AIHA (Not by the book case) We need hope

[Emilia]

Hello,

I am here because I was looking for some positivity as our Labrador was just diagnosed with this terrible disease.
Dog, Female Spayed, Labrador, 50 Lbs, 7years old

Our case is different, as the immune system is attacking the cells in the reticulocyte state. The PCV has been dropping since June. At first we thought it was something else and treated with iron (she had it before and got better on her on), it when it didn’t improve we tested for tick diseases (twice) and got sent to a specialist where we did the bone marrow biopsy.
We started treating with Pred (40mg for 5 days), then 20Mg for two weeks, then we introduced Cyclosporine (100mg twice a day), after 7 days with no improvement we added Mycophenolate 250Mg 1x day. We started it on Tuesday (08/15) and will re test her on Friday (08/18). On Monday (08/14) her PCV was at 22.7%.

Our family vet said that if this new med does not help her, we must consider letting her go because her non response to medication and we will be just prolonging her suffering.
Our specialist said we could do blood transfusions and try other medications. We love this dog like a child, but we don’t want to prolong any more suffering on her and on us.

We are so heart broken and I am just getting ready to say good bye to the most perfect dog I ever meet.

I wanted to know if there are any happy cases out there where it looked like no improvement but then the meds ‘kicked in’ at some point and things turned out.

Thank you,

[Emilia]

Forgot to mention we also had antibiotics going at the same time but we finished it already.

[Patrice]

Emilia,
I am so sorry to read this. I am very familiar with this diagnosis.

I am pressed for time but I wanted to at least let you know I will respond in more detail. Meanwhile please read Our Stories, and start with my dog Chance’s story. He had exactly the same condition you are describing.

https://www.secondchanceaihadogs.com/our-stories/chance/

All the other Stories are under Our Stories.

We are here to help you and firmly believe in honoring the will to live. I too was told the same things as you have been told. But Chance had a strong will to live. As you will read he survived. Some dogs do not. But we also honor the owner’s desire to do all those things that will help save their dog.

[Emilia]

Thank you Patrice. I briefly read the story, as I am at work and tend to get very emotional.

I wish I could post Suri’s bone marrow results here for you to see. Her bone marrow is responding and actually has marked erythroid hyperplasia (which I believe is a over production of reticulocytes), but to my understanding her immune system is killing everything.

Our girls name is Suri and here is the opinion of the pathologist:
” There is marked erythroid hyperplasia, but there is no evidence of a true maturation arrest in the marrow. This suggests that there may be an immune mediated process targeting very late erythroid precursors (possible at the reticulocyte state) leading to the appearance of a nonregenerative anemia. No other cause for anemia is evident and production of other cell line appear adequate. ”

I lay in bed at night wondering the reason why this is happening.. could it be another reason why the RBC are not developing instead of the immune system attacking?
Could it be something else instead? Because the non response to the immune suppressants…

I remember she started to pant before her RBC dropped. Actually, I took her to the vet because of the panting and her RBC were in the 50%. Then it started to drop from there bc I took her back again after two weeks. I knew something wasn’t right.

Anyways, we are trying to remain positive.

[Vally]

Hi Emilia, welcome to the site, although I’m sorry you had to come looking.

I know what you mean. Many times I’d have to stop reading or not read anything at work as I would start to cry and once I start, I’m a mess.

First of all, there is hope. I promise. As Patrice said some dogs don’t make it but many do. My boy, Bingo, had the same I think, although I’m not as good technically as Patrice. Bingo’s red blood cells were being destroyed in the marrow before being released. He survived for 5 years after the diagnosis and did very well. I only lost him in January this to a cancer.

First of all for difficult cases, it’s really worth doing a consultation with Dr Jean Dodds. She has helped many of us. It’s well worth the consultation fee as it’s a one-off charge. Once she replies, you can email her with any other questions you have and she’ll answer you.

This is the link to the page and it’s the second box on the page.
https://www.secondchanceaihadogs.com/hemopetresources/

I know Dr Dodds pretty much always recommends thyroxine which helps the marrow make red blood cells.

Also the reduction of the prednisone was very quick. I think with our dogs, they need to be on the prednisone until they are no longer anaemic and steady. I’m a bit concerned by the predynisone dosage too which should be 1mg per pound, so slightly more and I wonder if Suri’s reduction happened too quickly.

As to why, there are never any real answers to that. There may be clinical, but still not why it happens to our special ones.

Ask anything at all Emilia. We would love to help.

Vally

[Emilia]

Thank you Vally. I read about Dr. Dodds and thought about calling her for a consultation. I am wondering how to consolidate the treatments between our doctor here and Dr Dodds. What if she says something different from our doctor here?
As for the pred dosage, I thought about that too, but our specialist said to just keep at 20mg and add the Cyclosporine. Now we are taking all 3 meds plus denamarin for liver protection, famatodine, b12, fish oil etc. I am also cooking ground beef and brown rice with veggies for her.

When I got home from work today she seemed better. Like more energy and wanted to take a toy to play outside. Maybe this is good news.

[Patrice]

Emelia,
What your vet “guesses” is happening, really is that. It’s way more complicated than just this, but is exactly what Dr Dodds told me about Chance in 2007. At that time there was NO INFORMATION about this on the internet but yet Jean Dodds had been diagnosing this and treating it for years.

On this page you will find the very same protocol she put Chance on 10 years ago.
https://www.secondchanceaihadogs.com/hemopetresources/

Look for the picture of HEMOPET Immune Mediated Hematologic al Disease and Bone Marrow Failure, click on it to open it. You can then open it full and save it or print it. Show this to your vet. Tell him that Jean has saved thousands of dogs with this condition using her protocol. As Vally said, you can do a consult with her for $150. Consider this a second opinion, as you would do for a human. She is also agreeable to doing consultations with your vet, as she did with my local vets who couldn’t believe someone so famous was helping me!

Please don’t worry so much about the diagnosis, that is why I am here, but consider yourself her patient advocate, her nurse. And invite your vet to be partners in her care, not to just sit back and let the vet drive the bus. If you want to be successful you will need to learn some things, but consider that I have been studying this exact condition since 2007, it will take some time for you to grasp just a small part of it.That divides your attention away from her. Live each day to its fullest, make it count for her.

I am again short of time, but please take a deep breath and relax for her sake, show her you are happy at all times, she reads your emotions and will mirror your sadness. At some time way out in the future you will be able to spend a whole day, if you wish, crying but not now. I was never so focused and determined as when I devoted myself to helping Chance recover.

Get a good night’s sleep for her sake, and take a few hours a week for yourself to recharge.

I have great faith in owners who wish to do all they can to succeed. This can happen.
My best Patrice