Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Riley's latest bloodwork

I have added Riley's latest bloodwork values to the chart below. (Not sure of the best way to post these...if anyone has a suggestion so that they're not all crammed together please let me know!) His blood showed a good improvement on Friday. In fact, we could hear the staff cheering in the back and wondered what was going on. The vet came in with a big smile on her face and said it was for Riley's bloodwork! Guess that Pet Tinic really works! :) 3/1 3/5 3/11 3/18 4/1 WBC 13.9 35.1 27.2 21.9 22.6 LYMF 1.9 8.5 7.6 3.4 5.9 GRAN 9.7 20.3 13.8 13.9 11.9 MID 2.3 6.3 5.8 4.6 4.8 LYMF 13.7% 24.4% 28.1% 15.8% 26% GRAN 69.5% 57.9% 50.7% 63.5% 52.6% MID 16.8% 17.7% 21.2% 20.7% 21.4% HCT 18.5% 21.1% 27.4% 28.2% 36.3% MCV 58.8 74.4 80.4 75.9 72.6 RBC 3.16 2.84 3.41 3.72 5 HGB 6.5 6.6 8.9 9.8 13.1 MCH 20.6 23.3 26.1 26.5 26.2 MCHC 35 31.4 32.4 34.9 36 RDW% 12.4% 12.4% 12.5% 12.5% 12.6% MPV 7.6 13 11.2 9.2 8.3 PLT 48 157 361 278 431 Tentatively, the plan is to start prednisone reduction in two weeks. She said if he was holding steady she would recommend a 20% reduction at that time (he is on 100 mg presently...she would take it down to 80mg). His weight was 87lb. at this last visit so that's just a bit under the recommendation of 1mg prednisone per lb. of body weight. I am happy to think of reducing the pred in the near future, but at the same time the idea is scaring the bejeebers out of me. It's weird to have such conflicting emotions! Riley is just not his usual bouncy self on the drugs and we're beginning to see the muscle weakness which is really bumming me out....so I'm trying to focus on the positives of reducing the pred and not be scared. So, if all goes well the pred reduction will begin on April 16...which leads me to a question. My husband is scheduled to go on a business trip for two nights -April 19 & 20 and really wants me to go with him. It is to a resort area about 150 miles away and we would be going by car. My tagging along has been kind of up in the air due to Riley's illness but I am considering the possibility of going since he seems pretty stable (not 100% sure but considering it). If I do decide to go, should we hold off on the pred reduction until after we get back?

Jennifer

Jennifer, How wonderful that the whole staff is so on board! The only worry I would have with you joining your husband on his trip is how does Riley handle your absence? Stress can play a big part in this disease and I would hate to see you lose any ground now.

Penny Lytle Creek Calif

Good point, and something I did not think about. I think he is generally OK when we go away. We never board him and usually have someone come to the house to stay with him and our two cats. We would either have our pet sitter stay at our house as usual, or take him to my parents' house (the option I am leaning toward because they are retired and around all the time.) He just loves my dad. I am just worried more than anything about a relapse coming on while we are gone.

Jennifer

Jennifer, I would leave Riley with somebody he is used to be with, a situation that does not stress him out and somebody who you would trust 100% with giving him the meds. Make sure they have very good, written down instructions that leave no room for guessing. I think it would be good for you to get away too. You probably could use a break by now. It will only be a break if you don't have to worry though. I think I would go ahead with the reduction even if you go away. He seems to still be on a very high dose and needs to come down from it. Best wishes, Brigitte

Brigitte BC Canada

Jennifer, Congratulations! Riley's lab results are spectacular. This group is a look at that success: HCT 18.5% 21.1% 27.4% 28.2% 36.3% (Norm is approx. 38-55%) RBC 3.16 2.84 3.41 3.72 5 (Norm is approx. 5.6-8.7 HGB 6.5 6.6 8.9 9.8 13.1 (Norm is approx. 14-20) PLT 48 157 361 278 431 (Norm is approx. 145-440) Hematocrit is a representation of the "red stuff" and is somewhat equivalent to PCV packed cell volume. 36.3 is nearly normal, just a few points away. RBC is red blood cells, in millions. 5 is just .5 from normal. The more normal this number is, the greater oxygen carrying power Riley has. HGB is hemoglobin. This is the part inside the red blood cell that actually carries the oxygen. Again, just a few points until it is considered normal. PLT is platelets. These are the smaller elements in the blood that are responsible for repairing any internal or external injuries to blood vessels. So you are looking at close to normal, but not quite. There is a lot of healing still happening. Riley is still on a high, immunosuppressive dose of prednisone. 80mg would also be considered a high immunosuppressive dose as well. Prednisone is considered to be a miracle drug. It does save lives, not only in dogs but in humans as well. However, it does not come without some very negative side effects. And Riley is still well under the thumb when it comes to those side effects. Gradual reduction will eventually cause most, if not all, of these side effects to disappear. The shortest administration period is always the best in terms of side effects, but it must be reduced very carefully. Your vet understands this and is well versed how to do these reductions safely. I had to go back and look to see when Riley was first diagnosed. It was March 14, so you have not reached the one month mark quite yet. Your husband's trip is just about one month from that date. If this were me, I would not want to be away from my dog in an early stage like this. Others may have differing thoughts. I do not want to tell you what to do, but only advise you of some of the reasons why I would choose not to go. If I absolutely needed to go somewhere in a situation like this, I would only do it if I could find a reliable family member or dear friend with lots of doggie experience to keep my dog. If I were to do this, I would have a trial overnight (or 2) for Riley at this person's home to see what kind of problems might arise. Suppression of the immune system by prednisone means that Riley is not as capable of fighting off some things like bacteria etc that he would normally be able to fight off. Exposure to other dogs in a kennel would definitely be out. I would also avoid exposing him to any person who has a compromised immune system, such as an elderly person or someone with a serious disease. If you can find a quiet home of a friend who doesn't currently have any animals, this would be the best choice. my best patrice

Patrice NYS

Wow - Jennifer, I'm so happy for Riley ! A major bounce back ! and Patrice, I would never have thought of a human with health issue commuting to my sweetie by having them in proximity... so many things to think about. I know the struggle you're going through Jennifer - Even if you left the pred at the current level and waited till you got back, there's still that worry of the stress. I wonder if you could bribe your dad to stay at YOUR house....My dad is cheap - He'll do it for a half gallon of Blue Bell Ice Cream. Then Riley would be in everyday environment with a comfortable, known person. Good luck - and Keep up the good numbers !!

Lisa TX

Thanks all for your thoughts. Riley was actually diagnosed March 1, so it has been a little over a month. I am leaning more toward not going on the trip. We went to my husband's family's house today for Easter dinner. We didn't want to leave him for the amount of time it would take, because it is a little more than an hour's drive away, and we thought it would be best since he needs to pee so often and med time would be while we were gone. I think being out of his normal environment was hard on him today, so that's something I need to consider as well. We are really happy with the progress he has made and don't want to do anything to set him back.

Jennifer

Yup these numbers are excellent! Especially the HGB, RBC and HCT!!! I was expecting the MCV to drop some since adding the pet tinic and it did. This likely means the pet tinic IS doing its job! Did you have a chem panel done lately? Thyroid?

Johnny

Yes, very happy about the numbers!! I thought it was so cute the vet staff was cheering in the back over his labs. :) Johnny - we decided to forego the thyroid/chem this time since things were looking so good. My two 17-year old cats with chronic kidney failure also needed to go to the vet and we are just tapped out in that department at the moment. If his labs hadn't been so good I would have done it but felt ok not to. I told my husband I was thinking I wouldn't be going on the trip and he is upset with me. :(

Jennifer

Hi Jennifer, Congrats on the great numbers! It is hard to leave our babies when they are sick. I did leave Millie for the first time about 4 months after she was diagnosed. she stayed with my parents, which she loves, but I really did not have fun as I was anxious about her. It has gotten easier but I still worry. I am sorry your husband is upset with you though.... Sam and Millie.

Samantha Geelong Australia

Jennifer, I am sorry that your husband has expressed some disagreement with you about not wanting to leave Riley to go on the trip. It's much harder to care for an AIHA dog when not everyone in the family contributes equally or has the same high level of dedication to ensuring a good outcome to treatment. Human parents sometimes have the same difficulties caring for children who are seriously ill. And it's not a great time to have a heart to heart discussion with your husband about this. It will be upsetting to both of you. I know your heart and you are fully dedicated to caring for Riley. You do have everyone's support here on this list to accomplish that. Perhaps you have a close family member, a friend or a clergyman who would help you sort out some of this difficulty? Having someone else acknowledge your sense of duty and responsibility might ease the tension with your husband. You don't love your husband any less because Riley is ill. He might understand better if he knew that you would do the same for him if he needed that kind of serious care. My husband supported me in all the care we gave Chance. He knows how stubborn I am anyway, but eventually, when the medicine began to work, I think he realized how powerful it feels to take care of another life and save it. I wish you all the best and I am thinking about you tonight. patrice

Patrice NYS

How true your words are Patrice! My husband and I had serious disagreements about Millie's care. When Millie got sick, his view was she should be euthanised. I wanted to try to save her. He did not take any interest in learning about IMHA, so when we were discussing Millie's health, we could not agree and I was frustrated because he was uneducated on IMHA and in my opinion, not in a position to make the decision to end Millie's life. It caused strain on our relationship no doubt, as the financial cost was also an issue with my husband, even though we could afford Millie's treatment. In the end, a good talk with the vet helped us. John would listen to her, and acknowledged that I had made the right decision with Millie's care. I hope your husband comes around Jennifer. I am more attached to our pets than he is, and I think now he understands what that means to me. I still have Millie here with me today, and for that I am very proud. Good luck Sam and Millie.

Samantha Geelong Australia

Thanks all for your words. I don't want to paint my husband in the light that he doesn't care...he has actually been really good about Riley's care. He takes time off work to go to each vet appointment with me and has been going home and lunch to let him out, because the poor pup has to pee so much. (My work is too far away for me to go home at lunch.) I think he just doesn't recognize how serious this is. He sees that Riley has gotten a lot better and doesn't understand why I probably shouldn't go. He's much more of a live and let live kind of guy whereas I worry about every little thing. It doesn't help that this trip coincides with my birthday and he probably has something special planned. :( Thanks for the support.

Jennifer

This thread was discussed between 04/04/2010 and 06/04/2010

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