunna doing - is she still at Royal Dick - did you ask to speak to Alisdair?

gill uk

Gill, I am sorry to hear of Phoebe’s return to the hospital. My dog, Ren, had a similar experience during the worst time of AIHA. Ren's breathing became so labored. And her whole body swelled up with fluid. My former Vet suggested euthanasia at that time. I requested a prescription for at home oxygen. The Vet complied and wrote the script. I guess she figured what harm could it do. For almost a week, non-stop, my Hubby and I held the oxygen to Ren's nose. At times it seemed to help and there were times when we thought this was an act of desperation. I consulted a new Vet who immediately did x-rays on Ren. She found that Ren had an enlarged heart, very large liver and spleen. Fluid taps showed no blood but only clear fluid. Through a strict medication regimen and incredible dedication from my Husband Tim and me, Ren has recovered. Her breathing is still labored at times. That is due to the enlarged heart, which will not repair itself, and the high doses of Pred that she was taking. Ren also had "TIA's" or mini-strokes during her recovery. Although it took a little while to come to that diagnosis, she is now being treated with daily aspirin doses to counter the blood clots. Blood clots in the lungs are one of the most serious complications. Unless there is serious bleeding problem, I strongly advocate the use of aspirin or heparin. Our prayers are with Phoebe and your family. These are difficult days to deal with but they will pass and Phoebe sounds like she is in the best of care at Royal Dick. Sue & Ren

Susie delaware

Thinking of you and Phoebe. Take care she is in excellent hands.

Julie Australia

Gill So very sorry to hear that Pheobe has been re-admitted to Royal Dick - but as you say, she is in the capable hands of Alistair, and he is clearly a vet you have confidence in. However, I know this is little consolation when one minute Pheobe is at home, appearing well, and the next, she's being rushed across the border to the animal hospital. I get the impression from looking through this forum and elsewhere that these blood clots are a common secondary problem of PRCA and AIHA. Saying that, if blood clots are a potential problem why aren't preventative drugs given at the beginning - is it because the likes of aspirin can cause tummy bleeds? Hoping you have some good news soon Gill. Best, Claire

Claire Cumbria

Gill I do hope things are better for Phoebe today.You probably didn't get a lot of sleep last night,so I pray that you get news today that makes you feel Phoebe's a lot more stable. Take care Kathleen and Nollaig

Kathleen North Ayrshire

You and Phoebe are in our thoughts and prayers. Stay strong - she is in good hands. Chris & Alex

Chris Pa

Hi everyone most recent news on Phoebe is that she is responding well to the oxygen administered and has been for a short walk and has eaten. Alisdair is phoning me every day with an update and has told me that, so far, there is no evidence of heart disease but that there seems to be something in her left lung - a blood clot being the most obvious conclusion - she has been put on heparin (just like you mentioned Susie) and he wants her to stablise before he does any ct scans or ultrasounds. He does not want her to be any more stressed. I think he loves her as much as we do - he said when she arrived at Royal Dick that he had forgotten how beautiful she was - what a lovely thing to say!! I know she is in his most capable hands and that is what is keeping us going. I asked about her kidney stones and he said that again she would need to be scanned and he thinks that the marks may be mineral deposits but until she is stablised he cannot test for sure. As I explained to Joanne our house seems lifeless and dull without her, her little wagging tale and huge dark eyes are sorely missed, so, following on from past forums I have put her beautiful photograph next to my pillow and am talking to her and telling her to hurry home. I am being as positive as possible to stay strong for WHEN SHE DOES return home. As she will be on the Atopica for some time to come I did some research on the web and have discovered that www.petmeds.co.uk are selling Atopica for £16.55 for 15 tablets - that is virtually half what we pay at the vets (we did have to pay £10 for a prescription from our vets and you would think that after the thousands of pounds we have paid so far this would have been waived, but I guess they have to make a living too!), the also sell prednisolone much cheaper - so I hope this helps anyone who needs to keep their furbaby on Atopica for some time as it works out very expensive - thinking especially of you Claire as I know you do not have pet insurance! Will keep you uptodate following Alisdair's call tomorrow. Thank you dear friends and furbabies for all your best wishes and prayers - please keep on praying for my beautiful little girl. Kindest regards Gill & Phoebe

gill uk

Hi Gill Thanks so much for the update, I was wondering how Phoebe was doing. I am so happy to hear that she is responding well to her treatment. What kind of dog is Phoebe? We will continue to send our prayers and hope she can come home soon. Cheryl & Ginger

Cheryl & Ginger Pineville PA

This thread was discussed between 18/08/2009 and 19/08/2009

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