Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Riley Part 2 - ran out of room

Sorry for the lengthy story but wanted to give you the groundwork. It is now 16 days down the track for Riley since that day I found the blood - not sure if thats a long time, but he still continues to sleep a lot, eats very well, suddenly appears when food is being prepared and also when I am eating! He is interested in going outside, and also when dogs/owners walk past the house. He is obviously still anaemic, but the vet doesnt think it is AIHA, when I asked her. I think now they want to look for the "possible inflammation" so an ultrasound is scheduled for Monday, and she did mentioned possibilities of a tumour somewhere - or she said he could be given cyclosporin, which as I understand it, is a serious medication, but without knowing what is going on I am reluctant. Im very nervous about Monday. I wondered what people here thought and whether there are similar experiences. I am currently reading through the threads, and as I understand it, there are some knowledgeable people here! :) Thank you Brigitte. I will try not to be so wordy next time. Thank you all. Silka

Silka Melbourne

Silka posted her story on an other board and did not get any responses or acknowledgments, so I pointed her towards this board. To me it sounds like Riley has IMT, the bleeding and tell tale bruising. I don't think hat would happen with a tumor. Maybe somebody has some ideas about the numbers Silka posted. Thanks for your help, Brigitte

Brigitte BC Canada

Hi Silka, Yes, it looks like your Riley has had IMT - my kent had this too, when he had a aiha relapse, it started with IMT. It sounds like your emergency vet and vets are doing what they should be - checking blood frequently, and prescribing prednisone - the key to the pred is do not lower it too fast too soon. I dont know if Riley has AIHA - it does sound like it. Kent was treated initially until drugfree the first 9 months with ONLY prednisone, but alot of people and vets go for pred and imuran. Then maybe cyclosporine. Has your vet suggested a tick panel? this is often a cause. If not, suggest you do get one done. If this is a tick caused disease, must be treated, and Riley should be okay. If it is internal - tumor, or otherwise, the tick panel needs ruling out. Most tick diseases are treated with doxy for at least 8 weeks, i think. Keep posting, and i am sure others will have better knowledge re the numbers. Also, with increased appetite, consider feeding carrots, good for them and low calorie - they get a voracious appetite and thirst. Best, Christine

Christine Fl

Dear Silka, I am so sorry to hear about Riley and this sudden bleeding event. How very frightening for you! I know your vets have been checking many things out as possible diagnoses. I wonder if they asked you if there was any chance that Riley was in a situation where he could have ingested rat poison? This can either be in bait for rats or can be inside an animal that had ingested rat poison that he would have eaten or gnawed on. Are you located in farm areas? Did they at any time say they were administering Vitamin K? This would be the treatment for rat poisoning. Rat poison comes in several different forms, but one popular form is basically a blood thinner like warfarin or Coumadin. The blood becomes unable to clot and thus you would see petechiae or the little pinprick red spots in the skin. Symptoms can occur many hours and even days after contact with the rat poison. This included serious and unchecked internal bleeding. Signs might be vomit or bloody stools. I am not familiar with the types of ticks in Australia and if you have similar diseases as the rest of the world. But that is definitely something to ask your vet if they checked for. Inflammation or "blood poisoning" is also a possibility and they are already in the process of checking for that. You would be given special antibiotics for this and he might need to be hospitalized. The side effects of the high doses of prednisone are many. Increased appetite, drinking and peeing are just a few. Weakness and fatigue begin to show up after a time on high doses. Long term use will show muscle mass loss, liver problems, increased risk of infections. If this is an autoimmune disease, it is necessary to continue with this drug until another one can be added to assist (like cyclosporine). I think the next couple of days will be very revealing. If this was contact with rat poison and they have been properly treating him, he should show great improvement. my best patrice

Patrice NYS

Dear Christine and Patrice Thank you so much for your responses, I have made note of all the things you have mentioned. As far as ticks are concerned, I dont know, we are not in a known tick area and Im not in a farm area, but I had thought about it, and certainly will raise it. Would it hurt to have Vitamin K anyway? I will ask about a tick panel, is that part of the blood count? Rat poison ingestion was raised with me by the emergency hospital and I dont believe that would be the case unless someone actually fed it to him, I dont use it, and if it was just there I would imagine my other dog would be affected as well given her appetite and Riley was such a fussy eater. Of course now its "voracious", which helps when giving medication. I have been worried about his little round tummy, not sure if its food or what the vet is talking about as a possibility - tumour. I guess everything you read you imagine is happening to your dog! I was worried about cyclosporine, not that I know too much about it, but the vet did suggest that as an option, but feels the ultrasound needs to be the initial treatment. Sometimes Riley seems quite responsive and wants to share in whats going on, but mostly he sleeps, but wants to be close - could that be the medication? Last night when I took him outside he ran with Bonnie who had spotted a possum in a tree. Im not sure that was a good thing as I was supposed to keep him quiet, but it was nice to see. Thank you both again, and thanks Brigitte for the introduction. :) Silka

Silka Melbourne

Sorry to hear about Riley. I live in Melbourne too, in Langwarrin. I lost my little Maltest/Shih tzu 12 months ago to IMHA bone marrow failure at 9 months of age. After reading all the posts on this board for 12 months, I realise you really do need excellent vet advice. I had a local vet advising me because of the distance who didn't know what she was dealing with. It sounds like you are in good hands, but if you need a second opinion I highly recommend the University Teaching Hospital at Werribee. They get all the specialist cases and have dealt with IMHA a lot. If I had gone straight there I believe I would have had a good chance of saving Scruffy. Lort Smith did the initial blood transfusion but the local PAA vet clinic did all the follow up. It sounds like your emergency vets are good though I was never told about cyclosporin Also never offered a bone marrow test either. He fact that he is regenerative even if mildly is very positive. I wish you well with his treatment. Julie.

Julie Australia

Hi Julie, Im not far from you, up the road in Mitcham. Im so sorry to hear about Scruffy at only 9 months of age, that must have been been so difficult for you. Thank you for the recommendation, I havent heard of the Werribee Hospital. I will see what the ultrasound brings tomorrow to see if there is anything underlying. Did you take Scruffy to Lort Smith because the vet did not know what to do? How did you get to hear about the Werribbee Hospital? I will admit to being scared of tomorrow and what it might bring. Yes indeed, this is something I have never heard of, and its all so sudden. Im not exactly sure what is keeping Riley going to be honest. Your wishes are greatly appreciated. Silka

Silka Melbourne

Hi Silka. I came home from a week's holiday leaving Scruffy at home with my family looking after him, to find him extremely ill, he could hardly walk. My initial vet the Peninsula Animal Aid, gave me the horrendous news he save seriously anemic and I should promply "put him down". I refused and rushed him to Lort Smith Hospital. They told me he had a chance with an immediate blood transfusion. I left him there but by the second day they told me he was ready to go home (way too early). He had had a transfusion but only got a PCV of 17 from an earlier low of 8. I made the mistake of letting the PAA monitor his treatment. They put him on the right drugs (pred and imuran) and we monitored him every few days for his PCV. However, he never responded at all and PAA never told me that I could have tried other treatments. I got him back to Lort Smith about 4 weeks later. However, by this time he was very ill again. They told me about Werribee University Hospital and that they were the only place who did cross-matching of blood. By this time I was faced with a gravely ill dog, Lort Smith convinced me he had other issues (enlarged liver) now realised the result of pred. and that he had little chance. However, Werribee Hospital can handle all these issues. I decided not to go to Werribee to continue treatement as he was described on the lab tests as "severe worsening and no response at meds at all with a retic count of less than 0.01. Now with a PCV of 8 again. I was confused and decided to put him to sleep and end his suffering. Since this time I realise there are other options and I am sure he would never have got so sick with a much more aggressive approach. PAA just told me there was nothing more that could be done. I now know this is not so. Julie.

Julie Australia

Hi Julie, thank you for sharing the story of Scruffy. I can tell from your relating of the situation that it affected you deeply. Im so sorry. I dont know how else you may have handled it, not knowing about the surrounding conditions, but it certainly sounds as if you did all you could at the time. Thank you for sharing this with me. I am currently waiting for a call from the vet to let me know the ultrasonographer is on his way, I have asked if I could sit in on this. Needless to say my nerves are shot.

Silka Australia

Dear Silka, I have been away on holidays and am just catching up on the posts on this forum. My 11 year old Maltese Shi tsu X was diagnosed with IMHA just over 9 months ago. After initially seeking treatment in Geelong, Millie was in crisis and our vet referred us to the Melbourne University vet clinic in Werribee. Let me tell you - they are awesome. I highly recommend them. Their emergency vets deal with IMHA/AIHA frequently and see a lot of cases each year. My regular vet estimated they only ever saw about 5 cases a year! Please go there - they have all the diagnostic equipment and labs there to treat Riley. Good luck, Samantha & Millie.

Samantha Geelong Australia

Dear Samantha Thank you for your post re the Werribee Clinic. Julie had already put me onto them and I have looked them up, but I feel that perhaps my vet and the emergency clinic in Mount Waverley have done the right thing by Riley. Having said that, I would indeed be keen to go to Werribee and have Riley assessed just to be sure. How is Millie going? Did you have to leave her there? Silka

Silka Melbourne Australia

Dear Silka, If you feel your vet is doing the right thing by Riley, probably no need to change vets right now. At least you know Werribee is there as an option. Millie was a very sick little girl when we rushed her to Werribee. She was in intensive care for 5 days (they have 24 hour care - something I find very reassuring), after crashing to a PCV of 14. She received a tranfusion at our regular vet (who probably saved her life). After about 5 days, Millie was hardly moving, and retaining some kind of fluid. I went back to our normal vet, who thought it was internal bleeding and they referred us to Werribee. The vets in Emergency at Werribee did diagnostic tests on Millie that night to check for the possible cause of her IMHA (cancer etc). Nothing was found, and the fluid was only fluid - not blood! We take Millie to their day clinic for her follow up checks where they have a vet who is very knowledgeable on IMHA. So far so good, fingers crossed. Nine months on and all still looks good. How is Riley? Samantha & Millie.

Samantha Geelong Australia

Hi Samantha, thank you for letting me know that, and Im so glad Millie is doing well - what type of dog is Millie? A PCV of 14 is low, she fought well to get back from that. Riley's PCV has not been below 24, from the records I have - Im still learning and finding out about all of this. You probably saw my other post re Riley, waiting for some result of blood tests, but the blood I saw, which I must admit to, didnt seem like blood, was actually tomato! Now I know that tomato is not good for dogs, so another learning experience. Riley does seem to be fighting to come back, but does sleep a lot, but springs to life when there is food around, and when I go outside, or someone walks past, and I did read here, that if they are still going outside to do their duties, then there is life and fight there. The vet is hoping to reduce the cortisone on hearing about the result, hopefully today - I think she indicated cutting it in half, but given what others are saying about reducing it slowly, Im not sure, but I trust her, she has done a good job. Im on leave at the moment, working at home as well, as its term break at school (no Im not a teacher, admin) but I will have to go back to work next week so I want to be sure things are going okay. You must have turned cartwheels when Millie just had fluid and not blood! Amazing.

Silka Melbourne Australia

This thread was discussed between 19/09/2009 and 29/09/2009

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

This thread is from the Vetnet archive. The live Vetnet forum is active now.