New to this disease

[Cindy]

My dog just like all other cases went in for an ear infection and tumor and also teeth cleaning. Two weeks later he was treated with what we thought was a kidney infection or stones until he got worse. We took him to the emergency doctor. They said imha but are looking for any secondary while they transfuse him. I have another cocker that got severe diarrhea after shots. Seems there could be correlation between shots or meds. We are just at the start of this journey. Didn’t want to put him down until trevor has a fighting chance with 50 percent. Just wanted to tell my story and here some successes over some of the doom I have been reading. He is 7 so I hope he has a few more good years

[Vally]

Hi Cindy and Trevor, and welcome.

Sorry I answered you yesterday, but it’s not here. My iPad hates me.

Just wanted to say nobody here would have doubts that shots can certain set off all sorts of things. My boy Bingo started having seizures about a month, I think, after his shots. Vet said it had nothing to do with it, but I started researching and found a lot of information saying the opposite. He never had any further vaccinations after that.

The important thing is to treat quickly and you are doing that. You will likely see that the drugs will make Trevor feel very poorly and there are lots of side effects to the drugs, but it saves our dogs lives. So you may see that he will look worse before he gets better.

Ask anything at all, we would love to help.

This is my boy, Bingo’s, story.
https://www.secondchanceaihadogs.com/our-stories/bingo

My best, Vally

[Darlene]

Hi,
My female English bulldog was diagnosed with IMHA Saturday morning. She was fine one day and down the next. She is 4 yrs old. They did a blood transfusion on her and her counts are coming up. She is very jaundice and upset stomach. I am going back to hospital after I get off work today. They said she did not get sick last night, but an update is hard, unless I am face to face with the staff. Still have IV in and I am hoping we get her stable. My vet is over an hour away, due to him being the best bully doc around. I am losing my mind! I am worried about her diet, the side affects of meds and her all around health. I have another bully that is 8, he has had nothing wrong with him.

[Vally]

Hi Darlene and welcome. I’m so very sorry your girl is going through this. I know what you’re going through right now too and I would’t wish it on anyone. Yes, I remember going to work and being totally useless as I couldn’t get Bingo out of my mind, and stressing and worrying about him, doing endless research to find out about AIHA.

What is your girl’s name? First of all she is in the right place and it’s important that they stabilise her as quickly as they can.

Has she had any shots recently, or is it possible she has been bitten by a tick? Its very important that they check for tick disease, so please ask them if they have checked. Anything different at all lately? Sometimes we never know what may have triggered the immune system to go haywire.

Do you have any of her blood numbers? When you go to visit, ask for a copy of blood test results. Yo can send them through on Urgent Advice and Patrice will have a look at them for you. She’s very good with results and can help you understand what’s happening. It’s also good to familiarise yourself with them, as you can follow progress. This is the link to Urgent Advice, which will send them to us in an email:
https://www.secondchanceaihadogs.com/urgent-advice

The drugs they use are very harsh on the stomach but very necessary right now to get her stable. Once stable the drugs will be reduced and it will be much much easier on her.

Ask anything at all. By the way, I’m in Australia, so different time zone, so sometimes takes 12 hours to get back, but I’m always about.

Regards, Vally.

[Darlene]

Hi, my baby girls name is Maggie. We also call her crazy girl, due to her high energy. Which she has zero now.
The only thing out of the ordinary, she stold and ate, my English block head labs pig ear. I thought she had a stomach ache and within hours she went down hill. She was supposed to get her shots in another month. So no recent ones. She hasnt been out of our yard to be bitten by a tick, we put stuff down, but I will ask this morning when I call and check on her.
Her count went down by 3 yesterday, she hasnt eaten and puked on me twice when I was visiting w her. I will get a copy of the blood results and send them. I asked about another blood transfusion and dr said she might need one. She is also scheduled for an ultra sound this morning. Thank you for reply and concern. I’m glad I found someone w knowledge to ask questions. My vet is amazing, yet has terrible beside manor and doesnt dumb things down for me. Makes me feel stupid! Thank you again!!!

[Patrice]

Hi Cindy and Darlene,
I am so sorry both of you are here because of these sudden events. I know you mus t be very frightened and worried. We can help you with this. There is so much to learn but neither of you have the time. We can help you make some important decisions with facts and information. If you can, please upload your latest two CBC and chemical screens on the Urgent Advice page.

I am sure Vally will nod her head when I say that we seem to see a huge increase in reports of AIHA IMHA diagnoses in the spring, well at least here in the US. (It is fall where Vally is.)

Why is this? Dogs that have sensitive immune systems in general tend to react more frequently with autoimmune conditions in the seasons where they are exposed to pollens (canine atopic dermatitis) and tick diseases.

Vaccines are also another trigger as are hormones and stress, plus certain breeds seem to be more prone as well. So a common patient might be a female of a certain breed and age, who may have been in heat recently, was vaccinated with boosters she didn’t need and has experienced certain allergic symptoms like itchy skin, paws and ears and may even have always had certain digestive issues.

So it is a condition that more often than not is triggered by multiple things. Vets now use the term IMHA more often, because it more accurately describes how the condition is triggered. I stands for immune, M is mediated, H is for hemoytic (destruction of red blood cells in circulation) and A for anemia ( a shortage of oxygen being carried to the body cells by red blood cells.)

This condition is considered secondary, or mediated by outside triggers. Our hope is always that those triggers are identified immediately by your vet and that the bulk of the triggers are treatable in some way. So for tick diseases, which should be one of the first things a vet should check for, the treatment is immediate doxycycline.

Primary IMHA has no known triggers, it just happens. Most veterinarians now think along the lines that they haven’t figured out the trigger, but there must be something causing the condition. Vets should be doing all kinds of testing looking for triggers when they suspect IMHA.

The first treatment in almost every case is high dose immunosuppressive prednisone (2-3mg/lb/day in two doses 12 hours apart.) It is an absolute necessary treatment because it works quickly to suppress the immune system, which is critical so the destruction of RBC can be stopped.

Vets (and we too) don’t like to treat for a really long time with prednisone because of multiple negative side effects. So secondary drugs are added to take over some of the suppression in a more targeted way. Two that are used a lot are cyclosporine (Atopica) (10mg/kg for 5 days, rest 2 days and cycle as long as needed) and azathioprine (Imuran) 1mg/lb/day for 7-10 day and downward tapering over several weeks. All three of these drugs can be used concurrently while we are looking for the rapid immunosuppression to start working. We want to stabilize the ongoing immune destructive process. The dosages should be adjusted to maintain the absolute lymphocyte count at about 1/3 of the normal range. (750-1500/ul.)

Transfusions are commonly used for patients with critically low PCV HCT levels. Sometimes a dog may need a second transfusion to buy more time for the meds to work. This is a bit more tricky than a first transfusion and so a vet should be experienced in administering this second one. For safer transfusions vets can used universal donor blood. Hemopet.org provides this blood donor product in most places around the world and they are safe to use for this treatment.

There are other less used treatments and they should be applied judiciously depending on the situation.

But still, it is critical to find the treatable triggers asap. Getting those cleared up can keep a dog healthy enough to tolerate the drugs they are taking. So some of the causes can also be variable depending on the sex and age of a dog. Older dogs tend to have other conditions like tumors, kidney disease, liver disease, pancreatitis, some forms of serious gastrointestinal disease. Younger dogs tend towards inappropriate ingestion of something like coins, rat poisons, lead paint or contaminated water, onions, tick diseases, inherited autoimmune tendencies like allergies.

There is also a list of breeds that are over-represented with these conditions because it is a genetic trait. Cocker Spaniels, Poodles. Irish Setters and Old English Sheepdogs are at the top of the list of these breeds.

On this page click on the the article titled The Canine Immune System and Disease Resistance.
https://www.secondchanceaihadogs.com/canine-disease-resources

Dr. Dodds has outlined the autoimmune conditions in this article. The list of triggers towards the bottom are extensive. Close to the top however she points to the big 4:
“The four main causative factors of autoimmune disease have been stated to be: genetic predisposition; hormonal influences, especially of sex hormones; infections, especially of viruses; and stress.”

I’ve made two short videos about IMHA you can see here, unfortunately they are in Flash and may not play on your computer well.
https://www.secondchanceaihadogs.com/aiha-video-library/aiha-introductory-videos

Do you have any questions for us?
my best, Patrice

[Vally]

Darlene, don’t panic about the drop. It’s very common after a transfusion because, as Patrice said, the transfusion is there to buy time for the drugs to kick in – it doesn’t treat anything, and the drugs take time.

Right now Maggie will be on high dose prednisone (or the like), to stop her body destroying her red blood cells. Once her body stops doing that, her blood count should start to go back up. Also, there is always a slight variation in blood counts. If dog is more hydrated, and if Maggie is on fluids, then she will be hydrated, then the count will drop because there is lots of fluid in her. Does that make sense? If a dog is dehydrated, the count automatically goes up. Even if Maggie is just stressed, her counts will reflect that.

Happy to dumb things down for you. I’m not super clever with this stuff, I’ve just lived through it, but Patrice is very clever, so really don’t hesitate to ask.

Get those blood tests if you can and send them through. If they are funny about giving them to you, just say you need to understand what’s happening or you are better seeing stuff in writing. People don’t generally ask for them I don’t think, so I tend to think it’s an unusual ask. But in reality, Maggie is yours, you’re paying for them.

Get to work Maggie and make some reds for mum.

Vally

[Darlene]

They did emergency surgery to removed her gallbladder. They removed her spleen also. She crashed 3xs and passed about 10 minutes ago. My heart is broken.

[Cindy]

My dog just like all other cases went in for an ear infection and tumor and also teeth cleaning. Two weeks later he was treated with what we thought was a kidney infection or stones until he got worse. We took him to the emergency doctor. They said imha but are looking for any secondary while they transfuse him. I have another cocker that got severe diarrhea after shots. Seems there could be correlation between shots or meds. We are just at the start of this journey. Didn’t want to put him down until trevor has a fighting chance with 50 percent. Just wanted to tell my story and here some successes over some of the doom I have been reading. He is 7 so I hope he has a few more good years

[Vally]

Hi Cindy and Trevor, and welcome.

Sorry I answered you yesterday, but it’s not here. My iPad hates me.

Just wanted to say nobody here would have doubts that shots can certain set off all sorts of things. My boy Bingo started having seizures about a month, I think, after his shots. Vet said it had nothing to do with it, but I started researching and found a lot of information saying the opposite. He never had any further vaccinations after that.

The important thing is to treat quickly and you are doing that. You will likely see that the drugs will make Trevor feel very poorly and there are lots of side effects to the drugs, but it saves our dogs lives. So you may see that he will look worse before he gets better.

Ask anything at all, we would love to help.

This is my boy, Bingo’s, story.
https://www.secondchanceaihadogs.com/our-stories/bingo

My best, Vally

[Darlene]

Hi,
My female English bulldog was diagnosed with IMHA Saturday morning. She was fine one day and down the next. She is 4 yrs old. They did a blood transfusion on her and her counts are coming up. She is very jaundice and upset stomach. I am going back to hospital after I get off work today. They said she did not get sick last night, but an update is hard, unless I am face to face with the staff. Still have IV in and I am hoping we get her stable. My vet is over an hour away, due to him being the best bully doc around. I am losing my mind! I am worried about her diet, the side affects of meds and her all around health. I have another bully that is 8, he has had nothing wrong with him.

[Vally]

Hi Darlene and welcome. I’m so very sorry your girl is going through this. I know what you’re going through right now too and I would’t wish it on anyone. Yes, I remember going to work and being totally useless as I couldn’t get Bingo out of my mind, and stressing and worrying about him, doing endless research to find out about AIHA.

What is your girl’s name? First of all she is in the right place and it’s important that they stabilise her as quickly as they can.

Has she had any shots recently, or is it possible she has been bitten by a tick? Its very important that they check for tick disease, so please ask them if they have checked. Anything different at all lately? Sometimes we never know what may have triggered the immune system to go haywire.

Do you have any of her blood numbers? When you go to visit, ask for a copy of blood test results. Yo can send them through on Urgent Advice and Patrice will have a look at them for you. She’s very good with results and can help you understand what’s happening. It’s also good to familiarise yourself with them, as you can follow progress. This is the link to Urgent Advice, which will send them to us in an email:
https://www.secondchanceaihadogs.com/urgent-advice

The drugs they use are very harsh on the stomach but very necessary right now to get her stable. Once stable the drugs will be reduced and it will be much much easier on her.

Ask anything at all. By the way, I’m in Australia, so different time zone, so sometimes takes 12 hours to get back, but I’m always about.

Regards, Vally.

[Darlene]

Hi, my baby girls name is Maggie. We also call her crazy girl, due to her high energy. Which she has zero now.
The only thing out of the ordinary, she stold and ate, my English block head labs pig ear. I thought she had a stomach ache and within hours she went down hill. She was supposed to get her shots in another month. So no recent ones. She hasnt been out of our yard to be bitten by a tick, we put stuff down, but I will ask this morning when I call and check on her.
Her count went down by 3 yesterday, she hasnt eaten and puked on me twice when I was visiting w her. I will get a copy of the blood results and send them. I asked about another blood transfusion and dr said she might need one. She is also scheduled for an ultra sound this morning. Thank you for reply and concern. I’m glad I found someone w knowledge to ask questions. My vet is amazing, yet has terrible beside manor and doesnt dumb things down for me. Makes me feel stupid! Thank you again!!!

[Patrice]

Hi Cindy and Darlene,
I am so sorry both of you are here because of these sudden events. I know you mus t be very frightened and worried. We can help you with this. There is so much to learn but neither of you have the time. We can help you make some important decisions with facts and information. If you can, please upload your latest two CBC and chemical screens on the Urgent Advice page.

I am sure Vally will nod her head when I say that we seem to see a huge increase in reports of AIHA IMHA diagnoses in the spring, well at least here in the US. (It is fall where Vally is.)

Why is this? Dogs that have sensitive immune systems in general tend to react more frequently with autoimmune conditions in the seasons where they are exposed to pollens (canine atopic dermatitis) and tick diseases.

Vaccines are also another trigger as are hormones and stress, plus certain breeds seem to be more prone as well. So a common patient might be a female of a certain breed and age, who may have been in heat recently, was vaccinated with boosters she didn’t need and has experienced certain allergic symptoms like itchy skin, paws and ears and may even have always had certain digestive issues.

So it is a condition that more often than not is triggered by multiple things. Vets now use the term IMHA more often, because it more accurately describes how the condition is triggered. I stands for immune, M is mediated, H is for hemoytic (destruction of red blood cells in circulation) and A for anemia ( a shortage of oxygen being carried to the body cells by red blood cells.)

This condition is considered secondary, or mediated by outside triggers. Our hope is always that those triggers are identified immediately by your vet and that the bulk of the triggers are treatable in some way. So for tick diseases, which should be one of the first things a vet should check for, the treatment is immediate doxycycline.

Primary IMHA has no known triggers, it just happens. Most veterinarians now think along the lines that they haven’t figured out the trigger, but there must be something causing the condition. Vets should be doing all kinds of testing looking for triggers when they suspect IMHA.

The first treatment in almost every case is high dose immunosuppressive prednisone (2-3mg/lb/day in two doses 12 hours apart.) It is an absolute necessary treatment because it works quickly to suppress the immune system, which is critical so the destruction of RBC can be stopped.

Vets (and we too) don’t like to treat for a really long time with prednisone because of multiple negative side effects. So secondary drugs are added to take over some of the suppression in a more targeted way. Two that are used a lot are cyclosporine (Atopica) (10mg/kg for 5 days, rest 2 days and cycle as long as needed) and azathioprine (Imuran) 1mg/lb/day for 7-10 day and downward tapering over several weeks. All three of these drugs can be used concurrently while we are looking for the rapid immunosuppression to start working. We want to stabilize the ongoing immune destructive process. The dosages should be adjusted to maintain the absolute lymphocyte count at about 1/3 of the normal range. (750-1500/ul.)

Transfusions are commonly used for patients with critically low PCV HCT levels. Sometimes a dog may need a second transfusion to buy more time for the meds to work. This is a bit more tricky than a first transfusion and so a vet should be experienced in administering this second one. For safer transfusions vets can used universal donor blood. Hemopet.org provides this blood donor product in most places around the world and they are safe to use for this treatment.

There are other less used treatments and they should be applied judiciously depending on the situation.

But still, it is critical to find the treatable triggers asap. Getting those cleared up can keep a dog healthy enough to tolerate the drugs they are taking. So some of the causes can also be variable depending on the sex and age of a dog. Older dogs tend to have other conditions like tumors, kidney disease, liver disease, pancreatitis, some forms of serious gastrointestinal disease. Younger dogs tend towards inappropriate ingestion of something like coins, rat poisons, lead paint or contaminated water, onions, tick diseases, inherited autoimmune tendencies like allergies.

There is also a list of breeds that are over-represented with these conditions because it is a genetic trait. Cocker Spaniels, Poodles. Irish Setters and Old English Sheepdogs are at the top of the list of these breeds.

On this page click on the the article titled The Canine Immune System and Disease Resistance.
https://www.secondchanceaihadogs.com/canine-disease-resources

Dr. Dodds has outlined the autoimmune conditions in this article. The list of triggers towards the bottom are extensive. Close to the top however she points to the big 4:
“The four main causative factors of autoimmune disease have been stated to be: genetic predisposition; hormonal influences, especially of sex hormones; infections, especially of viruses; and stress.”

I’ve made two short videos about IMHA you can see here, unfortunately they are in Flash and may not play on your computer well.
https://www.secondchanceaihadogs.com/aiha-video-library/aiha-introductory-videos

Do you have any questions for us?
my best, Patrice

[Vally]

Darlene, don’t panic about the drop. It’s very common after a transfusion because, as Patrice said, the transfusion is there to buy time for the drugs to kick in – it doesn’t treat anything, and the drugs take time.

Right now Maggie will be on high dose prednisone (or the like), to stop her body destroying her red blood cells. Once her body stops doing that, her blood count should start to go back up. Also, there is always a slight variation in blood counts. If dog is more hydrated, and if Maggie is on fluids, then she will be hydrated, then the count will drop because there is lots of fluid in her. Does that make sense? If a dog is dehydrated, the count automatically goes up. Even if Maggie is just stressed, her counts will reflect that.

Happy to dumb things down for you. I’m not super clever with this stuff, I’ve just lived through it, but Patrice is very clever, so really don’t hesitate to ask.

Get those blood tests if you can and send them through. If they are funny about giving them to you, just say you need to understand what’s happening or you are better seeing stuff in writing. People don’t generally ask for them I don’t think, so I tend to think it’s an unusual ask. But in reality, Maggie is yours, you’re paying for them.

Get to work Maggie and make some reds for mum.

Vally

[Darlene]

They did emergency surgery to removed her gallbladder. They removed her spleen also. She crashed 3xs and passed about 10 minutes ago. My heart is broken.