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I stumbled upon this website when I was frantically searching the internet for information about IMHA when my 8 year old dachshund Murphy was diagnosed 10 days ago and it has been so helpful. He was acting lethargic and not himself (not interested in eating, playing) and then had some abnormal stool. I took him to the vet where on exam we noticed his spleen felt enlarged and his gums were not as pink as they should be. He suspected IMHA after we checked a PCV (32%) and he noticed the way the blood separated in the tube but would need more testing to confirm. Although Murphy did not need a transfusion, he wanted to admit him to the hospital to start IV fluids and dexamethasone (he was hesitant to start pred with an him not eating anything at all). He was in the hospital for 5 days mostly because he would not eat at all (quite a struggle for me and his doxie brother Milo). We finally just bit the bullet and started him on pred, mirtazapine to stimulate his appetite and he came home eating scrambled eggs and chicken (his favorite). He is regenerative as he has lots of reticulocytes and his PCV has not dropped below 30%. He had a very high bilirubin (47!!) and was very yellow which was probably contributing to him feeling yucky. Bili is slowly coming down, was last 6 about 4 days ago. His last PCV was 35% and the vet was concerned we just aren’t seeing the improvement we would like to know we have stopped the process. So he wanted to add doxycycline (to cover incase of tick born illness) and Atopica and rechecking labs in 4 days. Murphy’s meds are:
Prednisolone 5mg twice/day
Atopica 25mg once a day
Aspirin 1 mg once a day
Famotindine 5 mg twice a day
Doxycycline 25mg twice a day
From what I read of everyone one’s experience is that there are a lot of ups and downs (we have definitely experienced that!) and you really need some patience. I just have a few questions, for some of you much more experienced with this disease. Do we need to be more patient to see his PCV really improve? I think adding doxy and atopica were definitely the right thing to do, but I really want to give the meds time to work. Also I have seen some information on this website about possible vaccines inducing IMHA, Murphy had his rabies and distemper about 8 weeks ago, he seemed like he felt yucky for about 2 days after but then bounced back to his normal self. Not sure if that is too long of a time period to induce IMHA or not. I haven’t asked my vet about it yet, but I will, just wanted to see some opinions on here. We still don’t have a cause, and I am still definitely concerned about cancer, on his ultrasound his spleen was enlarged (vet said that could definitely be from the IMHA) and he had one lymph node that was enlarged. We have not biopsied anything yet as he was improving and I didn’t want to set him back by putting him under anesthesia.
Sorry for such a long post, but wanted to see some thought and input on Murphy’s case. This website has already helped me so much, helping me advocate for my Murph in trying to get him better! Very thankful my frantic internet search lead me here!
Erin&Murph
Hi Erin and Murph and welcome to the site.
First of all Erin, you did great to pick up that Murphy wasn’t feeling good. The best news is that Murphy is making all those nice fresh red cells and regenerative is the best ever word on this site.
I’m glad he’s eating now too. There’s nothing more worrying than a dog that won’t eat. The prednisone will turn him into a hungry monster. It also has a lot of side effects too, like panting, extra drinking, weeing, but don’t worry about these as they all go away when the dosage is lowered.
What does Murphy weigh? The prednisone dose should be 1mg per pound, so is Murphy under 10 pounds?
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone/
The injections absolutely could have started this and Murphy may not be able to have the injections in the future. Ask about titer testing when he’s next due.
Did they do a tick test? It’s a very simple test which is done on the spot. The doxycycline sounds as though your vet does suspect some sort of infection. Doxycycline is a safe drug for our dogs.
It definitely takes time and we do have to be patient, one of the hardest things for any of us to do. Keep an eye on Murphy’s gums and eye sockets for colour. If it goes pale, take Murphy in to be checked. Don’t panic if they are pale when he’s lying around though, because a dog’s spleen produced blood when they need it, so when lying around, it’s stored in the spleen. When they are moving about the spleen puts the blood cells into circulation.
Erin, ask anything at all, we love to help.
Vally & Bingo (diag Nov 2011, in remission)
Thank you Vally for the kind words! He is definitely experiencing the panting, thirst and peeing. When he does eat he scarfs it down! We did not do a test for tick born illness because my vet said it would take 3-5days to get back and he wanted to start him on doxy just in case. I have been excessively checking his gums, it’s been hard because he is so jaundice from the bilirubin. He’s finally starting to clear up, so I can see some pink under the yellow.
He is 11 lbs, so he is slightly under dosed on his pred, I’m not sure what other increments they come in. I’ll ask tomorrow when we are at the vet.
Thank you Vally and Bingo (and everyone that contributes to this site) for giving me some much needed hope in a very dark time.
Erin, 11 lbs is probably close enough for the 10mg dosage.
There is a Snap 4Dx test which gives an instant result. I’m actually in Australia and we don’t actually have that test here as we supposedly don’t have Lyme disease.
Just thought, are you giving the Atopica away from the other drugs and away from food? Ideally at least 1 hour away.
Our boys look good in pink don’t they !!!!
Vally and Bingo.
I’ll ask about the snap 4dx test, we are going today for labs, so fingers crossed for some better numbers! Or just not worse number, I would be happy with that too! I do make sure to give him his Atopica on an empty stomach without other meds, the vet was very clear about that.
Ha ha pink gums are my new favorite color on Murphy! He will just have to be secure in his manhood to rock pink :)
Thanks for asking about Murphy Vally. He’s stable so far, last PCV was 35, not better but not worse. Rechecking labs on Saturday ( vet wanted to see 2 weeks after starting atopica and doxy). Hoping for some trending upwards! His overall demeanor is better, wanting to play with his brother and chase squirrels from his backyard.
One question I had was liver protection, I’ve see info about milk thistle, any recommendations? Just want to get ahead of things before they get too bad. These drugs are no joke!
Erin, his demeanour says a lot. Fingers crossed he can produce a better blood test result.
The best product for liver protection is Denamarin. It contains containing S-Adenosylmethionine (SAMe) and silybin. Silybin is the ingredient in Milk Thistle which helps to protect the liver. It’s dose precise so that’s why it’s the best there is. It’s cheaper if you don’t get it from the vet though. Amazon does carry it. If you use Milk Thistle, make sure it’s a quality human grade brand as the quality of milk thistle can vary. Dr Jean Dodds recommends a dog between 5-10 lbs gets 15% of the human dose and between 11-20 lbs, it’s 20% of the human dosage. I’d probably start with the 15% and gradually go up to the 20%, as it can upset their tummies.
Good luck on Saturday.
Vally & Bingo
![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\\"")
