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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - What's our next step??
| Hi everyone! I hope you and your pups are all doing well! We haven't posted in awhile but It's been very hectic. As I may have posted before, I had to come back to college ..and we had Lola living with me...After about a week, and seeing that she was homesick, she is now living at home with my parents,,Although she was always happy to be with me..this just wasn't her home. But I will still see her every week. Very hard though. Anyway, we just got her latest test back..and its the best results yet..the only problem is, since we don't have a vet working with us outside of our local vet that just takes her blood..i'm not really sure what to do. I already decreased her prednisone a couple of weeks ago..but I don't know what else I should be doing. Here are her latest results.. WBC= 9.1 RBC=5.31 HGB=13.9 HCT= 43.1 !!!!!!!! MCV=81 MCH=26.2 PLATELETS 230,000!!!!!!! Her neutrophils are slightly high and her lymphocytes slightly low, but i read that the prednisone causes them to be that way.. Basically I just don't know where do go from now. Dr. Dodds suggested the first prednisone decrease which I followed, and Lola seems unaffected by this decrease...still progressing..Dr. Dodds also said a couple weeks after the prednisone decrease, to decrease her atopica dosage from 10 mg twice a day to 5 mg twice a day..but my question is, I can only find atopica in the smallest dose at 10mg...so how would I do that!!?? What levels should I be worried about right now? I am afraid that I am going to be so preoccupied with her blood levels that something else could be going wrong and I wouldn't notice, especially now that I am away. Any advice would be very much appreciated. Thank you as always xoxo Christina and Lola |
| Christina New Jersey |
| Hey, girl!! WooHoo!! Look at those awesome numbers!!! Congrats from me and Mr. B :) Here's a thought....Bentley VERY seldom sees the specialist at LSU for an actual clinical exam. Instead, my vets draw blood and urine. I drop off the samples to LSU, as their lab can do more extensive testing than my regular vets. Then LSU forwards copies of all results to my regular vets, his current condition is discussed, and the specialist makes med changes as needed and decides the next step in treatment. My vets then follow through. Can your vet just get a specialist on board, and communicate via phone and fax? Samples could be delivered to the specialist if necessary, or if your vet's lab can do all the testing, then results just faxed over. It has been a great partnership for Bentley, and I think may work pretty well for Lola too....That way, as you decrease meds, a specialist can watch closely. IDK about the Atopica at such a small dose....can a compounding pharmacy take care of that maybe? We use Diamondback in Arizona.... Mr. B sends puppy hugs and kisses to Lola!! Sally |
| Sally Louisiana |
| For the cyclosporine, instead of 5mg 2x day, give 10mg 1x day Glad to hear Lola's doing much better!! |
| Monet Sammamish |
| Christina, good for you to get Dr. dodds involved! the HTC sure looks great, keep it up Lola! As for the Atopica, compounding is one option, I don't know about cutting it, we never had to deal with such a small dose. If you get a pill cutter you can cut very small pills but I don't know if it is possible or ideal with Atopica. ask the pharmacist or the vet. I think with this drug it is recommended to give it 2x in 24 hrs. It would not have to be exactly two of the same doses, as long as it is 10 mg in 24 hrs. est wishes, Brigitte |
| Brigitte BC |
| Christina, Good report! Check with Dr. Dodds again, I am sure she will say just use the 10mg once a day. The more important thing is to get the prednisone decreased slowly to a low dose. That will help eliminate some of the more serious side effects. Atopica has few side effects at 10mg. As for lab results, watch the liver enzymes ALT and ALKP to make sure that they begin to drop towards a normal result. Watch the value of reticulocytes RETIC to see that they maintain at or slightly below 1% and 60,000 absolute. If you see a gradual drop in the HCT and no increase in the RETIC then you would need to re-evaluate for a relapse. It's hard to say why dogs develop non-regenerative anemia and why this treatment is so effective. Have faith and enjoy your time with Lola. my best patrice |
| Patrice NYS |
| Hi Christina, I have been so busy too and have been trying to get to post here. So glad to hear Lola is doing much better. Yeah Lola!!! Happy for you both!!! I too would think about reducing prednisone as a priority. Although I have yet to see a dog as reactive as Dylan, I do think if it can be reduced it should be. Preventing the more serious side effects is desirable. Bone loss, arthritis etc., are much harder to undo than even the severe muscle loss, hind end paralysis and skin problems Dylan experienced (we walked 3 miles the other day :-) Still wishing you both the best and praying for Lola to keep on her positive path to recovery. Richard and Dog Dylan PS. Good luck at school! |
| Richard Burnaby |
This thread was discussed between 14/09/2011 and 18/09/2011
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