Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Popeye update :(

I just spoke to my husband on his drive, returning from our vet. I am very upset. Our friend the vet just doesn't "get it". My husband showed him the info I'd collect at Meisha's Hope. Basicall, I just wrote down some medication names, and suggestions for this first relapse. My husband said that he didn't want to see it and mentioned something about there being "many kinds of treatment and this is his." That "the dogs they see with this usually respond, but mine is different". The vet had a large number of patients to see. They waited an hour, in which the dog declined rapidly. When he left the house he could still walk and after an hour at the vet, waiting he had to be carried to exam table. His PCV was 21. They are in route to house now and I believe he has more of same meds as first time (just Pred, perhaps a higher dose and the Lixo and maybe the Denoysl -not sure yet as husband was driving) I am anxiously awaiting their arrival. The dog must be kept crated or still and vet said it would "take longer this time" (for him to get better). I am so angry this happened and now I am angry at our vet for refusing to explore other treatments. We cannot afford to have another vet and especially a specialist get involved. I don't know how or what we will we do. I have seen some of you offering meds you don't need anymore. I would be willing to purchase some of that Imuran(?sp) or try anything at this point with or without my vets advice. Which at this point, it may not matter.....

Allison TX

Allison, I am so sorry you are going thru this. I haven't been on here too much lately so haven't been really keeping a close watch, but from your post, I assume Popeye is having a relapse. It is so critical that they get on a high enough prednisone dose to begin with ( usually 1mg per pound ) and then when it's time to taper off, go VERY slowly. It took our Cody from last August until April went he got off the pred completely. There were times when his dosage when up and down but his CBC's were done frequently. I can't really speak to the other drugs that are often used along with the pred. since we were able to handle Cody only on pred. AND, being in Dallas also, if you want to see another (very reasonably priced ) vet, please call Dr Paul Carroll at Midway Hollow Pet Clinic. He worked wonders with Cody and, infact, we've moved all our dogs over to him. He works with many rescues and is ALL about the pets, not the bottom line. Let me know if you want his number.

Betty Dallas

Thanks Betty! yes, a relapse:( I seem to remember you posting abot this vet. Please post his phone # again. I am too numb to look for it now...so sad seeing my big pretty Popeye in such a state - he can barely hold his head up now. And I know it can get worse. I seem to remember someone else posting a good vet in Dallas on Greenville Ave...? Right now he is back on 20mg of Pred.2x day. I seem to remember someone saying this dose was too low for a GSD (back when this initially occured). I think his weight is somewhere between 70-80 lbs, so it does sound too low. I don't know how to convert lbs to kgs but I thought perhaps it may of been a mix up. Could it be that it is 1mg of Pred per Kg of dogs weight. Can anyone tell me for sure (since I don't think I will be going with my vets advice from this point).. Is 20mg. of Pred. 2x a day for an approx 75 POUND dog enough? Also he is taking Vitimin K and Lixo.............

Allison TX

One more "detail" on Pops meds. The first time he developed the AIHA, the dog was given Tetracycline as part of the treatment. That point was when vet thought some sort of infection may of triggered this. When dog survived, appeared to recover, the vet said he was certain it was caused by the vaccs. And at this point, it was when he said, "if he relapsed, he probably wouldn't make it". So here we are at a "relapse". I forgot to mention that he also is giving him 2-500mg of Tetracycline, THREE TIMES a day, which calculates out to 3000mg A DAY for TEN DAYS! I was not at the vet to question that but does anyone else out there think that is strange? Can anyone intelligently speculate why he would give that again and at a much higher dose? I am going to try to find someone else to see him..........

Allison TX

Allison, No disrespect to your vet, but I would find someone else. Its bad enough that poor Popeye isnt well and I know how stressed you already are because of that. No two dogs are the same when it comes to this disease and that is why there are many different treatment options. The original vet that my Jacob saw kind of had that same attitude...telling me that some of the meds I mentioned would do more harm than good and he was willing to try them. I thank God I found someone that was willing to try anything to get Jacob better. We just got lucky and Jacob has did very well on the pred and imuran but so many others on here have basically been on every drug that I know of that can help a dog with aiha. If you choose to stay with the same vet be stern with them. Let them know exactly how you feel. You will be doing it for Popeye, so remember that!!! I am so sorry you are going through such a tough time. Please keep us posted and KNOW you and your Sweet Popeye are in my thoughts and prayers. Teresa and Jacob

Teresa va

Allison, Dr Carrolls numberis (214) 902-0797. He's on Northwest Highway right around Midway. He is a general practitioner, but I thought really up to date on AIHA protocol. And yes, your dose of pred seems WAY low. Cody is 60 lbs and before tapering, his pred dosage was 30 mg 2x/ day ( 60 mg daily). The other vet that was mentioned was an internal medicine specialist and was located in the same shopping "strip" as the emergency vet there on Greenville south of LBJ. I so hate that you are going thru this on a weekend........... please don't give up on him and if he worsens I would get him over to the ER vet. I think Dr Carrolls office closes at 1 on Sat..... might be worth a try to see if anyone is in though. Keep us posted.

Betty Dallas

Allison: Please get Popeye to a vet (Betty's vet?) who knows about this disease. Shadow is a very energetic terrier mix and has always (since being diagnosed) needed a transfusion whenever her pcv fell below 20. Popeye is dangerously close to that number. Shadow's had three transfusions (one of artificial blood, two of whole dog blood) since Oct. 19 - when she was diagnosed - and just (yesterday) scored a 31.9 on her pvc. She's doing GREAT and Popeye can, too. We have extra cyclo (she couldn't tolerate it) in 50 and 100 mg. capsules. Cyclo is one of the "standard" drugs prescribed in the AIHA cocktail. I AM NOT A VET, but if your (new) vet prescribes cyclo (quite expensive), I can and will readily send you Shadow's surplus. Best to you and Popeye . . . and, please, do keep us posted! Sandy & Shadow

Sandy Utah

Allison, The least amount of pred that a dog with AIHA/IMHA should be on at the onset of the disease is 1 mg per pound of the dog's weight per day divided into two doses, one dose to be given in the morning and one dose to be given in the evening. Some vets will prescribe an even higher dosage at the onset of the disease so indeed Popeye is getting way too small of a dosage. Please Please try to get Popeye to another vet who knows how to PROPERLY handle AIHA/IMHA ASAP.

Joanne MN

Joanne is right....Popeye needs another opinion and probably needs to be hospitalized. Your vet's advise is very curious. What does he mean when saying your dog is 'different.'? No matter how many patients your vet has to see a critically ill dog such as you describe Pop, should not have had to wait an hour and furthermore be sent home without a thorough work-up. I don't blame you for being angry. Is there a teaching hospital or 24 hour clinic nearby? You have an emergency situation. Jan

jan philly

Allison, I am so sorry that you are going through this. April is an 8 y/o Shih Tzu who relapsed on Nov. 12th after a 5 year remission. At 18 lbs. at the onset of her relapse she was taking 10mg of Pred twice a day, Azathioprine (imuran), and Doxycycline because my vet also thought there was an infectious process going on. However, very early on when she was so sick after that initial transfusion that the vet decided to discontinue the Doxycycline and 'let her body deal with one thing at a time'. Her PCV was 38 this past Wednesday and her Pred was reduced to 10mg every other day. I have a lot of extra Pred, as Kat was very generous to send me the leftovers of Allie's meds. I also have some Azathioprine left but would have to check as to how much, but either way I'd be happy to ship both to you (at no cost). I also want to mention that one thing my vet insisted on during April's rough times were to get as much natural iron rich foods as possible into her. I started cooking steaks rare on the bone, cutting it into the tiniest pieces and hand feeding whatever small amounts to her that I could get her to nibble. When she started to feel a little better I added some fresh spinach to the cooked steaks and allowed the leaves to wilt in the heat of the meat juices. She has made a remarkable turn aound in just a few short weeks. I don't know if the steaks made that much of a difference but it's worth a try, and in the scheme of things as far as the bills go, it's definetely worth the expense for me. Let me know if you want me to send the meds to you. And hang on, this will get better... increase her Pred feed her what you can, keep checking this site for other info, and be patient but advocate in the best interest of your pet. Lisa

Lisa Florida

Allison, I don't know where in Dallas you are, but there is a 24 hr Emergency clinic on Greenville Ave, South of LBJ. They will be open all weekend until Monday am when the regular vets office open.

Betty Dallas

Allison My Lab "Daisy" weighed the same as Popeye 75-80 lbs. when she contracted AIHA. The Internal Medicine Vets that are close to my office get referrals from around the S.F. Bay area and see on average one case a week. The minimum doseage they start a dog on is 1mg per pound divided in two doses. Combined with Cyclosporin 100mg twice a day. To combat the side affects from the meds they advise Pepcid AC or equivalent for stomach problems and "Milk Thistle" to help with high liver function tests. If the Cyclosporin creates too many problems they switch to Immuran. The Immuran is much cheaper than the Cyclosporin if cost is an issue. If Popeye is not doing well I would think the vet would entertain any suggestions you may have. I have some cyclosporin you may have if it gets prescribed by your vet if it will help. You have to be the activist for your dog... Remember that in any profession, M.D's, Dentists, Attorneys,Vets,...Someone always graduates last in their Class....

Ron B San Mateo

Hi all, Thanks for the kind words and concern. We just got through cramming two big Tetraclycline pills down Popeyes throat. Poor guy, he used every bit of his strength, trying to resist them. (and I am still not sure why i am giving them...) Anyway he looks a bit better than he did early this afternoon. He ate a little, got a doggie massage,walked around, did a pee and was ready to lay back down in his crate. My husband is at the store, buying him some steak. LISA - I may email you later about the Azathioprine (that the "Imuran" - right?) I than all for your offers and any advice. I'm going with my gut and the tidbits I have picked up online (mostly here and Meisha's Hope). I am a bit afraid of the Cyclosporin and I'll make a new post to tell you why: When Pop had his initial bout, I contacted a vet that seemed well versed in AIHA and he emailed his standard "Treatment Protocol". I won't post his name. I will say he is in the Houston area. I will copy/paste his emailed contents on new thread - for anyone to use or comment on. If I recall, he warned against the Cyclo....but who is to say he is right...? I'll just put it up there. I'll call it "one DVMs AIHA protocol"

Allison TX

Allison, My German Shepard TC 75-85 lb, was on 40mg of pred 2 x a day when he came home. I think my vet is reducing too fast, he initally went in September 28th,and he is still on an every day dose of the pred, but I don't want a relaspe. I am taking him to an internal specialist in Tampa for a second opinion. I am not looking forward to going through it all with someone new, but I really feel I need a specialist. Hang in there!

Wendy Florida

Allison: Noah my 60lb collie was diagnosed 2 weeks ago with AIHA. The vet placed him on prednisone 60mg a.m and p.m.,azathioprine 50mg once daily, cyclophosphamed 50 mg once daily, dolycycline 100mg a.m. and p.m.(antibiotic), famolidine 20mg a.m. and p.m.(stomach protection)and phenypropanalomine 50mg (bladder control). It all seems too much to me and makes him feel terrible. He also became blind on Friday. Does the meds usually make them feel sickly or is it too much for the dog? I wish I could find a vet that was interested in the animal/family and not the bottom line. It's over whelming and I wish I knew I was doing the right treatment for him. I hope you will find a new vet that you can believe in. Linda

Linda LaGrange KY

One more frustrated rant on my vet. My husband told me the vet said Pop relapsed "because we (HE) reduced the pred too fast" Well, I knew (or at least thought (remember I am not a vet) that at the time it was reduced too fast AND we tried to tell him that then. He was going with his own protocol, which was base on bloodwork at time. By the way, a sideline for Sandy: Pop was originally diagnosed within a week of Shadow...don't know why that popped into my head now... Anyway, the irony of todays vet visit was that Popeye came in there in condition I described and had to wait over and hour as the vet had a full waiting room of "first come/first served" - (as he does all the time, but especially on Sat ams) - AND most of the patients he waited, as he behind as he declined, were there for their ANNUAL VACCS! And this is what my vet has told me caused this whole mess! We were in that "1% statistic" he sees annually for this (AIHA caused by vaccs.) This man, our vet, our friend...it makes it hard when you you a a history if trust and respect for someone and their opinions and expertise. I will say what I have said again - IF.......................................... If we didn't know him for as many years as we have and if we hadn't lost another dog 8 yrs back to vacc induced AIHA, (but didn't know at the time) that caused us to reflect on similar symptoms in connection with vaccs in this dogs symptoms and good info online that caused us to confront our friend the vet in a very direct fashion, stating at initial onset of this case that it was directly related to the boosters, the dog would not be here with us now. I do not think our friend would of "clued us in". Doing so would directly fly in the face of his profession and the way or philosophy with which he has been taught, experienced and conducts his business in on a daily basis. I still have enormous respect and feeling for this person. That is what makes this especially difficult for me or anyone else for that matter, when getting medical advise for yourself or your animals. It is our nature to "trust" the doctor and to respect a friend advise. This problem is much bigger than him or any single practitioner. It's a problem with a systemic philosophy in which the wheels are driven by corporate profits and a veterinary system built to thrive on annual vaccs as steady income. This will not change easily.

Allison TX

Allison, I'm glad that you'll consider the Azathioprine (yes that is the Immuran). Also have you considered Rescue Remedy??? I believe it definetely helped during the two weeks that she was very ill. And I'm going to through one more thing out there that may sound ridiculous, but I swear by it for every medication that I ever give to my dog, cats or children..... Have you ever used a pendulum to decipher the negative or positive energy of a particular drug??? If not maybe you know someone who has... I know it sounds bizarre, but trust me it works!! And for Wendy - since you are obviously in the Tampa area, I strongly recommend that you contact Dr. Scott Lamb located in Trinity (the New Port Richey area) He has been in practice more than 30 years and is very proficient in IMHA. He saved Aprils life this month, and his fees are incredibly less than any other vet that I have ever been to. His bottom line is about the pet that he is treating and the family, NOT about the money. And I know you could get an appt. with him first thing Monday morning, and if you can't but want to ---- let me know and I will get you the appt. (their clinic is in the shopping plaza as my own business) They are a family run clinic and I am sure you would come away from there feeling a total confidence about their ability to treat your dog properly.

Lisa Florida

You speak of having trust and respect as well as a history with your vet. I had a 25 year history with my vet, trusted him TOTALLY and absolutely loved him. However after I lost Stormie to AIHA he dumped me w/o so much as answering my phone calls! He does annual vacs and I began questioning this with our new dog...and I KNEW no one in that office liked my questioning anything...who was I to question them? (well, it's called love for your furkid..but they apparently don't see it that way..they want to be the high and mighty, never wrong vet clinic...and it became apparent with the office girls that they were trying to force me out of the clinic which they eventually succeeded in doing..even threating to call the police on me when I wanted Stormie's records) Also, they refused to see Stormie the day I KNEW she was so ill...so I had to take her someplace else...they didn't belive me that she was that sick..they thought I was being neurotic. And so ended a 25 year relationship. I was stunned and angry about it but there was nothing I could do...so I have moved on. I am still searching for a vet I can trust and that I like after 2 years. Mrs. Gates

Mrs. Gates Michigan

Mrs. Gates, I am sorry that you had such a horrible experience, and I very much know how you feel. I have never had my kids vaccinated either and you can only imagine the responses I have received over that news. After a while I simply starting stating that they were 'up to date' with vaccines and had to lie my way through the schools for them. I wish you luck in your quest for a vet that you can feel comfortable with.

Lisa Florida

Allison, I'm sorry you have had this experience with ANY vet, esp one you consider (ed?) a friend. It just shows that we have to be super vigilant in being our fur-babies advocate. Many, many vets receive a substantial portion of their annual income from annual vax.so definitely there's a profit motive there (just as there is with them pushing substandard food-----ching, ching, ching ... kickback ). I'm sure we all are either looking for or have a vet that we consider knowledgeable and willing to make the extra effort to keep abreast on new research and at the same time have the animals welfare as a first priority. It absolutely astounds me that Popeye had to wait for an hour in his condition............ that alone would have sealed the deal for me ! Even now, Cody is immediately put in a room when we arrive and I don't think we've ever waited for more than 10 minutes ! I hope he does ok today and that you can get him seen either by Dr. Carroll or someone else that will do right by him tomorrow.

Betty Dallas

Lisa, Thank you for the info on your vet. I am actually in the Sarasota area. I have an appointment next week at Florida Vet Specialists( I think that is the name) in Tampa,they have Internal Medicine Specialists who treat IMHA/AIHA daily. It is difficult as my dog is large(shepard) and does not like strangers, especially men. He knows the Vet specialist we see now and likes them all, they like him. The Vet is a woman, usually if the vet is a man he has to be muzzeled to draw blood. For those of you that have a vet you can work with and is knowledgeable you are so lucky! In my case once I had some knowledge from this forum and understanding and asked questions and questioned reduction timing the vet became very difficult.

Wendy Florida

Allison, that's rough that your vet is acting like that. Can't say I'm shocked, but am disappointed. I trust my vet and she's been good for my pets for any yrs. now. She's subtly encouraged me not to let Bailey go until we've exhausted med mgt. Bailey's PCV was 13 on yesterday, and she mentioned that a transfusion would be more risky now that she had one already. And, she explained the difficulty type matching blood. I don't know to what extent she has researched this illness as those doctors in Tampa. One gripe I have w/all vets my pets have seen is that they hardly, if ever, ask me if I have any questions.

Al Florida

This thread was discussed between 01/12/2007 and 02/12/2007

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