Sorta new here — need advice on new AIHA diagnosis in hospitalized dog

Lauren

Guest

Hi everyone,

Never thought I would be back on a forum asking about this. My first dog, Goose, was diagnosed with ITP in April of 2013, and overcame it after a few days inpatient. We were tapering his pred and azathioprine, and almost had him on a low maintenance dose when his gallbladder ruptured unexpectedly on December 31 of 2014 and he passed two weeks later due to complications post-op. We had done regular bloodwork, all the way up until Dec 15, and everything looked good, according to our vet. When I was in it, I knew all the dosing info, all the labwork numbers, but since then I have had a daughter with special needs, so I cleared out the pain of managing his care to make room for new challenges.

Fast forward to yesterday, when we brought our other dog Ernie in for vomiting and lethargy. Well, we brought him in because ever since the ITP I am an obsessive gum checker when things are wrong, and he went from pink and healthy to pale in a span of about 45 minutes. We thought he had eaten something while we were out camping, and he may have, and that we were dealing with some sort of GI distress. NEVER did I think we would be dealing with another weird blood disorder from unidentified causes.

So first, I wonder if anyone has gone through this with two pets, and if you have some coping techniques to suggest both for dealing with the sadness/anxiety though I will be talking with a therapist about that, but also for how to cope when I’m scared that we’ve got some unidentified scary thing in our environment causing this? Considering the “odds” we’ve encountered in the last few years (we also got a 1000 year rain and our house flooded right before we lost our dog) I have been grappling with the question of whether it’s possible to be this unlucky, or whether there is something else going on. We do have another dog, who we got after Goose passed to be Ernie’s friend, and it makes me so nervous to think that there could be something we are doing or living with that could get him too. I know there aren’t concrete answers, but would love any advice.

Next, we are aren’t new to the immune mediated blood disorders, so I get the highs and lows and watching the labwork, but I am new to some aspects of this form of the disease and want to get any advice you all have.

Some back ground: Ernie is a 5-6 year old red heeler. He’s been totally healthy except for two things: back when Goose was sick and then passed, he had a stretch where every few weeks he would get an upset stomach and puke first thing in the morning. We took him in for bloodwork, liver panel, ultrasound, xrays maybe even a scope and it all cam back clear. It eventually stopped, and has only happened once or twice in the past few years, so we chocked it up to anxiety. He also has had problems with weight gain/loss, but mostly we think it is from eating our other dog’s food. We tested T4 this March and it was low normal, and I have been considering doing a full panel. I probably will now. There’s the health history!

This weekend we went camping, and he got a hold of some table scraps at dinner Saturday night. Sunday morning, he woke up and puked, but given his history of sensitive stomach, we figured he had just eaten to much rich food (lots of kids). He was lazy all day Sunday, but again, we figured it must be GI related. I could tell that night he wasn’t feeling great, but his gums looked good, respiratory rate was only slightly elevated, and so we decided to call the vet the next day. Same thing at 2:15pm the next day, when I made an appointment for that night: lethargic, no appetite, but pink gums. Then my mom instinct said to keep checking his gums, because he just didn’t look right, and at 3pm I checked again and they were pale yellowish, and I was having flashbacks.

So we rushed him in to the specialized hospital we used to treat our other dog (hadn’t been back since the night he passed, so that came with it’s own set of challenges). That was yesterday. His PCV when admitted was 18, so they stablized him with fluid and started him on dex and mycophenalate. At 12:30am it dropped to 10 so they did a transfusion, which he seemed to tolerate. This morning, it was up to 14, but just got the call that it is at 11 again, so they are starting another transfusion now. Then I hope to go spend some time with him. We had have xrays and an ultrasound done, which came back clear, and we are waiting on the results from the tick bite blood work (whatever that’s called), but at this point we are pretty certainly looking at IMHA.

So, there’s the background. I’d love to hear from you all what your biggest tips are. Things you wish you’d known sooner (for example, with Goose I learned that I would have trusted my gut and tapered a little faster than we did. We were extra conservative with him, and I felt very nervous about how hard the drugs were on his system). What should we ask while inpatient? What should I start thinking about now in terms of drug regimen (are the drugs mainly the same as what are used for ITP)? Anything you all have for me would be much appreciated!

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Patrice

Keymaster

Lauren,
I am so sorry to read this. While I am short on time today I wanted to get back to you asap with some known genetic conditions that the Australian Cattle Dog (Red Heeler) is susceptible to.

Among the list are several of direct concern to me considering his current problems. While this is a laundry list of possible disorders it doesn’t mean that he has ANY of them! What it does mean is that you should talk to your vet about ruling each one out at this point. Hopefully, none of them apply. But if one or two are found, it can indicate a predisposition to autoimmune conditions.

“Multidrug resistance is a genetic defect in a gene called MDR1. If your Australian Cattle Dog has this mutation, it can affect his processing of many drugs including substances commonly used to treat parasites, diarrhea and even cancer. For years veterinarians simply avoided using ivermectin in herding breeds, but now there is a DNA test that can specifically identify dogs who are at risk for side effects from certain medications. Testing him early in life can prevent drug-related toxicity.”

“Cattle Dogs are prone to a condition called hypothyroidism in which the body doesn’t make enough thyroid hormone. Signs can include dry skin and coat, hair loss, susceptibility to other skin diseases, weight gain, fearfulness, aggression, or other behavioral changes. ” (My notes: this is often considered a canine genetically inherited condition called autoimmune thyroiditis, destruction of the thyroid glands by the immune system. I recommend that he be tested by Hemopet with a Thyroid Profile 5 to determine if this is an inheritable condition)

“Inherited bleeding disorders can occur in dogs. They range in severity from very mild to very severe. A pet may seems normal until a serious injury occurs or surgery is performed, and then severe bleeding can result. Von Willebrand’s disease is a blood clotting disorder frequently found in Australian Cattle Dogs. There is a specific DNA blood test for Von Willebrand’s disease.”

“A relatively rare blood disorder called Pelger-Huet Anomaly can occur in the Australian Cattle Dog. A carrier of this disease may have a dysfunction of the infection fighting white blood cells. ”

“Red Heelers are more likely than other dogs to have a liver disorder called portosystemic shunt (PSS). Some of the blood supply that should go to the liver goes around it instead, depriving the liver of the blood flow it needs to grow and function properly. If your dog has PSS, his liver cannot remove toxins from his bloodstream effectively.” (My notes, we have helped several owners with dogs that had this condition and it contributed to the chronic anemia and poor health and went undiagnosed for some time. These PSS are sometimes difficult to diagnose and your own vet is the best person to discuss this with as special testing like ultrasounds may be necessary.)

Here are some links where you can begin to read about some of these conditions.
Hemopet Thyroid Testing
Canine Hypothyroidism
List of common ingredients in flea and tick products

My best, Patrice

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