Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - What is this Symptom

My dog was diagnosed 2 months ago and we've been thru quite a time with AIHA. She is currently on 80mg. prednisone. Before the stomach bloating happened I had read somewhere about a stomach condition due to the medicine. We are due to see our vet tomorrow, but in the meantime, can someone please tell me what that condition is called? My Dobe's stomach is so bloated and tight and I can tell it's causing her discomfort. I do know it's caused by the Prednisone, or so I was told, but I need some knowledge about it before I see my vet tomorrow so I can know what to do to aleviate this discomfort. I'm hoping we can decrease the Pred some this time around. Thanks so much.

Sue Michigan

Sue, Fluid does move around during prednisone use and can accumulate in the abdomen causing great discomfort. It makes dogs thirsty all the time and they may drink to excess. It would be a good time to begin decreasing the prednisone if there has been good recovery or if the vet has an alternative med like Imuran or Cyclosporine to add to the treatment protocol. There can be other causes of a swollen abdomen that should be investigated. Has your vet done a careful abdominal exam? Have there been any xrays done? Fluid retention can be caused by several conditions. If this were me, I would want to have the vet rule out tumors of any kind, listen to the heart and check kidney function. Chance had a 7lb tumor on his spleen that left his abdomen looking potty. He was very uncomfortable. We had the mass and spleen removed and pathology showed a benign hematoma. If your vet has not already done a chem screen/panel, ask if they could do that this time along with the cbc. It can be somewhat expensive but is a very good test to rule out a number of things. From this test you can tell how several internal organs are functioning, and whether things like electrolytes are in the proper ranges. I wish you the best of luck and good results tomorrow at the vets. patrice

Patrice NYS

Yes, at the beginning of the diagnosis(not since the bloating) he did a thorough exam, ran all tests, x-rays of the stomach area and we went to have an ultrasound done to rule out tumors. She had one transfusion. Has been on Doxycyline for about 1-1/2 months. I'll update you when we return from the vet later today. Thanks for the info!!

Sue MI

I just read your thread after I had posted mine. My dog also has the swollen stomach and had x-rays to rule out tumors. Did your vet say the Prednisone could cause this? My vet wasn't sure. My dog is also on 80mg--40mg 2x a day. Jennifer

Jennifer AR

wishing Dobe the best

josh california

Sue, That is very good that your vet has been proactive in investigating all causes of this condition. Sometimes vets with limited experience with this condition don't exhaust all avenues of testing. Ok, being on doxy for 1 1/2 months tells me a lot. Your vet isn't sure if this has been caused by a tick disease because doxycycline is the most prescribed drug for treating these diseases. So they are probably prescribing it "just in case." It is usually given in high doses for prolonged periods of time. The feeling is that tick diseases should be hit hard, the first time. I have belonged to a tick discussion group for several years and the one thing I hear more than anything else is that their dogs have lost their appetite when on doxy. The other thing I have heard over and over is how doxy can seriously impact the liver. Liver enzyme values can shoot sky high, these indicate liver cell damage. Both of these conditions (not eating and compromised liver) can lead to a very sick dog. The liver can enlarge and become quite tender and uncomfortable. I know this because Chance's liver was like this. He was so swollen and uncomfortable that he could no longer lie on the bed or couch. He could hardly tolerate lying on the floor and frequently groaned when shifting his weight. Prednisone will also cause this kind of impact on the liver. The two drugs together are a double whammy to the liver. I can reassure you that in most cases when the drugs are decreased and removed the liver will recover, it has the ability to regenerate. Until the time when those drugs are removed it's important to provide protection for the liver and assist it in recovering. There are two ways to go about this. The vet will probably carry a prescription med called Denamarin. I used this for Chance when he was in very bad shape. It is dosed for weight and is somewhat expensive. The other way to do this is to use the same ingredients that are in Denamarin, but use over the counter. The two ingredients are: Sam-e, which can be found at most any drug store, and some variation of milk thistle. Many folks on the tick list use a supplement called County Life Liver Support Factors, which has the essence of milk thistle in it. I have checked every ingredient in this supplement and have found them all to be safe. It's not very expensive and I found the best prices at vitacost.com. I do not benefit from this mention. I used the Sam-e and the CLLSF both with Chance for several months while we were decreasing his prednisone. To give you an example of how severe his condition was, one item on the chem screen called alkaline phosphatase, is normally under 112 or so. His number, at it's highest, was over 8600. This can be indicative of extreme liver cell damage, among other things. I would also ask your vet if you still need to continue the doxy now at this point. Find out why they wanted to prescribe it. You may be able to stop giving that drug now. I hope everything went well for you today. my best patrice

Patrice NYS

As Patrice said I too would ask about her still being on Doxy. Wylie was on it for 30 days, Isnt that the normal period or do they want longer? I recommend putting a chart together of her blood blood readings. I did that and wow it it was like as soon as she started on pred and doxy her ALT and ALK sky rocketed to 600. WOW I cant believe CHance had a 8600. and now that she has been off of everyting her levels are normal. She is on denimaryn and milk thistle. Patrice, a ? about Sam E I took the bottle to my vet and because he was not familiar with all of the ingredients he didnt want me to use it. She Wylie takes the denamerin. Laurie

Laurie CA

Sue...another contributing factor is the muscle wasting that occurs from the large doses of the prednisone. Most dogs start to show signs of this in their rear legs getting weak,and some develope a "pointed" looking head. This loss of muscle function also occurs in the abdomen and allow the internal organs to sag. Most survivors will regain their muscle tone.

Ron B San Mateo

Laurie, Check the ingredients on the back of the package of the Denamarin and you will indeed see Sam-e or S-adenosylmethionine. See Nutramax's website: http://www.nutramaxlabs.com/products/animal/denamarin/index.asp Your vet probably did not want you using Sam-e in addition to the Denamarin because this would be a double dose. Silybin, the other ingredient, is the essence of milk thistle. I can't believe the vet didn't read the back of the Denamarin label? The value of using Denamarin is that the dosage is carefully tailored to the weight of the dog. This company also claims to be using very pure Sam-e. When you have a very sick animal, sometimes using a high quality product insures the best absorption. When Chance was doing better, I switched to over-the-counter to save money since it wasn't as life threatening anymore. Some of you may be using Denosyl by the same company, this is just the Sam-e, no silybin. And the same company markets Marin, this is the silybin without the Sam-e. All of these are weight dosed. Either one or both assists the liver in recovery. So if you want to use both together, use either Denamarin or use otc Sam-e and Country Life Liver Support Factors (will do the same thing.) If you just want to use one otc, I suggest the CLLSF. Doxy is usually prescribed for known tick disease exposure at 10 mg/kg of body weight for about 8 weeks. This is a very high dose and there is some disagreement about this high dose. But those vets with frequent patients of tick disease in epidemic areas know this dosage to be the correct one. Unknown or unconfirmed tick exposure might be for less time at lower doses. patrice

Patrice NYS

Ginger currently gets 450mg of Milk Thistle a day, do you think I should also have her on Sam-e as she is starting the Neoral tommorrow and I want to give her the best protection I can. And if so what would be a good dosage for a 72 lb. dog. Thanks Cheryl & Ginger

Cheryl & Ginger Pineville PA

Cheryl, Before you add anything to your treatment protocol, check with your vet. You could mention that you know that the veterinary formulas Denosyl and Marin are Sam-e and milk thistle and that you would like to use the over the counter types. Your vet will either agree with you or suggest they prefer to have you use the prescribed veterinary forms. I used the otc only after Chance's liver numbers dropped substantially. Before that I used Denamarin, and that is really pricey for a 100lb dog!! I think it was around $50 a month. I checked the Nutramax website and they have the dosage for Denosyl (which is their version of Sam-e) for 66-120lb dogs as 2-425mg tablets per day. That would be 850mg per day. I believe you can get Sam-e in 200 or 400mg capsules over the counter. I was using the vitacost.com NSI brand because it had the best price. But you can buy this most anywhere. Note: Under the Denosyl information are these two recommendations: 1. The number of tablets can be gradually reduced or increased at any time depending on the pet's needs. 2. Many pets are maintained long-term on every-other-day or every-third-day administration. I eventually went to a "pulse dosing" schedule with Chance, m-f on and off s-s. This is just one version of maintenance dosing. Their dosage for Marin (silybin or milk thistle) for 50-99lb dogs is one 200mg tablet per day. This is easy to substitute with any product on the market by looking at the label. I used Country Life Liver Support Factors because of the additional added benefits of other ingredients. The label can be seen at http://www.vitacost.com/Country-Life-Biochem-Liver-Support-Factors It shows: Milk Thistle (seed) (70% silymarin equal to 98 mg) 140 mg So comparing that to the Marin dosage (200mg), I felt safe giving Chance one CLLSF tab per day, a little under, but with the other ingredients, sufficient. For instance, Choline is one ingredient in CLLSF that is known to be beneficial for older dogs livers. I attended a full day seminar last weekend on Canine Nutrition by Dr. Joseph J. Wakshlag, DVM, PhD (Cornell University College of Veterinary Medicine, Nutrition Dept) and he mentioned several of these ingredients like choline as beneficial. Taurine: good for the heart, alpha lipoic acid is a potent antioxidant. etc. Oddly, after going through all the information about processed dog food on the market he noted that in many cases there are no regulations governing the addition of supplements in dog food. In many cases, if something is mentioned on the label as a supplement, it is very possible that it is in such small quantity to be negligible. However, it makes the food sound great and makes for a good marketing ploy. A few examples were blueberries as antioxidants and lactobaccilus as a kind of probiotic. The first would be in such small quantity that it would do no good and the other is sprayed on the food after it is cooked and processed into kibble. Probably won't survive the processing. In the end he seemed to tip toward home made food and, here is the surprise, recommends to his clients using a simple one a day vitamin for dogs on these diets! In any case, I could go on, but I won't, suffice to say I have a head full of details right now I need to keep straight as I make food at home. patrice

Patrice NYS

My dog, Baby Girl, was diagnosised on Friday, August 1st with AIHA. We really don't know what to expect at this time. She is lifting her head and moving around a couple times a day. She is on prednisone 10mg daily, doxy, val syrup, and an iron supplement 2x a day. We also feed her liver and rice 3x a day. However, she doesn't like it. We have to add water to the mix and put it in a syringe to feed her. The vet recommended the liver because of the high iron content. Does anyone have any recommendations on how to make this meal more pleasurable? Also, from ya'lls experience, what can I expect with this disorder? I was reading what others had posted and noticed the high prednisone prescription. Should Baby Girl be on a higher dose? Thanks, Marti

Marti Texas

This thread was discussed between 31/07/2008 and 05/08/2008

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

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