Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Throwing up meds???

Reggie has started to have trouble keeping food down. He took his meds at 9:30 this morning, but around 11am he threw up all the food he'd eaten before the meds and the bread used to wrap his meds in. So, how do you know if the dog is actually absorbing enough of the medication to do any good?

Amy Wisconsin

Amy, try giving the meds in a smaller bite, not a meal. On that 1 worst day, I used a little low fat ice cream (low fat to help the liver) to get the prednisone in her. Nothing else with it, but maybe some milk thistle after, again for the liver. Richard

Richard Burnaby

Amy, I don't think 1 1/2 hours is enough to absorb all the meds. I would give the vet a call and ask what you should do. Maybe they can give Reggie an anti nausea drug? sorry I don't have a name. Is he on a stomach protectant now? Try and stay away from bread and fatty foods. I guess if you use just a tiny bit to wrap his pills that would be ok. I used pill pockets which are not great and pricey. maybe you could hide it in a bit of cooked fish or chicken. Best wishes, Brigitte

Brigitte BC

If you found the pill still in the bread, that would make the decision easier. Low fat cottage cheese might be better, but I sued ice cream as it is used in breeding when things are tough and the mom needs energy and Calcium. Don't use dairy if your dog has ever reacted to chees or other dairy products. Canned pumpkin migh be a good choice (pumpkin only, not pie filling). It is easier on the liver. Good Luck, Richard

Richard Burnaby

I actually tried the pill pockets a few days ago for variety, but he spit it back out at me (this from a dog who, when well, inhales everything that gets near his mouth!). I've been feeding him (smaller amounts) and then about 30 min. later giving his meds wrapped in small bits of bread - I figured they would be easier to handle with some food in his tummy. He's always taken his Phenobarbital (started last Nov. after a weekend of seizures) wrapped in a little piece of bread, so that's what I've been doing with the AIHA meds. I wasn't home when he threw up and my daughter cleaned it up. I did take a look at the pile in the garbage and didn't see any whole pills, just his breakfast and the partially digested meds.

Amy Wisconsin

Hi again; certainly being able to give food with the meal is better. If you can't though, because they won't eat, then alternatively, Pepcic AC, Sucralfate (or other protectant?) and meds with a very small amount of food that is way more attractive than anything they have seen. When Dylan refused her meal that one day, I knew I needed something more powerful and I know how much she loves ice cream, ergo my choice. This was a short term solution due to being so anemic she could not eat. I Was certainly hoping she would turn the corner and luckily she did, as there was not much room to get worse that day (I truly though I was losing her that day). Good Luck, Richard

Richard Burnaby

Amy, i remember Johnny giving meds with ice cream, it is definitely worth a try. of course there is always forcing it too. i would however leave that as a last resort. i would still call the vet to ask if you should give the whole or maybe half the missed dose again. Best wishes, Brigitte

Brigitte BC

I agree with Brigitte, the vet needs to tell you when to give the next dose. Because I used ice cream once only, I did not care if it had fat either. If I had to do more than one and given Reggies current condition, I would want to use the low fat version if possible. I have done pill forcing in healthy dogs and I too would only do that if I had no other choice. Forcing is where you put the pill at the very back of the mouth on the tongue and then push a little more down the esophagus until they reflexively swallow it. I hope Reggie is still drinking. If he is unable to, you might also want to get a large syringe to use to force water onto his tongue through the side of his mouth. That would start him lapping at the water. You don't want to force water at all. It is better to let it flow through his mouth onto the floor and definately not into the back of his throat. Keeping my fingers crossed, Richard

Richard Burnaby

He is still drinking, but not nearly as much the past two days. He ate fine this morning, but has refused anything since throwing up around 11am. I'm sure he would eat a number of human food items, but shouldn't I stick with things that are easy to digest? I've been staying with a bland diet in the hopes he would keep it down. I'm sure he would eat canned dog food, but wouldn't that be too rich for him right now? Every day that goes by he looks worse and worse and his gums are showing no signs of pinking up :-(

Amy Wisconsin

Hi Amy, what you are saying about easy to digest is true. Bread is not easy to digest though. I bought this book after the thread on raw diet and Dylan (Raw Diet post AIHA - what is a good diet?). It has advice on cooked human food and things you can do for liver trouble. http://www.b-naturals.com/newsletter/liver/ This diet was recommendeed for Liver cleans: http://www.canine-epilepsy-guardian-angels.com/liver_cleansing_diet.htm Also, look a the raw diet thread and read what Patrice and the others said. This all applies to you and Reggie. I would never revcommend anything raw for Reggie. This is a choice to be made under healthy conditions. Everything about cooked human options is a valid choice for you and Reggie depending on his current state (eating etc). Remember, changes to diet can be stressful, so introducing new things cautiously is important. Your cirucmstances dictate that you must do something. Read through the suggestions on the raw diet thread. Feel free to read what I have said, but none of it applies to Reggie (I fed raw and Dylan did not have liver issues, nor stomach issues). What the others say does. Richard

Richard Burnaby

Hi, keep an eye on his water intake. He has only slowed down because of his current state. The prednisone still requires he drink regularly, so get that bowl close so he can lap at it if he needs to. While Dylan was immobile, I always kept a bowl in reach so all she had to do was move her head slightly. Richard

Richard Burnaby

Hi Amy - I'm sorry Reggie is having a tough time today. I'm not sure if this would help with giving his pills or not but you might try baby food for a bland, palatable diet. Look for a plain, all-meat variety - be sure it has no onions added. I'm not sure where you are in Wisc. but I can get Beech-nut brand in Chicago and they have Stage 1 meats - beef, turkey, chicken (I believe chicken is the lowest fat so you might want to try that first). My dog was hospitalized with sepsis after his immune system became too suppressed by the meds and had severe gastroenteritis as a result. The ER gave him baby food to get him back on "solids" and he came home on that as well. It's extremely palatable (to most dogs). Murray is about 45 lbs. and I would give him a couple Tbsp. at a time every few hours. You could try freezing small "scoops" of it and maybe sliding his pills in there. Take care - I hope Reggie is better soon. Bonnie

Bonnie Chicago

I spoke with the vet and she told me to bring him in for a shot that would take away his nausea. She'll also probably check his red blood cell count at that time. She very much sounded like she is suggesting we call it and put him down . . . but from what I've read here, the meds haven't even been on board long enough to take effect. Right? After about $4,000, I'm just not ready to give up when he's only been on the meds for less than two weeks.

Amy Wisconsin

Hi Amy, I think you have choices other than giving up :-) If giving up is the only choice (no saving him? I have had to make that choice too, sadly), maybe, but given a choice I would rather choose either to stick it out and see if Dr. Dodd's or someone here has a solution after seeing the bloodwork. Both Johnny and Patrice are very good, but they need to see it. Or I would try to reduce the pred in half maybe, ask your vet or Dr. Dodd's? Anemia is a peaceful way to go and is no different than euthanizing. I have had both right here on my kitchen floor. So doing something by continuing to fight is not about huge money at the vet, rather it is about your effort and the help from people who know something your veterinarian does not and choosing a path to try. To fight on is your choice for you and Reggie (every one here will support whatever you choose). It is not your vet's choice. Still wishing you both the best, Richard

Richard Burnaby

Amy, you are doing such a great job for Reggie. Richard

Richard Burnaby

Well, they gave Reggie a shot at the vet's office to help with his nausea from the cyclosporin - they also sent me home with two syringes of it to give him every 24 hours. The vet told me today how frustrated she was because she truly thought Reggie would be recovering by now. She told me that if he was going to make a recovery, he would be doing better after two weeks of the aggressive treatment. So, I'm feeling a bit sad and lost right now. We don't want to give up on Reggie, but also want to be realistic. His red blood cell count is not rising (his gums are still white) and the drugs are ravaging his body. We also simply cannot afford to be any more aggressive by messing with the bone marrow, etc. The vet told me today that his red blood cells are "barely regenerative" which tells me we are not headed in a positive direction.

Amy Wisconsin

I think it is important that they eat something with all the meds the are on, and if Ginger would eat canned dog food then that is what she got, I remember she only would eat dog treats for about a week but that is what I feed her, baby food is an excellent idea too. I would give him very small amounts of a good canned food like evo or merrick a few times a day to see how he does with it. Some have cooked steaks for their dog if that's what they would eat, you can also try boiled hamburger or chicken. Go back and read the success stories, that's what I did when I was feeling down about Ginger's recovery and they gave me hope. It might take the meds a few weeks to kick in. What was his PCV on his last check? My vet once told me they only need a transfusion when they are in the single digits.

Cheryl & Ginger Pinevile PA

also Ginger gets her pills with low fat peanut butter and looks forward to them. Just a small amount to cover the pill and a tiny bit over that to hide the taste.

Cheryl & Ginger Pinevile PA

Good call Cheryl! Get creative Amy, he will eat when the prednisone will kick in. then you won't be able to stop him. You might have to hand feed. If he would eat the canned food, go with it. if he is not regenerative I still think contacting Dr. Dodds is a good avenue. If your vet is frustrated, she might be willing to learn from an expert? Richard is correct, only you can say when Reggie has had enough. Actually I believe Reggie will make the decision. You know him so well and you will sense when he is done fighting. As long as there is a will to live there is no reason to give up! Dr. Dodds even goes as far as saying if there is life there is hope. thinking of you, best wishes, Brigitte

Brigitte BC

I don't know what I would have done without this forum! Thank you SO much for taking the time to reply to all of my questions and concerns. We were all feeling down about Reggie so I took the kids to McDonald's for dinner. Our near-death dog sat intently watching and caught every single french fry and chicken nugget the kids "dropped" his way. Not the healthiest dinner, but at least it's something! I can see why this disease is so tough and emotional - one minute your dog looks near death and the next he's listening to all the usual commands to earn a fry. Is there still hope that the meds will kick in after two weeks of waiting with no results? I think he's pretty much been surviving off the transfusion he had nine days ago. We're not feeling very optimistic, but praying hard nontheless.

Amy Wisconsin

Amy: Hang in there. It's still early and it often takes 4-6 weeks for the cyclosporine to kick in. Our GSD/Cocker Spaniel mix Sheba was on pred and cyclosporine and it took awhile for her numbers to improve. I think she came home with a PCV of 22 or so. (It's been 3+ years so I don't remember exactly anymore.) I know it was quite some time before we saw it creep up into the 30s again. How close are you to the U of WI at Madison and their veterinary teaching hospital? On the recommendation of our vet we took Sheba to Iowa State's VTH for treatment and I am forever grateful that he sent us there. They were wonderful and we found that the medications were much cheaper through them. Sheba had a cast iron stomach and only threw up meds once. After awhile though she got stubborn about taking them and we had to find ways to get her to swallow them. We used pill pockets, canned dog food and peanut butter to persuade her to take them. Be careful about the fat content though as you don't want to tax Reggie's systems. If you haven't already contacted her - I highly recommend emailing Dr. Dodds. She is wonderful, compassionate, caring and despite being a busy woman, always willing to answer questions, make suggestions, etc. You won't regret it. Again - hang in there, know that we are here for you and we are all thinking about you and praying for Reggie's recovery. Rita, Mike and (angel) Sheba

Rita IA

Our regular vet (not the one we're dealing with now) actually recommended the vet teaching hospital in Madison. We are about 80 minutes from them. My main problem is that I have six young children at home and also care for three others (daycare kids), so it would be really tough to fit in the drive time. Also, the be completely honest, our funds have been exhausted and I don't think we have anything left to fund additional appointments. I do think our current vet has the experience (she's dealt with thousands of AIHA cases), but she seems a bit impatient and quick to give up. As long as Reggie is breathing and not in any obvious pain, we're going to keep hoping. My main concern right now is his not eating. I bought a variety of canned dog foods tonight and he won't do any more than lick them and turn away. Now, he did eat a number of chicken nuggets and french fries tonight (crazy dog!), so I'm hoping that will be enough in his stomach to keep the meds down tonight. He even came in the kitchen to lick the dishes as I was loading the dishwasher (he's always loved handling the pre-wash cycle for me).

Amy Wisconsin

This thread was discussed between 21/06/2011 and 22/06/2011

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