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I’m so sorry the trip to the internist was disappointing — but it sounds like you and they are still in the information gathering stage and waiting for results to come in. It will be helpful to find out if her body is destroying red blood cells; then you will know if the drop is only due to the GI bleeding, or if the disease is still active. They will be looking for spherocytes, abnormally shaped red blood cells, and also will hopefully look for auto-agglutination, when those abnormal red blood cells stick together. It would be a good idea to ask about both.
Ashki, too, has had thickening of the stomach and intestines, due to inflammation. We have never done a scope or biopsy. He had GI problems before IMHA, and we think this is a piece of his anemia.
The thing that is so difficult about Jackie’s case right now is, until you get that bleeding under control, she will continue to be anemic. What did the internist say about the bleeding and the current treatment plan? I’m surprised that he had no answer, when it seems logical that the reason her PCV has dropped is at least partly due to the bleeding. Perhaps he didn’t want to say it was solely due to that, when it could be also that she is still destroying RBCs.
I’m assuming she is strongly regenerative because she was able to maintain a PCV in the low 30s with that going on, but it really sounds like the bleeding just got to be too much and she lost ground — however, it would probably be a good idea to ask just to make sure. Or, if you have copies of her labs, look to see what her reticulocyte count is, and the percentage.
It sounds like they are doing the test to see if she has pancreatitis, and if she does, they will switch to mycophenolate? Just want to make sure I understand that correctly.
I’m so sorry this feels hopeless, but I just want to encourage you, too. Thinking of you and Jackie and sending big hugs, and hoping you’ve gotten more information.
tamara and ashki
The internal DR later told me that after her blood was analyzed by the pathologist that there were no spherocytes in her blood so he felt that her current anemia was not due to her destroying blood but because she is losing blood in her stool. He wanted me to reduce the prednisone and discontinue the cyclosporine because that can also cause diarrhea so I have done that. This morning was the first time I have not given cyclosporine. He did mention it but I can’t remember what he said about the auto-agglutination, I am assuming she didn’t have that since he is not convinced her anemia is because of the IMHA. I didn’t really know what that term meant until now so I didn’t know to ask more about it. I think she must be regenerative because she has been as high as 38 before the blood in her stool. I have been feeding her chicken and rice and she really likes that but isn’t drinking as much and hasn’t had the need to go to the bathroom as much, which I guess is good because the less she goes diarrhea the less blood she is losing. However, she did go this morning and it was not good, still bloody but didn’t go as much as she has been. I think she must be absorbing the food. She seems very tired and has no spark today. I am still really worried that her blood is still dropping but she does not have yellow in her eyes as she has had before and her urine looks normal but that didn’t happen when she went from 32 to 24 in just a few days. I was supposed to have an appointment on Tuesday for a recheck but I think I am going to bring her in tomorrow because of her lethargy today. I gave her a pain pill today because I know that pancreatitis can be painful but she doesn’t seem to be showing she is in pain, just very tired and weak even before the pain pill. I just don’t have a good feeling today but at this point either the meds are going to kill her or the IMHA. It seems that pancreatitis is a pretty serious complication of this disease and of the studies I have read, doesn’t have a great prognosis on top of not having a great prognosis from IMHA. I feel defeated today.
Hi dear Anna
I agree with Vally – small meals following the diet & a check up as soon as you can. Feeling defeated has been in all our pasts. At one point, I was sure Worzel would never become regenerative because of what I’d read & the constant, depressing downhill PCV every single time we went to the vets ( countless times, Anna), but he did eventually start to recover. He was literally on death’s door with no energy – he could hardly stand up sometimes – & I know Bingo was very, very ill too. We can only tell you that there is hope, no matter how bad things seem to be just now & there honestly were times when I thought I was being cruel putting Worzel through the treatment. It is ravaging. There is no certainty, but there is hope. If Jackie is not in pain, wants to be beside you & is wanting to eat, these are the most positive things. I would never, ever allow any of my pets or family to suffer needless pain, I promise you that.
Joe doesn’t post on here regularly, but his beautiful dog Dunes went through many bouts of pancreatitis. She had a wonderful 5 years of life after diagnosis with IMHA. I know he would tell you never to give up – Jackie wants to be with you & will fight on because of your close bond. Always trust your feelings – the love between you & Jackie shines out through all your messages. This is the most difficult disease to deal with mentally that I have ever come across.
Crossing everything
Love & hugs
Sheena x
I know it’s so discouraging when they’re so tired and seem to be feeling so poorly — I feel the same way when Ashki is feeling less energetic. He has been in the mid 20s now for about 5 weeks and his energy is noticeably reduced, especially for the last couple of weeks. I think the persistent lower PCV is taking a toll on him. I can’t imagine how tired and weak poor Jackie must be after having bloody diarrhea for this long. It’s such good news though that they are not seeing spherocytes, and it’s probably that there is no agglutination if there are no spherocytes. I agree with you, I think she must be regenerative if she could maintain and make the progress she did. I have so much hope for her and for you, and we will hold that hope for you when you can’t. She is getting better, she’s eating better, her diarrhea is reduced, no yellow, better urine, all such good signs. If you can, continue feeding her soft wet foods, homemade if you can, very bland and low fat. Vegies are good too, just cook them very very well so that they are mushy, baby food is good too. We are all thinking of you and Jackie and sending you love and hugs and so many healing vibes.
tamara and ashki
Good news!! Just got back from our primary vet and Jackie has gained 3 pounds in a week and her blood went from 24 to 27.5 since Friday even on the reduced prednisone!! Her diarrhea is still reduced and she is eating very well so we are very happy today. I did find a little sore on her leg last night but they said it is just from laying down so much and probably the prednisone. I am just supposed to put antiboitic cream on it and cover it. Yesterday she was so tired I thought for sure it was going to be bad news. Amazing how one day you can be totally depressed and the next day happy with this disease. Thank you for all the support. I told my vet how much I am learning from you guys and how it is so nice to talk to people who have gone through this.
GREAT news Anna!! I am following your story and rooting for you! The similarities to Jackie and my Romeo are uncanny! Even the sore on the leg. I am sorry if you have already posted this, but how much does Jackie weigh? What dose of Pred is she on? Am I correct that she is ONLY on Pred now (No Cyclo and No Aza)? I have been really thinking about asking to take Romeo off his Aza because his pancreas and liver levels aren’t good AND his PCV is not going up, therefore I don’t know if the Aza is working. I am so so SO glad Jackie is doing better! Keep her resting! Sometimes when they feel better they are active and then the next day they seem “worse” but it’s just because they were too active the day before. I am thinking of you and Jackie, hang in there!
![bingo-14-5_1200x775](https://www.secondchanceaihadogs.com/wp-content/gallery/aiha-dogs_2/bingo-14-5_1200x775.jpg "Vally\'s Bingo \\"Smile\\"")
![Brigitte_Cleo_Ripley_Enzo_4](https://www.secondchanceaihadogs.com/wp-content/gallery/aiha-dogs_2/Brigitte_Cleo_Ripley_Enzo_4.jpg "Brigitte\'s Cleo, Ripley, Enzo and Guest \\"Rockin\\"")
