Diagnosed today.

Debra

Guest

Hello everyone, my name is Debra I live in PA “my” sick little girls name is Sadie she’s a 9 month old standard poodle. She was diagnosed today after being sick for 2 weeks.

Debra-Sadie_500x402

I use quotation marks on my girl because this sweet pup was my moms. My mom passed away suddenly December 20th. She was not in the best of health and had stopped going to cardiac rehab because her new puppy was “going to give her plenty of exercise”. Nothing I could say changed her mind. I was not happy to say the least. My mom and Sadie lived in Utah. When I visited my mom in September I fell in love with Sadie too. All was not forgiven but I told my mom how lucky she was to have such a special sweet pup. She said ” I’m so glad you like her because if anything happens to me I’d like you to take her. ” of course but we don’t need to worry about that.

When my mom passed (I was told she was just laying back on the bed, it was her heart.) she was getting ready for bed Sadie was in her kennel in my moms room her other dog Rosie was out and about. My mom was blessed with a wonderful neighbor who noticed something was wrong about 4 am. My son came and got the dogs by 7am. Sadie stayed with my son, Rosie and his pup Dick from the 21st until Jan 10 when I had her flown here. I don’t have another dog.

They don’t have a reason for the AIHA. She was not vaccinated recently or on any meds. Her blood work pre spaying in August was perfect. But this little girl has been through so much.

She never ate well when she got here but I figured it was due to so many changes. Then one day she didn’t eat at all and was listless the next day I had her in the vets January 22nd. ( no vomiting or diarrhea) They took blood and X-rays at the local vets then we went to a different vet for and ultra sound and needle aspirations on her enlarged spleen and lympnodes. She was in the hospital 2 separate nights on fluids. She remained listless. She was on a low dose of prednisone, doxycycline and appetite stimulant. While we waited for the tick tests and biopsies to come back. All negative. Her counts continue to drop. She was jaundiced and her pee was orange. When the test came back as nonregnerative. They upped her prednisone. I was told I should have a transfusion but that chances are it was cancer. When we got home I didn’t think she would last the weekend. She was breathing so hard and just laying around.

The prednisone must of kicked in because this weekend she was 70% normal dog. I though she was getting better. But her counts are very low and still showing no signs of regeneration. They took her off her antibiotics and added a new med cyclosporine and a low dose of asprin as soon as we can get it.

We need your help!!! This is so overwhelming.

Details

Patrice

Keymaster

Debra,
I first need to tell you that your vets have been trying to very detailed in their examination of Sadie, they are aware of many of the appropriate tests that are needed to discover the cause of this, so they can treat it properly. As I write medical terms they will automatically link to the glossary so you can hover over them to see a synopsis and click on them for a more complete explanation.

From an overall view of the blood work you uploaded, Sadie is a relatively healthy young dog who has had a sudden “event.” She is profoundly non-regenerative (not making red blood cells in the bone marrow.) She also has neutropenia, most like immune-mediated neutropenia and this means she has stopped making white blood cells in the bone marrow. Also, her platelets are a tiny bit below low normal.

We have seen this condition a number of times. This website is dedicated to my dog Chance who had the very same condition in 2007. Yes, he survived.

Whenever an owner comes to us with a very young dog I always think of special things that happen to puppies that older dogs don’t necessarily encounter. First and foremost I think of things that puppies put in their mouths. There are certain heavy metals that, when ingested, can cause this kind of profound reaction. Pennies made with zinc are one of those things. This causes a unique type of anemia called Heinz Body Anemia. Hopefully your vet has thought of this, quizzed you about it and perhaps done an xray to see if there is a penny still inside her. A blood smear can also be diagnostic, as the Heinz bodies can be seen on the RBC.

Next I would think of vaccination reactions, since this is the age that these dogs are receiving their second puppies series and their first rabies vaccination. It appears your vet may have explored this. However I would not discount this offhand. Combined with a recent spaying, it is possible that she has had an autoimmune reaction. Are there tests that can show this? Yes and no. Most vets, when faced with this possibility just treat as though that is the case.

Tick diseases are epidemic in Pennyslvania and a young puppy can be prone to being bit by a tick without you ever even knowing it, especially a Poodle with lots of dark hair.

Here is a super mapping program that shows how prevalent certain tick diseases are in your area.
http://www.capcvet.org/parasite-prevalence-maps/
If you click on tick diseases>dogs>ehrlichiosis >PA you will get a map showing the prevalence in counties. Also click on anaplasmosis. These two tick diseases can cause this profound non-regenerative anemia and neutropenia.
https://sites.google.com/site/tickbornediseaseindogs/ehrlichiosis

They are usually most often contracted in either early spring or the very late fall when ticks have matured over the summer and are looking for meals to tide them over in the cold weather. So months can elapse before the signs of disease show up. Your vet is prescribing doxycycline and this is the drug most often used to treat these diseases. Tick-L, a long time internet group, recommends you hit these diseases with twice the usual dose and for 2-3 times longer than usual in order to eradicate all of the disease.
https://sites.google.com/site/tickbornediseaseindogs/treatment
“The dosage we recommend on Tick List is an aggressive one: 5 mg. of doxy per pound of body weight given every 12 hours for 8 weeks.”

When a dog is infected with ehrlichiosis, they may be mildly sick to begin with and then seem to recover. The disease goes into a chronic state where it gathers numbers. Eventually, as long as a year or even two later, it returns with a very strong attack on the body. Please share this information with your vets in case they are not familiar with it. There are several tests and I am positive they are doing those tests right now.

There have been dogs in treatment for these tick diseases that were also experiencing this form of IMHA that had to be treated for the autoimmune destruction simultaneously as they are being treated for the tick disease. This includes the use of prednisone and is an extremely complex treatment, requiring the skill of a vet who knows exactly how to juggle these two drugs, doxy and pred.

What else do we think of in young puppies? Other things like genetic predispositions come to mind immediately. In other words they inherit from their parents an immune system that is sensitive to the environment around them. These dogs may present with skin allergies or other autoimmune tendencies when they are very young. They may have sensitive stomachs, frequent diarrhea, be particular about eating certain foods etc. A dog like this can spontaneously develop AIHA and there is no known specific cause. In these dogs you must treat as though this is the condition, without ever having the diagnosis to prove it. This is necessary.

Puppies can also get themselves into things like spiders, bees and snakes because they tend to be less cautious and more curious. They will explore these things and if bitten or stung can develop a sudden and profound autoimmune reaction. Their bodies begin attacking “self” their red blood cells, white blood cells and platelets. This can happen in the blood but it can also happen within the bone marrow.

What else? Well, I can tell you for sure I hear this damn C word mentioned all the times and it irritates me. A young puppy is rarely a candidate for cancer. I suppose it can happen, but it would be the last thing I would think of.

I do not recommend, nor do most authoritative veterinary resources, the removal of the spleen. Especially in a dog this young. It used to be done more, in an effort to remove the source of the greatest destruction of red blood cells. But this autoimmune destruction is happening deep in the bone marrow and that is where the fight must be.

Cyclosporine is a super medicine and will begin a proper attack on the destruction of the precursor cells, HSC Hematopoietic Stem Cells, in the bone marrow. I highly recommend this medication in dogs with profound bone marrow failure. This was recommended to me in 2007 by Dr. Jean Dodds to treat Chance. I will recommend that you contact Dr. Jean Dodds for Sadie. She can be your “second opinion” and will do so graciously and with great caring.
https://www.secondchanceaihadogs.com/hemopetresources/

You can read Chance’s story here:
https://www.secondchanceaihadogs.com/our-stories/chance/

I have given you a lot of information on causes, those that I think are common in puppies. Other folks will come along here soon and help you understand all the drugs, the side effects, what to expect in the way of transfusions and things like liver inflammation, risks of clotting, heavy breathing etc. There is a wealth of information on the website. Please be sure to view the introductory videos.
https://www.secondchanceaihadogs.com/aiha-video-library/aiha-introductory-videos/

my best, patrice

Details

admin

Keymaster

Hi Debra

First of all, I’m so glad you’ve found us, but very sorry poor Sadie is so unwell. I am also very sorry to hear about your Mum & you are wonderful to have taken Sadie in. She is really beautiful and I can see why you fell in love with her.

Patrice has given you loads of information which will help you understand what is happening a bit more. I would also recommend contacting Dr Dodds – I did. She is extremely knowledgeable, very kind & worth her weight in gold. She is happy to consult over the internet too.

I wanted to say we are all here to help you & will do our best to answer any questions you have – I had a million questions when this happened to Worzel & this great bunch of people on here kept me going with their tremendous support.

This is looks very similar to what happened to my dog Worzel who had ehrlichiosis, a tick borne disease – his baby red cells were being killed off in his bone marrow & they never got a chance to get into his bloodstream. He went downhill quite slowly & we didn’t know what was the matter. He was also classed as non-regenerative (bone marrow failure), like Sadie. As Patrice says, her other blood cells are low too, so whatever has caused this has affected those lines of cells as well. I saw on the blood tests that babesia had been written at the bottom by hand & they also mentioned tick diseases. Does this mean that Sadie was positive for babesia? Do you have any other test results at all?

What worked for Worzel was a high dose of doxycycline (5/6 weeks) and antibiotic to kill off the ehrlichiosis, high dose prednisone to stop him destroying his own cells in the short term & azathioprine to suppress his immune system in the longer term. I am glad to read that Sadie is on atopica (cyclosporine), which many vets prefer to give rather than azathioprine, and this will suppress her immune system (be patient – it takes time to take effect) & fingers crossed she will become regenerative. It is a waiting game, I’m afraid, and there are side effects to deal with.

Is Sadie on stomach protectant? This is very important. The prednisone can really irritate the tummy & cause ulceration, which can cause bleeding in the intestines – you don’t want any more of that precious red stuff being lost. We all like to warn everyone about this & get vets to add in famotidine & sucralfate. They must be given 2 hours away from the other medications, otherwise they can stop absorption of these important parts of the treatment.

It is so important to find the cause & treat it to eliminate it. I see your vets are on the ball, checking everything. I also see Sadie had an ultrasound – it says “may need operation”. Can you tell us any more about what they found? Also, what antibiotic was Sadie on? What was it for? I see she had a fever. Sorry to ask so many questions!

I’m really happy to read that Sadie is feeling better than she was & that the prednisone seems to have helped. I will be thinking about you & anything we can do to help, just ask.

In the meantime, I’m sending you & Sadie encouraging hugs – she can get through this .

Best wishes from us all
Sheena, Worzel & Ollie

Details