Aspirin has been stopped for Molly

[Vally]

Leza, Molly’s meds are currently

6am – Aza 50mg – 1 tablet every second day
6am and 6pm – Pred 25mg
6am and 6pm – Noroclav antibiotics
7am, 3pm, 11pm – Ranitidine 75mg
8am and 4pm – food

Just a query about these.

I think the Aza,the Pred and the noroclav should actually be given with food. So will we move the Ranitidine to say 6am, and the food and Aza, Pred and noroclav to 8am with food.

Same at night, the pred and noroclav with food at say 5pm (or 6pm).

Can someone check these please.

Vally & Bingo
xxx

[Linda]

Hi Leza. I’m on my itty, bitty cell phone and can’t see much of anything, so please excuse typos.

I wanted to tell you that originally I asked for all written reports so ‘I could put them in Sadie’s AIHA file’ (we all have these ‘bibles’) and I could keep up with it all. Tell them too, that you realize this is a lifelong illness (because they are never really cured, but go into remission) and this will help you through this. Most reports are digital and if not, can easily be scanned. My vet now, writes Sadie’s PCV (which we do every 10 days still) and TP (total protein) on my receipt. When we do a CBC or any other blood work – I always get a copy.

Most of us have leaned the art of gentle insistence. I also tell them, I will never have their expertise, but all these reports will help me in my endeavor to attempt to put the pieces together. After almost three years of this, they don’t even question my timing for weaning – they know I have lwarned a tad bit. ;)

I hope all of us have helped ease your mind a little. The ‘first’ gentle insistence is the hardest – you’ll become a pro in no time. And, as Sheena says, you paid for tests – the results are yours anyway.

Best of luck.

Linda and Sadie

[Leza]

Hi Everyone

Wow, amazing responses and plenty to consider :)

Firstly an update as we saw our vet today. Molly’s PCV has stayed at 23 which is not the best news. We were all hoping to see another teeny improvement however it hasn’t dropped so we’ll concentrate on the positive.
I’m also not surprised as it was Tues she started on the reduced Aza. Based on your info it seems most meds adjustments can affect her PCV.
We’re in again on Saturday morning. If her PCV still hasn’t improved we’re likely to add in the cyclosporine to compensate for the reduced Aza. So far Molly is tolerating the steroids well so that’s also good news. We’ve never been so obsessed with her poo and pee! Colour, amount, frequency LOL!

I’ve asked again about the aspirin, sharing the research. We didn’t see the lead vet today so he is going to discuss this with her and we’ll review on Saturday. His view is that much of the research is anecdotal and that there is no real proof the aspirin makes any difference. When I (gently) pushed he also told me that the decision may be relAted to Molly’s track record of tummy upset & the concern for what adding another drug known to cause problems in that area might do to her.
I’ll call tomorrow to discuss further and politely request the lab reports. Now I know it’s perhaps not common practice here I can tailor my communication style. I expect this will be fine & I’ll get them to you ASAP.

Molly is on anti-biotics as a general precaution as she’s taken longer to respond to the steroids than their previous cases. The view is that her vaccinations are the cause as she had them 2 days before the symptoms started.
Prior to that Molly was v fit & well however had just taken a short course of anti-biotics for an upset tummy that wouldn’t clear up. Its common for Molly, she’s always had a sensitive tum bless her. Its worse if she’s anxious & her Daddy had worked away for a couple of weeks which we think triggered it. It’d completely cleared before she had her jabs but only just.
It’s been v cold in the last few weeks and I haven’t seen any snails. We’d been pavement walking in the last couple of weeks prior due to her tum problem & we prefer to see her poo so we can judge that it’s cleared up. Obviously not ruling out a snail situation but I don’t think she’s snarfed one.

Vally -thank you v much for the med plan. I didn’t think we had things quite right & we’ve adjusted today.

Thanks as always for your advice & support. In herself Molly is doing so well despite being constantly fussed about & checked by us ;)
Obviously still desperately worried about her but I think we’re adjusting better now we’re over the shock. I’m in full ‘fixer’ mode now and am focused on getting her through this. I’ll keep my naughty control freak in check when dealing with the vet too LOL!

I’ll get the lab work over soonest and will update when we know more.

Much love & licks to you all

Leza & Molly xxxxx

[Leza]

Quick update – I’ve spoken with our vet today & she has left a copy of the latest lab results with the vet we’re seeing in the morning

I’ve pitched my case about wanting to learn about IMHA and that I wouldn’t expect them to take time out to give me an IMHA tutorial. I’ve advised that we’ve found eachother and that you’re helping me with my knowledge/learning.
She’s seems totally fine with my plan.

I’ve asked about the aspirin & she is concerned about the impact on Molly’s tum given her track record and to be fair, Molly does have 3-4 courses of anti biotics a year due to tummy problems. She has also voiced her concerns that should Molly develop an ulcer & start bleeding it would complicate things if she’s been taking aspirin.

So I’ll get the lab report over tomorrow for you to have a look at. If you see evidence that she has a clotting risk, perhaps you could help me build a persuasive, fact based argument to change her mind. I’ll also then have something for Dr Dodds to work with so will engage with her too.

I have a plan! Hoorah!

Meanwhile, Molly is holding her own and seems stronger each day despite her PCV taking its sweet time to improve.

[Anna]

Hi Leza, I am sorry you are going through this. We all know how you feel. I was a mess about my dog Jackie for two months before she started to turn around. My vet had me discontinue the aspirin very quickly after her two transfusions due to the ulcer risk and she was also taking cyclosporine that increase tummy upset. Jackie also had a history of upset tummy and when she started having diarrhea they thought it was because of all the meds so they put her on Sucralfate but it was actually pancreatitis so make sure to watch that especially on Aza, which can also cause pancreatitis. Don’t worry about the PCV not improving quickly, as long as it doesn’t drop she is doing good! It took Jackie several weeks of going up and down before it actually started to go up but part of that was because of the undiagnosed pancreatitis at the time. The people on this site saved me from going insane with worry. Jackie is now off her meds after being diagnosed 4 months ago but I still am checking her poo and pee all the time! Good luck to you and Molly!

[Linda]

Hi Leza and Molly. I just lost an entire post to you. User error.

But quickly, I wanted to tell you that Sadie did not take off at all until cyclosporine (Atopica) was introduced, which was 10 days after onset of AIHA and starting prednisone (20mg 2XD). As she was not climbing very fast, her vet added the cyclosporine (25mg2XD). And then it took about 10 days more and she really started to climb.

Also, is Molly on a tummy protection? I don’t see on your list anything like Sucralfate. You mentioned her already tummy problems.

You’re doing an awesome job with Molly!

Much love, Linda and Sadie

[admin]

Hi Leza

Please don’t worry about the PCV – it really does take time for the drugs to start working & patience is a virtue with this disease, much to all our frustration! Slowly, slowly. It’s really good news that she is stable – well done both of you. If Molly is eating well, more active & generally more like her old self, that is what really matters because it shows she’s improving.

You are getting much better information from the vets now – your insistence is really paying off. It’s difficult sometimes & you are doing the right thing.

Tummy problems are important too – I do agree with them about the risk with the aspirin if Molly has had tendencies for an upset GI tract regularly. I wish they had explained this to you start with & we would have known a bit more too. It would still be good to see the tests anyway, just in case something important flags up. This tummy trouble is also a very good reason to add in the sucralfate, as Linda mentioned. Sucralfate can heal ulceration & protect the GI tract from further damage & these drugs are very hard on the stomach etc. Ranitidine (Zantac) is also a tummy protector, so she does have something to help for now, which is good. You too can now become an expert on pee & poo!

I’m really pleased to hear you are getting Dr Dodds involved – she is incredibly knowledgeable & has many years experience dealing with this disease. You can trust her to give you the best advice – any blood tests or other information & Molly’s health history will help her immensely.

Hoping for a rise in PCV very soon.

Love & hugs to you both
Sheena & the boys xxxxx

[Vally]

Hi Leza, as with Linda, Bingo wasn’t doing well with just the prednisone and it wasn’t until the cyclosporine was started that he started to improve. So I’m glad it’s being considered if Molly’s PCV doesn’t improve.

It’s good that the PCV has held stable. Although we all want a rise and want it quickly, stable is better than a drop. But, Molly, a rise would be nice :)

You’re doing great. I’m glad you have a plan. Yes having a plan is a positive step and that’s good for both you and Molly.

My very best
Vally & Bingo