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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Thyroid Test
| I just spoke with my regular vet about Darcy's thyroid panel results. Last Monday she sent a blood sample to Dr. Dodds' for testing. She doesn't agree with Dr. Dodds that Darcy's thyroid level (Free T4 RIA was .42) is low enough to be creating the anemia problem, but said that it wouldn't hurt to start her on Soloxine and give it for a 6-8 week trial period as Dr. Dodds suggested. She said that she wants to do all that she can for Darcy. She did tell me that Dr. Dodds office sent the blood work to the same place her office would have sent it to for testing. I realize that Dr. Dodds did her own evaluation of the results, but the panel could have been done by my regular vet. However, if the internal specialist would have done the panel she would have charged double what Dr. Dodds charged. My regular vet told me that if Darcy were her dog, she would have done a bone marrow test. Dr. Dodds told me not to put Darcy through that. The test could turn up something like cancer, but it might not tell us anything. Darcy's bone marrow is not making any new RBCs and her body is attacking those she has, according to my regular vet. The internal specialist has not told me that Darcy's body is attacking her RBCs, only that she doesn't know what is causing her bone marrow not to produce them. She said that Darcy does not have AIHA. I am to the point that I don't know who or what to believe and feel like I am going out of my mind. I will start Darcy on the thyroid medication, which she will take along with Cyclosporine, Azathioprine, Prednisone, Carafate, Pet Tinic, and a glucosamine capsule every other day. She will finish up on her Doxycycline in four days. I don't know how they will be able to determine what medicines are working. I take Darcy to the internal specialist tomorrow for a full blood panel test. I'm praying that her PCV hasn't dropped below last week's reading of 25%, but her gums are not quite as pink as they were last week. She acts like she feels much better and she has a huge appetite. Your feedback, suggestions, and prayers are greatly appreciated. Thanks, Karen |
| Karen NC |
| Karen, I am sorry that you seem to be getting so many confusing messages. It must be very hard to sort things out and learn as much as you can in just a few weeks time. It is a credit to you that you are not giving up but continue to search for the right answers. I sat through a 4 hour workshop about thyroid with Dr. Dodds not too long ago. The information you may find helpful is that she has kept an extensive database of all breeds that she has either examined herself or has reviewed blood work for over the past 25 or so years. From this data and treatment results, she has been able to develop her own clinical thyroid protocol. So when she looks at your thyroid results, she is using that extensive database to determine specifically what your dog's breed clinically expresses when there are thyroid problems. She looks at her treatment database and sees how these dogs responded to dosages. She looks at your dog's history and test results and determines the best treatment for you. She showed us microscopic slide views of the thyroid gland in various stages of autoimmune destruction. It is very clear that it is being destroyed by the cellular changes occurring. So when she says autoimmune thyroiditis, she means the body is destroying the thyroid gland. Symptoms and testing may not show this definitively until there has been significant damage. That is why she treats low normal levels. And some breeds respond really well to soloxine even when they have low normal results. Like Giant Schnauzers for instance. Giving soloxine at proper dosage and timing it so that it is given exactly 12 hours apart signals the body that the thyroid levels are ok. The body then slows down the signaling to the thyroid to make more hormone (Thyroid Stimulating Hormone TSH). The thyroid in return stops working so hard and this slows down this damage that is happening. I don't say it quite as well as Dr. Dodds said it but in general this is how it happens. Soloxine should not be given with food, and this is something she just discovered in the last 3 years. I didn't even know this! We had to change Chance's soloxine dosage times when I came home from the workshop. Kelp, and other supplements that contain kelp should not be given more than a few times a week. Brand new research she had been given in early August is indicating that too much iodine given to dogs is CAUSING this destruction of the thyroid. She was very excited to tell us this new information from a European study. When Chance had his bone marrow test and the results came back with no cells, or in other words non-regenerative, the specialist could not say either what the cause was. He thought perhaps it was autoimmune but wasn't sure. It wasn't until I talked with Dr. Dodds did she explain to me that in some very serious cases, the autoimmune destruction can occur AT THE RED BLOOD CELL PRECURSOR CELL LINE IN THE BONE MARROW. I have since found plenty of accepted veterinary literature to back this up. This is a very important thing to understand. If you did do the bone marrow exam, you most likely would find the same thing we did.... no cells. If your internist cannot find other evidence in the blood smears and blood tests for cancer, then this is the most likely scenario. This kind of auto destruction of red blood cell precursor cells can be looked at as a death sentence. Or it can be looked at as just a more severe, but treatable case of AIHA or IMHA. Ask me how I know this.... Your meds sound right, it's good that the doxy is almost done, it's a hard drug to take. I know you can't trust just one person you know from a communal discussion board. But if you can at least take my advice to trust Dr. Dodds, then I will feel I have helped you. She has been my guiding angel when Chance was so very ill. It is with her constant help via email that he is alive today and doing so very well. She expressed a great need to help *all dogs* that are suffering from this disease. I feel a great responsibility to continue to pass on information she has made available about treating this disease. I have great optimism from Darcy's behavior that she really is responding to the drugs. It might take a while, but on the other hand if you can hold on to a pcv of 25%, you will be most likely will be successful. The maturation process of blood cells can take a while to get going in order to produce healthy viable circulating blood cells. This is where diet and rest come into play. If this was a human they would be in intensive care. I do think that you are up to the challenge though, I will be thinking about you tomorrow. Patrice |
| Patrice NYS |
| Canine Hypothyroidism, An Overview http://www.vet.uga.edu/vpp/clerk/bell/index.php "The classic hematologic finding associated with hypothyroidism is a mild, normocytic, normochromic, nonregenerative anemia." In other words, the red blood cell sizes are normal. (This means that when blood cells were being made there were no production and maturation problems.) There is normal hemoglobin in the cells, but there are little to none reticulocytes. The anemia is mild, 37-30% hct. (moderate 29-20%) (severe 19-13%) Blood is no longer being made. Old rbc are aging out and not being replaced. Anemia starts out mild and slowly drifts downward towards moderate and severe ranges. |
| Patrice NYS |
| Sorry, but I would do the marrow test. It may or may not tell you anything, but why not have all of the info? The test is not as instrusive as you may think. Just my opinion. |
| Courtney SLO |
This thread was discussed between 23/09/2008 and 24/09/2008
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