12 year old mixed breed; new IMHA diagnosis - 2. page

Hi Ashley, a consult with Dr Dodds is ALWAYS great. Now, she often responds in very brief language, so don’t be put off if she does this. It’s always been her way ever since I’ve had anything to do with her. If you have any queries about anything she says, you just email her back and she’ll respond. Don’t hesitate to ask anything.

The Reticulocytes, I wouldn’t be too worried about. I know that sounds terrifying, but what’s happening is that Flynn’s body is recognising that Flynn isn’t losing much blood (and so is slowing production of red blood down). This is NORMAL. A result of 33.2 isn’t anywhere near dangerous. If, for example, Flynn had a stomach ulcer where he was bleeding, then you would expect to see the reticulocytes suddenly jump up. Normal reticulocytes is 0-1.5% so 5.3% means Flynn is still making extras. This is good.

Azathioprine does suppress marrow production, so I’ll bet you’ll find with that being reduced, it will increase Flynn’s red blood count. I also think his prednisone needs to start coming down. Probably not at the same time though as you don’t want too many changes happening at once. Flynn may now be oversuppressed.

Make sure the thyroxine is given 1 hour before food or 2 hours after to let it work properly.

Let me know what Dr Dodds says.

Regards, Vally.