Need Your Help for Zeus with IMHA

Dawn Middlestead

Guest

Our Giant Schnauzer Zeus, 4 years old, was diagnosed with IMHA on January 14th. He became suddenly ill…pale gums, wouldn’t eat, lethargic (no vomiting or diarrhea thankfully, no dark stool, no blood in his urine or stool). On January 15th, he was taken to his Vet. After doing a full blood panel, it was determined that he had IMHA. His HCT was 22% (low-normal is 35-37%). On January 8th, he had been given a Bordatella vaccine which apparently could have been the cause of the IMHA. At that time, it is what his two Vets concurred that was the probable cause. Zeus began taking a regiment of Prednisone and Azarhioprine along with Melatonin and Bayer Aspirin (as his blood was not coagulating correctly…it is now thankfully). He was also given a shot of Dexamethizone. We have taken him for blood tests every 2-3 days. Within 10 days, his HCT rose to 34%. He was looking and feeling better. Both Vets confident that he was beating this and would make it. Unfortunately on February 3rd, his HCT number fell to 28%. He was immediately given a shot of Dexamethizone and the next day, his HCT was 29%. Over the next 10 days or so, his HCT number remained at 28-29%. By February 12th, his HCT number dropped to 24%. His Vets decided to consult with an Internist after his radiographs and ultrasound showed nothing. The Internist could not find anything. At this point, it was becoming more and more puzzling and a mystery. On February 16th, his Vet thought maybe he had an underlying infection…some of them can mimic IMHA…Zeus began taking Minocycline and Cindamycin in hopes of seeing an improvement. His HCT also dropped to 22%. On February 19th, his HCT was holding at 22%. Zeus had a bad night last Saturday night, just couldn’t get comfortable, breathing hard, panting. We took him to his Vet yesterday and his HCT has fallen now to 18%. His white blood cells are off the chart which has never happened before and his red blood cells are very low…his bone marrow is not shooting out red blood cells like they should be. We take him back to the Vet this morning. Extremely critical will be if his HCT falls to 12% we understand. I have contacted the Veterinary school at Texas A & M. Zeus’s Vet is going to call and consult with someone there today. I am also going to recommend changing one of his medicines…the Azarhioprine and changing it to Cyclosporine. Perhaps it is not working. I am also concerned that he is having a reaction to the two new drugs introduced to his system last week. Thank you very much in advance for any suggestions, advice etc. Giant Hugs, Dawn

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Sheena

Guest

Hi Dawn

I am so sorry you are going through this awful time with Zeus. Glad you have found us though – I cannot express how much I valued the support of the lovely people on this site when I felt overwhelmed & desperate for help. Brigitte, Vally & Patrice got me through a rough time.

I completely agree with Brigitte – Dr Dodds is the best person to contact & her knowledge is second to none. And she is a very compassionate lady too.

I am relieved to see that your vets spotted the clotting risks & aspirin has been prescribed. It is essential for Zeus from looking at the tests results.

My dog Worzel also had non-regenerative anaemia (bone marrow failure actually). Looking at the results (as Patrice rightly says) it is evident that Zeus is also non-regenerative – the reticulocyte level should be much higher. Worzel literally had no reticulocytes at all – big fat zero – so I hope it makes you feel better when I tell you he is lying beside me 3 years down the line with a PCV of 62 (age 14 plus!). He did respond to azathioprine quickly (around 2 weeks), but the preferred drug is cyclosporine & I would have put him on cyclosporine if he had not responded. Like you, I would have done anything in my power to get him better.

Vally’s suggestion of thyroxine is absolutely vital – it is part of Dr Dodds protocol & has actually turned the corner for so many of our dogs who were struggling with recovery. It promotes red cell production for sure.

I saw the reference to suspected hemangiosarcoma in the tests – that definitely needs further investigation. Patrice went through this with Chance, as you know, & Chance made a fantastic recovery – I know Dr Dodds was amazing with her help too.

We were prepared to transfuse Worzel as many times as needed until he became regenerative. Transfusions are a life saver & keep our dogs comfortable & out of danger until we find the right drug protocol. As Brigitte says, the limit is usually around PCV of 15, but it if they are really struggling, they may need a little help earlier than that. Also, it is important not to transfuse them to over about 25 PCV as this stops the body’s natural response to produce new red cells. So small amounts of fully crossed matched packed red cells would be good if needed.

It also looks like an infection is highly likely from the high neutrophils on the test results – they are very high indeed. We were also the victims of having a vaccination, but it was on top of an infection that the vets were “unaware” of at the time (long story). It sent Worzel over the edge & his PCV dropped & dropped.

I know you have absolute determination to get Zeus the best help. With your vet, Dr Dodds & Texas A& M beside you, you can fight this. And of course you have everyone on here behind you with any help we can give, anytime.

Sending you huge supporting hugs from the heart

Sheena, Worzel & Ollie xxx

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