Blood clots with AIHA

[Meghan]

our sweet shih tsu, Gabby, got sick while we were out of town last week. When we came back Saturday night, she wasn’t able to move and wouldn’t drink or eat anything. We took her into the vet, then to the Vet er Sunday. She was diagnosed with AIHA with a pcv lever of 16. She was given a blood transfusion and her pcv went up to 30. It’s been between 30 and 24 since Monday (now wednesday) She seems to be stable. The main concern is that they found blood clots in her abdomen during the ultrasound Monday morning. We weren’t given much hope, but there is no way we were giving up on our baby so we told them to do everything they could do for her. She has been on predisone and cyclosporin for steroids, doxycycline for antibiotics, a gi protectant, and Heprin injections 3x/day plus plavix. The hope is that they can go off the heprin tonight and just be on the plavix and other drugs. They had said if she is stable that she could possibly go home. My question: We really want her to come home! We want to be able to have her here to recover and rest but also worry about not being able to test her pcv and know about blood flow/clots. I don’t want the vet to convince us she needs to stay if we can take care of her at home. What can we expect for when she gets home and what do we look for as signs of low pcv and blood clots? Again, I’m worried to not have her under constant dr. supervision, but on the other hand she is in a cage all day, and is so happy to see me when I visit. Plus as everyone knows, we’ve already paid lots of money for her care so far, and want to be able to care for her here if we can. OK…long post, I’ve been in a haze and constantly researching and worrying since sunday. Any ideas, suggestions, info, etc would be helpful. thanks!

[Meghan]

Possibly go home tomorrow, forgot to say that.

[Meghan]

Possibly go home tomorrow, forgot to say tomorrow….again, lack of sleep this week worrying about my sweet baby

[Vally]

Hey Meghan, I’m glad you’ve found us, but sorry your Gabby is sick. Don’t worry about long posts, there’s always a lot to explain and a lot going on.

First of all you did everything exactly right in getting Gabby to care quickly and it sounds as if they know what they’re doing. That’s so important as it’s not a very well known disease.

The abnormal clotting is being caused by her immune system going haywire. There’s an item in the glossary about this:
https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/

It’s very important that she stay on the Plavix while there is any risk.

Do you have a copy of her blood results? If you don’t ask for them. You can then post the results here, or attach them to the Urgent Advice at the top – here’s the link too:
https://www.secondchanceaihadogs.com/urgent-advice/

There are a few people here (not me) who understands them and will help you to understand what’s going on. Don’t panic at any f the abnormal results for the moment. The drugs will send the whole body out for a while and there will be abnormal readings for a while.

Gabby will feel a lot better at home and I know you’ll be worried when you do get her home, but it will get better. It’s important in the first days especially to get her PCV checked frequently. I was going in 3 times a week to have it checked. You can also keep an eye on her gums and the colour in her eye sockets. The paler it is the more anaemic she is, however, if she’s resting, the colour will always be paler. It’s best to check when she’s more alert.

The PCV often does drop after a transfusion. That’s quite normal so don’t panic on that score. The transfusions are only there to buy time for the drugs to start working.

Prednsione has a ton of horrible side effects that can be scary, but this drug is a life saver and the side effects all start to reduce when Gabby becomes stable and the dosage can be reduced. Some of the side effects are panting, drinking lots, and therefore peeing lots, muscle wasting, tiredness. Have a look in the AIHA terms for a good explanation about it.

Can you post a list of Gabby’s medicines when you get them. Some drugs shouldn’t be given with food and some should. We’ll help you through that. I’d be happy to make up a chart for you too, if that would make things a bit easier.

See, another long post, and I’m sure I’ve left out tons. Others will be responding too. Ask anything. Someone has been through it.

Big, big hugs,
Vally & Bingo (diagnosed Nov 2011, in remission)

[admin]

Hello Meghan,
please don’t apologize for long posts! We want to know as much as possible, so long posts are more than ok. It was great to read what your vet has done for Gabby, they really know what t hey are doing and it is good to know she is in good hands. I totally understand that you want to take her home and I think you should as soon as it is possible. With this disease (or any other) dogs should be in their familiar environment to get better and heal. The question is, how close are you to your vet? If it is not too far, you could always go in and get a quick PCV check, to make sure Gabby is not loosing precious red blood cells. I am pretty sure you will notice if she would decline. It would be pretty much the same as it was with her initial diagnosis. No food intake, not moving and just not being herself. I am also pretty sure that the vet would not let you take her home if they were not sure that she is stable. Once that is the case, don’t worry, she does not have to be under doctors supervision. All she needs is to get her meds on time (take Vally up on that meds chart!) have good food and lots of TLC. It is a big job but you can do it! We are here to support you so please keep those long posts coming and ask anything that comes to mind.
I was glad to read Gabby is on a stomach protectant, with he hash drugs that is so important. Do you know if they suspect a tick parasite? Is that why she is on the antibiotic? I would also talk to the vet about getting something to help Gabby protect her liver. We usually recommend Sam-E, Denamarin. An other great supplement is petinic. What are you feeding Gabby? You might want to look at Dr. Doods liver sparing diet:
http://www.canine-epilepsy.com/Liver%20cleansing%20diet.htm
You can replace the fish with chicken or turkey, just remember it should be lean.
Please keep us posted, best wishes,
Brigitte

[Meghan]

Thank you guys so much! You are awesome, I’m so glad I found this site! I am going to talk to the dr. in the morning after gabby’s exam and see if I can take her home tomorrow. I will ask about blood results, medicine list and if shes on a liver protector. I so appreciate your help! I’ve had to do lots of research the last few days because we had never even heard of AIHA before Sunday.
Does anybody know about blood clots and how long it normally takes for them to dissolve (if that’s even what happens)? Again, one of the doctors wasn’t giving us much hope with the blood clots. But we are trying to stay positive and do everything we can to help her get better, and focusing on what we can do to get her back to her normal self.

[Meghan]

last question for tonight…in researching online, it looks like there could be a link to vaccines, heartworm meds and flea and tick meds? We had given Gabby frontline plus about a week before her symptoms started. We had never given that kind to her before. I can’t help but to think it’s related. And am hoping that maybe once that’s out of her system it will help her.

[admin]

Meghan,
there are many possibilities for triggers. You are definitely on the right track with all you mentioned. Vaccines, insecticides, certain medications and also stress. Please don’t blame yourself though. Most of us had never heard of AIHA/IMHA before our dogs got ill. And as far as I know there is no way to tell if a dog is predisposed to getting it. it seems there are certain breeds we see more than others, but there are not many breeds or mixes that we have not seen.
I think you should be very hopeful that Gabby will recover from this. If you come across a vet who is not giving you much hope, please just brush it off. Maybe he want’s to paint it black and then when Gabby is recovering he is the hero:) We know many dogs here that have recovered and lived many happy and healthy years after that. I think it is very important to stay positive and bring that across to your dog. If you are constantly worrying and fretting, your dog will feel that, be insecure what is going on and you guessed it, be stressed. You certainly don’t want that. So please Meghan, be positive and confident that Gabby will be just fine. It will take time and you will have to be patient, but it will happen!
Best wishes,
Brigitte