Libby Lab Mix

[Patrice]

Hi just had worst memorial day weekend, my Libby (4 year old 50lb lab mix) was diagnosed with AIHA. She was fine Wed. by Thur. morning she was lethargic we decided to give her a day. Fri. work up to wet bloody carpet, my boyfriend Steve panicked he skipped work and took Libby to vet. She was peeing black after blood work she was diagnosed with AIHA. Her HCT was 17.5% they started iv. In the mean time I’m tring to hold it all together at worked failed miserably. After work 4pm we had to make decision to take her to animal hospital a hour and half away. We picked her up and went. Her HCT dropped to 14.9% they gave her a $1000 iv treatment and blood transfusion. Sat. morning her HCT was 22.5% Sun. morning 19.4% and this morning 18.8%. We brought her home today. She needs blood test at local vet tomorrow, I’m so scared it’s going to be lower %. She has 3 meds to take tomorrow morning (prednisone,doxycycline and mycophenolate). I hope we can get them in her. We both have to work so I have family checking in on her. I’m praying she gets better. Thanks for this forum so I could talk about Libby. Carol

[Elizabeth]

I’m sorry about your Libby. I lost my dog in January to this horrible disease . You will find wonderful people who want nothing more than to support you. My prayers are with you and Libby.

[Vally]

Hi Carol, and welcome to the site. First of all I’m very sorry you’ve had to come looking for us, but we’ll do everything we can to help you through this and get Libby back to old (young) self again.

First of all, it’s very normal for bloods to drop after a transfusion. The problem in her body is still going on and it’s destroying some of that new blood, but once the medications kick in, it should start to level out and improve. So, I know you’re panicked, but even if it goes down a little for now, it’s not all going wrong. If the bloods do get too low, she may need another small transfusion to give the drugs time to work, but hoping that she’ll respond really quickly.

Do you have a copy of blood tests? If not, it’s always good to ask for them. Some of the ladies here are very clever and will help you understand what’s happening. What tests were carried out?

Is she on any other meds besides the prednisone, doxycycline and mycophenolate. They can be very harsh on the stomach, so it’s good to have stomach protection in place too. I know, more drugs. The best for stomach protection is sucralfate, but it needs to be given away from other drugs, or it blocks them. Also was aspirin mentioned? Some dogs need to be on aspirin to prevent clotting which can happen, particularly, in the early days. This depends on what the bloods show. A blood smear would tell if necessary or not.

If you don’t have a copy of results, ask them to let you have a copy of them. Most places are fine with it. If they are funny about it, tell them you’d like to see the results to help take it in. That’s what I did in the early days. They never question my asking for a copy of my boys results any more.

Hang in there Carol.

Regards, Vally & Bingo (diagnosed Nov 2011, in remission)

[Patrice]

Carol,
I am so sorry to read about Libby. This is frightening experience for you and having to work just makes it more stressful.

But you have both done the right things! Good job Mom and Dad and thank you to your family as well.

The drugs should begin to work fairly quickly. I suspect they also gave her a shot or two of dexamethasone, a very strong immunosuppressive, while in hospital. The prednisone is a significant immunosuppressive at higher doses. One side effect you need to think about now is that it can cause stomach ulcers. If you were not told this and weren’t given any meds for this, go to the store and get a bottle of generic pepcid (not the advanced version) and give one tablet about 30 min before the meal in which you will give the prednisone. This will reduce stomach acid.

The doxycycline is an antibiotic and was probably given on the suspicion that this could be related to a tick disease, as this is the only drug that treats most of them. A few of these tick diseases can cause the symptoms you are describing. This drug tends to make dogs feel very ill and can also lead to stomach ulcers.

Give this with a very special treat halfway through a meal. Make sure you wash your hands after putting the doxy inside the treat, it is a very bitter drug and dogs will refuse to eat anything that tastes like doxy. Many folks have success with making a tiny bread sandwich with some very smelly food inside. Carefully drop the doxy onto the smelly food, wash your hands and then roll it up. Offer it while Libby is eating. A greatly loved treat at my house is warm deli chicken (no skin).

Mycophenolate is another immunosuppressive drug that is marketed to help humans avoid transplant rejection. Its use tends to be as an additional drug with other immunosuppressives, not entirely successful on its own but an excellent maintenance drug. It is also called CellCept. This drug is marked for humans but is used in veterinary clinics in some AIHA IMHA protocols. It can cause diarrhea in some dogs.

There will be a natural decrease in the PCV HCT after a transfusion. Small changes are not worrisome. If Libby can hold herself above 15% I would consider this a good sign. Be prepared to do another transfusion and talk with your vet about planning this ahead of time so there is no last minute emergency. They will need to take tests to ensure the blood donation they use will match properly. The first transfusion is free of reactions, the subsequent ones are not.

The side effects of the drugs can become worrisome to you and it becomes hard to sort out which one is from the disease and which one is from the drugs. But let’s be proactive and try to avoid the development of ulcers from the prednisone and doxycycline, ok? You can give one or even two pepcids a day safely.

The last advice I want to give you is to call your vet now, if you can, and ask about the use of low dose aspirin to avoid any emergency blood clots. This is a very critical time for those to develop, and low dose aspirin will help reduce this serious risk. We have been helping owners a long time and we tend to see vets forget this very important treatment. If asked they may say something like “oh, you know that is a very good idea, lets do that.” We can hope. If they offer something more exotic like heparin etc, then agree to it.
my best
patrice

[Sheena]

Hello Carol

Again, a big welcome – anything we can help you with or questions you have, just ask away.

It sounds like (as the others have said) your vets suspect an infection – this is what happened to my dog Worzel back in Dec 2012 & he was on doxycycline for about 5 weeks to make sure we killed it off. He also had a vaccination after he had started being a bit off colour – that sent him into a worse state.

After a couple of weeks of adding in a second immuno-suppressant into the meds, he started to slowly recover, as most of our dogs do. You have done a great job getting Libby to the vet quickly & I appreciate how worried you are just now – the drugs take time to work & patience is something we all have to have!

Just to repeat what Vally & Patrice have said, a drop in PCV after transfusions is very common, so do not get too worried about this. Fully cross matched transfusions are often necessary after the initial one – no big deal – they are available to help our dogs until they stabilise.

It is absolutely vital to check if Libby is at risk from abnormal clotting – we can check the blood tests/smears for you gladly. Anti-clotting medication such as aspirin or plavix / clopidogrel or even heparin is usually required.

And (sorry!) to repeat the importance of stomach protector – these drugs are extremely hard on the tummy lining, so she will need something – preferably sucralfate from your vet – in the meantime, Patrice’s suggestion of pepcid is brilliant.

Many dogs on mycophenolate get upset tummies – just let your vet know if you have a problem straight away as it’s vital they get the second immuno-suppressant absorbed properly to treat the disease.

I also found Worzel had tummy ache after the doxycycline – he had to have it or he would have died from the infection – and adding in sucralfate (2 hours after other drugs), plus a dose last thing at night soon got him back on track. I was really lucky as he was a dreamboat for tablets – he opens his mouth & I pop them down his throat gently. My other dog Ollie is a nightmare with pills – a vice-like jaw you can hardly open & a tongue that can flick a tablet out across the floor!

Hoping Libby will soon be on the road to recovery – I’m so pleased you’ve found us as it’s always nice to hear how other owners have coped with this disease. It certainly helped me when I found these lovely people!

Please let us know how things are going – any questions, however trivial you think they are, ask away – everything is important! Libby can beat this – always remember that. We never give up because we know they can make a complete recovery – but it takes time.

Sheena, Worzel (age 15ish now, in remission) & Ollie

[jill]

Hi Carol, so sorry to hear about your Libby being ill,thankfully you got him to the vets quickly, you have found the best site here for all the information and support you should need. They are a great team on this site who have helped many people and there dogs, including mine,i don’t know were I would have been without them especially Sheena, who is a dear friend .They helped my dog Snoopy who has AIHA, and now recovering nicely.Ask them anything you need to know because there is always someone who will help you here. One thing that Valley mentioned is to always ask for the results everytime you go to your vets like I did they e mailed them to me or sometimes printed them off, they can be very useful to keeping an eye on whats happening .The drugs do take time to kick in, and i hope Libbys tummy meds get sorted for you, its a long road , but its so worth it when you see them recover, which they can do given the right treatment.love and hugs from Jill & Snoopy xxx

[Carol]

Hi. Thanks for all the info and support. Blood test turned out good 18%. She ate a little bit at dinner and drinking. Called vet got aspirin and stomach medicine. She has a little more energy today, got up on favorite chair and came upstairs when I was getting changed, had to help her on bed but that’s normal. She has short little legs, joke is she is half wiener dog. More blood work on Fri. fingers crossed. I’ll keep you all updated. Thanks carol

[Sheena]

Good luck on Friday, Carol – hoping things will soon be on the up. So happy you have aspirin & stomach protector too – great news.

I had to help Worzel up onto the bed when he was weak & wobbly – even though he has long legs!!!! Funny all the dogs on here sleep on the bed? No, actually, it’s lovely having them right beside us. And she sounds very happy in herself as well.

Fingers crossed for Libby

Sheena, Worzel & Ollie xxx