Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Recently diagnosed with AIHA

My pup was diagnosed July 3rd with AIHA. I had noticed that he would stagger his hind section every now and then when walking which is was got me to the emergency vet on July 3rd. I had thought he had arthritis as he is a springer/basset mix and 11 years old or so. The vet did all the checks and discovered his PCV was 22 and referred to my regular vet the following week. We left with Rimadyl and doxycycline. After checking with our regular vet the following week, his PCV had dropped to 20. The vet scheduled an ultrasound which came back a ok. He has been on Prednisone and Imuran. Neither appear to be working. The doses of Prednisone have gone from 15mg per day to 120mg per day, now down to 60mg per day. He is still on the doxy. The Imuran has been discontinued. His PCV today is 15. If I didn't know he was sick I could never tell. He has never lost his appetite or his thirst nor has his energy level changed. Bodily functions haven't changed. He experiences the very pale gums to semi pink gums off and on daily. His breathing can be a little labored at times, especially when exerting himself. It could be the Prednisone too. I researched high and low on the internet and found the Bio-Preparation site. Holistic therapy. I started my dog on Monday. I am hopeful that this will help him, as I don't have anything left to do. This last month has been awful, but I also have my pup still and that is a blessing. Every day is a blessing. I have received an incredible amount of support and words of wisdom from people from the yahoo site and their kind words have helped. I am so sorry for all those who have had to go through this. Thank god for those pets who have survived and god bless those who haven't. As everyone has told me. Don't freak out, be calm, love your pet. This is an awful disease. I, too, had never heard of it before. Bless you all.

Mardi California

Mardi I am very sorry to hear your dog has been diagnosed with AIHA. Has your vet ever mentioned cyclosporine if not please ask him about it. Have you checked out the Meisha's Hope website. Please read the treatments and the success stories. http://www.cloudnet.com/~jdickson/newhope.htm Try to find a vet that has experience in treating AIHA. From what I have heard the Imuran takes a few weeks to being to work and I am confused by such a variation in the amounts of the prednisone over a period of 3 weeks. It is a very good sign that he is eating and acting okay. Keep us posted on how he is doing. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Dear Mardi, It sounds like the Prednisone has been reduced to quickly and why has the Imuran been discontinuted already? Imuran can take up to 6 weeks to take it's full effect. Maybe post your dog's weight and we can see if others agree with his dosage. Meds shouldn't be reduced until the dog has reached a stable PCV, in the 30's. Another thing to consider is a blood transfusion to buy your boy some time. Please get a second opinion, I'm not sure that what is happening currently is best for your boy. Good luck, Samantha & Millie.

Samantha Geelong Australia

I would have his PCV checked on a regular basis. You will see increased panting, increased appetite, increased thirst, and decreased muscle mass, as side effects of the prednisone. Bad as the side effects are, the medicine can be life-saving with hemolytic anemia. My little guy had all of the side effects, but unlike yours, also loss of energy. But his PCV came up, and he's almost weaned off of prednisone. With every decrease in dose, he's more like himself. Best of luck, Ann

Ann Ct

Hi Mardi, I'm really sorry that your dog has been diagnosed with IMHA. The whole treatment that your sweet baby has been leads me to believe that neither vet you have seen has much experience in treating IMHA. If you go to the main thread page, much has been posted recently about appropriate, aggressive Pred dosages. Most vets will want to start at the MAX dose for the dog's body weight- in our case this was 120 mgs/day for a 64 lb dog. It should not be reduced until a stable PCV has been reached- usually vets will suggest a reduction of 25-35% every 2-3 weeks. If his PCV is really 15, a transfusion may be necessary, along with aggressive steroid dosage, and Imuran/Azathiaprine and/or Cyclosporine/Atopica. Aza takes up to 6 weeks for full therapeutic value, therefore, this was D/C'd far too early, unless your dog wasn't tolerating it well. Along with Pred, Aza, and Cyclo, your dog should absolutely be on a stomach protectant like Pepcid, and you might want to push an ultra low dose of aspirin, which many studies have proven to be effective to combat blood clots, which are a leading cause of death to dogs with IMHA. Please get your dog to the vet ASAP- tonight or tomorrow am, and insist that your vet consults with an internal medicine doc, teaching hospital, or another vet who has experience in successfully treating this disease. Please keep us posted, and please see a knowledgable, experienced vet ASAP. melissa and tiggs

melissa slc

Mardi, As Cheryl said it is really important to find a Vet who is experienced in treating this. Also Rimadyl has been suspected in actually causing this disease. It sounds like the dosage of the Pred and such has been prescribed rather haphazardly? It is strange that you also say that his energy levels and eating habits haven't changed. I think you need to see an internist and figure out what is going on. Keep us posted. Penny

Penny Lytle Creek Calif

thank you everyone. I appreciate it. I have been going to the same vet for 20 years. I think I will get a second opinion. My vet indicated he has only seen maybe 1-2 cases of this a year and received instruction/recommendation from another vet who did the ultrasound on the initial dosage of prednisone/imuran. First tests indicated regenerative anemia. I though it was a bit of a drastic change too as everything indicates you have to wean off slowly. It could be because the medication isn't helping stop the destruction of the red blood cells, hence the descreasing PCV. I will make an appt tomorrow. It may be the same news, but at least I checked. thank you folks. I'll be in touch.

Mardi Cali

I forgot to add that at least weigh in he was 59 pounds. Down from a month before of 65. This weight, 59, was last week. He is tolerating everything well. No vomiting, diarhea, etc. I live in a small rural area. No teaching hospitals. Was only on Rimadyl for approximately 4 days. Had vaccinations for Bordadella (sp) in May and surgery in April to remove growths, one was a squamas cell carcinoma, (discovered after biopsy) which was completely removed. I asked about transfusion today and was told it wouldn't help. One transfusion costs $820.00 here. I would have done it, but they indicate it would only up the PCV value for a day or so and would return to low amount. I will most assuredly make an appt to get a second opinion. thank you all.

Mardi Cali

Good Mardi, Please keep us posted and let us know if you have questions. I'd say the dose needs to be close to the 120 mg (split twice per day) for you dogs weight. Also, our Aza dose for Tiggs who is about 64 lbs was 30 mg, but that was even considered a bit low- some are on more like 50 mg/day. He was also on about 20 mg/day of aspirin, and about 15mg of Pepcid twice per day. Transfusions do help usually, they will boost the PCV to an acceptable level and help your dog in the interim, but yes, the body might destroy the new cells within a couple of days, but that couple of days can be necessary as the Pred can take up to a week to 'kick in' and Aza as stated can take weeks. It's positive if there is regeneration. I hope you get this all sorted out as soon as possible, time is really of the essence. Thinking of you and your sweet baby, melissa and tiggs

melissa slc

Hi Mardi, are you in California? I I dont know why your vet would say a transfusion wont help. Many many dogs here have had one transfusion and thats all it took. And having your vet drop the pred that fast can cause other problems. Many of us here have consulted with Dr Dodds, either email or phone she is fabulous and will help, she is the most authorative on this disease. Please contact her asap her eamil is hemopet@hotmail.com, she should respond asap. Put in your title AIHA dog and living in a rural area, need help If you are in Calif, your vet can also phone consult with UC davis good luck and keep us posted. Laurie

Laurie CA

Hi, I would take this dog off Rimadyl immediatly and ask why the pred was not slowly weaned, and get on imuran or cyclosporine - i second all of the posts suggesting a vet consult with uc davis or another vet... best Christine

Christine fl

I listened to what all of you have mailed and took my pup to another vet this morning for a second opinion. She has had more experience with this disease. She put him back on a higher dose of Pred: 50mg 2X day. Back on the azathiprine 50mg, every other day, suralfate 1 tablet 2 x a day 30-60 minutes before Pepcid, and Pepcid 1 1/2 tabs 10mg twice a day. She said that even though his PVC is 15, his RBC are way high @ 80,000 which indicates he is still producing a whole lot of red blood cells. It's considered "high" according to the lab tests. She said it is a very good sign. His heart and lungs are in good shape. So far he is not in a dangerous situation which would require a transfusion. Since taking the Bio-Preparation, beginning on Monday 4 times a day his gums are a lot pinker. You never know with this disease, but as of right now things are pretty darn good. Goes back for labs again next Thursday. I can't thank you all enough for all the wisdom and words you have sent my way. I know this is a serious disease and things can change for better or worse, but as of right now the stress load I've been carrying and my dog for the last month has been lessened greatly. As I've been informed, don't give up, don't freak out, take a breath and find a vet who knows what they are doing.....Bless you all, I'll be in touch. We are all here for each other. Thank you.

Mardi Northern California--rural area

Mardi, I live in Redding so maybe not too far from you, one thing I dont see on your drug list is doxycyclene which is extremely important. THis is the first drug along with pred that vets give dogs because of majority of AIHA cases are caused by tick diseases and here in Northern California and we have way too many, so please ask your vet about that. Laurie

Laurie CA

I actually live in Eureka! We aren't too far away. I lived in Redding for 4 years back in the 80's. Lived in Oak Run. Ollie had been on Doxy for several weeks. She wanted to discontinue because his WBC's don't indicate any infection or anything and they already ruled out tick borne problems. Thank you very much for thinking of that though....this site has been a god send. Keep in touch and thanks again. Take care.

Mardi Northern Cali

Hi neighbor! I have been drooling over Eurekas Best Western commercial this week with the heat we have been having. There was a vet that worked in my dogs practice and moved to Eureka last year and opened up her own practice. her name is Comus, not sure of the spelling. Would that be your vet? Give big hugs to Ollie Laurie

Laurie CA

No, I go to Sunny Brae. The vet is Dr. Burdon. I haven't heard of the one you mentioned. Be prepared if you come this way for FOG. It was sunny for about 4 hours today and the fog is starting to come in. Oh well. Life is good!

Mardi Northern Cali

This thread was discussed between 31/07/2009 and 01/08/2009

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