Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Question for Josh/Update on Holistic Vet

Josh, Would you mind telling me what anabolic steriod shots you give Sway? Is it Durabolin and do you purchase them from Franck's Compounding Lab? Dr. Dodds recommended that I start Darcy on one injection a week for a period of six weeks. We had a visit today from our new holistic vet (yes, she makes house calls and she's wonderful) and she took a PCV sample and said that if it's low (it was 12% week before last and her gums are very pale) we should go ahead with the anabolic steriod injections. I've put Darcy back on Soloxine, at Dr. Dodds suggestion and our vet agrees with this protocol. Darcy is still on the Neoral and Prednisone, but this vet has added back in some of the Standard Process immune building and blood building supplements (to be mixed in with her food), along with liquid amino acids to be incorporated in with the PetTinic. She's also working with me to introduce more red meat, dark turkey, and dark chicken into Darcy's diet, eventually eliminating the kibble. Also recommends grated raw carrots, steamed greens, baked sweet potatoes, and raw peas. All veggies are to be grated and/or steamed so they will be digestible; juicing is also acceptable. I can still give Darcy the Paul Newman's canned organic liver. She suggested adding Nordic Naturals Fish Oil (1/2 tsp/day) and giving freeze dried liver treats. Will keep everyone updated on what this holistic vet has to say. She does sometimes incorporate accupuncture into the treatment for anemia. She is very familiar with Dr. Dodds and has attended several of her conferences. It was so wonderful having her come out to our home. Darcy really liked her and she was very relaxed, even when the blood sample was taken. Oh, and she told me not to give Darcy any Interceptor until March and to never give her any of the booster shots. We will deal with flea/tick preventatives when the time comes and they will be something natural. Darcy's rabies isn't due until 2010. Karen

Karen NC

Hi Karen, ? about the dark meat, what does that do? I know read meat has iron in it but what are the benefits of dark chicken and turkey? Has anyone suggested pancreatic enzymes? I have a write up that says they really help the liver digest food and possible pancreatic attacks. I have the explanation at work so cant post it now. IT also said to add vitamin C because if helps the liver absorb the iron. So that is something to ask about. Laurie

Laurie CA

Laurie, I'll ask about the enzymes. I do know that the amino acid formula the holistic vet added has lots of vitamins and antioxidants. She seems to think that dark chicken and turkey meat are better than the white, but she really believes in red meat, red organ meat such as liver and heart, beef, buffalo, etc. She told me to add in the Paul Newman organic beef liver, too, but it does have some water in it. She suggested using it, also, to wrap the meds in since peanut butter is so fattening. The holistic vet just called to say that Darcy's PCV is 10%! It's going down 1% a week it seems. She wants to get her started on the anabolic steroid shots asap. I contacted the compounding pharmacy, but they must be closed. Hopefully, they'll contact me tomorrow. I also sent an email to Dr. Dodds, alerting her that my vet will be in touch with her about the protocol. I don't know if they'll want to take her off any of the meds if they start the shots. Please pray that Darcy holds strong until she can get started on the shots. I've pretty much washed my hands of the specialist I'd been taking her to, as she didn't seem to know what to do. I'm praying that this holistic vet, along with Dr. Dodds guidance, will be able to help Darcy turn around. At any rate, I'm thankful to have a caring vet who makes house calls. At least I know that Darcy can be at home, where she feels safe and happy. Karen

Karen NC

Karen, Thanks for sharing that dietary info, that is really good info. I was making Tiggs food for a while, but I've sort of fallen off that train. I want to do more things with it though, and I definitely see the ease of the veggies. I was giving him a bunch, and he really likes them now. I'm really sorry to hear that Darcy's number is going down. She is such a trooper. I hope that the steroids will be the trick for her. It seems like some dogs that drop slowly like that just adapt to having low PCV's, not sure if Sway is in that boat too, but they seem to hang in there and keep going, it's amazing. I really, really hope that it comes up though with the anabolics. Keep us posted, I'm glad your happy with the new vet, she seems to be pretty in tune with the bigger picture. melissa and tiggs

melissa slc

Karen, I'd just like to send my best wishes for you and Darcy. Darcy is very lucky to have you. I will be praying for you both. Karen H.

Karen H. MO

Karen -- I, too, want to send my very best wishes to you and to Darcy. You guys are fighters, a formidable combination. This holistic vet working with Dr. Dodds sounds like a wonderful approach. I hope Darcy responds and brings that PCV up. You are lucky to have each other, and your love for each other is so clear in the way you fight to be together. Hugs to both of you.

Brenda VA

If you do not hear from Josh, he does mention that Sway is on Nandrolone in the post dated 8.28.08 titled Barkley Brief, he is responding to Cheryl. You can also see Cheryl's email address there and I believe she used Franks Compound Pharmacy and had very positive comments about them. You might want to get in touch with her, however I don't think she had the chance to gave Barkley the steriods. Sending our hugs and prayers to you and Darcy. Cheryl

Cheryl & Ginger Pineville PA

Thanks to everyone for your kind words. I received a reply from Dr. Dodds and she thinks Darcy should have a transfusion, using the Hemopet universal blood. I guess that would need to be done before starting the steroid shots. Now I really don't know what I should do. I said I'd never put Darcy through another transfusion because of the horrible reaction she had with the last one. The place where she's had the three transfusions told me that they always cross match, so I don't know if the blood I would order from Dr. Dodds would be better. I've forwarded Dr. Dodds' info to our new vet, so I'll see what she says. Any thoughts on this? I'm really scared because Darcy's PCV is 10%. She's still eating and all the usual things, but I do worry. Karen

Karen NC

Karen, I'm so incredibly impressed with the thoughtful and intelligent choices you're making for Darcy. As someone said earlier, you're quite the team! Raven had issues with matches as well, and had a bad reaction to her second transfusion. Then they went to hemoglobin, which was a real disaster, at least for my poor little pooch. I had tried to have my specialist call Dr. Dodds at the end of Raven's surgery, but it wasn't soon enough. See what she says. I'm sure she can explain the difference, but I do have confidence in her advice -- and especially, you. Sharon

Sharon CT

Karen- Yes, sway gets 1 injection of durabolin, it also is called nandrolone or deca-durabolin... i got mine from a bodybuilder a long time ago, sways been on it for over a year now. i do believe francks compounding will make it up for you though, when i run out i plan on contacting them... i am wishing darcy well, please know that i believe this anabolic steroid is the foundation for what has kept sway alive... her # has not fallen below 16 since starting it about 16 months ago. before i started it she was getting double bagged blood transfusions every week and consistently below 10 and dropping. the main thing with the steroid is it holds sways number consistent. we are still struggling with getting it to rise and stay, she has been a very difficult case to crack. but the steroid is like an anchor for us. sorry i havent been on here updating as much as id like to. im going to post something tonight

Josh california

Josh, Thanks so much for the info. I did order the same thing you're using on Sway from Francks and it should arrive on Friday. The holistic vet is coming out to give the first shot Friday afternoon. Dr. Dodds recommended one shot a week for six weeks. Darcy's PCV is so low at 10% that my husband said we should have done the shots much sooner. I'm praying that she doesn't drop below that level. Do you know how long it takes for the shots to kick in? I'm so afraid we've waited too long, but the specialist we'd been going to said absolutely not when I questioned her about the shots. I got so fed up with her and felt like she was just experimenting on Darcy that we stopped going to her two weeks ago. We started with the holistic vet this week and she is consulting with Dr. Dodds. She feels, as I do, that another transfusion would be life threatening for Darcy. The shots are our last hope. I've been crying off and on all day long. My heart is breaking for my dear little Darcy. Please keep her in your prayers. Karen

Karen NC

Dear Karen -- I am glad that you are getting the Durabolin shots and can begin on Friday. I am hoping and praying that these shots help Darcy the way they help Josh's Sway. It seems to me that Darcy is fighting hard, and she had you and Dr. Dodds with her. It is a good sign that Darcy is still eating and doing the usual things -- she wants to be with you and she's fighting. I have been lighting candles occasionally for her at Gratefulness.org. Here is the website if you are interested. I like to light candles for my Wiley and for other dogs. http://www.gratefulness.org/candles/candles.cfm?l=eng&gi=AIHA As for transfusions and low PCV, I don't think Dr. Dodds would prescribe if she didn't think it was right. As for "life threatening," at this point, Darcy is fighting a life-threatening disease and her PCV is very low. As I've said before, I wish I had known this forum and Dr. Dodds when my sweet beagle, Wiley, was fighting. I would have gone for the hemopet blood in a heartbeat instead of the oxyglobin that the specialty vet used. I've since heard that use of oxyglobin can decrease a dog's survival chances. Karen, you hang in there and trust yourself and your sweet beagle and Dr. Dodds. You've been so strong. You've mounted a Herculean effort to give Darcy every opportunity to survive. You made every decision with the information you had available at the time to give her the best chance of fighting IMHA. She couldn't ask any more of you, and she knows that she can trust you to do what's best for her, because you love her. She knows that.

Brenda VA

Karen- Sway got her 8th transfusion on the same day that we started the durabolin... after starting the durabolin she hasnt had a single transfusion, and its been 16 months. in our case, it began to hold her count immediately, now she was still not regenerating new cells, and didnt begin to do so till months later, but it began to hold her count almost immediately. dr. dodds is saying another transfusion would risk darcys life? what happened during her prior transfusions that makes u say they are dangerous? i know that dr dodds usually wants to transfuse anytime an animal drops below 12% based off that she might need 1 more transfusion just to give her a shot of rbc and then if the shots work like they did in our case, it will maintain more blood that is already in her system. that is atleast what i am thinking, consult dr. dodds on that scenario if you get a chance my best to you and darcy

Josh california

The reason I am choosing not to give another transfusion is that the last one almost killed her. Dr. Dodds is not saying that. In fact, she suggested ordering blood from Hemopet and giving Darcy a transfusion. The specialist did the cross match and the packed rbc the last time. When I picked Darcy up she was so pitiful. She cried and held out her little leg to me. She was so sick at home and threw up. I had to take her back and they kept her for two nights. She had developed pancreatitist. The specialist told me that it could have come from the blood and that every transfusion after the first is risky. Of course, the pancreatitist could have come from the Azathioprine and the high dose of Prednisone. The specialist said that the thought of giving Darcy another transfusion really scared her. Now the holistic vet tells me that she would really have to do some soul searching about a transfusion if Darcy were her dog. She did say we need to start Darcy on the steroid shots asap. If the shots just make her PCV hold, that might not be enough to save her. I am torn about this decision, but I did say that after the last transfusion I'd never put her through such a thing again. Josh, is Sway on any meds or just the steroid shots? Karen

Karen NC

Karen- Just keep in mind that this disease affects every dog differently, so i wasnt intending that the shots would only make the count "Hold" ...i was just speaking from my experience alone. holding is not a bad thing, it is definately a life saver and provides an anchor for any treatment going forward. going up obviously is aanother good thing, so either result is a positive. anything to get the count from dropping. it saves ur dogs life and bounces him back under the very best scenario, and bies you time under the worst scenario. i think not giving the shot would be a huge mistake, considering Darcys condition now. as far as the blood transfusion goes, Sway got blood directly from Dr. Dodds everytime. so i cant really speak to any other way of doing it. but she got 8 transfusions, double bags... so literally 15 or 16 and i dont think sway ever had issue with them... but again, every scenario is different... that is the main thing ive learned from this disease. i dont know how you are, but when this was initially dumped on us, i spent hours and hours reading everything i could find out about this thing. if you want to read about sway and the effect some of the medications had on her then i can send you a web address where i document it all. i just cant post it here because the board bans my IP for some reason.. put your email in one of these responses and i will send the link to you- Wishing Darcy well

Josh California

Thanks, Josh. I heard from Dr. Dodds and she strongly recommends the transfusion with universal blood from Hemopet. She explained the difference in it and what Darcy has been getting. How I wish I would have started with it and insisted that they use it even though the specialist is one of those who doesn't go along with Dr. Dodds' protocol. Even if we do decide to give the Hemopet blood transfusion, we might have to rely on that specialist's office to do it. Believe me, I would much rather find another place. Too bad we don't live near Dr. Dodds. I'm waiting to hear from the holistic vet right now. Darcy should be getting her first shot tomorrow afternoon. She's still hanging in there, eating well, begging for food sometimes, wagging that tail, but definitely not her old self. She lies around and seems depressed unless she's eating, which has always been her very favorite thing to do. I pray she keeps her appetite and the clinical signs stay strong. Thanks for all of your input. I hope Sway is still doing well. Karen

Karen NC

the holistic vet wont administer the transfusion? did she give a reason for that or...? my vet who is holistic, was the one who gave sway all of her transfusions outside of maybe 2

josh california

The holistic vet works basically on her on. She's somehow connected with a veterinarian where she has access to equipment to run tests and such, but she doesn't do transfusions. She told me that if Darcy has one it will have to be through our regular vet or through the dreaded internal specialist at the emergency animal hospital. Today when the holistic vet came out to give Darcy her first anabolic steroid injection, I questioned her about what she had told me about not being certain about another transfusion. Well, today she said she hadn't meant that at all, that Darcy needs a transfusion. I had passed along Dr. Dodds' information about a transfusion to our regular vet just to see what he thinks and if he will be willing to do the transfusion in his office, which is very close to our house. No response as yet. I also spoke to one of the other internal specialists at the emergency hospital today and, of course, he doesn't go along with what Dr. Dodds says about not cross matching. He did say that Greyhounds (those Dr.Dodds uses) have more red blood cells than other dogs and he admitted that he doesn't know if the blood she sells is better than what they can get here. He tends to think that Darcy's bad reaction of pancreatitist was from the medicine, not the transfusion. Here's my dilemma. Darcy is at 10% PCV, but her clinicals are good. She's acting likes she feels much better today. Should I go ahead and get the blood from Hemopet, or can I trust the local vet or specialist with their source? And here we are right in the midst of Christmas, when some of these places will be closed. I kept running around, asking questions, trying to determine what is the right thing to do. All my husbands says is we're not getting any answers or guarantees and we've spent a lot of money. Well, I think Darcy's worth it, my concern is what is the best way to go about doing this transfusion.

Karen NC

My personal opinion is go with what Dr. Dodds says to do. that is definately what i would do, she is very highly respected and well known for these exact diseases... ive personally ran into a vet or 2 in my life that are just stuck in there ways and refuse to think outside the box or take note of other opinions. those are the type of vets in my opinion that you need to avoid, the ones on power trips. if your internist is refusing to do it, or even giving you the slightest bit of pushback or attitude, i would take my dog elsewhere. find someone that is open to helping darcy in any way possible, not just how there schoolbook taught them 20 yrs ago. that is my personal opinion, hopefully others will come in here and give theirs-

Josh California

Every dog is different but my dog Scruffy took two to three weeks for his PCV to drop from 11 to 8. He got an infectin then so watch carefully for that. I decided not to transfuse again and will regret that decision always.

Julie Australia

One of the veterinary specialists I spoke with today said that if I request the Hemopet canine packed cell blood, they will order and use it for the transfusion (this was very late in the day before I could speak with anyone). The bad thing is now it is the weekend and that means emergency only situations at the specialists. I will have to wait until Monday to get things moving. Our regular vet was to have emailed me back this evening with his opinion and to let me know if he would do the Hemopet transfusion, but he never answered me. I've emailed Dr. Dodds since I cannot pull up info about the canine packed cell blood on her products site. I need to know the cost and the shipping time, etc. This is all very frustrating, especially with the holidays and people being off work. I'd like to get Darcy the Hemopet transfusion asap. I fear that her PCV will drop over the weekend and we'll have to go with the less reliable blood. Please pray that everything will work out for the best for Darcy and she won't have to go to emergency. Thanks to all of you, Karen

Karen NC

Karen, I'm so sorry that you are going through this dilemma. Also, with the holidays, it's so hard to get a hold of the docs. I would say that if Darcy needs the transfusion, and the blood from Dr. Dodds is available, it's worth a shot, since Darcy is still not giving up. Hopefully they can get it shipped super quickly with the chaos of the holidays, and get her transfused asap, then you can just take it one day at a time as you've doing. Whatever you decide, we're all behind you, you and Darcy have been through so much. I know it's so hard, I try to tell myself that money is just money, you can't take it with you, and there's always a payment plan, or those care cards if you need more time. I hate that this disease makes us make even more hard financial decisions when we're already just so stressed as it is. We are thinking of you and praying so hard. Please keep us updated. melissa and tiggs

melissa slc

Dear Karen -- glad to know that Darcy got her first shot of the steroid today, and I hope it helps. If I were in your shoes, I'd be really worried about the transfusion too -- given Darcy's previous reaction -- but I think I would try to trust Dr. Dodd's recommendation on the transfusion. It's good to hear that Sway, who was a very weak girl, had so many transfusions from Hemopet and those, combined with the steroids, have strengthened her health. But I also know that Josh is right, that every dog is different. I'm hoping your weekend is quiet and that Darcy's behavior remains as positive. She's quiet, because her blood isn't giving her much oxygen, but at least she's still interested in eating and loving. Those are good signs. Take care, Brenda

Brenda VA

Does anyone know...Is the (transfusion) outcome potentially compromised without crossmatching? The ER Specialists advice to you is what they (Vet teaching hospital) also told me when Choe was undergoing (4) transfusion treatments...that the blood had to be crossed matched or else there was potential negative reaction. Is the blood provided by homeopet a universal cross match because of the greyhound's RBS 'make-up? Will your local vet be responsive if for some reason the homeopet blood is not a good match? Can your ER hosp. cross match (their blood supply) which might produce a better outcome? This is all a bit confusing. I am so sorry for your pain. We all understand and have been through it also.

jan pa

Jan, Blood types in dogs are infinitely more complicated than those in humans. We have 4 types, which just about everyone can rattle off: A, B, O and AB. Then we have either negative or positive. In dogs there are generally accepted 11 types. The first transfusion for dogs is considered "free" of any transfusion reaction. From that point on, everything else must be carefully cross-matched. So let's say dog A gets their first transfusion from dog B (using the vet's donor dog) in the clinic. Dog B has certain proteins in it's blood. Those proteins are seen by Dog A's system as possible "not self" elements. Dog A may develop antibodies to these antigens. Even if the first transfusion was successful, the second with the same dog's blood may now cause a reaction due to the new antigens to dog B's blood. Thus the need to cross-match for EACH SUBSEQUENT TRANSFUSION. If you used dog C's blood the second time (and that was a universal donor dog's blood) and then decided to go back to dog B for the third, you now have another set of proteins from dog C involved. Thus the need to once again cross-match dog A and dog B. Some dogs can be considered universal donors, other dogs can be considered universal recipients. My Cassie is not a universal donor, but is a universal recipient. My vet's donor dog is considered a universal donor. Dr. Dodds greyhounds are considered extremely safe universal donors. She is very proud of the safety of her blood. When you hear about generic donor blood it is usually type DEA 4. In many cases this blood will be "super washed" to get many of those proteins out of the blood to minimize transfusion reactions. If it were a life or death situation, this blood would probably be safe. My vet was extremely cautious about transfusing Chance and studied in depth before attempting them. They are labor intensive and require quite a bit of time. She was very successful each time. Chance was able to get up and walk to the car on his own. He never had any negative reactions. Hemopet most likely provides extensive assistance with their donor blood. patrice

Patrice NYS

This thread was discussed between 17/12/2008 and 20/12/2008

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