Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Question about NSAIDs

Hi Everyone - Over the years, I recall several posts concerning giving NSAIDs to an IMHA dog. I will look through the archives but I'm wondering if anyone has any experience/information on that they can share? I understand they are contra-indicated when a dog is also on Prednisone but is there a concern with using them at all for an IMHA dog in remission? I know they are sometimes used to treat arthritis and it's come up a couple times for Murray - I just wanted to be fully informed to make the best decision for him that I can. Thanks, Bonnie

Bonnie Chicago

You might contact Dr. Dodds she sent me some very useful information but it was lost on my last computer crash. I try to avoid all NSAIDs even with my healthy dogs if you read up a lot of them have it listed that they could bring on AIHA. Be extremely careful with anything that they suggest for arthritis. I tried what I thought was a safe one can't post the name because it blocked me last time and my dog developed a gastric bleed within 24 hours. I miss the innocence sometimes. Hugs to you and Murray! Penny

Penny Lytle Creek Calif

Bonnie: Our GSD mix, Sheba takes Deramaxx for pain related to arthritis and has been for quite awhile now. She is in remission and has been meeds free for her IMHA since December 2008. She started off with aspirin but after a time it became obvious she needed something stronger. We spent a lot of time considering our decision and talked to our vet extensively. We check her PCV every three months and so far things have gone well for us with regards to her numbers. We also use a supplement (DLPA), three Chinese herb combinations and Dasaquin. She also gets acupuncture every 2-4 weeks. It is a tough decision and one you have to make based on what's right for your dog. There are many on this board that I know would not choose to use these drugs and I respect them for making that decision. But for Sheba, the medications help her get around and make her comfortable. And at 13 1/2 we try to make sure she is happy, healthy and comfortable. If you make a decision based on what you are comfortable with and what is best for your dog - it will be the right one. Rita, Mike and Sheba

Rita IA

If Ginger needed them I would seriously consider them, Ginger is 11 and does have arthritis but she is not that bad yet. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Bonnie, I really like the comprehensive information on this website for treating canine arthritis. She covers all the NSAIDS plus many other treatments: http://www.dogaware.com/articles/wdjarthritis.html It is wise to be cautious about using NSAIDS with dogs. Dogs are different physiologically than humans so the side effects and actions are a bit different. It is important, too, to keep in mind that dogs express their level of pain differently. They can be in excruciating pain, but not show it. They say these dogs are very "stoic." And if you relieve pain significantly, they can actually feel so good that they can do stupid things and re-injure themselves. So it is a tricky balance to relieve pain in a dog with arthritis. In general though, routine mild to moderate exercise (to tolerance) still remains one of the best treatments. Since I teach aquatic therapy to humans, I always encourage owners to try to find a canine pool somewhere. But that's tough to do. my best patrice

Patrice NYS

Hi Everyone - Thank you so much for your responses and sharing your information. Rita - I remember Sheba takes Deramaxx and the other supplements. I'm going to ask my vet about DLPA. He mentioned Dasequin or Cosequin and I went with the latter b/c Dasequin has a soy component and, I don't know if it would make a difference or not, but Dr. Dodds and other have recommended Murray be on a grain-free diet. He had been on Arthroplex for a couple years but I didn't see it helping him once he became so painful this winter. Patrice - thank you so much for forwarding the article - great information & very helpful. FYI to anyone who is dealing with arthritis/joint issues - this is definitely worth a read. I would love to get Murray into a pool - we tried the water treadmill 5 or 6 times about eighteen months ago and he would "soldier up" and do it but I think the visits stressed him out and essentially "wiped out" any benefit of the therapy. I was so hopeful it would work b/c he has peripheral neuropathy too and it was one of the few things the neurologist said would help. And, Penny, I couldn't agree with you more on missing the innocence. I am so afraid for him right now and afraid of doing/trying too much and, on the other hand, not doing/trying enough. The vet thought arthritis, then disc issues but the neurologist said no disc issues & it was most likely orthopedic disease (no arthritis showed up on his x-ray but he is painful in his hips). So, we switched to Cosequin (are 2-3 weeks in on that), have done 4 acupuncture treatments (first two he tolerated well and they seemed to help - now he's not so keen on the needles) and we did three weeks of 2.5mg Pred/day for the pain (he had been on 2.5mg every third day for a couple years since his IMHA crisis.) Now, we are tapering the pred to 2.5mg EOD for several weeks and I'm even worried that! Is it too aggressive since he had been taking it daily (even though it is such a small dose for him)? We currently don't have a "back up" plan for pain meds & I can't see just bumping his pred up & down on an ongoing basis. His mobility is somewhat better than late Oct/early Nov but he is nowhere close to where his was - he was walking between 1 and 1.5 miles a day and now we're lucky to go around the block three times/day. And, I think he's done with all the vet visits - he just seems depressed when we put him in the car - luckily, the acupuncture vet will come to my house. He also has a cardiac problem that is likely contributing to all this. We had a Holter monitor on him last week and are waiting for those results to see if there are meds we can try. So, I'm not really not sure where we go from here but you've given me a lot of information to pour over. Thank you again for replying and any additional thoughts or suggestions are welcome! Best Regards, Bonnie

Bonnie Chicago

Bonnie wrote: "The vet thought arthritis, then disc issues but the neurologist said no disc issues & it was most likely orthopedic disease (no arthritis showed up on his x-ray but he is painful in his hips)." Bonnie has your vet done any tests for tick disease? I didn't know about this variability in diagnosis. These symptoms sound suspiciously like many of the dogs on the tick list that have a tick disease like Lyme. Often these dogs respond fantastically to doxycycline. The Lyme spirochetes are insidious and will invade all body tissues, even going into joints. This accounts for the lameness symptoms. That is why the Arthritis Foundation acknowledges Lyme disease as another form of arthritis. A friend, who has had painful problems since 1998, was finally diagnosed with chronic Lyme after years of failed diagnosis. They originally told her she probably had MS. Now they are struggling to find treatments so she can walk again. my best patrice

Patrice NYS

Chloe was on Deramaxx and when Dr.Dodds found out she told me to stop it immediately. Chloe did really well the 8 days she was on it. She was bouncing around and feeling no pain! I think the calcinosis cutis tumors around her joints really hurt her and she is very stiff getting up. She does not have arthritis. Dr.Dodds sent me the links to NSAIDS from the FDA and on sulfonamide hypersensitivity. Dr.Dodds recommended DGP but it has not worked yet for Chloe. Chloe had blood drawn today and tomorrow I should find out whether her hematocrit is stable in the high 30's. Except for these fairly large tumors she looks fine. I might have to try the DMSO protocol though to try to shrink the tumors and keep checking her blood calcium level. It's the same old news-the drugs saved her from IMHA but tried to kill her with iatrogenic Cushings and the calcinosis. Does anyone use Deramaxx and do frequent PCV's?

Cheri Maryland

Patrice - thank you for the suggestion. Do you think we would see any indicators on a standard CBC or chem panel if this was a tick disease? I will definitely mention it to my vet. I'm in the city and Murray's always on leash & walked in the neighborhood so, sidewalks and no tall grasses. But, I know it's possible b/c I found a tick "loose" in my house a year or two ago. Best Regards, Bonnie

Bonnie Chicago

Bonnie, Well no, not on a standard CBC, but there is a simple in house blood test called SNAP 4DX made by IDEXX that requires a little draw of blood and takes about 8 min to give results. This is a yes or no test for heartworm and three of the more common tick diseases, Lyme is one of these. Once a dog is in treatment for tick disease, there are more specialized tests that can determine more detail, most esp used for determining if treatments are successful. A single tick can transmit the disease(s) and it is very possible that it could have been transmitted multiple years ago and only begun to show up with severity recently. Imagine that the spirochetes reproduce at a slow rate and their goal is to infuse into every tissue in the body. This can take a long time. In general treatment is with doxycycline. Ask for the test. It shouldn't cost more than $30. I am shocked that vets are not administering this as a screening test at lease once a year, if only to look for heartworm! But Lyme disease is in about every state in the US and other diseases are in many countries world wide. my best patrice

Patrice NYS

Bonnie: The vet who does acupuncture on Sheba uses a laser. Which is a good thing as she would never stand/lie still for needles! You might ask your acupuncturist about the possibility of using lasers instead. Cheri: Yes, we give Sheba Deramaxx and religiously have her blood work done every three months. So far we have had no problems. (For which we are very grateful!) Rita, Mike and Sheba

Rita IA

This thread was discussed between 07/12/2010 and 10/12/2010

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