Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Red spots on skin??

Hi Everyone,it has been almost 9 weeks since Cali was diagnosed & she has been doing really good. Last week the Dr. decided to take her off the aziothioprine & lower her prednisone to 2 times a week (10mg each time she's 44 lbs.). She was doing pred.3 times a week & 50 gms azio. every day. I have noticed no difference in her eating or level of activity. All seems to be fine, but I have noticed a few red spots on her skin. Her hair still hasn't grown back from the ultra sound & blood transfusions otherwise I wouldn't have noticed them. She has been on 10mg of aspirin every day since this started & I still give her prilosec when she gets the pred. Has anyone else experienced this? I don't want to freak out, but I don't want to pretend nothing is wrong either. Any advice would be appreciated. I'll call her Vet tomorrow. Thanks, Dee

Dee

Dee, Are these little bright red spots that almost look like bug bites or are these a bit larger and somewhat "weepy"? Little ones that crop up in groups esp in areas like the crotch are called pettechia and are a sign of clotting problems. If you have not had a blood test done recently it might be a good time to have that done to check the platelet levels. They could be very low. If this were me, I would try to get in tomorrow to see the vet or at least have a tech do a blood test. If the spots are larger and seem to weep or ooze yellowish liquid, these are signs of a staph infection. Dogs being treated with high doses of immunosuppressive drugs like prednisone will be more apt to develop staph infections because they can't fight the bacteria very well. Normally, we all throw off staph infections all the time without even noticing it. Treatment for this is a proper antibiotic, usually cephalexan. That will clear it right up. Meanwhile, keep the area clean with *gentle* soap sponge baths. Keep your hands clean when touching your dog and wash them after you do touch Cali. Avoid exposure to other dogs not in your household for now. my best patrice

Patrice NYS

Thanks Patrice, I actually ended up calling the Vet after hours. Cali & my other dog had a scuffle over a treat. I thought nothing of it at first, but then found her bleeding from her mouth.I wasn't sure what happened since I only heard them. I didn't know if it was disease related or from the fight. I got paranoid & it was a good thing I did. Her PCV had dropped from 40 to 26 in a week. She did lose a tooth in the fight, and now the problem is her mouth doesn't want to stop bleeding. The vet did say it could be her platelets are low. He uped her meds again & gave an antibiotic for her mouth. If not better in the morning we are to go back. He was concerned about the spots too & said it looked like bruising associated with IMHA. It all started after the mediaction was cut so thisis very disappointing. I know every dog reacts differently, but it is horrible to have a set back. I just hope she doesn't get worse over night. She is still acting "normal" sokeep your fingers crossed.

Dee

Also sounds like low platelets to me ... especially in light of the recent med reduction & the prolonged bleeding from her mouth. Since her meds have been re-upped I hope it resolves the problem. Maybe a little slower on the reductions going forward (?). Also, if Cali's platelets become dangerously low, consider asking your vet about a vincristine injection. One of the effects of this chemo drug is that is causes a release of platelets from the bone marrow. While they may be somewhat immature cells, depending on circumstances, it can be a life saver. Good thoughts to you & Cali that she is back on the recovery track.

Ronda So Cal

When Casper's platelets are low, he gets red spots and brusing on his thighs and belly. He also had the bleeding gums for a while. Upping the meds and monitoring the platelet level should help. I usually limit his activity level when his numbers are low.

leslie ca

Thanks for the advice. She was still bleeding this morning, so we are back this afternoon. Her face looks a little swollen also,so there may be some infection. I'll update this as soon as I know something. My Vet has only treated about 30 cases of IMHA. There aren't any specialists in the area, so when he reduced the med. I was concerned but trusted him. I did think it may be too soon since most people say their dogs are medicated for at least a year & sometimes forever.

Dee

Dee, Oh dear. I hope that they can get this under control over the weekend. Has your vet done a complete tick disease panel test at some point in the diagnostics? Platelet loss is one of the symptoms of some of these diseases. If this has not been done yet ask for a SNAP 4DX exam. That will get you results for 3 of the major tick diseases. Patrice

Patrice NYS

Sorry to hear she is still bleeding. We are hoping for the best for Cali. Hang in there.

leslie ca

Thanks Patrice,Leslie, & Ronda, When this started she did have the test for ticks. Initially they thought it was lymes disease because of some other symptoms. The Vet checked her platelets today and they were down to 9000 which is pretty bad. My Vet was afraid she might bleed out. Her PCV was holding in the 25 range. She was still acting normal eating & drinking normally. He refered her back to the Emergency Clinic which is 45 minutes away. They weren't really sure what they were going to do. They thought she might benefit from a whole blood transfusion. I did ask about the Vincristine injection. My Vet said that would be their call. So now we wait & see. The thought of starting all over again is pretty depressing. At least I only have 4 more days to work until I'm laid off for the rest of the year. That way I'll have plenty of time to focus on her. I'll keep you all posted

Dee

9000 is tremedously low and, imo, definately lifethreatening. Sierra's were down to about 16000 when she received the vincristine. Her vet at the time was also concerned about her bleeding out. If you can, I would strongly suggest an email to Dr. Dodds at hemopet. She is an immune specialist (as well as thyroid disease expert) and is hands down on of the most generous persons I have ever come across with her knowledge and willingness to help. I wold imagine that at the ER Clinic they have or have access to an Internal Medicine Specialist who has a lot of experience treating this disease. If not, maybe you can look one up and and ask the treating vets to call them. http://www.acvim.org/Specialist/Search.aspx I don't mean any offense, but I hope the vets at the ER don't do the wait and see at 9000 platelets. Will keep Cali in my prayers that her platelets rise, rise, rise.

Ronda So Cal

Well this is the message I didn't want to ever write. I had to let Cali go earlier today. They gave her a transfusion last night, and when I called this morning she was clinically OK. They wanted to keep her another night & check her platelets again. I said fine I would be in for a visit. When I pulled into the clinic I heard my phone beep & they had just called me. It had only been 2 hours & she went down hill very fast. They believe she had blood in her lungs. I was able to be with her at the end, but mentally she was already gone. I only hope she knew I was there for her. It's a very sad day here & things will never be quite the same. I'm so happy I found this site because most people just don't understand how devasting losing a pet can be. This is a family member that you see every day & they love you unconditionally despite all your flaws. I lost my Cat Bobo to cancer in October so the house is starting to feel pretty empty. Our other dog Brandy is now on her own & will be 11 in October. This one was the toughest loss yet. Good Luck to everyone else in this fight, Dee

Dee

I am so sorry to hear about your loss. Losing a pet IS losing one of the family and it can be devastating. Know that you did everything you could do at the time with the knowledge you had and so did your vet. When I lost Toby, that was the hardest thing too for me. I think it is because this disease has so many ups and downs. Mary

Mary Indiana

Dee, I am sure Cali knew you were there and that she knew that you did everything in your power to save her. Cali has now joined a lot of our dogs at the bridge where she will play until you meet again. Sharing in your sorrow Penny

Penny Lytle Creek Calif

Dee, I am so sorry for your loss. You HAVE lost a family member - I know that sometimes non-pet owners don't "get it" but it is truly devastating to lose a loved one that offers such amazing unconditional love. My heart aches for you right now. In the past year we have lost our lab buddy and our 20 plus old horse, and both were devastating. I hope that soon you will be able to see through the tears and smile at the good memories, and yes, I'm sure that Cali knew you were there to the end. Your family - including Brandy - will be in our thoughts and prayers. jeanne & matilda & sadie & bentley

Jeanne Texas

Dee, I am so sorry to hear about your loss. My thoughts and prayers are with you during this difficult time. Layla & Tipsi

Layla Brantley Raleigh

So sorry to hear that poor Cali did not make it. We are thinking of you at this difficult time.

leslie ca

This thread was discussed between 20/06/2008 and 24/06/2008

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