- Second Chance AIHA ›
- Forums ›
- AIHA Dog ›
- Need Your Help for Zeus with IMHA
Our Giant Schnauzer Zeus, 4 years old, was diagnosed with IMHA on January 14th. He became suddenly ill…pale gums, wouldn’t eat, lethargic (no vomiting or diarrhea thankfully, no dark stool, no blood in his urine or stool). On January 15th, he was taken to his Vet. After doing a full blood panel, it was determined that he had IMHA. His HCT was 22% (low-normal is 35-37%). On January 8th, he had been given a Bordatella vaccine which apparently could have been the cause of the IMHA. At that time, it is what his two Vets concurred that was the probable cause. Zeus began taking a regiment of Prednisone and Azarhioprine along with Melatonin and Bayer Aspirin (as his blood was not coagulating correctly…it is now thankfully). He was also given a shot of Dexamethizone. We have taken him for blood tests every 2-3 days. Within 10 days, his HCT rose to 34%. He was looking and feeling better. Both Vets confident that he was beating this and would make it. Unfortunately on February 3rd, his HCT number fell to 28%. He was immediately given a shot of Dexamethizone and the next day, his HCT was 29%. Over the next 10 days or so, his HCT number remained at 28-29%. By February 12th, his HCT number dropped to 24%. His Vets decided to consult with an Internist after his radiographs and ultrasound showed nothing. The Internist could not find anything. At this point, it was becoming more and more puzzling and a mystery. On February 16th, his Vet thought maybe he had an underlying infection…some of them can mimic IMHA…Zeus began taking Minocycline and Cindamycin in hopes of seeing an improvement. His HCT also dropped to 22%. On February 19th, his HCT was holding at 22%. Zeus had a bad night last Saturday night, just couldn’t get comfortable, breathing hard, panting. We took him to his Vet yesterday and his HCT has fallen now to 18%. His white blood cells are off the chart which has never happened before and his red blood cells are very low…his bone marrow is not shooting out red blood cells like they should be. We take him back to the Vet this morning. Extremely critical will be if his HCT falls to 12% we understand. I have contacted the Veterinary school at Texas A & M. Zeus’s Vet is going to call and consult with someone there today. I am also going to recommend changing one of his medicines…the Azarhioprine and changing it to Cyclosporine. Perhaps it is not working. I am also concerned that he is having a reaction to the two new drugs introduced to his system last week. Thank you very much in advance for any suggestions, advice etc. Giant Hugs, Dawn
Hello Dawn,
welcome to the forum. I am so glad you found us even though I am sad for the reason you had to. This disease can be such a rollercoaster but you will find that most of the experiences you have, someone here has dealt with before and can help you with.
At 18% Zeus is probably very tired, his body is not getting enough oxygen and he is feeling the side effects of the drugs. It is awful giving them all these drugs, but you have to keep in mind they are saving his life. I can tell you are worried that the PCV will be dropping even more. There is always the option to do a blood transfusion to buy Zeus some time for the drugs to kick in. This should not happen unless it sinks to 15% though. Since Zeus has recovered once already and then got worse again I am sure Patrice is on the right track, Zeus is non regenerative. This sounds bad, but with the right protocol many dogs have recovered and you have to believe Zeus can too! I am glad your vets have reached out to an internist and a vet school. In my opinion contacting Dr. Dodds would be a very good option since she is also a hematologist and a specialist for this disease. Her contact information is right on this website under Second Chance Resources:
https://www.secondchanceaihadogs.com/hemopetresources/
You can consult with her directly or ask your vet to do it.
I hope you will get some good results today! Please keep us posted.
Best wishes,
Brigitte
Hi Dawn
I am so sorry you are going through this awful time with Zeus. Glad you have found us though – I cannot express how much I valued the support of the lovely people on this site when I felt overwhelmed & desperate for help. Brigitte, Vally & Patrice got me through a rough time.
I completely agree with Brigitte – Dr Dodds is the best person to contact & her knowledge is second to none. And she is a very compassionate lady too.
I am relieved to see that your vets spotted the clotting risks & aspirin has been prescribed. It is essential for Zeus from looking at the tests results.
My dog Worzel also had non-regenerative anaemia (bone marrow failure actually). Looking at the results (as Patrice rightly says) it is evident that Zeus is also non-regenerative – the reticulocyte level should be much higher. Worzel literally had no reticulocytes at all – big fat zero – so I hope it makes you feel better when I tell you he is lying beside me 3 years down the line with a PCV of 62 (age 14 plus!). He did respond to azathioprine quickly (around 2 weeks), but the preferred drug is cyclosporine & I would have put him on cyclosporine if he had not responded. Like you, I would have done anything in my power to get him better.
Vally’s suggestion of thyroxine is absolutely vital – it is part of Dr Dodds protocol & has actually turned the corner for so many of our dogs who were struggling with recovery. It promotes red cell production for sure.
I saw the reference to suspected hemangiosarcoma in the tests – that definitely needs further investigation. Patrice went through this with Chance, as you know, & Chance made a fantastic recovery – I know Dr Dodds was amazing with her help too.
We were prepared to transfuse Worzel as many times as needed until he became regenerative. Transfusions are a life saver & keep our dogs comfortable & out of danger until we find the right drug protocol. As Brigitte says, the limit is usually around PCV of 15, but it if they are really struggling, they may need a little help earlier than that. Also, it is important not to transfuse them to over about 25 PCV as this stops the body’s natural response to produce new red cells. So small amounts of fully crossed matched packed red cells would be good if needed.
It also looks like an infection is highly likely from the high neutrophils on the test results – they are very high indeed. We were also the victims of having a vaccination, but it was on top of an infection that the vets were “unaware” of at the time (long story). It sent Worzel over the edge & his PCV dropped & dropped.
I know you have absolute determination to get Zeus the best help. With your vet, Dr Dodds & Texas A& M beside you, you can fight this. And of course you have everyone on here behind you with any help we can give, anytime.
Sending you huge supporting hugs from the heart
Sheena, Worzel & Ollie xxx
Hi Dawn. We have been e-mailing, but wanted to also post a welcome and again say what an awesome job you are doing in putting all this together for Zeus. You are so much faster than I was – it took me forever and I STILL question almost daily. You are so sharp and Zues is very fortunate to have you in his court. 😊
So glad you’re communicating with Dr. Dodds! She is amazing. As Vally said, between your great vets and Dr. Dodds, Zeus has a fantastic team!
Will be checking in. In the meantime, love and hugs,
Linda and Sadie
Hi Dawn! welcome on this forum that helped me a lot. I’m italian and i live in italy so sorry for my english. If you have time please read the experience of my Camilla, diagnosed with IMHA the last november….now she’s quite well (i say “quite” just for luck!) https://www.secondchanceaihadogs.com/forums/topic/camilla-aiha-dog-from-italy/
I agree with Brigitte….i think that Zeus needs a blood transfusion to take time to let the meds work in the best way. When we took Camilla in the clinic the first time we realized that she had something wrong, she had 3.8 RBC. she was immediately put under high dose of prednisone but within two days she has worsened and she has come to have 1.8 RBC. at that point the vet gave her a blood transfusion.her red blood cell production was restarted after 96 hours of starting therapy, the day after the transfusion. and it was a rigenerative anemia (she had very high reticulocyte). Camilla has taken 6 tablets of prednisone 25 mg a day for about 1 month, then we started to decrease the dose slowly (about 30% less – but sometimes also 50% less- every 10 days. however is better to reduce very very slowly , 25-30% less every 2-3 weeks. she needed to reduce a little bit fast because the prednisone caused her very serious side effect). at the end of december her anemia has become non-rigenerative (her reticulocyte were in the normal range) so on january the hematologist gave her also the azatioprina. Camilla stopped taking prednisone on 1st February. now she is taking only 1/4 of azatioprina every other days and she has 6.1 RBC. On December, because of the side effects of prednisone, she has also had to take different drugs for the liver, an ace inhibitor because she had protein in the urine, an anticoagulant, and a drug for the heart because she has had a myocarditis as a consequence of anemia. during all the therapy she has also taken some supplements of vitamin B and minerals. This disease puts a strain on the owners, but be strong for your Zeus: he needs you fight for him. Let us know how it goes. Good Luck and a big hug!
ele&milla
P.S. Camilla is the same age of your Zeus. I really think the young age is a point in your favor in the fight against this disease.