Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Scout's non-regenerative AIHA

Hello everyone. I've been reading these threads for the last week and can't even begin to thank you for the information and the hope that you've given me. Sadly, my darling dog Scout and I have joined the ranks of non-regenerative AIHA victims. After seeing the many recommendations for Dr Dodds, I contacted her yesterday and have been corresponding ever since. She is a saint. Here's our story: Scout is a 9 year old, spayed, 11.6 lb, Toy Fox Terrier, excellent physical shape, trim, muscular In mid October, I began noticing that she was somewhat lethargic, but more worrying to me was a disinterest in food. She was always a voracious eater and although now she would eventually eat her food, her initial response of disinterest was severely out of character. 11/5/11 Vet visit Tests Urinalysis: all tests normal, except cloudy urine and WBC high at 4-10 HPF Diagnosis: UTI RCV - 20 T4 - Low at .6 ug/dl CBC – all in range except RBC low at 2.98 10^6/ul Hemoglobin low at 7.2 g/dL Hemocrit low at 20.6% Neutrophils low @ 41% Lymphocytes High @ 49% Eosinophils low @ 1% Reticulocytes - .7% Absolute Ret 20860 Corrected Ret .3 Superchem profile - All in range except BUN/Creatinine Ratio - High @ 30 Anaplasma & Ehrlichia - Neg Heartworm Antigen - Neg Lyme - Neg Fecal exam – Neg 11/10/11 Start 62.5mg Clavamox 20mg Prednisone daily 11/11/11 Vet visit RCV 18 No change in appearance or demeanor. Changed to hamburger, liver and rice diet. Advised to keep an eye on her. If she appeared worse to take her to emergency hospital. Later that evening Scout appeared zoned out and was breathing rapidly Admitted to hospital. PCV 15-16. given packed red cell transfusion. No issues with transfusion. PCV 25 11/13/11 Released from RBVH PCV 25 Sent home with meds Atopica 25 mg 2xdaily Baytril 68mg - ¾ tablet daily Prednisone 5mg – 2 tab 2x daily Pepcid 10mg – ½ tab daily Doxycycline 100mg/ml suspension - .3ml 2x daily 11/14/11 PCV 24 11/16/11 PCV 26 Added Reglan 2.5 mg 2x daily to help with nausea 11/18/11 PCV 20 Coombs test negative PCR Tick Borne panel – all negative Discontinued Doxy as making dog very nauseous and ill CBC – all in range except RBC low at 2.79 10^6/ul Hemoglobin low at 6.9 g/dL Hemocrit low at 19% Neutrophils now ok @ 64% Lymphocytes now ok @ 25% Eosinophils low @ 1% Reticulocytes - .2% Absolute Ret 5580 Corrected Ret .1 11/21/11 PCV 16-17 Breathing relaxed. Slightly elevated heart rate. Demeanor fine. Playing. Eating well. Active. Attentive. Vet felt that second transfusion would be necessary and to take her in that evening or next day. I opted for next day. 11/22/11 PCV 14?? Scout still seems fine, better even. Energetic. Active. Sleeping well. Drinking a lot, frequent urination, moderately loose stool, but otherwise OK. Her tongue and gums very pale. Heart Rate 160 (120 norm) Heart murmur - new The emergency room vet said her PCV was 18, but that the CBC test showed 14? The inconsistency in this test is frustrating. Ultimately they said the transfusion was up to me (thanks!) but that they were concerned about her heart rate and jagged pulse. We did the transfusion. I hope it doesn't set her back and was not premature. 11/23/11 All went well and Scout has tolerated the transfusion. Her PCV is up to 25 and her color is good. Emergency vet wanted to do the bone marrow aspiration. I've decided not to do it. Too much stress for her and it won't change her course of treatment. Per Dr Dodds suggestion, we are starting thyroxine today. The good news is that they are now seeing a weak regenerative response. I'm trying not to get overly optomistic, but I can't help but see this as positive. I am desperate to help my little angel. After my husband was killed in an accident 8 years ago, she was at times my only reason to get out of bed. I will do anything, spend anything to save her and if she can’t be saved, I will do what needs to be done. I just want to be as thorough as possible in the search for a cure. My little girl has been on meds now for two weeks and was hoping to see results sooner. Has anyone else seen the drugs take this long to kick in? I know that you all have been on this roller coaster ride before and you have my sympathy, especially those of you that lost your beloved friend. It feels like every other day, I swing between hopeful and utterly despondent. I know Scout and I are in for a long journey, but need hope that some make it through. Thank you all for maintaining this forum and sharing your stories. Apologies for the long post. Sincerely, Dorothy and Scout

Dorothy New Jersey

Hi Dorothy and Scout, I completely understand your angst as do many others on this board. You may need to work with the dosing on the Atopica. Once you get this working, its really one of the more effective drugs for immuno suppression. Others on this board are more fluent in the explanation. It's only been two weeks. There will be a turning point in her treatment where she really starts to show the numbers she'll need to turn this thing around. Hang in there... Maggie and Robert

RobertN Superior

Hi Dorothy and Scout, I am Sorry that you are going through this. This Site is the BEST for advice. I knew nothing about Dr. Dodds and sadly, I discovered this site when it was already to Late. These people are knowledgeable, and will be there through the Good and the Not so Good Days. It is a Roller Coaster Ride, but there are success stories, That's what you have to remember. Our Daughter told us a few times a day, "Where There's Life, There's Hope." At times, that little saying of hers, Is what kept us going. I Pray for all of these Fur Friends and their People. I also Pray that one day, there will be a cure. Until that day comes, we all just do the best we can. Take Care. Kathy

Kathy Calif.

Thanks Robert. Thanks Kathy. I feel very lucky to have Dr Dodds on the team. Kathy, I'm so sorry about your baby Lucky. I'd read your story early on and must tell you that yesterday, when the demons were getting to me and the tears were flowing, I'd repeat your saying. "where there is life, there is hope" and it helped. A lot. My little darling is a fighter and so am I and we're going to go head to head with this thing. I'm now looking for information on milk thistle. It seems as though the human version is more potent than the canine version. Can I use the health food store liquid at a reduced dosage? Does anyone know the suggested mg per day for a ~12 lb dog? Thanks again.

Dorothy New Jersey

Dorothy, I am so very sorry to hear about Scout. But I am very happy that you have contacted Dr. Dodds! She will help you through this, as she did with me, and give you the straight answers you need. Non regenerative anemia can take longer to respond. So the down side is that Scout may be exposed to the side effects of drugs for a longer period. But I have seen many dogs survive this condition successfully, including my own. I continue to remain optimistic, esp with Dr. Dodds helping you. Milk thistle, and the effective ingredient silymarin (the essential essence of milk thistle) is a herb. So therefore its potency is dependent on where it is grown, how it is processed and handled and how it is packaged for consumers. The dollar store bottle isn't going to cut the mustard. I used a pharmaceutical veterinary grade called Denamarin. This is a combination of silymarin and Sam-e. Sam-e is well known to support the liver. This supplement was very successful in protecting Chance's liver. The company that manufactures Denamarin also makes Marin, the milk thistle only version. These products are fairly expensive, though for a small dog the doses would probably not be too expensive. If you cannot afford this, yes, high quality human grade will also work. Alternatively, go to the best natural food store in town and ask for their nutritionist. Have them help you find a good quality milk thistle that they sell. The Canine Epilepsy group has a wonderful reference page for using milk thistle with dogs. Dosing information is here, by weight. http://www.canine-epilepsy-guardian-angels.com/milk_thistle.htm my best patrice

Patrice NYS

Thanks, Patrice! I've ordered the Denamarin and it should be here on Friday. Fingers crossed that they release Scout tonight. I would be thankful indeed to have her home for Thanksgiving. Wishing you a happy Thanksgiving! Best regards, Dorothy

Dorothy New Jersey

Dorothy, Are you giving Scout any aspirin? You may want to get this dosed for her to address the possibility of clotting. Maggie, my yellow Lab and I just dodged this bullet which is incredibly rare. It was a very expensive lesson to learn, but one I was happy to pay given the unusually happy outcome.

RobertN Superior

Hi Robert, I'll ask the vet about it today. I know that they did do some sort of clotting test before the first transfusion and I believe the results were negative, but at this point, if there is little or no risk in giving it to her then I will want her to have it. Thank you for the advice!! Best regards, Dorothy

Dorothy New Jersey

Since Scout was just transfused, she is probably receiving some sort of low dose heparin injections to prevent clotting. This is not meant to scare you as they would have let you know if Scout was in any danger at this point. As I mentioned before, Maggie and I dodged a very large fast moving bullet, accomplished by skill, some luck and Maggie's will to live. Please keep yourself informed in this area. It is the number one killer among dogs with IMHA.

RobertN Superior

Dorothy, Do not get too worried, but send off a quick email to Dr. Dodds asking if you should add aspirin to the protocol. Since she has all your lab results she will be a good person to advise you. Not all, but a few dogs can have an allergic reaction to aspirin so it's best to give this under a vet's supervision. my best patrice

Patrice NYS

Thanks Robert! Thanks Patrice! I'll definitely loop in Dr Dodds and get her opinion. I've given Scout baby aspirin before and she's been ok, but it wasn't for longer than a day or two. Best regards, Dorothy

Dorothy New Jersey

Thank you Dorothy, We still suffer from our loss. We have good days and bad days. As we approach the time that she was diagnosed, It gets Harder. Aspirin is very, very important. We had Lucky on Aspirin from the day that she was diagnosed. She dies of a Blood Clot. I Am glad that the saying, "Where There Is Life, There Is Hope" helped you through a tough time. I also want you to know that our little Lucky was the worst case that the Specialist has ever dealt with. She responded to NOTHING. Our 8 month battle was with her on the highest doses of all medicines. Blood Transfusions didn't work. Nothing did. The Blood clot hit fast, but she was never able to have any of her med. reduced. Once they tried, shed drop fast. Back on the high dose, she was never able to get her percentages up high enough. She was at a 12% when she passed away, but the doctor said that she could have lived that low. The blood clots got her heart and her lungs. The toughest part of this disease was realizing that, it was time to let her go. :( I'm only repeating this, as there is a lot of hope for your Baby. Lucky just had a very bad Disease, that her little body could not fight. So many dogs on this site are fighting and having some good days. Take care and remember that you need to get rest too. We didn't get much. I wish you a Happy Thanksgiving! ( RIP Little Lucky) We were the Lucky ones, to at least have had some time with you. Kathy

Kathy Calif.

Hi, Dorothy, I am sorry to hear that Scout has become ill with IMHA....but you have found an amazing group to help you walk this path. It took several weeks for the destruction to stop for our Mr. Bentley....sometimes it just takes awhile for the meds to do their work. The transfusions can buy you time to reach that point. We used the Denamarin and PetTinic as supplements, and found those to be helpful. He was also on Pepcid and Aspirin....the aspirin was a dosage mixed at the veterinary specialist clinic, a smaller dose than a baby aspirin. This illness is a long, winding road....take it one step at a time. Each dog responds differently to meds, and each case can be a bit different. Please know that everyone here is happy to help in any way we can. Sally and (angel) Bentley

Sally Louisiana

Sounds like you have your little Scout on the right track! Dr Dodds helped us our second time around, when she stopped making platelets. Together, with our very well informed vets, her medicine protocol did a turn around and in 2 weeks had stopped the loss of platelets and she began producing again, but unfortunately her IMHA was triggered and she is now fighting to regain her "remission" status. The Soloxine for her thyroid will now be continued for her life, but it has surely contributed to her bone marrow production and overall health. She is now at 40% PCVs! Have a BLESSED THANKSGIVING with you pets and try to take a breather for yourself! Blessings, Cindi & Tori

Cindi FL

Thank you all for the words of encouragement. Scout is coming home today. Her PCV is holding steady at 25. The emergency room vet wants to check the cyclosporine level in her blood as she feels it is not having an impact at the current dosage. We're going to go back in on Sunday for some more tests. They've done some more blood work. I'll post results once I have them. Thanks once again and best regards, Dorothy

Dorothy New Jersey

Dorothy, I looked back at what you posted.....Scout's weight and meds are very similar to my Bentley. He weighed about 11.5-12 lbs too. He was on 10mg Prednisone, 2x day to begin....then a week later, he was put on Atopica, 25 mg, 2x day....the Atopica had to increased to 50 mg 2x day, and he needed a third immuno-suppressant before we finally got his destruction to stop (this took SEVERAL weeks). Our specialists did choose to do a trough test just to be sure the optimal level of cylcosporine was in Bentley's system at all peak and low times. The stable HCT of 25 is great....post the new results when you get them! Sally and (angel) Bentley

Sally Louisiana

This thread was discussed on 23/11/2011

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