Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Star, newly diagnosed

I am starting a new thread for Frank's post about Star. Joanne Posted 15 December 2007 at 19:54:41 UK time Frank, Rochester NY, fsumner1@yahoo.com I'm writing this because my dog Star, a chow/Lab mix, has just been diagnosed with AIHA, showing signs of lethargy, poor appetite, fever and a PCV of only 13% on 12/14. My vet noted agglutination of the platelets on the CBC. We started treatment with high dose Prednisone and Azathioprine along with Amoxicillin. Repeat PCV today showed a PCV of 14% and no fever but I'm worried that her urine is dark brown/red which seems indicative of further hemolysis. Star is 10 years old, and transfusions could also be risky...I just don't know how to proceed. Any advice??????? I fear that the prognosis is poor anyhow.

Frank Rochester

Frank, I am so very sorry to hear of your most beloved Star's recent AIHA diagnosis. While AIHA/IMHA is a very difficult disease, dogs who have been diagnosed with it CAN and DO recover and go on to live happy, healthy lives. If you have not read the Meisha's Hope AIHA/IMHA Web site as yet: http://www.cloudnet.com/~jdickson/ I would urge you to do so when you can. Be sure to follow the links on the first page to many other sites on AIHA/IMHA that will be very helpful to you and do read the SUCCESS STORIES pages. They will show you what has worked for other dogs in terms of treatment options as well as give you a lot of HOPE. It should be noted that it can take 5-7 days for prednsione to start to work and even longer for azathioprine to kick in. According to the Veterinary drug handbook, it can take up to 6 weeks to see a clincal response with azathioprine, although in some dogs it does start to work sooner. Blood transfusions can buy time until the meds do start to work. If you read the Success Stories pages you will see that some of these dogs have had several blood transfusions. I know this is hard so hard, but please hang in there and have hope. You and Star are are in my thoughts and prayers during these most difficult days.

Joanne MN

Don't give up hope! When Canyon, a Border Collie/Australian Shepherd mix, was diagnosed at the end of August, her PCV was only at 5.8. The lowest PCV that I have read about so far. Her prognosis was extremely poor, but she has made it! She also had dark urine that I believe was excess Bilirubin. This cleared up while in the hospital. She is 8 1/2 years old and was given 5 (yes 5) blood transfusions. She took these well, however she looked like death warmed over and couldn't walk without a sling holding up her back legs. She was in the hospital for 5 days and with the transfusions, she could walk out on her own. She was also sent home with Prednisone and Azathioprine. It has been a long 3 1/2 months, but she is on the way to recovery! Good luck and keep us posted! Shana

Shana Idaho

Frank, Hey, we are out here in Leroy but we both work in Rochester. Have you been referred to Vet Specialist of Rochester over on East Henrietta Rd. yet? They have all you need for an emergency transfusion. In fact, besides Buffalo (Orchard Park Veterinary) they are your closest full service 24 hour hospital for transfusions. If you would rather have your vet do the transfusion, you can have him/her buy the donor blood from them. For that matter they can call over there, order it and you can pick it up. We did that. They will guide you about what you need to do to make this a safe transfusion. All instructions come with the donor blood. What is your dog's weight and what are the dosages you are giving right now? The prednisone is your first line of defense and does need to be in a high dose right now. The Azathioprine is another med that suppresses the immune system. The amoxicillan is an antibiotic that will protect Star from infections and is also necessary right now. The other thing I can suggest is to ask your doctor about protecting her from blood clots. There are a number of things your vet can use. Right now it's very important to talk to them about this. The prognosis is not necessarily poor right now. There are many dogs that have survived this very low point with excellent nursing care. That is what Star needs right now, appropriate and experienced nursing care. Are you prepared for the expense of this? These next few days could be the most expensive. We were spending around $400 for a transfusion, but that was at our local vets. Many people who visit emergency vet hospitals can expect much higher bills. Please keep us updated frequently. We will be thinking about you all night. Patrice

Patrice New York State

Hi Frank. I remember my vet saying that she didn't think there was much hope for my dog, Duck but that we should give him his best chance and get him to a veterinary specialist (which we did). That was seven months ago when his PCV had dropped to 5. Now he is active and happy and has maintained a normal PCV for several months. So don't give up hope on Star. I agree with the advice of Shana and Patrice. Especially about giving Star something to protect her against blood clots. It is a very real danger. Initially we gave Duck Heparin and then switched to a quarter of a baby aspirin. The only other thing I might add is that you could talk to your vet about getting Star going on something that could protect her gastrointestinal tract. Duck takes sucralfate and Pepcid AC (famotodine) and hasn't had any problems. Good luck to you. I will be thinking of you and wishing you well. Please keep us posted. deb and Duck

Debbie BC Canada

Mohogany was diagnosed with AIHA in June of 2005 after I noticed his dark red urine and freaked out and rushed him to the vets. He was tested for all the tick diseases common in our area, although our vet says we probably haven't discovered half of the havoc they reap on us yet. he was put on prednisone. The doses fluctuated as his numbers changed. He had three transfusions, each one giving him some improvement, and us some hope of a miracle! Mohogany was a special boy, a beautiful Chesepeake Bay Retriever that everyone loved. He was like Lassie. If I was in the woods and I was to get hurt I would be able to say, "Go get Daddy!" and he would go get my husband to help me. He was that smart. If I asked him questions he would speak when I got to what he wanted. If I couldn't figure out the right question to ask him, I would tell him to show me what he wanted and he would lead me to what he wanted and he would then bark when he got there! Needless to say we loved him dearly and we spent money we didn't have. Our vet of twenty years let us run a tab after we spent the first $1300. It got to the point where I was bringing him in everyday to get his blood tested and though he was losing weight rapidly he was so weak I could hardly get him in my SUV when my husband was working. The prolonged steroids made him lose muscle and his chew muscles in the top of his head withered away so that his head started to look pointy and he had trouble chewing his food. Towards the end my husband was so mad at life and God he threw Mohogany's toy across the yard in frustration, and Mohogany trotted over and retreaved it. We thought he had turned a corner. But it was not to be. The next day he couldn't even stand up. A week later I made the decision not to let him suffer for us anymore. The vet came to our house to put him down. It was three months since his diagnosis and we had spent $5000. I am glad we tried everything, but in hindsight I think that the last month was really for us not him. I so wanted him to be one of the success stories!

Barbara brown Galloway

Frank: I think that most vets recommend that, with a pcv as low as Star's is, that she get a blood transfusion. When Shadow, my 10 1/2-year-old terrier mix was diagnosed on October 19, her pcv was 19. Our local vet (we live 360 miles west of Denver, 180 miles east of Salt Lake - truly in the "middle of nowhere") sent us to a full-service clinic in SLC IMMEDIATELY for a transfusion. After Shad's first (which she survived remarkably well, with no adverse effects) transfusion (of oxyglobin - something I, and many vet experts on AIHA do not recommend), her pcv fell to 11. She had a transfusion from a universal-donor greyhound and her pcv stayed in the 20's for two weeks. When it fell to 16, we went back to Salt Lake for a transfusion from a cross and type-matched Great Dane (Maximus). It took 450 ml of blood to "pump" Shadow back up to the 20's. She was pretty wiped out from that long (eight hour) ordeal, but was spunky the next day. And has been spunkier and spunkier every day since. On Friday, her pcv cracked the "normal" barrier - at 38.4. Our local vet and I celebrated - and it was only then that she shared with me that, when I brought Shadow to her on Oct. 19, she thought Shadow was a "dead dog" walking. I knew she was not optimistic about Shadow's chances; but, I had no idea how pessimistic she was. The vet in SLC was equally "cautious" about Shadow's chances of survival. But here she is, 10 weeks later with a low-normal pcv, running, jumping, barking, intimidating her much larger "brothers", and being the terrible terrier she's been all of her life. The blood transfusions bought Shadow time for the prednisone and aziathoprine to kick in. They were expensive, but without them, I wouldn't be living with my little black (and greying) girl. And her "normal" pcv is the greatest Christmas gift I've ever received. Patrice knows more about AIHA than anyone on this site, with the possible exception of Joanne. Whatever she recommends, I "ditto". It's great that you live in the same area and can take Star to her vet's. If s/he didn't know all there is to know about AIHA before Patrice started taking her dog there, s/he does now! Shad's the same age as Star - and she survived three transfusions (the first and second were on Oct. 19 and 20 - so they were back-to-back - with NO adverse reaction. She was only wiped out after the third, eight-hour transfusion - but, as I said earlier, she bounced back from that the next morning.) My best wishes to you and Star. This is anything BUT a fun roller coaster. Sandy & Shadow

Sandy Utah

Frank, about 3 weeks ago, I thought it would be better to have my dog put down as she had relapsed a week following a transfusion. The vet encouraged me to allow one more med, which I did. I'm glad I trust my vet! My dog Bailey is slowly improving on 2 meds: pred and azathioprine. My vet gave her a 50/50 prognosis 3 weeks ago. I've been reading this board for a few weeks now and have high hope that my dog will recover. She is 10 this month and I'm looking forward to her 11th. birthday. Don't let doubt get the best of you. It almost got me...

Al Florida

dont give up! they can make it through, i would suggest seeking out a specialist (if you havent already) that is well equiped to deal with this, as this is a very tricky disease to get a handle on. but they can turn around so just keep giving Star the oppurtunity to get better. good luck

josh california

After worrying for a few weeks, I contacted Frank privately to see how Star was. I am so sad to say that Frank lost Star on Dec 17. It has been a devastating lost to him and his family. He shared with me that he is starting to research IMHA and would like to contribute to research so that other families don't have to go through the same pain that his has gone through. Sadly, Patrice

Patrice New York State

i am in the same boat you are today. my dog is 11 years old and been diagnosed with this disease. he is at the vets as im writing this. he has a low red blood count and an extremely low white cell blood count.

debbie calif

This thread was discussed between 15/12/2007 and 06/01/2008

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