Lola – Page 2 – Second Chance AIHA Dogs

Keymaster

Hi dear Ashley

What a worrying time for you -I’m really sorry to see what has happened to your darling Lola. It’s heartbreaking when you think they are improving & I feel for you – it’s rotten luck.

It sounds to me from reading about what has happened that Lola has Evans Syndrome, which affects the platelets as well as the red blood cells (thrombocytopenia & anaemia). We have people on here who’s dogs have conquered this, so don’t be despondent, please. I am so very sorry she has relapsed – again, this has happened to other owners. You really have to start again with the high dose prednisone & immuno-suppressants, but do not reduce the doses – be far more cautious with getting her absolutely stable before considering starting any reductions.

Brigitte mentioned that this disease is very rare & many vets have not seen it before. I don’t know if this is the case, but I would also advise you to see a Specialist in Internal Medicine (if you don’t have one already) or preferably contact the wonderful specialist called Dr Dodds that Brigitte mentioned who has helped many of us on here – you can contact her for an appointment (via the internet is fine) through her website. I consider her to be the most knowledgeable & lovely person & she really helped me over here in France – thank goodness for the internet say I!!!
http://www.hemopet.org/contact-hemopet.html

I have not heard of melatonin being given before & am questioning it’s use – I am hoping someone else on here knows more about it than I do & can help you on that. My dog Worzel was also on azathioprine, however it is more usual to see cyclosporine given. This is an option which I would discuss with your vet as it may prove more effective if the azathioprine isn’t working.

There is a lovely lady called Samantha on here from time to time – her dog also had Evans Syndrome (in remission now). I’m sure she would reassure you that with the right drug treatment, Lola can beat this disease.

And to back up Brigitte even more, the tummy protection is essential – these drugs are very hard on the stomach. Sucralfate & famotidine (Pepcid) can be given by your vet – must be given separately (preferably 2 hours before or after) from any other drugs as they stop proper & full absorption.

Well, checking the dosages needed for Lola:
“Prednisone doseage for AIHA/IMHA is normally 1mg per pound (2mg per kilo) per day & should be divided into in 2 equal doses, given 12 hours apart.” Say she is about 37lbs, that would be 35 or 40mg per day divided into 2 x 17.5mg or 20mg doses.
“Azathioprine dose is usually 1 mg/lb/day for 7-10 days ,then taper down over several weeks. In the long term, Azathioprine may only be required every other day or even less often.” So for Lola, starting dose 35mg or 40mg per day.

Hope this helps!

Ashley, please know I am thinking of you – this is not a pleasant experience to go through. We are all here to help – there are lovely people on here with experience of this disease right beside you every step of the way.
All our best wishes
Sheena, Worzel (diagnosed with rare form of IMHA Dec 2012) & Ollie too

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Keymaster

Hi Ashley. Lola is precious. My dog, Sadie, was about the size of your Lola, 32 lbs at onset of AIHA (her story is on the forum – I won’t rehash it) in 2012. She now weighs 39 lbs, from the prednisone – weight gain is just one of the unpleasant side effect. BUT, it saves their lives – they can loose it later. :)

I too, am concerned about the dose of prednisone that Lola is on now, that perhaps it is not enough. Sadie, about the same weight as I said, was immediately put on 40MG of prednisone daily (20MG in the AM and 20MG in the PM) and one week later – after not producing reticulocytes – her vet added 50MG of Atopica (cyclosporine) daily (25MG in the AM and 25MG in the PM). My vet also added PetTinic (Amazon), an iron/vitamin supplement – from day one. I swear by it.

She too, had all the side effects you describe with Lola and I was shook up about it, in tears, in fact. But my dear and knowledgeable friends here assured me that all you described (and more) are normal. There was one night that I thought Sadie had passed away lying next to me in bed. I called her name (she knows her name and always responds), nothing. I sat up and called her name, nothing. I flew out of bed and switched on the light and she put her sleepy head up as if to say, “Come on now! Turn that light off – I’m TRYING to get some sleep!” – goodness gracious. Welcome to our crazy paranoid AIHA club – and trust, you are not alone. And then she did this commando crawl – which was very weird indeed. That only lasted a few days, but the panting and being tired is still present, although she is showing some spunk lately since getting much lower on her meds (weaning). She was also very antisocial. Not in a mean way, just in a ‘leave me alone’ way. She gets along great with other dogs. Even her best playmate buddy down the street could not get a rise out of her.

In only three months her vet started to wean her. She did great at first and then on the last weaning dose, crashed and collapsed. Relapse and back to square one, 40MG pred, 50MG Atopica. Now after a year, we are continuing to wean her SLOW, SLOW, SLOW. Sadie will most likely be a candidate for lifetime maintenance of prednisone, but a low dose. We’re not quite there yet, again, taking it very SLOW.

I know some of what we are saying may seem contrary to what you are doing. Please don’t get discouraged and feel pressured. It’s just that we all have been right where you are right now. Talking to the vets, the whole nine yards. It’s mind blowing, the information overload. And you think you have it, starting to understand and you’re okay with the ‘plan’ and we come in and stir things up again. But really, if this IS AIHA, the prednisone should, in my very humble opinion, be higher AND adding Atopica should be considered. Print this post and take it with you to the vet. I bet she/he will be proud of you for doing your research. Sadie’s vet was VERY impressed with the knowledge here, realizing – this information is from folks that have dealt with AIHA for many, many years and have lived it. We have lost too many, but AIHA CAN BE BEAT.

I know it’s hard, but try to be confident and supportive with Lola. They pick up on our angst and it can be detrimental. Smiles to them are good. :)

Also, just to add to your whiling mind, the tummy protection mentioned – a must. The liver protection mentioned – a must. The anti-clotting protection – a must. These drugs play havoc on their little bodies. The precautionary supplements mentioned will keep her organs healthy and working and therefore, help her body fight the AIHA. Otherwise, you’re helping the immune problem, but weakening the rest of the body.

Please, please don’t go away. Keep us posted. We are family here and have a tendency to fall in love with our ‘adopted’ AIHA fur family.

Love and supportive hugs, Linda and hanging-in-here Sadie

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