No more options for my doxie Klaus

[Michelle sutton]

Hi everyone, sorry for the delayed response. I have been trying to figure out what to do next. I did contact Dr. Dodd’s again and she agreed with taking Klaus off of the injections but she did recommend another metabolic steroid injection. We had to order it from a pharmacy in Arizona. I spoke with my vet and she was open to giving it a try. We will start that as soon as it is shipped.

I will try to answer all the questions above:

My other dog Diana had a spleen biopsy and we are waiting for the results. The vet said she looked fine but it was enlarged. She did say her Thyroid tests were very strange so they retested those but she is guessing hypothyroid for her too. I also started giving her glacosemine for arthritis and she seems a little less snippy.

As for Klaus he really has never had his PCV go up except after a blood transfusions. He has been non regenerative since December 2013. Since we rescued him he has always been hypothyroid so he has always been on solixine. He was tested for everything possible. Tic bites etc. I have not vaccinated him in a long time. I have not given heartworm or flea and tic Meds for a long time. He was diagnosed with inflamatory bowel disease right before IMHA diagnosis. The only thing I can think of was he had a recurrent UTI in December 2012. They put him on many antibiotics and had to change them out. Then he developed a heart mumor about the same time. That was all a whole year before IMHA diagnosis.

What was the shot Dunnes was on? I figured the same thing. My vet said nothing else to do. Why not try this steroid shot. As long as it does not hurt him. I am at the point of giving up for him. He has aged so much in the last year and I think he is living for me. I feel like I should take him off all the horrible Meds until the end. It just seems so cruel to me to keep him on the Meds and blood transfusions etc. In the end I can’t give up on him so I feel like I am keeping him alive for me.

Thanks to everyone who posted and sorry for my late response. Between having a broken ankle and leg and dealing with physical therapy, vet appointments and a 3 year old off from school I don’t know which way is up.

Michelle

[admin]

Hi Michelle

Goodness, you must never apologise for being “out of action” or busy – how on earth you cope with all this, I don’t know. I am so sorry to hear that you have tried so hard & Klaus has still remained non-regenerative for a long time. You have nothing to lose with the injections & anything is worth trying.

This is a horrible position to be in – I can see you’ve pretty much covered everything possible & have the soloxine in place. I have a few more questions. I got my haematology book out when you mentioned thrombocythemia, which is pretty rare actually (I couldn’t remember much about it!). Can you remember if it was ESSENTIAL thrombocythemia or thrombocytosis (maybe reactive)? Both are high platelets, but there is a big difference in what they actually are pathologically & have different causes & blood test findings. This is really the only thing I have picked up on & am asking because of what you said about inflammatory bowel disease being diagnosed. Thrombocytosis has a relationship to both IBD & iron deficiency, even haemorrhage. I am wondering if Klaus does not have adequate “ingredients” to make red cells because of the IBD? Malabsorption? I know I am a mere amateur and I’m sure Dr Dodds & your specialist must have thought about this issue, but I think anything is worth considering again. If we all use our thinking caps, maybe something will be useful. Is Klaus on iron or other supplements? Do you know if he is & has been iron deficient? Has Klaus had a bone marrow aspirate/biopsy, by the way?

The only other suggestion I have is canine recumbent erthythropoeitin – EPO – (the doggy version, NOT the human). I know this is controversial, but I think you have reached the “discuss anything possible” stage at the moment.

I also see he has a heart murmur – is he on meds for that? Worzel has pimobendane & prilactone. Just another thought.

I’m sorry I’m not really of much further help on dear Klaus – how is he doing today? I hope the injections will perk him up a bit & make him feel better. I also really Diana’s results come through with something nice & simple – maybe just a symptom of something else. Those arthritis meds must have helped her too – pain makes us all a bit grumpy! Please let us know how she’s doing too. You have such a lot to deal with at the moment, plus a little lass to look after & I hope you can manage to get some rest for that leg/ankle & little time for yourself. You must be exhausted.

Sending you all our best wishes
Love, Sheena, Worzel & Ollie xxx

[maura]

Hi Michelle,
I am new to the forum. I read your story about dear Klaus. I am so new I have nothing scientific to offer you except that I will hope for Klaus to recover. My 6 year old Shih Tzu girl Sunny has just been diagnosed with non-regenerative anemia on Aug 12 and had 1 transfusion and still no new cells are regenerating. So I am beginning my journey with this very awful dog disease.
All my best wishes,
Maura & Sunny

[Tamara]

Hi Michelle, like Sheena, I don’t know how you are doing it all — I have struggled so much coping with just one dog and able to walk around!

Some other ideas: is Klaus’ IBD well-managed? Anemia of inflammation is something we think Ashki had in addition to IMHA, as Ash has had recurring GI problems. Ashki’s manifest as mucousy soft poop, and our new vet had me add a therapeutic dose of rx probiotics. The mucous has finally cleared up, his poops are gorgeous (never thought I’d say that sentence lol) and his PCV has improved at the same time.

I can’t remember, is Klaus on weekly B12 shots? GI problems can inhibit absorption and B12 is necessary for regeneration. This is something else we added for Ashki that I think has been helpful.

As Sheena suggested, has his iron been checked? Low iron, but also high iron can be problematic. Ashki has had high iron, and the combination of high iron with ongoing inflammation can create a condition where the body “hoards” iron and doesn’t make it available and so there is not enough iron available for regeneration. If this is the case with Klaus we can provide you with articles to take in to your vet about this condition if you’d like. Silybin, the active chemical in milk thistle, chelates iron and could be something to explore. Again, we have an article on it. I chose not to add more silybin (Ashki is on denamarin, which has silybin in it, to support liver function) because Ashki’s iron was coming down and approaching normal.

Know this — I will support whatever you decide. You know Klaus the best, and if you think it’s time to wean him off the medications, I trust your judgement completely. I know someone else who is considering the same option, she has been fighting IMHA with her dog for over a year and her dog is not able to be out of the teens without a transfusion. My commitment to Ashki was that as long he was fighting, I would fight; but when he cued me that he was ready to stop fighting, we would wean off the meds.

I am thinking of you and your family and sending you much love and many hugs.
tamara and ashki xoxox

[Anne]

Hi Michelle,

I’m new to the board as well, and just started my learning curve on the disease. As a fellow rescued doxie lover, I know how heartbroken you must be. I cannot add anything to the amazing scientific knowledge all the others have added, but like Maura, I’m sending you positive vibes and love.

[admin]

Hi Michelle, I just wanted to add my warmest, most sincere thoughts too. You have so much going on right now – goodness. I know you’re just trying to keep your head above water at this point. Two not well pups, a three year old AND leg/ankle injuries – goodness. Please hang in there with all this.

Love and hugs, Linda and Sadie

PS – You have gotten some great advice from Tamara and Sheena. I hope it helps – the information overload is overwhelming – we’ve all been there. Sheena (thank you wonderful lady) had to drill into me several times before I “got it” and she and several others never gave up. You’re in the best of hands here – with you all the way.