AIHA PCV drop

[Jenny]

Hi everyone! My dog Zoey is very new to this journey. 7 days ago she was diagnosed with a PCV of 18… I drive 4 hours to an internal med vet and they decided to do a transfusion and kept her for 3 days. After her transfusion her blood went from 32, 36, 42. On the day of her discharge it was 40, and 1 day after discharge is now 37. Should I be worried????

[Vally]

Hi Jenny and welcome.

What medication is Zoey on? The transfusion doesn’t treat the disease, it’s only there to buy time for the drugs to work, so while the body is still destroying red blood cells, it’s not unusual to see bloods dropping after a transfusion.

I’m hoping Zoey is on prednisone and another immunosuppresent.

Regards, Vally

[Jenny]

Hi Val! Thanks for responding! She is on prednisolone, azathriopine, plavix, omeprazole, sucralfate. The azathripine was only started less than a week ago and prednisone exactly 1 week ago. Any thought on the drop or is it a good sign she has been holding almost a week after transfusion? She isnt due for a recheck until 5 says from now

[Jenny]

I think what was worrying me is that she was slowly tending up for 3 days after her transfusion, but has dropped a total of 5% since, but still holding in normal range. Hope it doesn’t go down any farther. I’m really destroyed with worry

[Vally]

Jenny, We all HATE drops, but I really don’t think you need to worry. The numbers can change up or down daily and it often has a lot to do with how hydrated they are. The more dehydrated, the higher the result, the more hydrated they are the lower the result. It can change depending on how stressed they maybe, or anything at all can change it.

I know how paralyzing the worry is and there’s no avoiding it until Zoey becomes stable, even then, this horrible disease scars you and for that reason, welcome to the Paranoid Pet Owners Club.

Keep an eye on her gums, if you think they are suddenly very pale, I would go to the vets for a check. Don’t check her gums though when Zoey is just lazying around as they are always pale at that time, check them when she’s being more active, waiting for food if she’s a food scoffer, or walking about. The spleen releases blood as needed, so when she’s just lying around you won’t see the pink gums.

Vally

[Jenny]

Thanks. She had a recheck and shebis now 32%….. dont know what we are doing wrong. Zoey has bad teeth that was supposed to be dealt with but now we are battling this. Could her teeth have anything to do with it? Also, my vet only gave us a 10 day course of stomach protectant and said we don’t need to use it after that but she is still on all other meds?????

[Patrice]

Jenny,
On the 14th it was 37% and today, 6 days later it is 32%. It’s common to see some variability in the regenerative process. This is still a fine PCV HCT level. It would be classified as mild anemia. She should be feeling and acting better now, is that true?

Make sure she is getting excellent nutrition moderate to low fat and really high quality protein. You can give her a small portion of liver every couple of days (1 ounce per 10 lbs dog per week.) Give her one egg per day, it also has super nutients. If she will eat fruit, try giving her a few blueberries in plain yogurt. Seared plain chicken smells really good, serve it warm so it tastes good.

I would recommend no change in medication doses until she has been stable for at least 2 weeks with a PCV HCT of 38% or higher. Then reduce only 25 % of the prednisone dose and do not reduce until 2 weeks go by and the PCV HCT has remained stable. We would not want to see any relapses, so easy moderate exercise and no stress. She needs plenty of rest.

If she is still on prednisone she should be taking stomach protection. Over the counter regular pepcid is fine, once a day about 30 min to one hour before meal with prednisone. Vally has a handle of the med chart, trust her.

Please don’t worry. We are always here.
My best Patrice

[Vally]

Have they done blood tests or just a PCV test? If they’e done blood tests, can you send them through the Urgent Advice
https://www.secondchanceaihadogs.com/urgent-advice

Patrice can have a look at them.

When does she get checked again.

I would want to keep her on stomach protection for now. Can you ask for more?

I’m thinking switching from azathioprine to cyclosporine, which targets the cells doing the destruction. Its much more expensive though.

Regards, Vally