My imha dog has cryptosporidium and it feels like another big dose of bad news!

[Jude Needham]

My dog Inca, an 11 year old border collie was diagnosed with imha at the start of Nov 21. She has one blood transfusion which got her RBC up to 29%. She had a poor reaction to high prednisolone so this was reduced and she was started on mycophenalate which she had an awful reaction to. This resulted in awful diarrhoea which would not go away – she ended up on a drip in early December and was finally put on antibiotics which cleared it. In early Jan she was eased onto cyclosporin which she has tolerated well. Her RBC has seemed to stagnate at around 34 but the vet reduced her prednisolone very slowly as her liver was not coping well. She is now on 100mg of Atopica twice a day and 5mg of prednisolone once a day. Unfortunately she started with pretty severe diarrhoea again and was found to have giardiasis and cryptosporidium. The giardiasis was cleared after two two week courses of metronidazole but the cryptosporidium is still there. Everything I have read is pretty depressing about the available drugs and I wondered if any one else has had this problem while there dog is on immune suppressants? More importantly did you find a solution? While I’m here also any ideas on how I can kick start her regeneration? She has held out at – infant very slowly crept up) her RBC with each reduction in prednisolone but is still only at 34.1.
Thank you so much for taking the time to read this. As you all know it is heartbreaking to see you beloved dog going through so much – and so frustrating because she is so often still so full of life, fun – and her trademark naughtiness!

[Patrice]

Jude,
I’m sorry to read all these difficulties.

I want to reassure you that a HCT or PCV of 34% after being treated for IMHA is actually quite normal for these dogs. Chance early recovery showed, I believe, a HCT of 42. But as time passed he settled into a quite normal 34-36%.

You should not worry about that right now. You are suppressing the immune system and Inca can’t fight infections very well or even not at all.

Here is what I suggest. Ask your vet to decrease both drugs to achieve a non suppressive dose. For instance prednisone at low doses treats inflammation, but doesn’t suppress the immune system. As soon as you can get below a suppressive dose, try again to treat cryptosporidium. Your vet can monitor the PCV during two or so weeks to ensure he’s stable. He may waiver a bit, I would consider low 30’s fine.

I learned this when helping an owner whose dog had tick diseases and needed to fight them with doxycycline. It was a clever vet who balanced the doses of both in order to destroy the tick disease. Do not be afraid and let your vet manage these doses carefully. Otherwise he is going to begin to get very sick. This is tricky, if your vet isn’t comfortable ask for a reference to an internist who is board certified and diplomats. They receive extra training and can handle difficult cases.

My best Patrice

[Jude Needham]

Thank you so much. I spent hours pouring over stuff in this forum last night and read about Chance settling at 34 – 36 which made me feel better. I was beginning to think that lowering the cyclosporin was the next step to help her get to a place where she can fight this thing herself. What would you suggest as a reduction rate for cyclosporin. She’s on 100mg twice a day at the moment? Also was excited to read about the addition of thyroid medication (which my old dog has been on for years) to see if that will boost her regeneration. Also interested in the liver cleansing diet. Very grateful for this forum. My little dog is no way ready to end her life! x

[Vally]

Hi Jude, this is a link to Jean Dodd’s liver cleansing diet:
https://hemopet.org/cleansing-diets-2/

To reduce the cyclosporine, it’s not as critical as the prednisone, however, I still, for my own sanity, took it very slow. You can reduce 20-25% and see how Inca goes.

Regards,
Vally

[Jude Needham]

Thank you – I will be seeing the vets on Friday so will ask her if we can start reducing the cyclosporin then! x