Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Weird skin and some strange behavior

Hey everyone, Tiggs has some seriously dry, flaking skin and little dry blister-like scabbies on his tummy and inner thighs. It just looks really dry and flakey, no blood or puss or anything, but it's super scaly, and his hair is really thinning. He's only on 5mg of Pred every other day, and still the 30 mg of Aza a day. Is this normal? I can't recall seeing this kind of dryness on his underside before. Also, and this could be totally unrelated to AIHA, but Tiggs comes to work with me alot, and we have a busy retail store. He's always been very happy-go-lucky, and still is, but ocassionally, he is displaying fear and whining with certain people that approach him. I don't know if the meds cause anxiety, but 99% of the time, he's a great little greeter...thoughts? Thanks, melissa and tiggs

melissa slc

Hi Melissa and Tiggs, I'll be totally honest that I have no idea whether these are side effects of the medication but were his thryroid levels tested. It turned out my dog had undiagnosed hypothyroidism which the vets had told me three times was a genetic disorder!!! He had the scaly skin and fearful behaviour and whining when seeing other dogs but also drank a lot. May be worth you checking the blood results if you have them? All the very best to you both in Tiggs' road to recovery, Karen

Karen Thomson Portugal

That's great advice, thanks Karen, I will have it checked. melissa and tiggs

melissa slc

Melissa, I wish I could find the website where I read this, but I can not :( The website said that one side effect of aza is alopecia. That is hair loss. When Ren had her first bout with AIHA, her hair thinned almost to bald patches. My former vet insisted that she had demodex mange even though the skin scrapes were negative. She wanted to place Ren on oral Ivermectine but I did not want to give her more drugs. After Ren went into remission, her hair grew back fine. Just over the past week I have noticed that Ren's fur is once again thinning. I really believe that it is a side effect of Aza. SUE

Susie Delaware

Alex had patches of dry scaly skin on his tummy that turned out to be some sort of a skin infection. I'm sorry I just can't remember if he had to take medicine for it or not - he must have though. He's been off and on so many things this past 8-9 months that I lost track of that one as it cleared up quickly with whatever we treated it with. Chris

Chris Pa

Hi Melissa: Sheba had a problem with scaly/dry/flaky patches on her back, shoulders and haunches when we reduced her pred down to a minimum and then eliminated it entirely. She also experienced severe loss of fur. We could literally pull it out by the handfuls - which makes for a TON of fur when you've got a GSD/Cocker Spaniel Mix! Since she stopped shedding altogether while on the pred the vet figured it was her system trying to return to "normal". We had to bathe her every 3-5 days with a special medicated shampoo for approx. 2 weeks but eventually the problem cleared up. She never seemed to itch and other than not totally appreciating the baths (our tub is a bear to get out of for her) she was a trooper. You'd never know she had a problem (in fact, we're starting to shed our winter coat now!) as her coat is as thick and glossy as ever! I don't have any answers for you regarding the fear/whining. Sheba has never been on Aza and we never had a problem with this. Rita, Mike and Sheba

Rita IA

thanks everyone! We have an appt on Saturday, and hopefully this will all be no big deal...the thyroid could make sense, then again, so does the Aza, so I'll get a full work up and see what it is. Almost looks like it could be a fungal thing too. Who knows, but it doesn't seem to bother him one bit. I'm optimistic that his Pred will be d/c'd this weekend, then we can start to move the Aza to e.o.d. melissa and tiggs

melissa slc

Hi Melissa, My dog Mac had the skin condition you're describing on his tummy for a period of time when he was on higher doses of prednisone and azathioprine. The doctor perscribed KetoChlor medicated shampoo that was made up of chorhexidine, gluconate and ketoconazole. I would lay Mac on his side and put a treat within his line of sight, wet his tummy down, put the shampoo on and let it sit for 10 minutes, then wipe him down with wet rags until all shampoo was gone. Then...treat time! His skin would return to a smooth, clear state for about two weeks, and then we would repeat the process. Lately I haven't noticed any flaking and peeling since he's reduced his pred to every other day. Good luck with that, and keep us posted on his recovery! Jane

Jane MN

My dog Bella was recently diagnosed with calcinosis cutis. Large areas of her skin have hard scaly patches on them. We were told that it was due to the prednisone so we are working on weaning her right now. The internist believe it will clear up as soon as she is off the pred. There is no treatment for it and we give her benadryl to help with the itchiness. She does not have hair loss related to it.

Tracy New Jersey

Tiggs went to the vet today, so far she definitely thinks it's his thyroid. She ran a full CBC, plus the thyroid/urine panel. I wasn't there, my husband took him, but it sounded like after she examined him, she was pretty convinced. Not to mention he is now nearly 80 lbs!!!! He was 64 at his dx of IMHA, we kept blaming it on Pred, but he's only on 5mg eod, and he's also way more active, and on a diet. So, the weight gain just keeps piling on, poor guy. The GREAT news was that his PCV was his highest yet, between 44 and 45 (his baseline before IMHA was 48, so we're not that far off the mark). Thanks all, Melissa and Tiggs

melissa slc

Glad Tigg's PCV is at such a nice number and I hope his vet can come up with a correct diagnosis and get him on the proper meds. It seems to me like a lot of the AIHA dogs are on thyroid medication, Ginger included she was on it prior to AIHA diagnosis. Ginger takes her soloxine 2x a day an hour before each meal and she lets me know when it is time for her pill. It is amazindg how she has a sense of time when it comes to getting a pill with peanut butter on it and when it time to eat her meals. Keep us posted. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Melissa, Here is a link to Dr. Dodds new Thyroid test just started last month. I don't know if the link will post correctly but you can just go to her site if not. It sounds like a more thorough type of test. http://www.hemopet.org/files/2009%20NewThyroid%20Panel%20Notification%20Ltr.pdf

Penny Lytle Creek Clif

Penny, Try this: http://www.hemopet.org/services.html "HEMOLIFE, provides the most comprehensive diagnostic profiles for detecting and interpreting autoimmune thyroiditis and hypothyroidism, with our specialized reference ranges. We use novel, 'green' non-RIA technology never offered before in veterinary medicine (patent pending). Our thyroid panel has been revised for 2009. The new Thyroid Antibody Panel (Thyroid 5) is comprised of T4, Free T4, T3, Free T3 and TGAA. No other diagnostic laboratory offers this technology or provides clients with the detail, personal assessment, and recommendations offered by Dr. Dodds and her staff." Then click on this link for the actual form: Test Request Submission Form and Instructions for Tests Patrice

Patrice NYS

Just got back all of the results of the thyroid testing. Tiggs T4 level was .4 (normal is 1.0-4.7). He will be started on meds tonight, and my vet anticipates that this will help him with the weight gain, skin scabbies, and hopefully the anxiety too. I would assume it will be a few weeks before we really see a change, but I'm optimistic that he'll get a little more energetic too. In 3 weeks she'll do the post pill testing process. I will probably wait to submit anything to Dr. Dodds, unless we don't see an improvement after these first few weeks and follow up. One other question, I see that his absolute neutrophils are in the high range, they are 12069 (normal is 3000-11500) as well as the Neutrophil SEG which is 81 (normal is 60-77). I am assuming this is probably somewhat normal in recovering anemic dogs? Everything else on the CBC was in the normal range...woo hoo!

melissa slc

Oh, and we are now alternating days of Pred with days of AZA, so that is huge too. 5mg pred EOD 30mg AZA EOD (opposite of Pred days) Yee haw, med reduction! melissa and tiggs

melissa slc

Oh one last thing, his cholesterol was very high, it's 644 (normal is 112-328) which also supports hypothyroidism apparently as well. Thanks everyone, melissa and tiggs

melissa slc

Great numbers on the PCV Melissa! I am also glad that you found some answers to the skin disorder. At least you know now what your dealing with. Give Tiggs a big hug for me! SUE

Susie Delaware

Hi Everybody. My dog has IMHA/AIHA and we weaned her off Pred about a month ago. 2 weeks ago she got the flaky skin with hard bumps on her back that quite a few of you had mentioned. She is on Cyclosporine only. We took her to the vet and he biopsied it. The results came back as Calcinosis cutis. There had been a mix up at the pharmacy where one time we got the non-modified version of cyclosporine so when it did not elevate her PCV we increased the cyclosporine to a higher than recommended dose. At the same time the pharmacy gave us the modified cyclosporine which has a high absorption rate. Now we've backed the dose off to the recommended amount and are trying to see if this will clear up. I am going to ask about the KetoChlor. I was wondering about how much time we should allow for this to resolve? The next possibility might be that she is reacting to the carrier in the modified cyclosporine (although I haven't heard of this) and that we may go back to the non-modified but in a higher dose since it does not absorb very well. Its been a while since anyone posted on this subject but trying to track down what caused this (ending the pred, changing cyclosporine or overdosing the cyclosporine). I'm really worried and would like to know what happened to you all with this Calcinosis cutis. My dog does not even act like she knows its there. She does not itch and she isn't losing any hair.

Michael Arkansas

Hi Michael, Thanks for your comments and follow up questions. So Tiggs skin thing isn't that Calcinosis Cutis, though I know I've read about other dogs here experiencing that as well. If you search the archived threads for that term, I think you might find a couple of posts. In Tiggs scenario, I think it's twofold: he is Hypothyroid (which you might get your baby tested for) and also when all of these guys are on the immunsuppressives, I think that it allows some things to fester on the surface, like the yeast and bacteria. At this point, Tiggs' blisters look like they may be Staph and we're treating it with a topical antibiotic. In addition, the skin on his tummy is blackened, and peeling in some spots, which I attribute to the Hypothyroid. I hope you can get some more info from people that have experiences the Calcinosis Cutis, I know I've seen it here before! The Ketochlor is good, but in Tiggs case, it seems to work for a couple days, then we're back to dandruff, flaking, and the oily feel. But, I think most dogs get the bath once a week at least (that's a tough one, Tiggs HATES water and baths!). Good luck, and I hope your baby is doing well otherwise! melissa and tiggs

melissa slc

Melissa Thanks for letting me knnow about Tiggs. I may ask about running a Hyporhyroid test since I saw that mentioned quite a few times when I googled Calcinosis Cutis. My local vets had never seen anything like it and one thought it was cancer. That scared me and I had them do a biopsy right then and there. Now, if the lab can be trusted 100% then it is Calcinosis Cutis which unless it gets infected it is not anything that an anti-fungal or anti-bacterial will do anything for. We're just going to try lowering the Cyclosporine and give it some time - I thought I'd try the Ketochlor just as a preventative because like you said.. Cyclops's immune system is down right now and I don't want that skin irritation to provide an opportunity for an infection. By the way what kind of dog is Tiggs? I like that name. Michael and Cyclops

Michael Bella Vista

Hi Michael, I also love Cyclops name! Tiggs is a striped pit bull-whippet mix, full on brindle! You can see him here: http://www.flickr.com/photos/dzinelvrslc/ What kind is Cyclops? I bet he's cute! The calcinosis doesn't seem all that uncommon for dogs with IMHA on Cyclo, so even though your vet hadn't seen it, it's definitely around on these guys. One more weird complication thanks to IMHA. I hope Cyclops is doing well! Definitely run the thyroid panel, just for peace of mind. melissa and tiggs

melissa slc

Hi Melissa, Great to see soem pictures of Tiggs! Kind of a similar look to my boxer Zodie. Glad you got the skin thing figured out. I wanted to write here because Zodie has been experiencing this little skin bumps as well. Tonight, I was rubbing one on here ear and it just came off with a bunch of fur. There was quite a bit of puss on the bare skin patch. Scary! I haven't seen others talk about a puss kind of thing here. Have you guys seen this at all? Like you all say, it could be the high med doses (80 mg pred, 100 mg cyclo, 25 mg azath daily), or a throid issue. But while the bumps feel dry on top they aren't underneath I guess and while she is losing hair on her sides her skin does not seem that dry. Any comments appreciated. Give my best to Tiggs! -Greg

Greg MA

Greg, This is most likely a staph infection that arises due to the immune system being so suppressed. It cannot fight off the staph germs that are normally on everyone's skin. Make sure that you limit Zodie's exposure to all other dogs and any person with a compromised immune system. Everyone should wash their hands before and after touching Zodie. Clean the areas with gentle soap carefully and gently. There is a very good antibiotic that will work very well. Ask your vet. The skin will probably remain bare and get kind of shiny after it heals. Not to worry. It will come back as the dosage of pred is decreased. It just looks pretty awful.. patrice

Patrice NYS

Hi Greg, Tiggs also had a staph patch on his skin, and we are treating it topically with an ointment called Pyoban, and it's responded very quickly and well to this treatment. I wonder too if it could be the Calcinosis Cutis that Michael was inquiring about or if it is staph like Patrice suspects. I have to say Tiggs patch wasn't puss filled or anything, just more a darker reddish circular patch with some peeling dry skin on it, right on his belly next to his private area. In Tiggs case, he's not even on Pred anymore, and only on a low dose of Aza every other day, so I think his staph patch also had something to do with the thyroid stuff going on. I hope Zodie is doing well! Kisses from one brindley block head to another :) melissa and tiggs

melissa slc

melissa- those pictures of tiggs and honey are really cool- wish they could meet and play with sway!! pit bulls running around playing is pretty much the best

josh california

This thread was discussed between 05/02/2009 and 17/03/2009

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