Maltese with AIHA

[Sheena]

Hi Christine

Oh, she’s so darn cute! Lucy – you are beautiful.

I think carrying her around is the best thing – she will have no energy at all at that level – as you say, not enough oxygen. It’s wonderful to hear she is enjoying her food & is happy in herself – these things are really good signs. I’m “jealous” (in a good way!) actually because we had a terrible time – Worzel stopped eating altogether at one point, which worried us terribly – this was the worst point for us as I thought he wouldn’t pull through. But then the pred kicked in and he was eating about 6 times his usual amount! As Vally says, a monster!

Yes- what dose of cyclosporine please? Sometimes vets start with a loading dose & then reduce it to a more usual level. I am honestly doubtful it will have started to work yet though – it’s very early days of diagnosis – but you never know – something could be happening.

Crossing everything for an improvement – let us know – we are all willing Lucy better from afar! Me, Vally & Jill, plus everyone else on the site are thinking about you.

Big hugs from me & the boys
Sheena, Worzel & Ollie xxxxx

[Christine]

Thank you everyone for the warm welcome!

The Cyclosporine was stopped when the mycophenolate was startd.

After todays blood draw I will post a timeline for everyone with the numbers and treatment.

Lucy seems to be starting the day very good again! Very good sign! She has also eaten a whole container of food for breakfast!

In reading some other posts it looks like I shoould ask the vet about something for her stomach? Pepcid?

[Sheena]

Hi Christine

Yes please – tummy protector – famotidine (trade name pepcid) and sucralfate would be perfect to take home with you. Also denamarin (& anti-clotting med if needed).

Great to hear Miss Cutie Pie is hungry – wow, that’s a big breakfast! Such good news.

In my opinion, the cyclosporine hadn’t even had a chance to work, but no big deal as you can always add it back in. So, you may have to wait for the mycophenolate to work – let’s hope it soon does the trick.

Good luck with the blood test

Sheena & the boys xxxxx

[Christine]

So Exciting news!!!! Wednesday was the day we started the Mycophenolate, stopped the cyclosporine. She was on IV fluids, her hematocrit was 10.5 I think or 12. She had a transfusion the end of the day.

Today her hematocrit was 24.5 !!!!!!!!!

Starting prylosec for her tummy and next is asking about the clotting prevention! Will post the timeline a little later. Just so excited about the numbers!

[Sheena]

That’s fantastic! It means the cell destruction is slowing down now , which is great news – the prednisone is what does this in the early stages, hence it is called the cornerstone of treatment – thank goodness it usually holds them fairly steady until the other drugs kick in. I am thrilled to hear this. Now we wait for her to go up & up with the mycophenolate!

Congratulations – happy dances here in France. Come on Lucy!

Love Sheena xxxxx

[jill]

Hi Christine , that’s great news on Lucy s Pcv rising to 24 ! Well done Lucy xxx I hope she continues to improve for you , lots of love Jill & Snoopy xxx

[Christine]

Thank you so much Sheena! We are hoping for the 30s on Monday!

Timeline

June 24th :
Comprehensive visit with vaccines leptospirosis and heart worm preventative.
hematocrit was 48
weight 9.5 pounds

June 29
we fly from Dallas Texas to Boston Ma
drive to Yale for my son to tour. Lucy was walking a lot more than she was used to. We then drove to Maine and we noticed he appetite wasn’t “normal” for traveling .. usually she doesn’t eat great but would eat. We also noticed her stools were looser than normal too. Since we were traveling we didn’t think much about it.

July 8
Fly back from Boston to Dallas and arrive home.

July 13
Lucy wasn’t eating or drinking and she was flinching when I touched her back so I called in for Prednisone and a pain releiver for her back (she has had this before).

July 14

Lucy went outside to pee came back in and crawled up on my lap while I had my morning coffee. It was time for her meds so I got up to get more coffee and her prednisone. there was a small watery blood spot on my pajamas. This concerned me and because she was flinching at her back being touched and the blood spot I was thinking UTI or kidney infection so I called to make an appointment. They said I could drop her off so I did. Did not hear back from them at lunchtime so I called about 2PM .. Dr said she seemed fine and alert but hadn’t gotten a urine sample yet. at 3PM I went there and the Dr came out and said “We were able to get a urine sample” and showed me a vial with Black/Red thick liquid :( she did a CBC and her red blood cells were at 7.04 ! her platelets were super low also. Several other tests were run. Lucy’s prednisone dose was increased and also put on doxy and was to recheck blood in 48 hours. Lucy still hadn’t eaten. When we returned home is when I discovered the large pool of dried dark red blood by our laundry room. That evening she was so lethargic and I really didn’t think she was going to make it through the night.

July 15

Large pool of blood in our bathroom, Lucy can barely walk. Take her in for IV fluids and a blood transfusion. she stayed most of the day .. this was the day her # was 7.04

July 16

Dropped Lucy off in the morning for observation all day, her number went up to 17
she finally ate when we got home

July 17

dropped Lucy off for observation again, number went down to 12.5. she received another transfusion and fluids Cyclosporine added. Recheck on Wednesday morning if she is stable.

July 18
Had some concerns so took her in for a CBC
Lucy’s hematocrit was 20

July 19

Lucy was not doing well at all. Very lethargic so I took her in. Hematocrit down to 12, very worried. Told about mycophenolate .. told the cost was $1,500 USD, found a place that I could get it for $700. Prayed she would make it through the night and the same prayer was “If this medicine is going to work please let her make it through the night” She made it through the night.

July 20
Drop Lucy off at the Vet for immediate IV fluids and CBC, # is 10.5, go to pharmacy to get the mycophenolate which happened to be $501 Whew that is a lot better than $1500!! Take mycophenolate to Vet. Lucy is there all day with IV fluids, starts mycophenolate and get a transfusion that evening. Bring her home.

July 21

What a difference! She is alert, not lethargic and has a really good appetite! Did not want to take her in for another blood test just to get numbers that might have residual transfusion numbers so waited until today and you saw the post! 24.5!!!! WOW!! so excited about that!

[Sheena]

Hi again Christine

Lots of superb information there. Highly suspicious of vaccination &/or heart worm treatment being the trigger from what you’ve written. Plus being a girl maltese – bit of a predisposition for females & the breed too. Maybe, like Worzel, there was a vaccination & infection issue. I was unaware that my boy had an underlying infection (idiot when I look back) & he had his piroplasmosis vaccination – he went downhill & ended up with bone marrow failure. Whatever it is , the treatment is the same! And Lucy’s doing soooooo well!

It amazes me how much these damn drugs cost & that you can always find them cheaper if you look hard enough. Linda (Sadie’s Mum) uses Walmart pharmacy for her cyclosporine – worth shopping around for everything? Yes! And worth paying the earth for? Yes!

I am saying a huge “yaaaayyyy” for Lucy – she must be feeling a hundred times better, bless her. Looking good, Christine, really good. If her platelets are also affected, this is called Evans Syndrome – quite common actually & again we have lots of folks here who have dogs with that. Anti-clotting meds must be carefully assessed with low platelets, but are sometimes needed. The blood smear/test will reveal all!

I’m so happy for you having your girl back home – I bet you have spoilt her rotten – too right! As Vally says, the hungry monster is great – lots of high protein, lowish fat (high fat is a no-no) & she’ll soon be back to her old self!

Sheena xxxxx