Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Tessy News

Hello everyone. I was going to continue the previous post but thought it might be better to start a new one. I erred on the side of caution and decided to put Tessy in the car and drive 5 hours to the Veterinary college in PEI. She looked like she was getting worse and she was getting weaker by the hour. I did not want to wait till it was too late so....here we are. I would have gotten back to you all sooner with an update but I had not internet access in the motel I am staying in. I walked (I bet) 10km today around the city to find an internet cafe and well...as you now know...I finally found one! Tessy was admitted on Wednesday. The doctors here are so great. Tessy is holding steady now and her PCV has been climbing approx. 1 point a day. I'm unsure what the CBC #'s are but I think her PCV is at 23 now. It was down pretty low when she was admitted. The doctors got her started on Cyclosporine (100mg twice a day) started yesterday. Does that seem like a large number to you? Anyway, I was asking them about doing Trough tests and they said it wasn't needed. I'm only allowed to see her once a day so it kinda makes things harder on me. I know thought that it is in her best interest because it probably stresses her out alot when I leave. SHE DOES LOOK LIKE SHE IS GETTING BETTER THOUGH. Thank GOD! I went out and bought her another toy to take to her today when I go in later. Currently she in on 50mg pred, 25mg azathioprine, 8mg aspirin ...all taken only once a day at 5:30 now. Cyclosporine is taken twice a day....100mg at 8:00am and another 100mg at 8:00pm. Any thoughts on this? I just find it weird that they will give her all the meds at once instead of how she was taking it. I will keep you all posted on any new updates I get. Thank you all so much for the thoughts and prayers. I'm sure that it helps Tessy. I'll continue to keep all dogs affected by this disease in my thoughts and prayers. Johnny and Tessy

Jonathan PEI now

Johnny, So glad to hear from you, and happy that Tessy seems to be responding, you are a great dad and caregiver. I think it's great that you have a Vet Teaching hospital accessible to you, even though you had to travel a little bit. It sounds like she is in capable hands, and is doing what she needs to do. We'll be thinking of you guys and praying for a total turnaround! melissa and tiggs

melissa slc

Oh Johnny, my heart goes out to you. You must feel so lonely on the island. I hope you know somebody there. If not, you know you have friends all over! It must have been quite a drive. Good thing they have a bridge! I knew something was up when we did not hear from you for so long and I am relieved about the news. How long will they keep her there? I don't have much input on the medications, since I am still new at this. The prednisone is usually given 2x per day from what I have been reading, question them about it. The only thing that you want to make sure is that she is given Sucralfate and possibly even an other stomach protectant. Kahlu still takes Misoprostol. Make a list of questions before you go to the clinic. I find that helps me not to forget any of the questions I have. Ask them LOTS of questions! It will help you understand and I am sure they are happy to explain, since it is a teaching clinic. the best thing is, that you notice an improvement in her!! Never mind the numbers. The high doses of prednisone will be hard on her, but they safe her life. I am sure Patrice will give you some more info on the meds. Take good care. We are sending best wishes to you from the other Island! Our thoughts and prayers are with you and your Tessy girl, Brigitte & Kahlu PS.As for internet connections, the Library is usually a good place. On my island it is free too.

Brigitte BC Canada

Hi Jonathan, Thoughts and prayers are with you both in bringing Tessy back around. All of Holly's medications were always given together in and out of the hospital. In fact, I know Brigitte metioned about the stomach protectant, but when Holly was in the hospital they never gave her anything for this, nor did they send us home with anything, it wasn't until at last a year later that we started her on it. I am assuming the long tem affect of the prednisone tears up their stomach after a while. I know probably very hard to only see her once a day, but in the interest of Tessy, probably better for her, like you said not to get to excited when you leave. Take care, Linda

Linda Sapphire

Jonathon, Good news! I figured you were on some kind of mission so I wasn't too worried. Cyclosporine in the form of Atopica is given to dogs for allergies. So for instance a dog Chance's size (95 lbs)would be started at around 200 mg Atopica for several weeks and then the dosage would be dropped until they could obtain good outcome (reducing the allergy symptoms) and then maintained there. Now, use of cyclosporine (Atopica is the veterinary brand made by Novartis) for serious autoimmune diseases is "off label." In other words, there have been no official studies done to determine if this drug is efficacious for this treatment and at what dosages it should be used at. However, Novartis has done very comprehensive studies to determine if Atopica is efficacious for the treatment of canine atophy (allergies). I have carefully read the overview of these studies and examined the possible side effects that can occur at very high doses, which is exactly how they perform studies like this. In general, the most significant side effects, even at high doses, are usually gastrointestinal. Things like diarrhea, stomach upset etc. A very small portion of dogs cannot overcome this and have to be removed from the drug. The other significant side effect (in a small portion of the study animals) are skin growths of a certain type that are generally harmless. As with every study, there was a very small portion of participants who had other side effects, but they consider these the exception. So, while there have been no studies to examine the use of cyclosporine in treating AIHA, it is becoming a "hot item" used by vet clinics all over the country for exactly this reason. Dosages are determined for the most part by clinical results. If a 95 lb dog takes 225 mg of cyclosporine and there are positive signs, then that is the right dose. So while I would say that 200 mg is a pretty high dose for Tessy, assuming she is probably around 45 lbs, this clinic has experience with this dose and knows the side effects at this dose are minimal. They really want to lower the dose of prednisone and that is exactly why they are starting the cyclosporine now and at a high dose. They will probably lower this dose over the next few weeks slowly. It is a very expensive drug and they know that. But you will not be at this high dose for a very long time. As for the timing of the doses of the meds, again, clinical experience leads them to this kind of dosing schedule. When Dr. Dodds advised us to use cyclosporine, we dosed once a day at 225mg to start with, monday through friday and gave no dose on saturday or sunday. There just isn't a textbook answer to this question. I suspect that they have had Tessy on an IV and that can work miracles when a dog has anemia. Good nursing care is essential at this time. You should see some real changes in the next 3-4 weeks. Keep us up to date, pending on your internet access patrice

Patrice NYS

Jonathon, Here is a slide show done by Novartis that shows how cyclosporine works to reduce allergic reactions in the skin. But it works the same way in dogs with autoimmune disease: suppressing the T-killer cell lymphocytes. http://www.us.atopica.com/howatopicaworks/ By the way the T stands for thymus as that is where these lymphocytes come from. It is really fascinating stuff (well at least to me!) See this article at wikipedia: http://en.wikipedia.org/wiki/Cytotoxic_T_cell patrice

Patrice NYS

Johnny, When Darcy was at the emergency hospital for a few days, they gave all of her medicine at the same time in the morning. It's the same with humans. They do that in the hospital, too. For instance, they think nothing of giving thyroid medication without allowing the one or two hours before meals and just mix everything together. When I questioned the vet internal specialist about it, she said it would still get in Darcy's system. Maybe when you get Tessy home you can readjust the medicine schedule and space everything out the way it should be done. Tessy is fortunate to have such a caring Dad. It sounds very positive that ther PCV is climbing daily. Will keep you and Tessy in my thoughts and prayers. Hope you'll get to take your baby home real soon. Karen

Karen NC

Jonathan, It sounds like you have gotten Tessy to a great place. Hopefully the added meds will get her back on track. Keeping you both in my thoughts and prayers. Penny

Penny Lytle Creek Calif

Johnny, You and Tessy are in our prayers for a full recovery. Sue & Ren

Susie Delaware

Dear J. & T, So sorry. I pray things will turn around & all will be OK. T

T.Rose Erie

I am new at this. My husky-border collie has been on Atopica for a year. She has an autoimmune disease and she has done well. Prior to med, she wouldn't play ball,swim.or enjoy anything else we did. Her temp was 105 for over a month and she had swollen glands all over her body. I was not prepared when they said it was cancer-I cryed for over a week.All the expensive tests were done and nothing showed. Within days of starting Atopica, she wanted to play ball and spent most of the summer in the pool just limbering up her joints. I am now in the process of weaning her and have many fears over this but it needs to be done. I praise not only the VETS and Atopica but just one dog who loves life and had the courage to help us find the way to make the right decisions. She is 9 years old and I bless each day I have her. Thank you for allowing me to share my precious pets story with you gloria

gloria new york

This thread was discussed between 03/04/2009 and 16/04/2009

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