Dog diagnosed with IMHA

Eric

Guest

Hello. Our dog Torrie was diagnosed with IMHA Wednesday October 7th. I just stumbled across this forum yesterday when I was researching her illness to get a better understanding of what we were dealing with. I was out of town on business when everything happened so I may be fuzzy on all the details but I will do my best. My wife called me when she got home from work saying Torrie wasn’t coming to the door to greet her like she normally does and that she was lethargic and her eyes were shifting side to side rapidly. She took her to our normal vet, and while she was there she had a couple of seizures. At this point our normal vet referred my wife to the local emergency clinic. It was at this point that the emergency clinic was a little confused as to what was actually wrong with Torrie. Her RBC levels had dropped to 18% which signaled IMHA but the seizures and vestibular disease were giving the doctors trouble determining exactly what may be wrong with her. She had a blood transfusion the first night she was there and hasn’t had one since.Over the next few days she remained at the emergency clinic in their ICU and was given a host of fluids and medications. I will do my best to remember what they were exactly and will update later when I get home. I believe they gave her dexamethasone, and I know they were giving her heparin. After a couple days the bills started getting too high for us to let her stay there and she looked very depressed when we visited her (very often). We made the tough decision to bring her home and try outpatient therapy. Over the course of her illness her RBC levels dropped to 18% before transfusion, up to 27%, down to 24%, up to 28%, and the last we had her checked they were at 25%. She was weaned off Heparin about a week from when it all started. She is currently on Prednisone, Cyclosporine, and Amlodipine (not sure on that last one) and i’m not sure on the dosages. My wife just texted me and said the specialist is certain she had a stroke which is why she has remained dizzy and unable to walk without assistance. We have been having to force feed her because she wont eat until yesterday when she finally ate some roast beef my Mother-in-law cooked. Her neurological functions seem to be improving ever so slightly and her morale seems to be getting better.

Im sorry for the novel but it has been an exhausting couple of weeks and I just recently discovered this forum. I guess my main concern is, is she getting the right treatment? Is there anything more we could be doing? I am sure there are other questions that I have but I just can’t think of them right now.

If any of you have any questions for me that might help, please ask. Thank you for taking the time to read my long winded post.

Details

Sheena

Guest

Hi Eric

You are NOT sending a novel or being long winded at all – the more information, the better. Poor Torrie – you must be very worried & I’m glad you’ve found us. Never worry about posting a long message – it always helps & you will find everyone on here supportive. We have all been through this horrible disease & completely understand how confusing & stressful it is when you are told your dogs has IMHA/AIHA.

I am so sorry about the dual problems Torrie is suffering from with the doggy stroke (not like the human version by the way) & the IMHA as well. A PCV of 25 & holding is just fine for now – you have to be patient at the beginning for the drugs to kick in & do their work. Prednisone & cyclosporine are the most usual drugs for treatment, so that’s good to hear.

The amiodipine is for high blood pressure, presumably to treat the stroke. One of my previous dogs had a doggy stroke & was really poorly for a couple of weeks, vomiting, not eating, couldn’t stand up on his own, wobbly & disoriented, but he made an amazing & complete recovery! I did think he wouldn’t make it as it is very distressing to see them like that, but it is often a matter of just giving them time to recover & many get back to their normal selves, although some may be left with a head tilt or similar – a small price to pay, I think. The IMHA is a much slower & more serious thing to treat, I’m afraid.

If you can tell us more about Torrie – age, weight & exact doses of medications – we can help you to see if the right treatment & doses are being followed. If you upload any blood tests & other reports/tests to the urgent advice area, someone will have a look for you.
https://www.secondchanceaihadogs.com/urgent-advice/

The drugs Torrie is taking are very hard on the stomach & I would recommend you get some sucralfate to protect the GI tract from ulceration. It must be given 2hours before or 2 hours after any other medications:
https://www.secondchanceaihadogs.com/AIHA_Terms/sucralfate/

The other very important thing is that our dogs can be at high risk from blood clots – abnormal clotting – in which case Torrie should be on an anticlotting medication – please could you look at this:
https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/
and ask your vet – a blood smear/test will reveal these things.

The drugs are also hard on the liver and pancreas – adding Denamarin provides goodies for building red blood cells AND milk thistle which is wonderful for protecting the liver. I would also get some of this wonderful stuff! Milk thistle brought my dog’s liver enzymes down very nicely when he was being treated.

I think I’ve written a novel, not you! That is probably enough info for you just now – please feel free to ask anything you like. Someone on here usually knows the answer. You are not alone now – we are all here to help in any way we can.

Please feel free to look things up in out AIHA Terms glossary (alphabetical), which contains drug information including doses, side effects etc, plus lots of other stuff which we hope you will find useful:
https://www.secondchanceaihadogs.com/aiha_terms/

Every best wish possible for Torrie’s recovery
Sheena, Worzel (in remission) & Ollie

Details

Eric

Guest

Thanks everyone for the kind responses. Torrie is around 7 years old and she is a mutt as far as we know. Potentially a mix of Doberman, Terrier, and something else. She is a medium sized dog and normally weighed around 55-65lbs. but she weighed 53.8lbs yesterday at the clinic. Her Cyclosporine dosage is 100mg every 12 hours, Prednisone 20mg every 12 hours, and Amlodipine 5mg every 24 hours. They weaned her off the heparin and did a full blood test yesterday (waiting on results) to determine what direction to take with blood thinners. The doctor said they need to know her platelet levels before they can make a decision on what blood thinner to use. I asked about aspirin last week and he said definitely not.

This morning I assisted her outside to do her business and she had diarrhea. The stool itself looked brown in color but as we were walking back to the house she stopped again and this time blood came out. I didn’t analyze it with a microscope or anything but it looked to me like a solid clump of blood with very little feces in it about the size of a large acorn. Since it was on the driveway I hosed it off and it didn’t have the same consistency as feces normally would. I called the vet and he said to just monitor her next bowel movements. He said it could be frank blood (not sure if I heard him right) which is nothing, or possibly an ulcer in her GI tract.

I see Sheena recommended Milk Thistle. What is this exactly and is it something I should consult with the vet about first before giving it to her? Is it something that is over the counter?

As far as her stroke is concerned, the doctors seem positive she will recover due to her already recovering quickly. Just last night she walked about a hundred feet unassisted down the sidewalk. She also stood up on her own from her bed, walked to me on the other side of the living room to eat some steak I was offering her, and then turned around and walked back to her bed and laid down. All of these actions are still pretty wobbly and unstable but at least it is progress.

The only tough part about this is we really cant afford any setbacks. My wife is four months pregnant with our first child and we had just gotten close to paying off student debts until this hole ordeal. Please keep Torrie in your thoughts and prayers because I am afraid if she has a relapse or if something major happens we may have to euthanize her. She is our best friend and it is killing us to see her like this.

If you have any more questions for me, please ask away. I feel I learn more from answering questions than asking them.

Thank you so much everyone!

Details