Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - relapse fears

As I told you two weeks ago, Kahlu is doing fantastic. Nothing has changed with that and I am extremely happy. Next week we will do a PCV and hopefully go on with the prednisone reduction. He is now on 2.5mg 1x per day and we plan on changing to, one day 2.5mg the next 1.25mg, then go to every other day 2.5mg. We have done the reductions fairly slow over the last few months, but i am still terrified about a relapse. The vet and I agree that we should give him the chance to be medication free and aim for that. I do remember Silka from Australia mentioning a test (anti nuclear something?) that would show, if the dog can go off medication. Is that really available or is it just wishful thinking? I would not mind spending the money to have peace of mind. I know there is a test to check if the adrenal glands are working properly, but the dog has to be off meds for a couple of weeks, to do that accurately. Our plan is to have him medication free and then send the blood to Dr. Dodds for analyzing. Any thoughts? best wishes to you all, Brigitte & Kahlu

Brigitte BC Canada

Hi Brigitte, you have done so well, I can understand the fears. I am at work at present, let me check what the ANA report I have at home says - it was recommended I get this done as a prognostic measure, but it could all be frippery for all I know now - it was good news supposedly, measuring how many antibodies are in the bloodstream, and Riley's result was positive, but he just seems to stand still with his results and numbers. Ill check what I can and get back, and others will probably know more than I do at this stage. I am going to see a specialist on Monday so I will ask her too what it all means and if there is any basis to it. Good luck to you both - on the home stretch now. Silka

Silka Melbourne Australia

I was so excited to get charlie off the meds we redduced A little faster but charlie has been acting fine for quite A while. I would go off the meds if kahlu is acting fine, just Watch him but you will be surprised how good you feel and how Good he will feel med free. Take care Carol

carol

Hi Brigitte, I totally understand your fears. I was so paralyzed when we reduced and reduced and reduced...and the only next step was off. My vet was confident that the benefits would outweigh the risks. I agonized for weeks- it was such a difficult decision. I remember asking my vet- what if we do relapse, can we just go back on a low dose, and she said no, it would be an immuno suppressive dose...that made my decision even harder. It was so agonizing, I lost a lot of sleep. But, after making the decision to go med free, I can honestly say that it was worth it. No yucky side effects of pred and aza. Tiggs has been off of his meds since about May now. I still worry daily, check his gums, make sure he eats his breakfast, but I think he feels fantastic. And I'm confident that we'll be far better equipped to face IMHA in the future should it reappear (God, we hope not!). But having Tiggs off of meds for the last seven months and seeing the FULL Tiggs, in all his glory has been totally worth it. I say if your vet feels it's a good plan and you've gotten this far with his or her advice, go for it! Take your time to think about it, and the answer will come, whatever it may be. Hugs to you and Kahlu. melissa and tiggs

melissa slc

Hi Brigitte The result of Riley's ANA test - Antinuclear Antibodies on 22 September was POSITIVE >-1:40. It doesnt tell me much, but I noted on my records I am keeping that it was a good result, low positive, and shows that Riley can eventually be weaned off medication. How I do not know, as he seems to not be moving at all, so I have no clue how they measure this. I think it means there are 40 antibodies per field, whereas <20 is not significant. High is >160. Maybe that is how they work it out. Some of the drugs affect the result as well. I dont know that you need to do this, given the stage you are at with Kahlu, and his PCV is good, it would probably come back at <20, not significant. Patrice may be able to help more.

Silka Melbourne Australia

Since Wylie did have a relapse a year ago this month, the fear is always there. She was First diagnosed 4/08. I think her relapse was caused by either 2 things, or the combo. 1) she responded very quickly to the pred and was only on it 2 months. My vet felt that she hit the magic number, off with the pred. I had my fears since reading here, you dont do that. I even kept her on 2 weeks longer because I had extra pred. 2) the week before her relapse I gave her heartgard plus. My vet thinks this is what triggered it. So she is now on interceptor. Again, her humbers shot up immediately in 3 weeks to 41, but this time she was on pred for 5 months. Since she is over 12 years old I glad she has responded so well and not on anything. What I still dont understand is how it is determined after a first diagnosis, when a dog needs to be on some sort of med for life. I have read that a lot here and on Meishas success stories. Laurie

Laurie CA

Hi Brigitte, We're at the exact same point with Kola - 2.5 mg daily. Interesting, because I think you and both joined this message board about the same time. Our vet is saying such a low dose can't be doing very much given Kola's weight (about 60 lbs) but he understands our decision to keep him on this dose for now. He's completely back to the dog he used to be. My plan is to begin reductions of the low dose Pred at his year anniversary of diagnosis. It may be superstitious but I feel better this way. Best to you and Kahlu

Leslie Philly

Brigitte, I love the way you think...."2.5mg 1x per day and we plan on changing to, one day 2.5mg the next 1.25mg, then go to every other day 2.5mg"....you're giving me some good ideas! I can completely understand the paranoia of relapses. If I hear Tessy snore the wrong way I get worried. Suppose that comes with the game though. I'll be cautious the rest of her life now probably. Like Melissa was saying I think the benefits would outweigh the risks with regards to leaving a dog on drugs permanently. I'm planning on taking Tessy totally off her meds at some point. We'll cross that bridge when the time comes I guess. I think that the last few reductions are the most important and critical. Slow and steady! Anywhooo....sending some positive Nova Scotia vibes to Kahlu for a successfull trip to the docs next week. Hugs, Johnny & Tessy

Johnny

Kahlu is awesome. Your a good mom. I don't know about the rest of your statements/questions, I just know I'm happy that Kahlu is alive and doing well. Take care.

Mardi Northern Calif

This thread was discussed between 18/11/2009 and 29/11/2009

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