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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Popeye update 12/15
| Pop went in for his check up yesterday. It was about 2 weeks after his major relapse. His PCV has not moved up much over these 2 weeks. It's now only at 26 and his protein at 5. The vet increased his Prednisone from 20mg/2x day to 30mg/2x day. Vet did a manual exam of his organs and says he may feel a mass on or near the intestion, that he didn't feel before. He thinks (again), that the dog probably has cancer. He said it would be a $500-$800 workup to confirm and a few thousand to treat. His theory is that the dog probably had this "underlying cancer" and when the vaccinations triggered the AIHA, the body could no longer fight it. Some of you may of followed the expression of my frustrations with our friend, the vet. Well... it's gone on too long. My husband is currently in route to get a "different opinion" on this. I want to thank all of you who have given me names of possible vets in our area. I collected a handful of vet names from this forumn and a few from friends and fellow dog lovers. I chose a woman who is near our home and has a very reasonable initial fee. I know I have mentioned before, that we are not in a position to spend a great deal of money on this. If we had it, I would spend it, but... Anyway, I will post anything new, when they get back from this appointment. I have some additional comments, frustrations, personal thoughts on this whole AIHA thing, that I may post later on. |
| Allison TX |
| Allison, thanks for the update on Popeye. I have my fingers crossed for you guys. Let us know what you find out. deb and Duck |
| Debbie BC Canada |
| Allison: I am so happy that you have decided to get a second opinion about Popeye. I have long thought that you may have placed too much trust in your friend, Popeye's vet. When I first took Shadow to her vet (my friend, "Dr. Sheila" [I live in a very small town and am an animal welfare (especially spay/neuter and shelter vs. pound) advocate, that I'm friends with all four vets), I knew that Shadow was very, very sick. (My 20-pound girl had jumped over the six-foot fence three times on Oct. 18 [as was her daily habit, when she wanted to signal me that she wanted to go wherever I was going] and couldn't/wouldn't lift her head on Oct. 19. Anyway, I told the vet, "Dr. Sheila, no offense intended, but if Shadow needs to go to Fort Collins (shorthand for the Colorado State University Veterinary Teaching Hospital) or Salt Lake (shorthand for vets who have more "complete" clinics/hospitals), please tell me. Sheila ran Shadow's CBC and said, Sandy, take Shadow to Fort Collins or SLC NOW. I asked if Shad could survive the trip to Fort Collins (seven hours away); Sheila said she didn't know if Shad could survive the trip to SLC (three hours away) - so the decision was made: SLC. Sheila has remained my friend: actually, Shadow's AIHA has made us even closer friends. She is Shadow's primary care physician - she does all of Shad's CBCs and full blood tests; she sells me all of Shadow's drugs. We only go to SLC for transfusions (a thing of the past) - but she and Shad's dr. in SLC communicate on every aspect of Shadow's recovery. (They share CBC results and talk about her other "symptoms" [which, except for modest weight (about 1/2 pound every two weeks, but it's distributed grossly) gain and muscle atrophy, are becoming increasingly rare].) I hope you can find a vet in whom you have confidence to treat Popeye's AIHA (or whatever he has) and still maintain your friend as your friend and Popeye's primary care physician. Best wishes to Popeye, you and your family. Please keep us posted about Popeye's situation! All of us on this forum care about you and your fur babe. Sandy |
| Sandy Utah |
| Allison, I can understand your frustration right now not knowing what is happening with Pop. Very early this year, we took Chance to see our vet for unexplained and more frequent diarrhea. She seemed somewhat distracted until I mentioned that Chance seemed to have a "full" abdomen. Her face changed visibly, though she tried not to show her alarm. She suggested a blood work up and an xray. While the cbc was normal, the xray confirmed a mass on the spleen. She warned us that it could be a splenic hemangiosarcoma, which is a very deadly and fast moving cancer. She asked us if we wanted to get an ultrasound and we did. It was done within a few days by a specialist. From what he saw, he recommended removal and within a few days our local vet removed a 7.1 pound mass and the spleen. The pathology report showed a benign hematoma and the vet said removal was curative. What happened after that was a short period of "recovery," followed by signs and symptoms of severe non regenerative anemia. We are now here, at this point, with Chance in nearly full recovery and good health. I don't want to sugarcoat what I am telling you. Your vet is most likely suspicious that he has found a hemangiosarcoma and probably on the spleen. These cancers are aggressive and fast. I lived in great terror for a week wondering what I would do. I know much more now than I did then. Many masses on the spleen are not hemangiosarcomas. More often than not they are benign encapsulated hematomas. If they are removed promptly, recovery is often good. If they are not removed promptly, they can rupture and lead to sudden death. We were *very* lucky. Here is an article about these cancers: http://www.vetinfo.com/dencyclopedia/dehemsarcoma.html Here is what I can suggest to you if you want to try to find out what you have but do it inexpensively. First, a simple xray will show a mass if there is one. Second, a blood smear, properly examined, can often show cell types that are unique to hemangiosarcomas. I have seen a picture of a slide that shows these cells types. Weigh Pop and compare that to an older weight. Is there an unexplained gain? You can always opt for an exploratory surgery to remove a possible mass and the spleen (if that is what it is attached to). The surgery is within the skill set of a good regular vet, provided they have a good support staff and the ability to do transfusions. Once Pop is open they will be able to see where the mass is and probably get a good idea of what it is. If it is a hemangiosarcoma, the prognosis is poor, but removal of a big mass will make Pop more comfortable. If it is NOT a hemangiosarcoma, but a benign hematoma, there is an excellent chance of recovery. Dogs can live quite well without the spleen. An ultrasound will have a more definitive look at the mass. Hemangiosarcomas are very fast growing tumors and are very sloppy in how they do it. One of the hallmarks is their attempt to create a blood supply. On an ultrasound, the vet is looking for areas of "cavitation." These are darker areas of pooled blood, a clumsy attempt at a making a blood supply. But still, I could see that the images are poor and the specialist was not quite certain what he was seeing. I didn't see cavitations, but that didn't make me feel any better. In any case, if it was a hemangiosarcoma, I was fully prepared to treat the cancer. Chemotherapy is available for dogs and it is actually much easier on them than it is on humans. But I had also already contacted a Chinese medicine specialist about a blend specifically for these cancers. I get The Whole Dog Journal and about 1.5 years ago they did an article on alternative cancer treatments. One woman whose Golden had a hemangiosarcoma opted to use this blend and her dog lived another 3-4 years to about the age of 13! I would never tell you one way or the other what to do. I know that several people told me to have Chance put down and I resented that. You have to do what you need to do for your own peace of mind. There are many options for you and another vet might be more apt to give them to you. My only word of advice is, if there does seem to be a mass in there, keep Pop very quiet so that there is no chance of it rupturing prematurely until you have decided what you want to do. My best, Patrice |
| Patrice New York State |
| Allison- my dog Sway has been holding a low 20-25 count for the past 3 months and has slowly had her body regulating back to normal due to a lower dose of meds. she is also on a human steroid injection but my point is, if she is holding her count then consider not drastically upping meds. sometimes time is the key. how is her overall actions and behavior? how is her body? as far as the cancer...verify it or rule it out if you have the means, because alot of vets will take shots in the dark if they have a difficult case that isnt "following standard" expectations. i was told a few times that Sway could have Luekemia and we had a bone marrow tap that ruled that terrifying thought out. |
| josh california |
| Allison, I have a link to an excellent web site for a veterinary clinical pathology clerkship program that discusses in detail canine hemangiosarcoma. http://www.vet.uga.edu/vpp/clerk/frankhauser/index.php I warn you that there are vivid photos that some might find very hard to look at. Also on this page are pathology slides of great interest. There is extended information on diagnosis and treatment. This page would be good to have on hand to discuss with the vet even if you can't bear to look at the pictures. You would want the vet to "rule out" this condition in any case! Patrice |
| Patrice New York State |
This thread was discussed between 15/12/2007 and 17/12/2007
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