Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Vet called with Maggie's latest CBC

Maggie improved from last week. Last Friday HCT/absolute reticulocytes 29.5 and 73,000 This Friday HCT/absolute reticulocytes 31.8 and 107,000 So as long as there is improvement, I am happy. She is still anemic but has progressed from moderate to mild. Bear in mind, this is without increasing the dose on her cyclosporine as the emergency vet initially wanted to do. I am going to pick up Maggie's full report tomorrow. The vet is happy and said the Maggie's reticulocytes are ok given her HCT. According to one site that Patrice provided, anything above 100,000 is perfectly appropriate for mild anemia, assuming that around 32 HCT is mild. So I am going to consider this good news!

RobertN Superior

I forgot to add, Maggie's reticulocyte % is 2.4. Keeping in mind that Maggie and I are at altitude in Colorado, my vet is giving Maggie a target recovery HCT of 37.

RobertN Superior

Yea for you and Maggie! Keep those numbers going up. Penny

Penny lytle Creek

Richard, we are celebrating with you and Maggie! Love those improving numbers. Continued prayers for all our furbabies. Blessings, Cindi & Tori

Cindi FL

Congratulations on Maggie's improvement. Hope her numbers continue to climb.

Judy Medford

Congrats Maggie! Finally in the 30's..looking good!

Monet Sammamish

Excellent! 100,000 is an appropriate response to moderate to low anemia. You are just a few numbers away from low normal. Are you gradually decreasing the prednisone? It might be time to think about a little less now and continue the regular dose of cyclo. By less I mean no more than 25% reduction. If you are at 80mg a day, dropping down to 65-70mg a day would be a comfortable reduction. It's still a very high dose, but beginning to decrease the dose will reduce the bad side effects. What do the liver enzymes look like now? my best patrice

Patrice NYS

Patrice Maggie has been on a low dose of 20 mgs of Prednisone a day since Nov. 17 as it was believed to be contributing to her tendency towards hypercoagulability. It has been nice to see the effects of the Prednisone fade as she also continues to move closer to the low range of normal with regards to her anemia. So her anemia is successfully being managed by the following medications: 200 mgs Cyclosporine (100 mg 2 x daily) 50 miligrams Azathioprine every other day Per your suggestion, I did bring up the possibility of the Aza potentially inhibiting Maggie's bone marrow but my vet says that there are no signs yet. She wants to be cautious about lowering her meds, since Maggie is basically on a very manageable if inconsequential dose of Prednisone. We just took a short walk in the snow, and she loved it. I continue to watch her like a hawk and keep her from interacting with other dogs. But she is generally very happy these days.

RobertN Superior

By liver enzymes, I take it you mean neutrophils? I did not pick up her full results this morning as it was snowing, but I'll grab them next week. Maggie was only on a full 80 mgs of Prednisone from Oct. 26 to Nov. 17, so I imagine she will recover quickly. My vet wants to go very slow in reducing the rest of Maggie's protocol, but between the Aza and Cyclo, which do you think we could reduce first?

RobertN Superior

Alanine Aminotransferase: ALT Alkaline Phosphatase: ALKP/ALP These two liver enzyme values are probably very high. At one point Chance had an alk phos over 8600 (with a high normal value of 212.) His liver was very swollen and uncomfortable. After decreasing his prednisone and discontinuing it, his values returned to nearly normal. This is in direct relationship to prednisone dosage. The liver is processing this drug and cells are destroyed during this. The enzymes are in response to this process. The side effects begin very quickly after initiating the high dose pred. Of the two, alt is the more pertinent value. If the liver had no organic disease prior to this illness, it will most likely recover. It is a regenerative organ. However it is still a good idea to reduce the drug when you are able to safely because of this side effect (among many others). Aza can contribute occasionally to bone marrow suppression, I believe it is related to the dosage. Plenty of folks here continue it into the recovery period just fine however. I never used it for Chance, he was very responsive to cyclo. If this were me, I would stick with the cyclo because of the low risk of side effects, esp at lower dosages. You are thinking, of course she would pick the more expensive drug..... sorry. This is really Dr. Dodds area of expertise and she would answer in a heartbeat. But don't put the horse before the cart, get to PCV 35-37 before you decide what to do. You are well on your way. Time to relax a little. my best patrice

Patrice NYS

Robert, I am so happy to hear how well Maggie is doing! I know you've been through a lot recently and it is wonderful to see some good news. I'll keep you both in my prayers! Go Maggie!! Dorothy

Dorothy New Jersey

WOW! Keep it up Maggie, Oh and you too RobertN. ;) Prayers Continue for you both.

Kathy Calif.

This thread was discussed between 03/12/2011 and 04/12/2011

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