Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Still Fighting

I wrote a while back about my dog Canyon, a border collie/australian shepherd mix. She acquired AIHA at the end of August and is still fighting. Her RBC has been holding at around 32.5 but we can't seem to push her up into the normal range. Her meds are at 80 mg Prednisone daily and 25 mg Azathioprine daily (along with Prilosec, aspirin, and Cyotec for her stomach and 50mg lasix once a day). She started the Azathioprine 3 weeks ago. My heart is breaking every day watching her. She is a shell of her former self. She has also acquired Iatrogenic Cushing’s disease and she seems so miserable. She has gained so much water weight that she looks like a seal. She was only 35-40 lbs in August and is now 55 lbs. We started the lasix this week, but have not seen an improvement. It seems like the steroids are killing her, while saving her at the same time. Is 31/2 months a long time to be on this dose of steroids? She was on 120 mg of Prednisone a day,until I reduced them a month ago. The doctor mentioned that we may need to put her on chemotherapy drugs to bring up her RBC, can you tell me anything about this or have any ideas for me? I would be thankful for any advice! Shana

Shana Idaho

Hi Shana, Even though Canyon's count is not in the normal range, it might be the meds suppressing the bone marrow too much. Since she is on 2 immunosuppressive drugs it could be a combo of both or just one or the other. With that being said, the vet might want to lower one (always only one at a time) and go from there. Being that she has developed Cushing's , it might be best to start with the pred. Three months is a long time to be on such large amounts for her size. My Jacob was on large amounts for much longer but no more that 1mg per his body weight. I would sit down with the vet and discuss your options. The very same drugs that help fight this disease can also do much harm, as you already stated in your post. At this point, it does seem like Canyon is certainly going in the right direction. Now its just a matter of getting the meds at a better dose. I wish you and your girl the best. Please keep us posted. Just to let you know....my Jacob was stuck forever right about where Canyon is. He was only on the pred at the time. Since he was on the pred for so long and his count was just kind of stuck the specialist added the imuran and started lowering the pred and that did the trick for my Jacob. His count then swifting jumped into the 40's He has been battling aiha since July 2002. Teresa and Jacob

Teresa va

Hi again Shana, Just wanted to add the link to Jacob's story if you are interested in reading it: http://www.cloudnet.com/~jdickson/archives11.htm He is the Oct 2003 Success Story Teresa

Teresa va

Thank you for your story. I will talk to the vet next week when we get her next test results in!

Shana Idaho

Shana, How experienced is your Vet in treating this? It does seem like Canyon have been on a pretty stiff dosage of Pred for a lot longer than most. It might not hurt to get a second opinion. Hoping for the best for you boyh. Penny

Penny Lytle Creek Calif

I honestly am not sure how experienced she is. When speaking to her she seems knowledgeable and confident, but my husband takes Canyon in for her tests and she calls me with the results. I am going in for a second opinion next week with the internal medicine doctor who first treated her at the emergency clinic. I think she is on too much prednisone after reading all the information on this sight and looking at what the treatment is/was for other dogs. I don't know how good it is for her heart and organs to have 15 pounds of water weight on her. After looking at other sites, I noticed that many dogs are on 50 mg of Azathioprine per day and Canyon is only on 25mg. Do you think that should be increased? Thank you for your advice!

Shana Idaho

I just want to second what other people here said. Once Bravy's count was in the stable double digits, the vets started lowering her meds. They were doing it for several reasons: 1) (most important) she was constantly on the vere of liver failure as she had a very strong response to the meds; and 2) the pred is a suppressant and since she was still producing red blood cells at a normal pace (although they were being killed off by the white blood cells) it was important for her own body to stabilize. What does your vet say about Canyon's red blood cell production? Is it stable? Has it gotten slower due to the meds? Where is the problem? Because it seems to me you will want to treat the problem. Also, for Bravy's liver S-Adenosyl. It worked quite well. Good luck and keep us posted, Inna

Inna USA

HI Shana, Don't despair, the horrible Cushings symptoms will go when the pred is reduced enough, I know it is awful to see them so ill and weak. I was at the point of euthanasia with my border collie Boy, diagnosed 5 July. He was so ill after about a month on the initial pred dosage, and I could not bear to see him so distressed. He could barely stand up, stumbled often when he did get to his feet, panted horribly, and all the other nastys. In fact the vet was in favour of giving up. Thanks to this and other helpful sites I decided to reduce the pred and wait a bit longer, and he improved immediately. He has shown further improvement with each subsequent pred reduction, and he is still enjoying his life. Every extra day is a wonderful bonus for me, and I am now daring to hope that he will share Christmas with us one more time (he's about 14, so his days are numbered regardless of IMHA). Good luck, Hilary

Hilary Hampshire

i would honestly consider a reduction in prednisone etc... the side effects of heavy dosing almost killed my dog. 32.5% is a decent count esp if she is holding it. my Sway has been in the low 20's for the last 3 months and she is almost completely back to her old self... this only happened after we drastically cut her medication doses.

josh california

This thread was discussed between 08/12/2007 and 12/12/2007

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