AIHA-Just Diagnosed

[admin]

Wendy,
I am glad the blood transfusion went well, blood from a universal donor is ok, the next one needs to be matched as far as I know. In our experience it is beneficial to put these dogs on a secondary immune suppressing drug, azathioprene or better yet cyclosporin. How experienced is your vet with this disease? We live fairly remote, the next specialist would have been 250 km away. I was not prepared to travel that far with my sick dog. I always heard about Dr. Dodds in California and her organization hemopet. When our small town vet was at her wits end and said that she needed some guidance, I asked if it would be possible that she consult with Dr. Dodds. She was enthusiastic about this idea and we never regretted that step. Small town vets have a broad knowledge but this disease is very rare and not many have a lot of experiance with it. If you could suggest that you want the best for Frank and that Dr. Dodds would be someone you would like involved, your vet might be agreeable.
Frank is a big boy so he will be on a large dose of prednisone when he gets home. This drug is very harsh on the digestive tract and we have seen it that dogs get ulcers that are very painful. Trust me you don’t want this to happen. It is important to give the pred with food but it would also help a lot if you could ask for a drug called sucralfate. It basically coats the digestive tract and protects it from the drugs. Unfortunately it can also interfere with absorbtion of the other drugs and that is why you have to give it away from all other medications by at least 2 hours.
Now you see that it will be a juggling act to give all the right medications at the right time so many times a day. I would highly recommend you have a calendar or spread sheet where you can write it all down and tick of what you have given. Our Vally, she is one of the keymasters, is great at making calendars for people that need it, I am sure she would do it for you if you give her all the info on the meds Frank is on.
I am sorry but at he end of my last post something got lost. I will check it out and see if it was important. What is very important right now is that you stay positive and believe that Frank can beat this!
Best wishes,
Brigitte

[Patrice]

Hi Wendy,
Universal donor blood is blood from a dog that has a “common” blood type and may sometimes be superwashed to remove any antigens. There are essentially 11 different “types” (give or take) of canine blood. So this type of transfusion is virtually free of potential reactions. While I can’t say absolutely, but in general a dog that has had a universal blood type transfusion can have a second universal blood type transfusion without typing or matching.

I believe they may have given him more meds in hospital that you are not aware of that are pretty standard such as a shot of dexamethasone, similar to prednisone but at a higher effective dose. Sometimes they will administer some form of antihistamine along with the transfusion to dampen any reactions to the transfusion. He may also be on an anticoagulant. And we need to know this particular information.

Transfusions can and should take a relatively long time to administer. They want to put all the extra fluid into the body slowly so the body can absorb and handle all the extra. He is probably going to be peeing a lot in the next few hours and will actually feel pretty perky as his blood volume returns to normal. Will they let you in with him while he is recovery? He will probably be in IC and under a heating lamp. You could help monitor his reactions and figure out when he needs to go pee. Your voice and touch, quiet and soft, will reassure him that you are with him and that is “kind of” like being at home for him.

If they don’t eventually broach the subject of “going home” instructions, then you can bring that up yourself. During that discussion pointedly and politely ask about additional medications. What they are and what they do, the doses, the times to give, with or without food, side effects to watch for and for how long you will be giving them. Report back to us what they have said and we can work from there.
good luck
patrice

[Vally]

Wendy, just sneaking in a quick response while I’m at work, but the usual drug of choice WITH prednisone is cyclosporine. It targets the actual cells doing the destroying. This is what turned it around for Bingo. Ask your vet for a script for it and have it filled, it’s cheaper that way than buying directly from the vet.

The blood test results are really important, so remember to ask for a copy of them.

Vally & Bingo
xxx

[Vally]

Duh, I was on page 1 when I responded, so I’ve repeated a bit. Of course I’d love to do a medicine chart for you. When you get your list as Patrice says, or instructions, post them here, or use the urgent advice at the top if you like and I’ll get a chart back to you.

Vally & Bingo.
xxx

[Wendy Gonzalez]

I called the vet to request that I come and see him…just to be near him. I don’t want him to think I left him and that I don’t love him. She told me that she would prefer that I not and that she would call me when it was done and she had done another CBC. She also mentioned that she would like me to take him home after an hour or so of being done? Is this normal? Should he stay with them instead? Maybe I should just take him to my normal vet? I went to this vet because my normal vet was not open for emergency hours. I just thought it was best to stick with this vet since she first saw him? I would like to make sure that he is getting what he needs. I will get all of this information once I get the call to go see him.

[Alyssa]

Hi Wendy. So sorry you had to find us. :(
These ladies know what they are talking about, you couldn’t have found a better support group.

Personally, I never left my dog overnight. It has been 5 months since she fell sick. We had an emergency transfusion from a universal donor when she was at 10% – and it only held for a few days. We had to do another one when she fell again (she went up to 19%, then dropped to 15%, then back to 9%). We had a second transfusion from a universal donor, again. By this point, the meds kicked in – it took a little over a week.

Each time the transfusion took about 4-6 hours, then she stayed for a little while finishing other IV – water, meds, etc. Then I was able to bring her home. In my case, my vet was not a 24-hour vet. I had the option, but simple did not see the point in leaving her alone through the night when no one would be there. In addition to charging me for that, I decided to take her home each time to be with me and I watched her all night long. However, we were back at the vet literally the second they opened – we were early, waiting for the to unlock the doors., to check her blood levels.

Your pup will likely feel more perky after getting home and having more blood. The thing about this illness is it does not make them hurt. It makes them tired. They are unable to provide oxygen to their organs with such a low PCV, so it makes them so very sleepy. If you notice extreme lethargy, an emergency visit should not be delayed. However, the meds will also make your pup feel awful – so it’s important to know the difference between feeling bad from the meds, and feeling bad from crashing PCV – in Sassy’s case, when she would NOT stand up for any encouragement and I had to carry her to the car, her PCV was 10%.

I had to hand feed Sassy anything she would eat for about 2 weeks. Every meal. I just kept trying. I brought her water right to her nose, she also loved ice chips. Your pup will probably have to go pee as much as every 2 hours with the steroids. I had to set up a schedule with my family, where I was up with her all night long ad slept in the day until about 1, and they took care of her until then. If you can’t do this, you may need puppy pads or something to give them a place to pee.

Are you in Lakeport? Going by the link you posted to the vets page. You might considering taking Frank to a vet school, or at the very least calling them. Vet schools are usually far more advanced than vet clinics in treating this, AND – usually a LOT cheaper. a $900 procedure could cost $200. Going by Lakeport area – there are 2 within 3 hours of you.

http://aavmc.org/Member-Institutions2.aspx?area=1&dstate=CA#results

School of Medicine, Stanford University
Department of Comparative Medicine
300 Pasteur Drive
Stanford, CA 94305-5342
Phone: (650) 723-3876

University of California – Davis
School of Veterinary Medicine
One Shields Avenue
David, CA 95616
Phone: 530-752-1383

If I am not mistaken, UC Davis is an excellent school and many have taken their AIHA dog here.

[admin]

Hi Wendy. I love the name Frank for your precious boy. As all have said, sorry for the reason you’re her, but glad you found us because it made all the difference for me and my AIHA (diagnosed March 2013) pup, Sadie. Her journey is under ‘Our Stories’ along with the others.

Sorry for not writing sooner, but my little Sadie just got home from three days at Blue Pearl’s ICU after a relapse and I have literally camped out in their waiting room. I am fortunate that this facility is quite close by.

I am SO happy to share that after her low PCV of 13 and two transfusions, Sadie is home with me this afternoon. Her PCV was 24 this afternoon upon leaving the hospital. Here’s hoping she keeps going up and onward. We are staying optimistic.

It seems everyone has covered all wonderfully. This group is incredible and will be here for any and all questions you have. Sadie would not be here without this forum; their knowledge, kindness and constant reminders that this stinking disease CAN be beat.

You sound like you have things going in the right direction. This is key. Vally has mentioned the cyclosporine – and it may be a high load dose to get him going (as they have just given Sadie). You can lower it as Frank becomes stable.

Wendy, this is a roller coaster ride. Yes, the tears flow, but you can do this. You CAN. And so can Frank. I’ll remind you, as my dear friends did here with me, remember to take care of yourself too. We get caught up in the ‘doing’ and ‘worrying’ and forget us. Vally reminded me to eat – all the way from Australia! Weird, I hadn’t – she knew – she had done the same.

We have all been right where you are and will be here for you all the way. Please be sure to let us know the bloodwork (download as Brigitte mentioned) and how Frank is doing with the transfusion.

You and Frank are in my thoughts. We’ll get through this – together.

Love and hugs, Linda

[admin]

PS – Dr. Dodds has helped me with Sadie since onset of AIHA. She is incredible and deals with AIHA/IMHA dogs daily. I, and most of us here, typically look for her stamp if approval on treatment with our pups and this illness. I continually do with Sadie, including this weeks events. I think, as others have said, it would be so benificisl to reach out to here. She is on our Second Chance Resourse page:

https://www.secondchanceaihadogs.com/hemopetresources/

Also, I wanted to mention that the transfusion(s) is(are) buying time for the immune suppressants to kick in. This is why too, Patrice mentioned the dexamethasone injection, which Sadie was given this week also – a kick-start.

Huge hang in there hugs,

Linda