Honey

[lynda]

Just found this site, and need some support! Our gorgeous greyhound x, Honey, was diagnosed with non-regenerative IMHA two months ago. She has now had several transfusions and is on prednisolone, Imuran, antibiotics and low-dose aspirin…. but still no improvement in reticulocytes. It is hard to keep positive…. she does seem brighter after each transfusion, but is there any hope of improvement? We are feeling desperate :-(

[Vally]

Hi Lynda

I’m sorry to hear about your girl Honey. Yes 2 months is a long time to deal with this without something positive. It’s so very draining .

What was Honey’s PCV at her last test?

Can you give a bit more information. Do you have details of blood tests. If so, please post the information or you can attach it to the Urgent Advice page. There are a couple of people here who understand them and may help you understand what’s going on.

Also can you tell us what Honey’s weight is and what medication dosages she is on.

Is Honey being treated by a specialist? Most of us found that treatment by an internal specialist made a big difference.

If the prednisolone and Imuran are not working, has there been any suggestion of trying Cyclosporine instead of the Imuran to support the prednisolone.

Lynda, the people on this site are wonderful We help each other a lot. I know you’ll get some more responses shortly, but if you can post some more information, that could help.

My very best,
Vally & Bingo

[Vally]

Oh Lynda, I also thought I should mention, you could contact Dr Jean Dodds at hemopet.org She is a brilliant vet who knows so very much about the immune system and has helped numerous dogs. Hemopet operates a blood bank for dogs and also does greyhound adoptions, so I’m pretty sure greyhounds are her very favourite dog. The consultation is not very expensive at all and would probably be well worth it.

I think one of her recommendations when things don’t go forward is to also use some Thyroxine. Has Honey ever had her thyroid tested?

Regards, Vally

[Linda]

Hi Lynda. I am so sorry your greyhound, Honey, has come down with IMHA. It is a horrible disease, BUT it can be beat. We are here to help you, of course. As Vally said, give us the information mentioned and you will get the feedback you need within a short time. Stay with us.

Sending supportive hugs, Linda

[admin]

Hi Linda
First of all, I’m glad you found us, but I am so sorry Honey & you are going through this traumatic time.
I’m Sheena – another greyhound owner – Worzel is my lad. It sounds like the Imuran (azathioprine) has sadly not worked as well for for Honey as it did for Worzel – I’m so sorry to hear that. If Worzel hadn’t responded within a couple of weeks, we were prepared to try another drug or drug combination instead. This is what you need to talk about with your vet. Sometimes, a different drug makes all the difference. I do understand exactly how you are feeling – when they are non-regenerative, it is a real worry & you start to lose hope – please don’t do that – there are many different treatment alternatives available to you. Has your vet mentioned trying cyclosporine (trade name Atopica)? If not, I would recommend you talk this over with them as soon as possible. Honey must be feeling very tired & be totally fed up with transfusions & pills, poor girl.

You are right about azathioprine being a bone marrow suppressant, however it is often used successfully for IMHA treatment & has been proven to be effective in clinical trials & that’s probably why your vet has prescribed it. All dogs are different & some respond better to different drugs, though. Some dogs even need a combination or cocktail of drugs to become regenerative. There are many on here whose dogs have been sucessfully treated with cyclosporine, which is many vets drug of choice as it doesn’t suppress the bone marrow like azathiopine can.

This is an extremely complicated & rare disease – sometimes things are not straightforward on the treatment front. I am relieved to see Honey has anti-clotting medication (it is absolutely vital to prevent clots) , antibiotics & prednisolone too. I can’t see any type of stomach protection in your list – these drugs are very hard on their tummies & I would recommend you ask your vet about adding sucralfate & Pepcid to Honey’s treatment to prevent tummy ulceration. These drugs must be given completely separately from the others as they can inhibit their absorption & you do not want to risk that. You can read the information on our site about all these drugs in our AIHA terms glossary – here are the links (or you can use the blue bar at the top of this page)
https://www.secondchanceaihadogs.com/AIHA_Terms/sucralfate/
https://www.secondchanceaihadogs.com/AIHA_Terms/famotidine/
https://www.secondchanceaihadogs.com/AIHA_Terms/azathioprine/
https://www.secondchanceaihadogs.com/AIHA_Terms/cyclosporine/

Can you tell us a little more?
What weight is Honey?
Can you tell us her PCV before & after transfusions & what it is now?
What were the antibiotics for & what name & dosage are they?
Does your vet know what triggered the IMHA?
Has she had any previous illnesses?
Transfusions – was it whole blood matched blood?
Has Honey had a bone marrow biopsy?
Would it be possible for you to send us her latest blood results?
How is she doing in herself at the moment?
Can you give a us a figure for reticulocytes at all?

I have a very good reason for asking you to read the following about transfusions:
https://www.secondchanceaihadogs.com/AIHA_Terms/transfusion/
There is an important point in that item about not transfusing to over a PCV of around 25 which is sometimes forgotten by vets (not intentionally of course!), but it can actually stop the body from producing enough baby red blood cells.

Sorry to ask so many questions (& bombard you with information!), but it gives us a better idea of what’s happened to your girl.

Have I helped a bit? I hope so. Please feel free to ask any questions – we will do our best to answer them. Please remember – there are many treatment choices – Honey can beat this disease. If you have time to pop a photo of her on here, we would love to see her.

Hope to hear from you again soon, Sheena, Worzel & Ollie

PS we all live in different time zones, so your messages should get picked up pretty quickly by one of us.

[admin]

Sorry Lynda & Linda & Vally- we have all been typing at the same time!

[lynda]

Sorry, forgot to mention the Zantac!! Yes, she is on GI protection. We live in England, so consultations have to be here, or via internet. I can’t tell you what her PCV is, because it’s up and down all the time! Immediately after the last transfusion, it was 22, but before that, it was 10. She is about 20 kg.
Yes, she was biopsied (hence the antibiotics: the incision site became abscessed – and, of course, won’t heal). I don’t have the figure for reticulocytes; my vet just says, no signs of regeneration. We have no idea what triggered it – wish I knew.
Before this, she was super-energetic – I used to joke that I wish she could give me 10% of her energy. Now I wish I could give it back! Immediately after a transfusion, she perks up, and is willing to come upstairs, or go outside to bark; but once the PCV drops, she becomes more lethargic.
I will talk to the vet again, when she has her next blood test. And thanks for the support! My vet says hers is the most frustrating case (of anything) that he has ever experienced in years of practice, and that he won’t need to phone us if the reticulocyte count goes up, because we will hear them shouting from the surgery 2 miles away!

[lynda]

I forgot – the antibiotic is Enrox (I apologise if the drug names aren’t the same for you; I don’t know the generic name for them all)