HCT Dropping

Hi Augusta,
I’m sorry to read about your Bichon Frise and his diagnosis.

Let’s look at what happened in more detail. One of the triggering events, among many, for developing IMHA or AIHA is over-vaccination. I am a bit taken aback that your vet decided to administer the DHLPP vaccine at 10 years of age. I am assuming that he probably received this series as a puppy. Once the required puppy shots series are done, we here on Second Chance always advise to no long vaccinate, except for the mandatory rabies vaccination. On this page you will find Dr. Dodds 2016 Vaccination Schedule that we recommend for dogs that may have trouble with over-vaccination. Print this page (you can click on the upper right hand arrow to open this full for saving and printing.) Keep this with you and show it if you are asked to vaccinate again. If your vet continues to stress that you do, especially after this most recent incident, please try to find another vet.
https://www.secondchanceaihadogs.com/vaccine-resources

So there can be many triggers that can interact with the immune system to begin a disease like IMHA. Dr Dodds has written an excellent article that details how the immune system behaves and why it is sometimes prone to developing autoimmune disease. Here is her short summary of the most prominent factors. “The four main causative factors of autoimmune disease have been stated to be: genetic predisposition; hormonal influences, especially of sex hormones; infections, especially of viruses; and stress.”

You can read her article on this page:
“The Canine Immune System and Disease Resistance By W. Jean Dodds, DVM
https://www.secondchanceaihadogs.com/canine-disease-resources

So we need to look closer at your Bichon’s past medical history. At any time did you notice other unusual conditions like allergies (in dogs these present mostly as red itchy and possibly weeping skin conditions, weepy gooey eyes.) Did you ever notice digestive problems that kept coming back such as frequent diarrhea, gas, poorly digested food etc? Dogs that have trouble thriving may be experiencing autoimmune conditions of another kind. These things may seem different and distinct but in reality they have one thing in common; the immune system.

So it is very possible right now that he is having a relapse and in that case, yes I do agree with the increase in the prednisone dose. The part of the over active immune system that you had been suppressing with the high dose prednisone may becoming active again and this would be a relapse. We have seen many dogs relapse when the drugs are reduced to quickly. We recommend that in most cases the drugs should be reduced very slowly to avoid relapses. See our recommended schedule and see if your decreases are similar.
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone-dose-reduction

I know that Vally is going to want to see your complete medication and supplementation list and help you get on a good dosing schedule. She may have recommendations for you for other supplements that might be helpful.

What happens when there is a relapse? Well you have caught it early and that is a good thing! Anemia doesn’t actually come into consideration until there is a PCV or hematocrit of less than 38%. Sometimes when we begin to see an unstable hematocrit after treatment for IMHA, the body is still trying to repair itself and catch up. It isn’t unusual to see it be 46% one day and 42% the next. But seeing it drop from 50% to 40% in a month’s time may be a sign that there is a relapse or it could be that he is getting older and this is more normal for him. However, I don’t like to see a quick drop like this in a dog that has just recovered. So it is a good idea to explore the situation more closely.

You won’t normally see many signs of distress until the PCV /HCT goes below approximately 32, and some dogs seem to not be bothered much until they reach the mid to high 20s.

What I am also concerned about it that there may be some form of bone marrow failure causing this drop. If you have your last 2 CBC and Chemical Screens (and any other lab tests that were done) I would like to see them so I can have a better idea of what is happening. You can send these to us using the Urgent Advice form. See the Urgent Advice tab up above on the menu items.

What questions do you have for me?
my best Patrice