Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Tiggs Thyroid and Next Med Reduction- Advice

Hi everyone, I had posted last Friday, but no one got back to me but Jan, so I guess we are alone in the skin funk department. My vet said today that the thyroid meds would take about 6-8 weeks before his skin improves, however his T4 was in the therapeutic range now after being on the Thyrotabs for 4 weeks. He's on a topical antibiotic for the staph infection on his belly. His original t4 was less than .4 (normal is 1.0-4.7) and we are now at 3.7 with ALOT more energy. Just unfortunately terrible skin. Because his PCV is now in the mid 40's and stable, we are cutting the Pred to 2.5 mg every other day until the end of the week, then STOPPING it. I'm so freaked out. But, he'll stay on 30 mg of Aza every other day for a while, so that's a little more comforting. But, probably will be off of that soon too. Scary. Does anyone here dose Aza every 3 or 4 days? I'd feel better going to that before stopping altogether, but don't know if that is effective or recommended. Thanks in advance for advice.

melissa slc

Melissa, I'm afraid I can't offer much advice, but I will tell you that when Darcy developed pancreatitis several months ago, they stopped her Aza. cold turkey and lowered her Pred from 30 mg/day to 5 mg/day. She was also on Neoral at that time, too. As you may recall, her PCV has never increased on its own, but she didn't seem to have any adverse affects when the Aza. was stopped. My best to you and Tiggs. Karen

Karen NC

Hi Melissa, Ethel had some skin problems prior to and during her IMHA episode, primarily a yeast infection over most of her skin. The vet prescribed a medicated shampoo containing miconazole that eventually cleared it up. No real open sores or anything like that, but certainly a yeasty smell, and she itched a lot. She spent several days prior to her IMHA onset itching herself so badly she would cry out in pain. We don't know for sure, but somewhat suspect that a yeast infection in her ear got transferred to the rest of her skin by her feet/toenails, and her reaction to the infection may have triggered her IMHA. Just wild speculation, though. The only bacterial issues she had happened in her eyes, and we only found that after misdiagnosis of keratoconjunctivitis sicca (dry eye) and a lot of time spent giving her cyclosporine and lubricant eye drops. We got her internal med vet to take a swab which came back positive for E. coli and hemolytic strep. Her eyes, which had been so goopy she couldn't see (with us wiping them down with warm wet washcloths several times a day), cleared up after the second dose of a polymyxin antibiotic eye drop. After coming off prednisone and azathioprine, Ethel had some black flaky dry skin on her back with some decent hair loss. We changed her food (she decided she was just done eating the canned food we had been giving her for a couple years, after finding one she liked after a year of Hill's Prescription I/D), and started adding a borage/flaxseed oil supplement. Her brittle hair has softened up and she is regrowing hair where it had disappeared. I attribute that most likely to just coming off the aza, but healthier food + EFA supplementation can't have hurt. We also thought very hard (and asked the vet) about moving her aza to every three days instead of EOD -- vet said don't bother, just take her off it cold, and she did well enough that way. Hope you can get some more helpful answers this time through...

Brian Vermont

Thanks Karen and Brian, Brian, I have to wonder too, Tiggs has always has had really sensitive skin, allergies, and yeasty ears. Your experience with Ethel and your theory gets me thinking too. So is Ethel off of all of her IMHA meds then? So what food do you currently feed her? We had tried alot of the Natural Balance stuff last summer, in fact, that's the only change that Tiggs was undergoing when he was diagnosed last July. Like everyone, I'm always trying to figure out the cause of his IMHA. Does Ethel have any thyroid issues? I'm really hoping that the thyroid meds will help the skin stuff here soon. He is on the Dermcaps, he's been on those for several months, and at first, they really seemed to help, but not really anymore, though I will keep him on them for sure.

melissa slc

melissa- sway also has had a big history of skin issues, a few years of misery with them prior to AIHA coming into the picture... luckily since being on her small doses of pred, it seems to help immensely in keeping her from reacting to these allergies. she used to literally chew her padding clean off of the bottome of her paws. thank God she atleast doesnt do that anymore! hmm. she randomly has peeling and weird coloration on her tummy tho - sometimes some scabbing but nothing major from what i can tell

josh california

Josh, is Sway hyperthyoroid???? Has she been tested? That would be one thing causing the weight loss for her? For tiggs it was HYPO thyroid, so he was a big fatty! But, his skin is black and peeling, with some blistering occaisionally, lots of hairloss on the chest, black in the ears no matter how many times I clean them, etc.

melissa slc

Melissa, We're giving her California Naturals Chicken and Brown Rice now, after she decided she didn't like the Canidae Platinum any longer -- just stopped eating it about two weeks after her last azathioprine dose. The food probably just reminded her too much of all the pills we hid in there while she recovered. California Naturals was the first other food we tried, and she seems to like it, spending plenty of time licking the bowl after emptying it. Ethel has been off all her IMHA meds since December 30th. We stopped adding the digestive enzymes to her food in mid-January, at the same time we switched. Now she gets two different EFA supplements with her food: 1/4 tsp of California Naturals Skin and Coat Supplement in the morning; and 1/4 tsp of a human omega 3-6-9 supplement in the evening (Barlean's Organic Oils 'Omega Twin'). Ethel never had allergies until moving to Vermont in 2004 (Lucy's allergies went away), so we have some concern we might need to put her back on a low dose of pred once spring comes around. The vet didn't think she had any thyroid issues when her T4 was tested around the time she got off the prednisone, so I can't offer much help there other than hope for you and Tiggs.

Brian Vermont

Melissa, I don't know but Molly is off pred and still on Azi. Her ears are yeasty and skin is funky and gross. Dry, flaky and stinky! She goes back to the vet next week over Spring Break and I am going to get his opinion. I will take the stinky ears and skin any day over how she was b4. :) I had not had Molly tested for thyroid though. Best of luck. Amy

amy texas

Melissa, Dr Dodds had us reduce the aziathioprine first to every other day on the off days of the prednisone. Then she had us go to every two days and then once a week. We have now stopped the aziathioprine but she wants us to continue with the 2mg of prednisone twice a week for two months. We are one month into this and doing good. Linda

Linda Sapphire

Thanks so much guys. At this point, I'm following her suggestions, but I do kind of wish we were doing the Aza first, then the Pred, I don't know why, it just seems like this is what most people do. But, we've gotten this far, and my vet has done an amazing job. She really feels we are under control and stable. I'm terrified nonetheless! Thanks everyone, love, melissa and tiggs

melissa slc

This thread was discussed between 10/03/2009 and 11/03/2009

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