Nula (5yr old English Cocker Spaniel)

[Ruth]

….Because she’s gone down so fast, they want to scan again to see if she’s started bleeding internally which can happen if her immune system is destroying her red cells and her platelets (together it’s called Evans Syndrome). They’re going to call me about 6.30pm tonight to let me know how she’s responding and with any test results they have. Devastated. Xxx

[Vally]

Ruth, Bingo ended up in hospital for 10 days. The early days were the absolute worse. I totally understand how lost you must be feeling without Nula. It was such a hard time.

But, specialist veterinary care is what made the difference with Bingo. At our local vets, they ummed and arred about things for days until he basically collapsed. When they couldn’t work out what was going on, they referred him to a specialist vet. That made a big difference. They knew what they were dealing with. They did repeat all the tests that had been done previously – I remember being annoyed because blood tests and ultrasounds had been done by the local vet, but they had much more specialised equipment and wanted to see what was happening themselves rather than relying on images which were not anywhere near as good as their own.

With most of our dogs, the prednisone isn’t enough to keep the immune system in check. Bingo was also started on cyclosporine and that made a difference – at that point he started to improve in his red blood production.

When you’re able, let us know what the vets have said about the testing.

Thinking of you and Nula.

My best, Vally & Bingo.

[admin]

Hi Ruth

Nula is getting the best possible care – I’m really sorry to hear the news about the platelet problem, as well as the red cells. The treatment is the same – transfusions if necessary & high dose immuno-suppressants – dogs can & do recover very well from Evans Syndrome too.

It may be helpful to mention to your vet about Hemopet – they can provide cross matched blood & blood products for transfusions.
http://www.hemopet.org/canine-blood-bank.html

I agree with Vally – finding a Specialist in Internal Medicine with experience of AIHA/ITP & Evans Syndrome would be a good idea. My vets did not hesitate to put me onto a specialist as soon as they realised they were out of their depth. Worzel did not respond to prednisone on it’s own – it only slowed down the red cell destruction, but he was making no new cells at all to replace the ones he had lost, so was becoming more & more ill. The Specialist added an immuno-suppressant called azathioprine & a couple of weeks later, he was producing baby cells. Azathioprine may not be appropriate for Nula, but maybe cyclosporine or another immuno-suppressant would. Only a specialist would be able to advise on which is the best drug to use.

Hospital is the only option for Nula to get the 24 hour care she needs, but it is always horrible to have to leave them there. Let us know how things are going when you have time. Ruth, I will be thinking of you & Nula constantly – please know we are ALL here to help & support you through this.

Big hugs to you & Nula from Sheena, Worzel & Ollie

[admin]

Dear Ruth,
the great vet Dr. Dodds who is a specialist like no other in this disease told me once “Where there is life there is hope”. I know you are devastated but please remember Nula is not in pain, she is just very tired. You have to believe that she can get better, she is well taken care of where she is and once she comes home to you she will improve by leaps and bounds.
Take care and best wishes,
Brigitte

[admin]

Hi Ruth

I’m so sorry to hear that Nula has been so unwell. Molly was also at Dick White’s – I spent a lot of time there! Don’t be afraid to call them any time for updates. They are very used to it. I also visited at all hours.

When Molly was admitted to DWR, they re-did scans which had already been done at our local vets. I think this was partially as they have both internal medicine and radiology specialists, and are therefore able to look in more detail than primary care vets. They also do a lot of in-house testing, meaning you are able to get results quickly. Have they discussed bone marrow sampling with you?

Are they transfusing with whole blood or Oxyglobin? There are pros and cons to both, although whole blood tends to last longer depending on the regenerative status of the IMHA.

Hang in there Ruth. It’s such a difficult time but there is hope. Hopefully the specialists will get to the bottom of it, get her on the correct medication regime, and on to the road to recovery.

Sending love and best wishes,

Mary x

• This reply was modified 12 years, 6 months ago by .
• This reply was modified 12 years, 6 months ago by admin.

[Linda]

I am so sorry you and Nula are going through this. But she seems to be in the best medical facility possible with specialists that are highly competent. That’s key.

I planted to add a few thoughts, that made a big difference for me (and Sadie).

SHOT of prednisone? It helped jump start Sadie. This may not be advisable for Nula, but worth asking.

PetTinic – iron/vitamin supplement. Sadie was put on this from day of diagnosis and remains on it today. Dr. Dodds also promotes it. I had a hard time getting over the fact that ‘corn syrup’ is the first ingredient, but bypass that, it’s worthy of asking vets about too. Great product!

And last, PRINT these forum posts and take to vet WITH pen and pad (write down all they say – it all merges together and gets so confusing). This was recommended by those here and I’m glad I did it. Helped SO much. Plus, my vet was so impressed with what this forum knew AND my diligence.

You are doing ALL the right things. Remember that. Get some sleep while you can and take care of yourself. Nula will need your strength when she comes home.

Love and HUGE hugs, Linda and Sadie

[Samantha]

Hi Ruth, I was led her from Linda. I just briefly read through this message, but I saw you mention Evans. My Indigo had that. She was first admitted to the hospital with ITP, then later diagnosed with AIHA. (which like you said together makes Evans). She completely recovered. Please keep the faith. It is possible. I can not say what one thing helped Indigo because as one time she was getting 3 different injections and a total of 16 pills a day, but I feel like testosterone injections and also Epogen injections got her over the hump. The Epogen is rather expensive and is a human drug, but our vet was open to trying it and I believe it helped.

Take care and hugs to your sweet baby.

Samantha

[Ruth]

Update: Nula’s PCV level has dropped from 22 to 11. She’s had a transfusion and tolerating so far. She may have another during the night. Someone is sitting up all night with her which is good. Her platelets are down a little too so they think it is Evans syndrome and her body is killing her platelets as well as red cells. She is clotting ok but is on anti coagulants. She’s nauseous so on anti sickness meds. She’s on a drip with the steroids and stomach protecting meds. They are checking for tick disease in case but they said it’s rare in the UK. They’re treating her for it in case while they get results. Kidney and liver function is normal. Scanning her kidney tomoz as our normal vet found small abnormality but didn’t look like cancer but they’re going to take a closer look in case. Next 24-48hrs are really really critical. If she pulls through til the weekend I can go and visit her and I’m sleeping with her blanket until then so it’ll smell of me and I can take that for her. The vet said that all being well she will call tomoz afternoon with an update. So until then no news is definitely good news!! Thank you ALL SO MUCH for your replies!!!! It really, really helps! I burst into tears every time I read your replies but it’s really good to hear that other dogs have pulled through!! And Mary, so SO good to hear that Dick Whites were so good for Molly!!! I really need her to pull through! She is my first baby. Xxxxx