Puppy just diagnosed with IMHA

[Crystal]

Hello. My 9 month old cattle dog mix Ajax was just diagnosed with IMHA today. I haven’t had much experience with this disorder until today. After the blood work indicated IMHA my vet put him on a high dose of prednisone and an antibiotic and scheduled a re-check in a week. After getting on line and doing some reading I am pretty freaked, my vet didn’t really go over the statistics. Ajax was acting lethargic this morning, but still eating, drinking & fairly active. His HCT was 29.5% which sounds a lot better than most of the stories I’ve read that needed transfusions/hospitalization, but it seems like the HCT can change in a matter of hours. Is a week too long to wait between blood tests?

[Vally]

Hi Crystal, I’m so sorry to hear about your puppy Ajax. First of all, I’m thrilled to read he’s bloods are 29.5%, so that takes you out of the danger zone, although he is still anaemic. We want to get him into the mid-high 30s to start with.

What were Ajax’s symptoms to get you to take him in to the vet. Whatever it was you’ve done really well in catching anything really early.

Do you have any idea what may have triggered it? Any injections lately? Antibiotics, bites, stings? Some of us will never know what actually triggered it.

What does Ajax weigh and what is the dose of prednisone. Also what is the antibiotic for? and which one?

A good way to keep an eye on them, especially in between vet visits, is to check their gums and their eye sockets. Check to see what colour. If they ever go very pale, them get Ajax to the vet to check his PCV. Don’t check when Ajax is lying around though because they will naturally be paler then, so check when Ajax is more active. We’ve all driven our dogs nuts by constantly checking their gums. One lady, Lynn, said her dog was so used it to, she used to automatically smile for her.

You can also check his capillary refill time – see this:
https://www.secondchanceaihadogs.com/AIHA_Terms/capillary-refill-time/

High dose prednisone does a number on them too with a million side effects, in particular panting, drinking heaps, and therefore, weeing heaps, huge appetite, muscle loss. All these symptoms go away though when the prednisone is slowly lowered when Ajax has become stable. Read this:
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone/

If you have any questions, just ask. We all love to help. We’re all over the place too, so we’re all around at different times. I’m in Australia.

My very best,
Vally & Bingo (diagnosed Nov 2011, in remission).

[Sheena]

Hiya Crystal

Really sorry poor Ajax has this roller coaster of a disease – remember most dogs DO recover really well if the treatment is given properly, so ignore “statistics” – they just make you more worried. Concentrate on the positives! All of us have lived through this horrible scenario & are here to help you, but we need as much information as you can give us to see what’s happening with your baby.

Vally is just amazing at explaining things & I completely agree with everything she’s mentioned.

Just a thought – we have 2 other puppies on here – has Ajax had an vaccinations lately? They can trigger this disease. But if your vet suspects infection (the antibiotics give us that clue!), that could also be the trigger. My poor boy Worzel caught a tick disease (we didn’t know as it festered in the background for months) & then had a vaccination – a complete disaster. It was a difficult journey getting him back to full health.

It sounds as if Ajax is doing pretty well – that his PCV going up is great news! I have to confess I was down the vets getting a PCV every 3 or 4 days to start with – until he reached a normal PCV. I personally would do this with Ajax if I were you. If you think his gums look pale (don’t check when they are inactive though) get a quick PCV done – it puts your mind at rest & catches any problems early. I stopped worrying that my vets probably thought I was completely paranoid about his PCV. As Vally says, this is the crazy, paranoid world of AIHA/IMHA after all!

Sending best wishes for a speedy recovery
Sheena, Worzel (diagnosed Dec 2012, in remission) & Ollie

[Terri]

Hi Crystal,

So sorry to hear about your puppy. I too had a puppy – 4 months old diagnosed with IMHA. So scared when they are just puppies. I agree with everyone you are lucky you caught it early. My little Elvis had to have blood transfusions but he is doing good now. He did however have his rabies shot on March 7th and started to act differently on March 14th. So i agree it is strange this is the 3rd puppy within 30 days. My internal specialist told me they do not see IMHA in puppies and it is unusual. I still keeping a very very close eye on him. I agree with everyone that I have researched so much and happy i found other people that have experienced the same thing. Just never knew how more common this is getting. Elvis PCV was 46 a week ago and he was down to 12 when i brought him in. They said bring him back in two weeks, well I am like Sheena, I know i will be bringing him before then just to make sure!! Hope your little puppy gets well very very soon.

Speedy recovery!!!!!
Terri and Little Elvis

[Crystal]

Thank you everyone for your responses. Ajax is 39 lbs and is on 10mg prednisone, clavamox & 10 mg famotadine. I have no idea what might have triggered this, no recent vaccines or medications & no bug bite that I know of. He just wasn’t his usual high energy self yesterday morning, but still walking around & interested in things, eating but not as enthusiastic as he usually is. I checked his gums & they were very pale so I got him in to a vet. Today his appetite is worse, gums still pale & low energy. I’m not seeing an increase in appetite or thirst yet, any idea how long it takes to see that? Thank you for your advice.

[amy]

Crystal,
My heart is broken to hear of another baby with IMHA. My Coal was only 4mo when this horrid disease struck her to near death. I am so glad you caught this so quickly. You have to try and stay calm and let the steroids do their job. I would NOT wait week for another PCV we got one every other day for the first week and then every two days and then 4 then a week. Now we are at every two weeks and holding steady. If you want to read about everything that has happened with Coal please check out the post “4mo pup IMHA” There is a ton of good info in that thread from everyone on here. I hope you utilize this web site to it fullest potential. Do not be afraid to ask about anything even if you think it sounds like a stupid question. Also do not be afraid to annoy the hell out of your vet. Call for everything and anything! You need to feel confident in the process. You are your dogs only advocate through all of this and you can’t be too careful. Also please know we are all here praying and sending positive thoughts to you and Ajax. Lots of love and calming wishes for you both.
Amy & Coal xo

[Sheena]

Hi Crystal

Oh, he does sound a poorly boy. Let’s give you some ideas:

That is a low dose of prednisone actually – did you start at a higher dose? The recommendation is normally 1mg per pound (2mg per kilo) per day & should be divided into in 2 equal doses, given 12 hours apart so that would be 40mg in total, i.e. 20mg twice per day – a lot more than 10mg. I think this is why the thirst & greedy appetitie hasn’t happened – the dose is low.

See https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone/

Maybe they are being cautious as Ajax is very young? What was his PCV when you took him to the vets? In adult dogs, a second longer acting immuno-suppressant is usually needed, such as cyclosporine, azathioprine. Again, your vet may be reluctant to add them because he’s just a baby.

So if Ajax doesn’t respond, you can put the pred dose up & add another drug if necessary. Plenty of options & plenty of hope for a good recovery.

Do you have any blood results you can send us? It helps us to understand more about what is happening, possibly why, too. The clavamox – what was that given for? What did your vet say about infection? Infection as a trigger is common, so worth thinking about for sure.

Here’s where to upload bloodwork, tests results, anything from the vets that you can send us please:
https://www.secondchanceaihadogs.com/urgent-advice/

Hope this has helped – keep telling us what’s happening & what you are worried about – but please let us have as much information as you possibly can!

All my very best wishes to you & your dear pup,
Sheena, Worzel & Ollie xxxx

PS I am in France, so getting near my bedtime now – we are all over the world, so someone on here is usually awake to help.

[Sheena]

Amy was typing at the same time – Crystal, Amy is absolutely spot on with what she is saying & you can take comfort that she is going through this too – all pups together! Please do read her story:
https://www.secondchanceaihadogs.com/forums/topic/4mo-pup-imha/

There are definitely no stupid questions here – only questions – we don’t care what you ask!

Sheena x