Diagnosed last week need help

[Edwina Schapper]

My Cookie has been diagnosed with this dreadful disease. She’s a 6 yr old terrier mix, spayed and up on all vaccinations. Her last ‘normal’ day was this past Monday, Tuesday she wouldn’t fetch and had a little loose poop and no appetite. Wednesday I went home on my lunch hour and let her out to potty, she did something she never does, she squatted right in front of me and I saw the heavy tint of blood in her urine. We went to the vet immediately. He did the CBC (RBC was 23) and other tests for parasites (neg) her tongue and gums were very pale, her heart was beating crazy and she has a murmur. He told me that Cookie had an auto immune problem. He knew she was in serious trouble so he kept her overnight to administer meds and check her blood again in the am just in case she needed a transfusion. Thursday am her RBC was 27, a small improvement but we were hopeful she was on the mend. They sent us home with prednisone 30mg and doxicycline 300mg both 2xs daily. The vet was going to be out of town until Monday so he made sure to give me all the notes and test results in case we had to take her to an emergency clinic. Friday there was no improvement, she was just existing. I was hand feeding her and getting more worried by the minute.
I live in a very small town in N. Florida and my vet is just 3-4 years out of college so I’m not sure he had ever had a patient with the disease. It’s probably good fortune he was out of town a few days because on Friday we decided to take her to an emergency hospital an hour away in a much larger city. I just wanted peace of mind that she was improving. I called the hospital and talked with the doctor. They call our vet and had them fax all the information on Cookie to them. At the clinic the doctor explained the details of this AWFUL disease. Her test showed RBC at 34 and very good baby RB production. She prescribed and a complete treatment plan that included Sucralfate dissolved, 10mg Pepcid 2x day and an RX for cyclosporine 60 mg 2x day. She gave the RX but said it was just in case she needed it so we didn’t fill it.
Monday 9/25/17 Cookie was not getting better we went back to our local vet RBC at 17, So we start the cyclosporine. Wednesday RBC at 20, improvement but Cookie is still very sick, has spurts of perkiness then bottoms out.
Her appetite has not been good since she got sick but no vomiting until this morning. I started the GI protection at 6 and she was hungry so I made her wait about 15 minutes. I know I’m suppose to wait an hour but she’s so weak I don’t want to miss an opportunity when she’s hungry. I gave her all other meds at 7:15, Pred and Doxy are pills, Cyclo is liquid. At 10am she vomited all her food from this morning. So now I’m worried that the Pred and Cyclo didn’t absorb but my vet said it probalby did in that amount of time.
We go back tomorrow for RBC count.
I’m going to upload her records. Will you please look at them and tell me what you think? My Cookie is so sick and she is usually the happiest, energetic little pup. My husband likes to tell people how she can jump up and knock his shade off his nose. I’m really worried. Thank you for what you do.

[Vally]

Hi Edwina and welcome to the site. I’m sorry you’ve had to come looking though but we’d like to do everything we can to make Cookie get better.

First of all you’ve done everything perfectly. You reacted quickly and that’s the most important thing with this disease. Cookie’s best chances are with the fact that you treat it quickly and very hard and that’s why she’ll be looking very poorly right now. The medications to make them feel pretty awful. To be honest, she’ll look worse before she looks better.

I’m glad you’ve started the cyclosprine, that’s really the best drug as it targets the actual cells doing the damage right now. Only problem with it is that it doesn’t work instantly, that’s why prednisone at such a high dose is being used. It works quicker, but has greater side effects. See here:
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone/

The cyclosporine could be the culprit for the vomiting to, it’s a fairly common side effect
https://www.secondchanceaihadogs.com/AIHA_Terms/cyclosporine/

Dosing – prednisone should always be given with food. Ideally cyclosproine 2 hours away from foods and meds. I’d be happy to make up a chart for you if you like. If the cyclosproine is making Cookie sick, then you can give it with a little food to start with until her body adjusts to it.

Keep her quiet for now.

Ask anything at all.

My boy Bingo was diagnosed at 7 years and survived. I lost him just this year to a cancer. There have been many survivors so don’t give up.

My very best,
Vally, Angel Bingo and the new pest Saba

[Edwina Schapper]

Yes please I would like the dosing schedule. I’ve been giving all the meds at one time because I have to leave for work. My husband can give her the Pred a few hours later though with something to eat.

Thank you so much! This site is the best but not easy to find for some reason. I was desparate to help my Cookie so I kept looking. I live in such a small town no one has ever heard of AIHA. Luckily my local vet was familiar even if a tiny bit.

Best to you,
Edwina & Cookie (we have a pest too, Priss)

[Edwina Schapper]

I read the info on Prednisone and Cookie weighs 40 lbs on a heavy day. Her dosage is 30mg 2xs day. Is this too much or just go with it until she starts improving. It really is doing a number on her little body.

Best,
Edwina

[Vally]

Edwina, I’ve just sent you an email with a draft chart for you to check.

The prednisone dosage is a bit high, but I think that is probably to hit it quickly. When does Cookie get checked next? It might be worth asking then about the dosage. Also many dogs need to be on aspirin to prevent blood clots – not all dogs, but many do. Can you check this too.

Patrice, the site owner, will check the blood results for you and get back to you.

Vally

[Edwina Schapper]

Hi Vally,

Thank you the chart is great! It’ll also help my poor overwhelmed hubby :) he’s Cookie’s fav pal. We’ll start using it today. I forgot to mention the aspirin, the emergency hospital doctor told me to give her 1/8 of a baby aspirin. That’s almost impossible the pill is so crumbled up once I start chopping it up so I give her a speck of it once daily. Is this okay?

Edwina

[Edwina Schapper]

Oh and she goes today at 11am ET for her blood work. Fingers crossed and praying for good results.

[Vally]

Edwina the blood results have come through. Again, Patrice is the expert on these, so she should be getting back to you about them.

The aspirin, yes, do what you can. I’m glad they’ve suggested it. I’m thinking it would be twice a day WITH FOOD. I actually calculate for her weight (approx 40lbs), it would be a quarter of a baby aspirin twice a day. But please check with the vets.

I note from your email, you are also using Denamarin (great stuff!!!). It really helps the liver to cope with everything. To be honest, I would do it on it’s own again, so let me have a fiddle with the chart and see if I can drive you and your husband nuts by making you get up at ridiculous hours to fit the drugs in.

And CONGRATULATIONS Cookie on your PCV of 25 today !!! YAYYYYYY

My best, Vally & Saba (and Angel Bingo)

PS Beautiful photo.