English springer AIHA Bone Marrow Aspiration

[Patrice]

Sara,
Please read Chance’s story under Our Stories. His story is like your story and is why I built this website, it is named in memory of Chance . The specialist was clueless about what was wrong. He talked me into a bone marrow biopsy. It was terribly harsh on his sick body. It didn’t tell us anything we didn’t already know, he wasn’t making red or white blood cells. It did nothing to improve his treatment or identify the underlying cause. The specialist told me he was unsure what to do, told me I had a very beautiful dog and looked at Chance sadly. The message was clear.

It wasn’t until I contacted Dr Dodds, she put Chance on her bone marrow failure protocol and within 1 month he began to recover. He did survive and lived to the good age of 12.

Be conservative about spending large amounts of money on major tests, save that for expensive transfusions and drugs. If you can convince them to implement Dr dodds protocol and then don’t see any results in one month then consider doing more tests.

In any case, I recommend you spend the $150 for Dr dodds consultation right now. This is exactly the kind of situation she is expert in.

The moderators will help you do this and guide you along with how to manage your relationship with your vet. If you read Chance’s story you will see I did all my treatment at my local vets with consultation from Dr dodds at each step, for a full year! Jean dodds is my angel.

The extra time I got with Chance was a true blessing . I know you will be successful too. Right now it may not feel like that, but try to make each extra day count. It’s not easy but control your grief and tears right now. Be as cheerful as you can manage.

My best, patrice

[Sheena]

Hi Sara

I agree with Patrice completely on this – the bone marrow aspiration is pointless – I wouldn’t have had it done in hindsight because it really doesn’t make any difference – the treatment is the same regardless. I was unaware of this at the time & thought the vet was doing the right thing. An unnecessary anaesthetic & expense – save your money.

Sheena xxx

[karxlee]

Hi Sara
I agree with Sheena doing a BMA is a total waste of time and money, we agreed for Louis to have one and I feel awful about it now because it didn’t change his treatment , all it did was cause him pain and bruising. They shaved Louis’s shoulder and took the sample from there, and we could see the bruising which looked really painful, Louis has a high pain threshold but when we picked him up to put him in the back of our car he flinched, so I know it hurt him.
I would save your money for the transfusions (if she needs anymore) and medication it money well spent.
Hang in there you are doing an amazing job and I bet Flossie is enjoying being ferried about in her cart, what a brilliant idea by the way! I bet she delays in telling you when she doesn’t need it anymore haha.
We contacted Dr Dodds and she was brilliant, our only challenge was we couldn’t give her or the lovely ladies on this site and Blood results, because UK vets don’t give us them, even when you ask and beg like I did, so we just had to provide them with the discharge report from the hospital. But she still gave us her opinion and was there to answer any questions we had. I sent all her info to our vet and he did read it, and took a lot of it into consideration when he was dispensing Louis’s meds.
I hope you are managing to get some rest where you can, and that your Dad is feeling better.
Love Karyn and Louis xx

[Vally]

Hi Sara, just in case you want to do a consult with Dr Jean, there’s a link here:
https://www.secondchanceaihadogs.com/hemopetresources/
and you can do the owners consultation which is the second form on the page.

Truly it is the best value, because, after paying your $150 you get a response from her very quickly, usually within 24 hours (from Friday to Saturday evenings, she won’t respond as she observes the Sabbath). After she has responded by email, you can email her back and she’ll respond, so you’re not paying a fee each time you need to ask her something.

She’s not just Patrice’s angel, so many of us have needed her help, even once our mutts are in remission, with simple things , like is a medicine or herb okay for our dogs. You’ll realise we are all somewhat paranoid now – and no doubt you’ve paid your membership fees to the Paranoid Pet Owners Club too.

If you do do a consult, attach everything you have, and the best way to do it is scan everything together into 1 document because the form only allows one attachment.

Good luck with your appointment.

Vally & Bingo

[Patrice]

Sara,
The bone marrow aspirate procedure is performed by entering either into the shoulder bone or the hip bone, or sometimes both as they did on Chance. It requires anasthesia. They must go into the bone deep enough to extract marrow, so there will be some force and depth involved. So there will be a wound, trauma to the tissue and side effects of anasthesia.

Chance was in a lot of pain, he was a big dog and they had to go deep and hard to get to the marrow.

From my perspective now, with these very serious cases (and I’ve seen many ) the goal is to keep these dogs as healthy as possible while you fight the deep autoimmune condition deep in the marrow. It can take a long time for recovery and the side effects of drugs like prednisone can take a toll.

Keep stress low, no visitors etc. And I consider a bone marrow biopsy very stressful.

It is your choice however. Sometimes owners just need to feel like they are doing all they can. A vet can make a very firm and compelling argument why it should be done.

We here are, to the vets, just a group of know it all owners. In reality both Sheena and I have medical backgrounds and do have significant knowledge about veterinary hematology. Linda and vally have studied along extensively too. Together we’ve probably helped over 500 owners, perhaps more? Lost count.

You do need to do what is comfortable for you but I would recommend Dr dodds as your second opinion, just like you would do for a human family member.
My best Patrice

[Sara]

Hi Gals.. Just letting you know that I saw the vet today and we are not going to do the BMA. I told her I was uncomfortable with it and asked what it was going to tell us we didn’t already know. She agreed that she didn’t think it would tell us anymore than we already know that she was trying it in hopes of seeing something that would point us in a more definite direction and that it was the next medical thing to do. She also said she really didn’t suspect cancer at all with her age and the blood test results it just didn’t point in that direction. So that hurdle for me crossed.

So as for some of the meds we asked about trying she tended to have her own reasons why she felt they shouldn’t be used. And Instead wants to increase the Mycophenolate. And mentioned adding on another immunosuppressant in the next days such as cyclosporien or Luflunomide being the one she was leaning toward.

She said Flossie is bright and appears to be compensating her vitals are good heart etc. so no transfusion yet. Today’s PCV % was 17.

Next thing up is Prendisone. O.k. first off how long did your dogs stay on it. At what point how many weeks in before the Dr. started decreasing the amount ? I’ve read everywhere that decreasing too soon can cause them to relapse. She mentioned today decreasing it soon because you can’t leave them on to high a dose too long because of the side effects. This literally scared me.

She also mentioned a spleenectomy.. ?

I contacted my personal DVM today he’s not in till Friday so I am seeing one of his associates tomorrow ..to talk to them about their approach and if they are willing to work with other Vets that are in the field to help her along. Flossie will be staying home resting while I go.
I’ll keep you posted on that.

Just so you know Flossie is Bright today, has a healthy appetite and wiggles her tail, gives kisses, She is resting alot, it’s pretty quiet with all us adults.

She seems to be drinking a bit less since last night..and not going out every 2 hours .. it’s extended to 4 hours last night and today. Hope that’s a good thing.

We are at day 11 since going to ER… and keeping our hopes up.

[karxlee]

Hi Sara,

I am no where near as experienced as the other ladies on here, but I am sure every one of them will shout ‘NOooooo’ to a spleenectomy, in fact I can hear Sheena now!

In regards to the steroids, I can only let you know what our experience has been. Louis was put on 15mg of pred a day on the 27th Dec 2015, he seemed to pick up and after only 1 week his dose was lowered to 10mg a day and then the plan was the week after 5mg a day. We followed our vets advise, but when he dropped to 10mg he became seriously ill, and on the 9th Feb we were referred to a specialist. He was put on 80mg straight away, but by this time he had what we now know as a relapse. Louis was on 80mg a day and was doing ok’ish but his PCV was still dropping, so they introduced cyclosporine anyway to cut a very long story short his pred was reduced to 60mg per day on the 26th March, because he was developed a huge ulcer on his tongue, he has been on that dosage since, so please don’t worry too much about how long Flossie has been on her pred.

It sounds like she is comfortable at 17% and holding her own, Louis can go down to 15% -16% then he starts to struggle, be he was at 17% – 19% for weeks and weeks.

I’m so glad you haven’t agreed to have the BMA done, I really wish we hadn’t but we are where we are, and Louis has recovered from it.
Our Vet has advised he will not lower Louis’s pred until he is in the mid 30’s so I have that worry ahead of me yet, he is currently 29%.
It sounds like you have a good relationship with your vet, and I totally understand that they are sometimes a little reluctant to listen to advise from the amazing ladies on here, but these ladies know what they are talking about with this awful condition, and not through reading about it in books or writing papers, by actually living with the damn thing.
It’s lovely to hear Flossie appears happy and a wagging tail is just awesome, keep doing what you are doing, and remember this thing takes time, I wish we could have a magic pill and our dogs are ‘back to normal’ but that doesn’t happen, so hang in there, Flossie is doing her bit and you are doing yours, the turning of the corner will happen, please consider Dr Dodds, she is lovely, and very to the point, but that’s what we need to hear sometimes.
I wish we had been able to get all the blood results to the ladies here and Dr Dodds but UK vets never pass that info over to the owners.

Big hugs to you and an extra special ear rub to Flossie.
Karyn and Louis xxxx

[Sheena]

Hiya Sara

Yes – Karyn heard me going noooooo!!!!! We are all anti-splenectomy unless the organ is diseased. Full stop. This is actually a very old fashioned idea & I know Dr Dodds has said to people not to remove a spleen unless it is actually diseased, e.g. cancerous.

The spleen is a vital organ for many things such as blood storage, it is a major part of the immune system destroying foreign invaders & destroying abnormal cells, plus lots of other things. When bone marrow doesn’t work properly, blood cell producing stem cells can seed themselves into other organs, such as the spleen (&liver) particularly & it actually does start producing nice new blood cells – the is called extramedullary hematopoeisis:

https://www.secondchanceaihadogs.com/AIHA_Terms/extramedullary-hematopoiesis/

Patrice’s dog Chance had a diseased spleen & it had to be removed – no choice – and that was when he went down hill. His bone marrow had not been working, but the spleen had “taken over” blood cell production to keep him functioning normally, so removing it sent him into a downward spiral. When we are embryos, we don’t have bone marrow – the organs produce our blood cells, so the body is very clever at reverting to that state if it needs to! I hope that makes a bit of sense?

Removing the spleen means your dog would be open to infection. People who have splenectomies are given antibiotics on a permanent basis because it reducing their immune system’s ability to fight off infection.

I hope you now see why we are all really anti-splenectomy. It is included in some “older” IMHA protocols & it’s really outdated & is the very last resort in my opinion. I promise you I would NOT have allowed Worzel to have this done unless his spleen was categorically proven to be diseased.

The usual treatment protocol for IMHA is 1mg per pound or 2mg per kilo of prednisone – in severe cases, higher doses can be given initially for a short time, but should be reduced to the usual dose. Please trust me on this – leflunomide does not give very good results, but mycophenolate & cyclosporine do. Azathioprine is also used, but not as much these days, although it can also be added as a kickstarter. My dog did respond to azathioprine nicely after a couple of weeks, but we were ready to change to cyclosporine if we needed to.

Can I push you to contact Dr Dodds? Her guidance is fantastic – I trust her implicitly more than any other vet & I always consult with her when Worzel needs medication or supplements even now, 3 years down the line from diagnosis. Worzel hung around at 16/17/18 for ages – very weak, but “OK” – it seemed like an eternity waiting for something to happen!

Flossie is hanging on in there nicely too – that waggy tail cheers me up no end! It is a waiting game – nothing happens quickly, so be patient (says she who is the most impatient person in the world!!) for now.

I really do think it’s time to contact Dr Dodds – she has been a complete angel for so many of us & I know she will be able to advise you & your vet on how to treat this. Us ladies know a lot from “experience” & medical backgrounds, but we are not vets, so my advice would be to ask the real expert about which drugs would be best – Dr Dodds.

Big cuddles to you all, especially Miss Flossie

Sheena xxxxx