Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Pure red cell aplasia, please any advice?

Just wanted to ask Josh about Sway, if she was non regenerative for 10 months how did she survive, did she have multiple transfusions as her pcv would have kept dropping surely? I ask because I have a little darling beagle called Nollaig(pronounced null-ig and is Irish for Christmas)who was 3 there on Christmas day.Nollaig has what the internal medicine specialist at University of Glasgow vet hospital believes is pure red cell aplasia,she had a bone marrow biopsy done back in February but that proved inconclusive plus she had all sorts of scans and tests run to rule out anything else causing anaemia. I have to say he is very good and seems very knowledgeable about this disease. Nollaig has had 4 blood transfusions done now between February 16th 2009 and present day in order to save her life,last transfusion took 14 dogs to be tested before they found a match and they reckon if she needs another one they probably wouldn't find a compatible donor(the more transfusions they have the more difficult it becomes to find compatible blood.) Nollaig's pcv has never increased at all or even remained stable for longer than 2 weeks,vet says she was non regenerative to start with but is now and has been for while now poorly regenerative.Vet has tried her on firstly high dose prednisolone and azathioprine but although azathioprine helped pcv decrease slightly slower it reduced her white cell count down to dangerously low levels so she had to be taken off that,prednisolone didn't help either and he has gradually reduced that to 5mmg every other day now.She was then put on cyclosporine(100mg per day) which she still takes today but it hasn't helped either and she is within therapeutic range that this should be in her blood.Vet then spayed her as sometimes oestrogen can play apart in this disease so that was done about 4 weeks ago now but her pcv is still declining.Nollaig was then put on leflunomide just under 3 weeks ago but her white cell count again is dropping too low so dosage reduced to 40 mg from 60mg every day.Her pcv was 38% after last transfusion on 19th June and last week had dropped to 31% she is going today to get rechecked. I have to say my heart is breaking with this illness and I have tried to be positive along the way using this website to do so but vet says this is Nolliag's last chane and so far the only thing this drug is doing is reducing her white cell annd not improvinng red cell count at all. What do I do as Nollaig seems so well in herself and even when her pcv wass aas low as 8% all she was was a bit lethargic.How can I give up on her when she's not looking at me saying 'I've had enough?' Any advice gratefully received please.My husband and I have spent nearly £8,000 of money we have had to borrow to help her but it would all be worth every penny and more if she could overcome this horrible illness.I have 9 beagles and couldn't afford insurance for them all(only 2 insured) but I so wish I had had it now!! PLEASE HELP!! Kathleen

Kathleen Macdonald North Ayrshire

Kathleen, I am so very sorry to hear about your most beloved Nollaig's illnesss. PRCA can be very difficult to treat but dog's with it CAN and DO recover from it as they do other forms of AIHA. Has your vet done a full thyroid panel on Nollaig? If not I would suggest that be done. You might want to check out these URL's which contain infor on PRCA. http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/60205.htm http://www.ncbi.nlm.nih.gov/pubmed/12420831?dopt=AbstractPlus Also you might want to read these two Success Stories at my Web site. Both of these dogs had PRCA and did recover. http://www.cloudnet.com/~jdickson/archives16.htm scroll down to the May story http://www.cloudnet.com/~jdickson/archives17.htm scrpll down to the October story I know this is so hard but please do not give up hope. Both you and your beloved Nollaig are in my thoughts and prayers during these most very difficult days.

Joanne MN

Kathleen I know exactly how you feel, helpless, hopeless - and then you found this website. The knowledge that is available to you here is better than any general vet (in my opinion) can give you. You did well to get her to the specialist hospital in Glasgow - we had to send Phoebe to Edinburgh - so far away from home, but believe me I have learned so much from the replies of these beautiful, kindhearted people and the support you will receive will be second to none. Please hang on in there - there are now lots of people, information, websites and good wishes available to you. As I have said many times before this is the 'rollercoaster' disease - but you just have to try to hold on to the positive things when they occur. I'm afraid I can't offer you any medical advice, as I too am new here and getting just as much help as you will find you receive over the next few days - some of which will bamboozle you, i'm sure. all I can offer is my support, a friendly shoulder and my prayers and love. kind regards gill and Phoebe

gill uk

Kathleen and Gill, I have copied an older post from Sheila, that I found helpful. I wish you all the best on your journey! Brigitte & Kahlu 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)

Brigitte BC Canada

Firstly Joannne thank you for your kind reply,your thoughts and prayers for Nollaig are gratefully appreciated.Your website is a Godsend and even just under 8 years since Meisha's passing you still,in her name, are helping so many people and their furry friends. Could I ask why you mention a full thyroid panel, is this something you have come across through your research of this disease and that might contribute to the resistance of Nollaig's response to the drugs? Do you from what I have said believe they have tried every drug possible that could help with this disease? I have read other people mentioning a Dr Jean Dodds,would it be worthwhile contacting her?If so, does anyone have her contact details please? Gill, Thank you so much for your kind message and I too light candles and have said novena for my darling girl and all those dogs blighted by this awful disease.I read about your little Phoebe but what I don't understand in her case is if she is non regenerative in her bone marrow how did her pcv climb? As Nollaig is now what they class as poorly regenerative in her bone marrow and has been for a while which means her bone marrow is producing some but not enough red cells to replace the ones that naturally die off hence why her pcv just keeps falling.The fact that Phoebe's is climbing at this early stage in the disease is a very positive sign and take great comfort in that as Nollaig was diagnosed on 8th February and has not increased at all unfortunately since then despite all the meds. Brigitte, Thank you so much for the advice regarding us carers!It is so true what you wrote, I haven't looked after myself at all since this was diagnosed in Nollaig,you just become so... I would go so far as saying... OBSESSED about their welfare that you neglect everything else. Take care everyone Kathleen

Kathleen North Ayrshire

Kathleen, I have seen many cases of AIHA/IMHA in dogs that have either had low thyroid function or hypothyroidism prior to or after their AIHA/IMHA diganosis. If you read the Success Stories at my Web site you will see many of these stories mention their dogs being on thyroid meds. The Textbook of Veterinary Internal Medicine when speaking of IMHA say's and I quote; "The association of IMHA with other immune disorders, including hypothyroidism and immune mediatead thrombocytopeina lends support to the hypothesis of a general immune distrubance" end of quote. If you read Macy's Success story that I mentioned in my first post you will see her owner/caregiver believes that addressing the thyroid problem was a huge step in getting Macy on the road to recovery. If I were in your shoes I would get the FULL thyroid panel done as soon as I could.

Joanne MN

Kathleen I just wanted to post this URL again for you to read Macy's Success Story http://www.cloudnet.com/~jdickson/archives16.htm Scroll down to the May story. Jill, Macy's owner/caregiver says at the start of the story and I quote: "Unfortunately, our vet never discussed nor tested for hypothyroidism which, in retrospect, I've come to believe played a huge role in her anemia and pure red cell aplasia" Recently Macy was having some problems but when her thryoid meds were increased those problmes were resolved as indicated by the recent update to Macy's story

Joanne MN

Joanne I will get onto vet first thing tomorrow annd ask them to organise full thyroid panel, do you know if the results for this take a while? I remember asking vet about thyroid way back at onset of disease and he said low thyroid not cause a dog to become that anaemic that needed transfusions but I believe even if it's contributing at all it should be investigated,after all he spayed her in the hope that if oestrogen was playing a part it would eliminate that! Any knowledge of leflunomide the drug that Nollaig's on at moment she's been on it 3 weeks does it take a while to work? Do you know of Dr Jean Dodds do you have contact details? Thanks again Joanne

Kathleen North Ayrshire

Kathleen, Contact Dr. Jean Dodds at hemopet @ hotmail .com (remove spaces to send) Send a concise email with the results of the last (two is possible) complete blood count CBC containing: HCT (or PCV), RBC, WBC, HGB, PLT and RETIC. If you had a chemical screen done, she will want to know at least the current liver values: ALT and ALK PHOS. If there are other items that are OUT OF NORMAL RANGE, include those as well. Finally, add the attending vet's diagnosis. I usually title my emails with my pet's name and my last name in the subject line. She receives a lot of email so this will help her keep it sorted. Try to be short and concise so she can get the main details quickly. She will respond very quickly, within a day, if she deems it an emergency. If your vet is agreeable, she will work with them to develop and monitor a treatment plan. I did this with my dog and it saved his life. Since you are now facing multiple transfusions, it will be good to know that Dr. Dodd's organization hemopet.org provides safe canine donor blood nearly around the world. She can assist your vet with obtaining the proper blood if another transfusion is needed. For thyroid, Dr. Dodds provides complete thyroid panels and personalized results within a day or two of receiving the blood. Her website has complete details of how to take and prepare blood samples for mailing, including information for countries outside of the US. Please don't hesitate to contact her. I have been where you are now and I know how finite sounding the diagnosis of non regenerative is. In many cases this can be overcome. Jean can assist you to ask for the right tests and administer the right meds. Please don't give up hope. My Chance is right here next to me, making blood and doing just fine over 2 years after his diagnosis. my best patrice

Patrice NYS

Patrice and Chance Thank you sooooo much for your helpful and detailed reply. I will send this info onto Nollaig's specialist vet,as I'm sure he would work along with Dr Dodds and he has all the detail of all tests and meds that Nollaig has had since February and if not I will request all info and contact her direct myself. Will keep you updated as to progress. Take care Kathleen

Kathleen North Ayrshire

Kathleen- I just wrote up a big comment and tried posting it and it didnt go through, and now i lost what i wrote... Please ask Dr. Dodds about Durabolin (Anabolic Steroid Injection) Sway's PCV dropped continuously thru 8+ transfusions within the first 2-3 months of diagnosis, then after adding that injection to her on a weekly basis her PCV began to HOLD almost immediately.

Josh / Sway California

Josh Thanks so much for this info about anabolic steroid will get onto that right away.Hopefully can get those here in UK.A few questions for you if you don't mind... Could I ask did Sway have non regenerative anaemia in bone marrow i.e pure red cell aplasia? Also did you have problem of getting blood that was compatible after a few transfusions as that is problem we are having with Nollaig and she has had 4 now,last transusion vet had to test compatibility with 14 dogs before we found a match? I see that you live in California where Dr Dodds is based did you attend her directly with Sway or did she just work along with your vet?I presume you found her very knowledgeable and helpful? How is Sway now? Thanks and take care Kathleen

Kathleen North Ayrshire

I lost my puppy at 9 months to what was severe worsening non regenerative anemia in the bone marrow. That was what was written in the last CBC test. My puppy only had one transfusion as we didn't go on with further transfusions when the first one failed. But for your information he only ever got a PCV of 17 and then it started failing within two days of the transfusion. He had a regeneration of reticuylites of less than 0.01 percent. If you are ahead of that you are doing well and the only reason we didn't go on with further transfusions was that I listened to poor vet advice and I also had to consider the enormous costs which I was faced with. I would advise you to keep positive as I always regretted not getting further transfusions that could have saved him with time being the essence of the drugs starting to work. When he was put to sleep his PCV has dropped to 8 and I was told if it dropped further he would die. I thought I was doing the right thing for him at the time.

Julie Australia

Kathleen -- so sorry to know that your sweet beagle, Nollaig, has come down with one of these horrible diseases. I can't help you -- lost my beagle, Wiley, so quickly four years ago, in part because she had a compromised immune system prior to onset -- but the people on this forum are wonderful. You can get information and moral support here. I see that Patrice posted contact and other information for Dr. Dodds, and I hope you can reach her so she can help you with Nollaig's case. So many people have gotten wonderful help from her, and it has made a difference in their fight against IMHA and other blood/autoimmune disorders. Best wishes to you and to Nollaig. There's something about beagles! I'll keep you all in my prayers.

Brenda VA

Hi Kathleen, so sorry to hear about your beloved Nollaig. You did find the Holy Grail of sites on the internet! This site has been my safety net since Tessy got sick. Nollaig is a very lucky little girl to have you. If there's any advise I can give you it would be to listen very carefully to what the people on this site recommend....especially Patrice and Joanne. Their help throughout my and Tessy's ordeal has been life saving. I pray and hope you get to the bottom of this disease and that Nollaig starts to regenerate new RBC's. Give her some hugs from Tessy and I. Johnny & Tessy

Johnny

Julie, Brenda and Johnny Just want to thank you for all your kind words and support for both Nollaig and myself through this awful stressful time. It really helps to know there's someone to offload on when things get rough and yes please do keep up the prayers for her. I will be meeting up with specialist vet hopefully start of this week as unfortunately he's been away on hols last 2 weeks and I will be discussing with him all about Dr Dodds and hopefully he will agree to work with her, after all I have to be Nollaig's voice in all this and make sure everything possible is investigated that could lead to her recovery. Johnny so pleased for Tessy, you must be on cloud 9 at her latest results! Take care Kathleen

Kathleen North Ayrshire

This thread was discussed between 08/07/2009 and 11/07/2009

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