Just Diagnosed and starting treatment

[kristal]

Hello, My name is Kristal and my two yr old Whoodle (Wheaton Terrier/Poodle mix), Shelby suddenly became very ill and we were advised that she has AIHA this morning. She is at home with us and is on the following medication:
4X5mg Prednisone 2 times per day and she has received 2 injections of Dexamethasone.

We had full blood work done and her red blood cells are 2.4 – we were told she is living by the grace of god.

We were also advised that she has high level white blood cells so the vet has put her on an anti biotic and her thyroid count is off so she has been placed on a thyroid medication.

We were told that her bone marrow levels are showing that she is producing bone marrow.

We are taking her back tomorrow for another check in. From the research that I have done online I am not convinced that we now if this is the primary disease (AIHA) or the secondary (IAHA). To my knowledge the vet has not run any additional tests, although he did tell me that her blood was clumping. Should I request additional tests? If so, are there specific tests that I should be recommending.

I feel very helpless right now and want to trust our vet and his knowledge and abilities but of course the more I read online the more concerned I am.

Any recommendations that you have for me at this initial stage would be helpful. Our poor Shelby is just lying and has very limited movement. She is eating and drinking but not her normal amounts.

Thank you!

[Sheena]

Hi Kristal

We got your urgent advice request & I’ve sent you an overview of AIHA & Dr Dodds excellent information on this disease – let me know you got them OK please.

There is some very important information about abnormal clotting in those attachments. You mention clumping – Shelby needs anti-clotting medication in that case. Here is some detailed information you must discuss with your vet without delay as clots are by far the biggest risk of this disease:

https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/

It sounds like an infection could be the trigger of this as her white cell count is high, so I’m very happy about antiobiotics being given, but which one please? Certain antibiotics should be avoided with this disease. They are penicillins, cephalosporines & sulfa drug antibiotics. In some instances there maybe no choice but to use these drugs if there is absolutely no alternative, but this would be rare. If your vets suspects a tick-borne disease, a full tick panel should be performed. The usual dtug if choice for tick-borne diseases is high dose long term (maybe 6 weeks) doxycycline. A Snap4dx test is advisable for tick diseases.

Has Shelby had any vaccinations lately? Or eaten something naughty like onions/garlic in quantity? Or is there anything else unusual or strange you can think of?

Hypothyroidism is a huge factor in this disease, being a possible trigger, or just hampering recovery – glad treatment has been started as T3/T4 levels are very important for the production of adequate new red blood cells.

Happy to hear Shelby is producing new cells from her marrow – my poor boy was producing absolutely NONE – a big fat zero – so it’s excellent that Shelby is – that’s positive news indeed.

I can’t se any mention of stomach protection at all – this is very important because the drugs can really burn the GI Tract. Sucralfate is an absolute necessity, plus pepcid ir similar. Please mention this to you vets as you don’t want any ulceration or a GI bleed .

There is mention of a second longer acting immuno-suppressant either. Prednisone on it’s own is not enough – the vast majority of dogs need another drug such as cyclosporine or azathioprine to get back into normal PCV levels. I would personally not want to continue with prednisone alone as we don’t usually see a response with pred alone & you cannot afford to waste valuable time – my only exception to this would be a puppy or very young dog where the other drugs could cause growth issues.

Kristal, please could you upload all blood results, tests, blood smears or other pertinent information onto the URGENT ADVICE area. We can tell you immediately about clotting issues, infection plus many other things from these tests if we have the right information. You have paid for these tests & are entitled to copies. Just ask for them each time & send them on to us.

Last but by no means least, Shelby will be incredibly tired, lethargic & not wanting to do much as she cannot get enough oxygen around her body. She is not in pain because of this – just exhausted from anaemia.

I know this is long, but the more info we have from you, the better. Hoping Shelby will soon be feeling better. Ask anything!

Best wishes from us all in France

Sheena, Worzel & Ollie xxxx

[Sheena]

Apologies for typos -useless on this tablet thingy with one finger typing !

[Vally]

Hi Kristal, I’ve just resent you Sheena’s email, so see if you get that.

Sheena has covered a lot. Just to let you know we’re about at different times, so yell out when you need to, someone should be around.

Can you list all the medications and doses for now too and also her weight. As Sheena said, a second immunosuppresent is very important and if her blood is clumping, aspirin or the like is urgent.

What is your girl’s name?

My best, Vally & Bingo (diagnosed Nov 2011, in remission)

[kristal]

Thank you so much. I am now in receipt of your email and all of your wonderful information. I feel like I can know have an informed discussion with the vet tomorrow morning. I have switched vets this afternoon – I wasn’t quite comfortable with the lack of information that he provided – although it appears as though he is on the right track based on your email. However, I have been referred to another vet in our community that has a good reputation for treating dogs with serious medical issues and he was certainly versed when he called me at home.

I will provide you with a copy of the blood work tomorrow once my file is transferred over to the new vet.

Thank you so much once again. Your support has given me hope and comfort for our sweet Shelby.

Sincerely,
Kristal

[Amy E]

Hi Kristal,
I am so sorry you have had to join our little family. I am no expert on this disease and can only speak to what we have gone through. Vally , Sheena and Patrice as well as others are a great help and I encourage you to use all the information they give you. As for your pup. I am so sorry Shelby is going through this and I pray she continues to heal. Take a deep breath. I want to encourage you to ask your vet questions. Do not feel like you are annoying them. Even if you are… too bad! Keep calling keep asking questions. Do whatever it is you need to do to feel secure during this crazy journey. Much peace and love to you and your sweet girl.
Amy & Coal (Diagnosed Feb 2016 @ 4 months old ….still floating on the steroid river)

[kristal]

Hi Vally,

Right now our dog, Shelby weighs 31lbs and is currently on:

4X5mg Predisone every 12 hours
AventiCLAV 250 mgs 1/2 tablet every 12 hours
Thyro Tabs .2mg 1/2 tablet every 12 hours

She has had 2 injections of Dexamethasone.

I am switching vets to someone that I believe is more experienced and that I can connect with. I have had a brief phone consultation and we will be meeting with him tomorrow morning. I will be bringing along the printed materials and will also get a copy of her blood work.

Should I be concerned that that she is not on aspirin at this time?

Thanks Amy & Coal for your thoughts and prayers and good advice!

[Vally]

Kristal, it’s important someone checks her blood in a blood smear, where they physically look at the sample to see if there is abnormal clotting going on.

See https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/

If there is clotting, then yes, Shelby must be put on anti-clotting meds.

Vally
xxx