Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Transfusion #3 for Scout

Hello everyone. Its been another rollercoaster week with AIHA. After transfusion #2 on 11/22 Scout had a PCV of 25. Over the course of the next week, it decreased steadily to a PCV of 12 on Dec 1, so she went in for another transfusion. She left the hospital on Friday with a PCV of 25, but I feel like her numbers are slipping, yet again. She seems very lethargic. We have a appointment today with the specialist. Her meds are unchanged at Prednisone 20mg per day, split into two doses Cyclosporine 50mg per day, split into two doses Mycophenolate (Cell Cept) 100mg per day, split into two doses Pepcid 5 mg, once per day Denamarin Aspirin We did have her cyclosporine blood levels tested and they came back in the low theraputic range. I think the range is 100-1400 and she was at 200, so even though it seems to disagree with her digestion, they will probably increase it. The strange thing is that she seems pretty pink. Even on Wednesday with a PCV of 15, her gums looked ok to me, so now I distrust my ability to judge her symptoms. I'm really dreading the PCV results. I'm afraid that we'll be looking at transfusion #4 before long. When, oh when, will these meds kick in? Thanks to everyone for your thoughts, prayers and advice. Sincerely, Dorothy

Dorothy New Jersey

Hang in there Dorothy and Scout! I've heard of dogs receiving 8 transfusions before stabilizing. Not saying it will take that many for Scout, but keep your hopes high. Given her GI issues, you may want to ask the vet about increasing her Pepcid to twice a day, at least an hour before each meal. Maggie is on 20 mg 2x each day (Maggie is an 80 lb yellow lab). Just make sure that it does not hamper the Cyclosporine absorption. Scout is in good hands.

RobertN Superior

Dorothy, Wishing you and Scout the Very Best. Prayers continue.

Kathy Calif.

Dorothy, Hoping that Both You and Scout are doing okay?

Kathy Calif.

Hi Dorothy, Milly was on the same roller coaster - her counts to would rise to high 20's/low 30's with each transfusion then decline into the teens until she needed another transfusion. Last Sunday she had her third transfusion and her counts rose to 28 and stayed in the 24-27 range for 3 days. They let me take her home last Wednesday night with her count at 27. She was checked on Saturday and her count rose to 31. They added Imuran to her mix right after that 3rd transfusion and that seemed to do the trick so I would ask your vet about adding Imuran to Scout's meds. Good luck and keep us posted. Judy

Judy Medford

Hi everyone. I took Scout to the specialist yesterday. Her PCV was at 17, down from 24 post-transfusion on Friday. The vet did a CBC and wanted to wait for the results before changing the medications. He expects those today. She is lethargic and has not eaten much at all. I am so worried for her and am beginning to wonder if all of this is worth it. Her appetite is almost zero and I feel like all of the medication is making her really sick to her stomach. The vet is reluctant to give her anything to help her GI issues as it might hinder absorbtion of the meds, but I'm not sure how much more she can handle. I'm just sick over it. I hate to see her feeling so low. I just don't know what to do. I'm going to make her some plain hamburger or steak. Anything to get her to eat. I know the Pred is supposed to make them hungry, but that is not happening either. I'm scared.

Dorothy New Jersey

Dorothy, I am so sorry that you are going through this, No one deserves it. With this disease, we can only do the best we can. It's not easy to handle and it is a Roller Coaster Ride. You and Scout will have your good days and your bad days. Always remember, "Where there's life, There's Hope." Their eyes tell a lot. Good Luck!

Kathy Calif.

Dorothy, Using pepcid one hour before meals will not interfere with absorption of medicine. In fact, using prednisone without some way to reduce stomach acid will increase the risk of stomach ulcers and can lead to inappetance. She will begin to associate meals with pain (because this is when you are giving her the prednisone) and will refuse to eat. There are several drugs that do this, including doxycycline and some other antibiotics. Using a medicine to protect and heal stomach and esophageal ulcers is also a wise move. Ulcers can be a leading cause of internal bleeding that contributes to anemia. While these drugs do interfere with absorption, timing when you give them so they won't do this is a very successful way to administer them. I used Sulcralfate for Chance and gave it on an overnight fast. It is merely a sort of paste that coats and promotes healing of ulcers. Some people even use a homemade preparation of slippery elm as a cheaper substitute. The drug and this bark are similar in action. It is the fiber in slippery elm that interferes with absorption. I understand that you need to follow your vet's instructions, but keep in mind that not many vets treat such a complex condition as Scout has. What is standard treatment protocol in some clinics may be something your vet has never heard about. It's not wrong that they don't know, but it is your job as an owner to look out for your dog. Be proactive, but also be polite. Right now during this critical time you need someone on your side who is authoritative enough to help you work with your vet. Please write a concise email to Dr. Jean Dodds at hemopet @ hotmail .com (remove spaces to send). Let's see if we can get your vet to work with her closely on this treatment. my best patrice

Patrice NYS

Thanks, Patrice. I'd actually been corresponding with Dr Dodds, but haven't had a response from her on my last email. I'll email her again and I'll also speak to the specialist regarding your suggestion about giving it on an overnight fast. How did you get Chance to take the Sulcralfate? I can't imagine Scout willingly ingesting this when she won't eat chicken. Thanks again and best regards, Dorothy

Dorothy New Jersey

Dorothy, The Sulcralfate pills are pretty big, the only way I got them into my dog were pill pockets. as much as I did not like them, my dog got all exited about them and for quite a while this is how we got the meds down. good luck and best wishes, Brigitte

Brigitte BC

Dorothy, Just wanted to say I'm keeping you and Scout in my thoughts and prayers. I'm so sorry you are having to go through this with your sweet pup. We had to adjust Bentley's meds several times before his destruction stopped. I am hopeful Scout responds and you won't have to go to such high dosages as we did. If you happen to be on Facebook, there is an Immune Mediated Hemolytic Anemia in Dogs group on there...its been another great source of support for several of us. Wishing you and Scout all the best, Sally and (angel) Bentley

Sally Louisiana

Our vet gave us a way to give Tori the Sulcralfate. I pressed the tab into a fine power with a flat knife and used a Baby syringe (looked like a large eye dropper)which I could take apart and scoot the power into the bulbfrom the edge of the table. Then putting it together again, I then sqeezed up in the tube from a glass of water a very small amount(1.5 ml)shook it several times while holding my finger over the hole and then put it in her mouth and sweezed the bulb. Works like a champ, after a few mishaps of missing her mid tongue and it coming out the sides sides of her mouth. Now, after months & months of practice, Tori stands still and I don't usually miss. Ha Ha! I then put in another small amount of water and shake the eye dropper and then pour it over her food. That way, I have no waste. Just don't sqeeze the bulb too fast, so Scout can swallow it. I usually do it 2 times and allow her time to swallow in-between. We also, use the generic brand of Pepsid to help her tummy. Hope this suggestion helps. Blessings, Cindi & Tori

Cindi FL

Dorothy- I'm praying for your Scout. I've been where you are, and it's difficult, but please hang in there. My Sway had 8 or 10 transfusions over a span of 2 years, on and off. Please contact Jean Dodds like Patrice mentioned, she will be a fantastic ally and provide you with great insight and advice...

Josh California

Josh, I thought specifically about you today and wished you would visit here. How odd is that? Patrice

Patrice NYS

Thanks everyone. At the advice of Dr Dodds and in agreement with the specialist, last night we added 1/4 tab of prilosec to Scout's regimen. It seems to have helped within a couple of hours (I know from personal experience that it works well for me). I'm happy that her stomach seems much more settled this morning, but am still concerned about her lack of appetite. Due to my schedule, I end up giving her meds first thing in the morning and then asking a friend to feed her in a few hours. Today she still has not eaten since the morning meds. This morning she took all of her meds, ex. cyclo, in a tiny doggie meatball that I made for her. No problem. The cyclo was another story. The minute she realized what I was giving her, she spit out the meatball. She dislikes pill pockets and I've tried everything that I can think of to trick her into eating the cyclo. Wrapped in chicken, liverwurst, cheese, mashed potato. It usually works one time, then she figures it out. This morning in desperation, I gave it to her in a tiny bit of raw hamburger(i know, i know) but as I said, I was desperate. This is a real problem, since we've now upped her cyclo to three 25mg pills a day from two. I even tried just putting it the back of her throat and making her swallow, but easier said than done. Any advice would be greatly appreciated. Thanks for all the thougths and prayers. It is such a comfort to have you all with us. Sincerely, Dorothy

Dorothy New Jersey

Dorothy, Forcing pills down a dogs throat goes against my grain, but sometimes it has to be done. We got so good at it, that it is no big deal at all. I actually just gave my dog his 2x daily ginseng supplement and he does not resist it at all. I could grind the pill up, but believe it or not it is just as easy this way. Granted I am dealing with a healthy and hungry dog here and unfortunately since AIHA I have a lot of experience giving pills. What I do is I hold the pill with index and thumb, open his mouth just a little bit on the side, then slid the pill in with my thumb all the way down on the side. There is no gagging or spitting. I think the gag reflex is not there on the side and it is already too far down for spitting. And after that it is meal time. I actually thought that I am the only one doing it this way, I since have found out a lot of people do it this way. It is much less forceful than putting the pill at the back of the throat and you forcing the mouth open all the way. Just make sure it is all the way down on the side. Also make sure not to call the dog to you or she will associate coming with the nasty pills, always seek her out. I tried to find a Youtube clip of "my" method but could not find one. Everybody is forcing the mouth open all the way and putting the pills at the middle of the throat. I would fight that too! It takes a bit of practice but once you got it it is easy. Try not to get flustered, stay calm! I know it easier said then done, but Scout will pick it up if you are insecure or nervous and think there is something suspicious or wrong. Good luck and best wishes, Brigitte & the poodle boys

Brigitte BC

Dorothy, I hear you, it's hard and you are doing a great job. If ground hamburger works, great. I want you to watch a few videos of how to "pill" a dog and I think they will help you. Open google in your browser and copy this into the search area: youtube pilling a dog The first two that come up, Pilling a dog without restraint.MOD - YouTube and Pilling dog with restraint.MOD - YouTube are pretty straightforward. If you need more control look at a few more of the videos. This should work. You will need a large syringe filled with water. See the local pharmacy for this, some will give you a free one. my best patrice

Patrice NYS

Dorothy, When Cookie was first diagnosed, she got whatever she'd eat. Baked chicken breasts and tilipia fillets, chicken drumsticks and backs (I fed those raw, bones included), I went so far as to scrape the meat off of some salmon trimmings that were sold for very cheap.. $3 for trimmings off of 6 or so fish. I bought her some raw dog food (Answers brand) but she did seem to be sensitive to that so I ended up cooking it on a skillet. I encourage you to go to a health food store and buy a plethora of meats even some with bones (but don't cook the boned meat). Luckily dogs can go a long time on meats alone but if you could sneak in some carbs that'd be good too (I always drizzled anything in the oven with honey, and she would eat them with potatos or pumpkin as well) With the pill pockets.. have you tried wrapping the pill in a pill pocket, then wrapping something like chicken over the pill pocket (so if she gets through the chicken, she still won't taste the pill)? You can also replace the pill pocket with dough.. any kind of dough really if she likes it.. flour+honey/bacon fat/ground beef/peanut butter/chicken broth..etc.. To pill a dog without food, hold their head back, open their mouth, press tongue down and drop pill far down the throat away from tongue, then close their mouth and wait for their tongue to come out.. signifying they swallowed it.

Monet Sammamish

This thread was discussed between 04/12/2011 and 06/12/2011

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

This thread is from the Vetnet archive. The live Vetnet forum is active now.