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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - TC Update
| Tc went for his blood check today; I am very confused. I am making an appointment with another specialist to look at TC but I am so confused! The specialist we are going to now said as of today to stop the pred totally. TC is feeling better, he has been on 10 mg eod for 2 weeks. His count looks to be down a little from last time because she usually writes it out, today she just gave my Husband the print out. It says his HCT is 34.61, on December 4th it was 39. The specialist barely gives us 30 seconds, she has referred us back to our regular vet and said to have another blood test in a month. TC was diagnaosed on 9/26/07 he is a 85lb Shepard mix. He had IMHA back in January of 2007, but our regular vet did not tell us what it was. He recovered with just the pred, no tranfusions. This time in September he had to have three transfusions. Our regular vet vaccinated TC in August and I gave him heartworm 2 day's before he collasped. Because we don't know what caused him to relaspe, vaccines, heartworm or just being off the pred I don't want to stop the pred completly now. Sorry this is so long, just venting... |
| Wendy Florida |
| Hi Wendy, You have every right to be confused and concerned. That is good that you are going to take TC to another specialist. Taking TC totally off pred is of course one concern but for the specialist to tell you to do that then wait a month to recheck is also not a good idea. You are doing the right thing. It sounds like TC is certainly headed in the right direction so it would be a shame to crash again at this point. Please keep us posted. Teresa and Jacob |
| Teresa va |
| Wendy, I agree that you should get a second opinion before proceeding. What the specialist is recommending just doesn't make sense. Also it's important to be dealing with someone who takes the time to answer your questions and explain their prescribed course of action. Good luck to you and TC. deb and Duck |
| Debbie BC Canada |
| Wendy, A Doctor that doesn't have time to discuss your dogs treatment and state of health and address your concerns is definately one you want to get rid of. When you say your regular Vet did not tell you that TC had AIHA back in January did he not know it at the time or just didn't tell you? It might have altered your decisions about the Heartworm and vaccines. I think you need a new regular Vet too? You certaintly have reason to vent. Keep us posted and go with your gut feelings and what you have learned here. Penny |
| Penny Lytle Creek Calif |
| yea, wendy i would definately seek out another specialist that actually prides themselves on being personable and sharing information. it is so critical with a disease like this, so in my opinion it is ESSENTIAL that you feel comfortable with your vet choice. if they are rushing you in and out like a burger king drive thru and telling you to come back in a month, that is just not appropriate at all. this disease is far too serious for that nonsense. i wish TC the best and have a good Christmas :) |
| josh california |
| Wendy, I am so sorry to hear about the anxiety you feel, especially at this time of year. Perhaps it would help you to understand why they might be asking you to stop the prednisone? When we give high doses of prednisone to suppress the immune system we are also suppressing the adrenal gland output of cortisol because they feel that their job is no longer needed. Becuase of the very high dose that we have to give we actually cause a condition called Iatrogenic Cushings. I am sure you have seen all the symptoms of this, panting, drinking excessively, constant hunger, hair loss etc. When it is time to begin decreasing the dose, the desired way to do it is to decrease it very gradually. We hope that the adrenal glands will "wake up" and remember what they are supposed to be doing. Some confusion arises when owners are asked to go to an every other day dosing schedule. This is really an attempt to "jump start" the adrenal glands. If this process is done too fast, it can lead to severe illness due to the lack of cortisol in the body. And maybe the adrenal glands don't want to wake up! In most cases of Iatrogenic Cushings (caused by medication) the slow gradual decrease is effective and the dog (or human) begins making their own cortisol. Right now I'll bet your vet wants TC to start making his own cortisol. And he/she feels that the eod dosing at 10mg has been done long enough for this to happen. However, some dogs need longer to get to this point and I have consulted with some owners whose dogs have true Addison's disease that say their dogs need prednisone doses that are spread out. Something like 2.5 mg every three days and stuff like that. It's really an individual case each time. You do need someone who will be there for you as you go through this process. Addison's disease (the reverse of Cushings) is really a far more dangerous condition as it can cause things like very low blood pressure (this is not low blood count). There is probably not much of a risk of this happening to TC, but I think any vet would want to "make sure" for sure. If it were me, I would try to find another vet at the clinic who would be more sympathetic to my concerns. I have three vets at my regular clinic and each one has a different personality and approach. Dr. M is very cautious but has excellent clinical and nursing skills while Dr. C is full of patient education and takes each visit as an opportunity to educate me. Dr. S is always thinking about research and learning. We see all three and are very happy with our 3 pronged approach. Here is a website I found that seems to explain some of this quite well. http://www.newmanveterinary.com/steroids.html patrice |
| Patrice New York State |
| Thank you all for your comments it is much appreciated. I have made an appointment with an Internal Specialist 50 miles away. Unfortunatly there are no other Doctors at this clinic, the Specialist we were referred to runs a solo show. Penny, my vet back in January told us TC had a blood disease, he never mentioned IMHA or told us that further vaccines could be dangerous. This is our first dog, and he has been healthy for the seven years we have had him, so we assumed the vet knew what he was talking about, wrong! Patrice, I am sure the Specialist Vet wants him to start making his own cortisol, I am just concerned because he has gone from 80mg of pred to zero in 13 weeks. (It would have been faster but I resisted some of her reduction schedule)Also, I have read on this forum that going to 5mg eod or as you said 2.5 mg every third day is somewhat standard. This is my first real experience with vets as our cats have always been healthy and TC is our first Dog, we rescued him in 2000. Also, being the people pleaser that I am it is hard to question the vet because my vet did not like being questioned and became very short and almost hung up on me. Thank you all for your responses, it is truly appreciated. You are all a wealth of information and support! Happy Holidays to all and our fur friends. |
| Wendy Tampa |
This thread was discussed between 20/12/2007 and 21/12/2007
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