Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Update on Max and some questions

Well Max is back home after responding well to treatment - thanks to all those who sent good wishes and prayers. His hematocrit is around 30% which the vet is pleased with. He's on prednisalone and azioprine tablets for the next 6 months at least. We have to return to see the vet in 4 weeks, sooner if he is not well. He really is looking so much better, he has a bit of energy though flags quickly if we go for a walk, and he's not yet got strength to jump up on the sofa - so we lift him! Now the questions - do the steroids cause hair loss (he's moulting quite a bit)? Will he put on weight even if I keep him to the same amount of food he's always had? Should I give him more food - he's hungrier. Should I keep him away from other dogs? Hope you can give me some tips - you all seem to be experts sadly. Wish none of us had need of this site!

Theresa South East Kent

Teresa, I am so happy for you that you have Max home where he belongs. To your questions: Yes the medications can cause hair loss. My standard poodle Kahlu is still loosing a bit of hair, but it is coming back in in the places where he had none left! (After 7 months) It is coming in in a nice red, the color he had when he was a puppy. I told the vet I like that even though I would take him in green or blue..... Max will most likely gain weight. Instead of more food i would recommend to feed him high quality food. Lots of protein, low fat, no grain. I always laughed at people that home cooked for their dogs. Guess what? I cooked lots of lean chicken and fish, with yellow and sweet potatoes, beets, carrots beens and pumpkin. It is not just that dogs on these medications gain weight, the weight is weirdly distributed. Kahlu got a fatty hump on his shoulders and of course the tell tale pot belly. That is most likely causes by the muscle loss. Make sure Max always has lots fresh water. Keeping him away from other dogs seems sensible, since his immune system is very compromised. This was a hard one for us. We have lots of other dogs in the family and Kahlu enjoys them so much. I tried to only have contact with dogs he knows well and dogs that did not entice him to too much playing and running. My vet told me that in the beginning stages it is very easy for these dogs to get insured and you really don't need that. I also felt that in order to heal, Kahlu needed some quality of life and seeing other dogs was part of that. Best wishes, Brigitte & Kahlu

Brigitte BC Canada

Theresa, I am so glad that Max has been allowed to come home. This is a good environment for him to rest and recover. To answer your questions. There are many side effects that come from the Iatrogenic Cushing's syndrome that happens from flooding the body with too much cortisol. Some dogs do lose their coat temporarily while they are on high doses. My vet says it most especially is bothersome to dogs that have multi coats like terriers. My Giant Schnauzer lost a lot of his fluffy undercoat, but kept his outer dense coat. This side effect will reverse once the high doses are removed. He is not necessarily going to put on weight but rather the high levels of cortisol makes his body metabolism different and he will begin to lose muscle mass and shift fat reserves and body fluid around. This can give him a pot bellied look with flaccid muscle tone. This too, will diminish once the pred is lowered, but will take more time. Let him eat in moderation what he wants. Try to keep most of the food in the "high" nutrition category but avoid too many rich foods. This can possibly lead to pancreatitis as a side effect as some of the drugs you are using may also predispose to this too. If you use kibble, try to avoid ones with grains included and look for a moderately higher protein content of around 18-24% (dry matter). There are some excellent ones on the market. If you can, a home made diet is also good for him. If he is on very high doses of prednisone, he is more prone to infections like staph. If this were me I would limit his exposure to other dogs and people that have compromised immune systems. It is very hard to keep a dog clean and they do pick up so much on their paws. I would definitely avoid boarding Max for the time being. In my opinion, 4 weeks is an awfully long time to go until the next appointment? See if your vet will at least do a simple PCV (should be no more thant $15) in about 1.5 weeks. If he continues to improve and reaches a normal PCV then you could discuss beginning a slow prednisone reduction. my best patrice

Patrice NYS

I second Patrice's thoughts about frequency of appointments. Toby's PCV was checked every 5 to 6 days, and because the numbers were good, he was able to be weaned off of prednisone over the course of a month. He's been off for about 6 weeks, and the panting, increased thirst, and urination have cleared up. He's still heavier than he was prior to prednisone, though, but I'm hoping that will clear up too. Frequent checks will maximize the chance to wean as soon as possible. Good Luck to Max!

Ann CT

Hi Patrice and Ann, thank you both for your replies - it's been very helpful as I am in the dark! I do seem to have a quite knowledgable vet, he suspected AIHA immediately which I understand to be quite unusual. I'm so pleased he knew what he was doing as otherwise Max might not be here today. I'll speak to the vet later today and ask for more frequent blood tests, Kathleen also emailed me about that already. I'm not sure whether I should still be taking him for 2 walks a day or just limit it to one. We did 2 short ones yesterday but he did seem tired on the way home - am I pushing him to hard? I wll keep him out of the dogpark but hopefully it wont be forever as he really comes to life when chasing around with other dogs! Thanks again, Theresa & Max

Theresa South East Kent

Sorry Brigitte, I forgot to put your name in the thanks above! Thank you too, your answer really filled in some gaps for me. Theresa x

Theresa South East Kent

Hi Theresa, I'm glad that your Max is improving. I would let him be your guide as far as whether he can tolerate the walks. Sometimes short walks around the block can really help a dog that is recovering as it's mentally stimulating as well as physically, just read his cues whether he's up for it. We didn't take Tiggs to the dog park until he reached his one year anniversary, and to be honest, we don't even go that much, it makes me paranoid. Parvo and other viruses can live on grass for a year! Tiggs loves other dogs, so we try to arrange smaller play dates with friends' dogs that we know are healthy and vaccinated. If you are trying to add weight on, you can add in some yummy foods with what you already feed, like chicken or fish, eggs, white rice, etc. In our case, Tiggs lost a bunch of weight, then balooned up- Pred made him huge, then he developed hypothyroid, which made him huger! Now that's under control and we are back to his pre-IMHA weight. Hugs to Max, slow and steady is the name of the game here! melissa and tiggs

Theresa slc

Theresa, good to hear Max is getting better. Have you considered putting some food in water. It'll make him feel a bit more full. I give my dog Tessy all kinds of food throughout the day but I've been keeping her on a pretty strict diet (Dr. Dodds liver cleansing diet...slightly modified). Of course she would eat all day 24/7 if she could. I've really gotta watch her at dinner time so she doesn't get into the other bowls. I also keep Tessy away from other dogs...especially in the beginning. I also DO NOT use chemicals anymore in the house or outside the house for that matter. Better safe than sorry right. Try to keep his activity level to a low, he'll let you know when he's had enough. When Tessy first got sick I only let her go for short walks just to do potty until she got better. Then I slowly added a bit more day to day for her. Is he taking a stomach protectant? You could also consider putting him on sups like milk thisle and pet tinic. Others on here have been raving about bioprep lately....might be worth looking into. I haven't used it so can't really chime in on that one. Hoping all the best for Max. I'll keep him in my thoughts and prayers. Johnny & Tessy

Johnny Nova Scotia

I am very happy that Max is home and doing well. That is awesome. Keep up the good work. Mardi

Mardi Northern Calif

This thread was discussed between 22/09/2009 and 24/09/2009

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

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