Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Trixie 14/03 Red mark!

I have just noticed a red mark on Trixie's tummy,about 2 inches down from where her belly button would be, in the center of her tummy. It's about the size of a penny and round. At first I thought it was blood on her tummy so I got a damp tissue and thought I'd be able to wipe it off but I couldn't, if it was on the surface of the skin it would have rubbed off on to the tissue wouldn't it? It's really quite red in colour and I have no idea what this could be, could it be coming from inside and showing on the surface of her skin? (it's not a cut) Would anyone have any ideas please? Many thanks Tricia

Tricia UK

I'd call your vet and ask. It's better to be safe than sorry. Evelyn

Evelyn So Jersey

Tricia, This may be a staph infection, especially if you see the spot oozing a little thin pus. After that the hair on the spot might fall out, the spot would be bald and heal with shiny skin. If Trixie is still on high dose prednisone, this would be a very likely cause. The immune system is being suppressed, so there is a tendency to get infections that she would normally be able to fight off easily. For now, before you can see your vet, make sure that she is kept as clean as you can manage with her condition. Be sure to wash your hands before you touch her to avoid transferring anything back to her. In most cases staph isn't particularly dangerous and it is easily treated with antibiotics. I would be careful exposing her to other dogs until you see your vet. It isn't an emergency, but should be taken care of within a few days. Patrice

Patrice NYS

Patrice thanks for your reply. Trixie did have staph a few weeks ago on her leg, it was weepy/pus and the hair did come away, she was treated with antibiotics and after a week it cleard up nicely. It wasn't red, just weepy. This mark she has on her tummy looks totally different, it's almost like it's blood under the skin but the size and shape of a penny. I have to pick up some more Antepsin tomorrow so I will mention this to the vet. Her dose of pred now is 3/4 morning and 1/2 evenings, the dose was lowered just over 2 weeks ago from 1 morning and 1/2 evenings Tricia

Tricia UK

I'm back again...... looking at it again, she does have a lot of veins on her tummy and of course with the increased weight they are more prominent (her hair hasn't grown back much since she was shaved a couple months ago for tests) near where this blood spot/patch is there are tiny veins. My daughter has just come home and said it could be a burst cappilary? Any ideas please. Many thanks. Tricia

Tricia UK

Hi Tricia. I am noticing the same thing with Duck once in a while. I showed my vet one and she said it was like a bruise. Like you say, it looks like blood under the skin. I have since taken Duck off the small dose of aspirin he was on originally but my vet also commented it could be the prednisone that is making Duck bruise more easily. I have only ever noticed this "bruising" on two different occasions and it cleared up within a couple of days without treatment. Hope this helps. deb and Duck

Debbie BC Canada

Thanks Debbie, I was in a panic as you could tell! I thought, Oh noooooooo, not something else!! Trixie was put on aspirin when she came out of hospital a few weeks ago, she has 1 @ 75g per day, yes I suppose it could be the Pred. I'll speak to our Vet tomorrow morning. Tricia

Tricia UK

Tricia, Ok, this is something different than my original thought. This may be something called "Petechiae" or "Ecchymosis." These both refer to a kind of bruising spot or spots in the skin. In either case it is a sign of bleeding possibly caused by low platelets. The size and description seem like that. Check Trixie carefully, gums and other fleshy areas for more of these. Since she just came out of the hospital a few weeks ago, you might give your vet a call to see if they think this is something they should see. You can tell them that a friend said they thought it might be these things. I am hoping it isn't, but do make me feel better by calling them. My best to you, Patrice

Patrice NYS

Tricia, Here is a link to a vet site with a picture. http://www.vetmed.wsu.edu/courses_vm551_crd/notes/coag.asp Patrice

Patrice NYS

Thanks Patrice. The first picture looks much like what Trixie has on her tummy, although she only has one patch. I have made a note of the name and will mention it to my vet this morning. Tricia

Tricia UK

Thank God for Patrice and her infinite knowledge. Daisy has a bruise on her leg from where her transfusion iv was and in the past she sometimes bruises at the site of where her blood was taken. I've also heard that the bruising can be a result of one of her meds (side effect). Keep us posted Trixie.

Evelyn So Jersey

Trica. The red spot you see may be a sign of ITP (immune mediated thrombocytopenia). I have seen several dogs who have had AIHA/IMHA who have later developed ITP. You can read about "Midnight the Miracle ITP Dog" at this URL http://www.cloudnet.com/~jdickson/midnight.htm At the end of Midnight's story are a some links to more info on ITP. One link is not working (I'll take it off soon) but the other two are still functional an contain some good info.

Joanne MN

I took Trixie to the vets this morning and was told this mark could be a bruise, perhaps she hit herself against something, although I can't think what. I have been asked to take a urine sample tomorrow morning so that this can be tested to rule out anything else (not sure what the anything else is?) I just DON'T want there to be anything else! Their opening times on Sunday 10-30 - 11-00 am, so I must do my best to get this sample and I'm now trying to figure out an easy way (egg-cup?) I am hopeing they will test it tomorrow, rather than wait til Monday. I'll keep you posted, thanks again for all replies :+) Tricia p.s other than this, Trixie seems really well in herself, gums have been nice and pink for a while, no panting, wags her tail when out for walks (short walks)eats and drinks well. I just wish she would loose some weight! she is now 27kg, October 2007 she was 17kg, poor baby :+(

Tricia UK

Tricia -- good luck with Trixie. I developed a pretty easy way to get a urine sample from a female dog. If you have a pie dish or shallow bowl (I would use aluminum ones from those frozen pies in the grocers), take it with you when you take Trixie outside to tinkle. Follow her around (trying not to be too pushy about it) and when she squats, gently slide it under and get your sample. Then transfer it to a sterile bottle or plastic zip loc baggie. My Wiley had chronic urinary tract infections, so I usually had to do the sample routine several times a year. This technique always gave me a good quantity for the vets to test. Good luck with Trixie. Let's hope that the testing confirms it's just a bruise.

Brenda VA

Tricia, My other dog Rudy is a diabetic and I have to test his urine each morning. I agree with Brenda. I use a container that is about 2" high and rectangle. It's a little different for a boy as you have to be quick and have it angled perfectly as not miss but I would think with a girl it should be easier. Please keep us posted and good luck. Evelyn, Daisy and Rudy

Evelyn So Jersey

The sample went well, I used a flatish plastic lid of a container and then transfered it to the container the vet gave me. Looking at Trixie's wee, it looked very clear, I'm hoping that's a good sign. I took it to the Vets at 10:30 am, so fingers crossed, the tests will show positive :+) This morning I noticed that the red patch on her tummy seems to be fadeing. Thank you all once again for the replies x Tricia

Tricia UK

Hi Tricia, I am pretty sure they want the urine test to see if she has any blood in her urine. If this is a problem with her platelets, she will have trouble containing internal bleeding. What breed is Trixie? In any case, keep your eyes open for any more of these spots. By the time you read this you will probably have your test results back. The urine catches are easiest when a deep pan or other basin is taped to the handle of a broomstick. You can look pretty menacing walking around the neighborhood with it though. :-) Sorry, was unable to post all weekend. Patrice

Patrice New York State

Hello Patrice. Thanks for your reply. I hope to get a call this morning or afternoon, depending on if they have to send it away for testing, if they do, then I may not get resukts until tomorrow. Trixie is a Collie X, I will post a link here with a few photos, if it works, it will give you a better idea. Tricia http://triciaa.myphotoalbum.com/view_album.php?set_albumName=album01

Tricia UK

Test results are clear :+) so I'm happy, yayaaaaaaaa Tricia

Tricia UK

Hi Tricia, Good news! Trixie is one fine looking dog! I love the picture of her on her back, our Cassie sleeps like that too sometimes with her legs straight up in the air. What a hoot! I asked you what breed she is because some breeds, including my Giant Schnauzers, can have an inherited clotting deficiency. This affects how well they can stop bleeding. You know when you cut yourself, the bleeding stops pretty quickly. In humans or dogs, this can sometimes not work so well. Collies are not high on the list, but they are on the list that can have a clotting disorder. If you have further episodes of "bruising" ask your vet if they would be willing to have Trixie's blood tested for this clotting factor. Some of these factors are serious, others are very mild. Patrice http://www.ida.net/users/tonyd/Collie_Health.htm snip> "In von Willebrand's Disease, the dog is missing a substance which helps the platelets form clots and stabilizes Factor VIII in the clotting process. This substance is called "von Willebrand's factor". Because of the deficient clotting of blood, dogs with von Willebrand's disease have excessive bleeding upon injury. This would be similar to hemophilia. Certain breeds have a higher incidence of vWD than others. Even though there is less than 1% affected in the Collie Breed, this does not mean it is a minor issue. The CCofA and The CCofA Foundation support research for this and other aliments that effect the collie breed."

Patrice New York State

Thanks for the info Patrice. I'll keep an eye on Trixie and check for anymore patches like the last one. Tricia

Tricia UK

Our poodle Oliver was diagnosed on Saturday with red blood cell destruction, he's bleeding from his mouth occasionally. His platelet level was only 10,000. He was put on antibiotics and prednisone. It came on suddenly, within a few days. He has bruises all over his skin and is hardly eating and just lays on the sofa. He's only 7. I don't know if he's strong enough to fight until the steroids take effect. Has anyone's pet had this low of platelets and survived? Thanks.

Barb NJ

Tricia, I'm so happy to hear that Trixie's urine test was fine. Good luck. Evelyn and Daisy

Evelyn So Jersey

Hi Tricia, I think all the posts have just about covered everything for your trixie, but I just wanted to be sure your vet checked her blood count? If this red spot is bruising it could indeed by IMT, which can be handled. We noticed a bruise on Kents tongue, looked like he bit the bottom. I had taken him to the vet for a checkup and our vet initially said he could indeed have bit his tongue. But when he stopped by the next day he looked again and there were more spots, hard to see under his fur, and i brought him in again the next day for a blood count. He stayed for a blood transfusion and has been on the mend since - it was low platelets, IMT, and I am grateful we cought it in time. I think Patricia suggested this, and Joanne too, so definitely watch his body for more spots and do get a blood test, and at least mention it again to the vet. Christine and Kent

Christine Florida

Hi Christine. When I took Trixie to the vet, she asked that tests be done on her urine at that time. I have to take her back for a full blood count soon to see how she is doing on her reduction of Pred, as of now she has been on 3/4 morning and 1/2 evening, she has been on this dose for quite a while now. They would like to drop it to 1/2 morning and evening. Tricia

Tricia UK

Tricia, I second what Christine & everyone said. The red spots/bruising (Petechiae)is definitely something to look out for. This is one of our "warning signs" to look out for on Angelo. They are typically found on the belly and underneath their legs. I would get a quick CBC done if you could. Jeanne in NJ Goldens, Angelo & Archie

Jeanne New Jersey

My 7 year old maltepoo (Courage) has been battling with ITP and IAHA (low platelets and low red cells) for almost 9 months. This has been a very traumatic experience because he's like my child--he's followed me round the world, (I'm an ex-pat Brit living in the US and Courage was born in Sydney, Oz). I hope writing this helps someone somewhere. I took Courage to our local vet a few times last summer because of a skin infection, but not much was done. Then about three months after the infection began, I noticed bleeding under his skin (petecchia)consistent with finding a flea (he rarely gets fleas). The little bruises looked like very fresh red blood just under the skin and were totally cicular--in retrospect it was brusing from the flea bites. Our vet said he looked like he'd been running through brush and bruising himself. He continued to get worse and we started to do a suite of tests. In the meantime, we treated him with a 4 week dose of Doxycycline antibiotic and the skin condition cleared up. A CBC showed that, by that time, he had very low platelet levels (7,000). We did two transfusions, which bought some time till the prednisone (steriod) started to work. His platelets rose and we were ecstatic. We started to wean him off the steriod and he was fine for about 10 days, but then one morning, he just couldn't stand up and collapsed on our hardwood floor. This time it was his red cells. He dropped as low as 5%, but we managed to get him an emergency transfusion. At this point, we transferred to an internist, who has been wonderful. Courage has been on prednisone, along with two other anti-rejection drugs used on organ transplant patients--cyclosporine and danazol. The red cell recovery was much slower, but it did rise. We had to do a fourth transfusion to buy him some time while his levels rose, but it was getting too risky to do full blood transfusions. (The third one was really hard on him and cross-matching takes too long in an emergency.) So, the fourth transfusion was with a product called Oxyglobin. It was easy on him and I really think it gave him the edge to recover--how can the body possibly recover if it doesn't have enough oxygen? We've been very slowly weaning him off the drugs for the last three months. It's been great to get our baby back to normal. A few weeks ago, the skin infection came back. We cultured it this time and it's a Staph infection. We treated with Cephalexin and it went away, but 2 weeks later, his platelet level has dropped again. So, we're back on the high doses and hoping we can keep him with us. I really believe the original Staph infection got so ingrained it caused the auto immune issue. I've read that Staph can be a secondary effect of a lowered immune system, but this latest platelet drop is too consistent with the repeat of the Staph, in my mind. Anyway, we're hanging in there and he's really living up to his name. The reason I wrote this is to say that it is possible to pull them back from the edge. I would really recommend a vet internist, though. And the extra drugs (Cyclosporine and Danazol) seem to have helped. And I was thrilled with the Oxyglobin transfusion if you can get it. Do a web search for more info. I hope you can get these products in the UK--if not, the Oxyglobin can be stored at room temp and maybe you can get it shipped?? Good luck to all of you. Sarah and Courage.

Sarah Olympia

This thread was discussed between 14/03/2008 and 03/04/2008

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