Refractive IMHA – Lola

[Vera]

My dog Lola is a 7 year old Havanese who starting showing signs of not feeling well on Jan 30. I took her to the hospital on Jan 31 and they diagnosed IMHA after tests. She was on prednisone mycophenolate plavix and doxy and appeared to be doing well. I decided to take her to Dr Jean Dodds for a follow up on March 23. She made some recommendations but before they could be fully implemented Lola relapsed on March 25. She has been in the hospital since – was not responding to even aggressive treatment. We opted for plasma transfer – she had 3 over the course of 5 days. Her RBCs were amazing for a few days (47% at the high point) then she started crashing again. She’s had atleast six transfusions too. The doc is frankly surprised she did not hold after the plasma transfers – he’s had great success. She is no longer jaundiced. They now have added cyclosporine but she was so lethargic today after resting at 16% I asked them to do another transfusion so she would have a chance to respond to new meds. Some have suggested IgG but vet isn’t convinced – says he will do it if I want it but he wouldn’t do it for his own dog for s multitude of reasons. Looking for tips thoughts similar stories where something turned it around.

Thank you

[Vally]

Vera, I’m so sorry. It’s heartbreaking to have a dog doing well and then relapse.

I’m sorry I don’t know what IgG is. I’ll send Patrice, the site owner, an email to make sure she sees your post. I’m certain she’ll know about it.

I would contact Dr Dodds as soon as possible and get her ideas as to the best way forward.

Did anything change from when Lola was going steady and relapsed?

My best, Vally

[Vally]

Vera, IVIG has been discussed and Patrice has included a paper discussing it on the Resources so you can have a read here:
https://www.secondchanceaihadogs.com/medication-resources/#mg

It’s the second box down from the top (under the bottle of prednisone).

There is also reference to humoral-immunity. See this:
https://www.secondchanceaihadogs.com/AIHA_Terms/humoral-immunity/

I’ve also done a search in the forum of the term “IVIG” and it brings up a few different posts where it has been used successfully.

Again, my first thing would be to contact Dr Dodds and get her ideas.

Regards,
Vally

[Vera]

Thank you, Vally. I have been in contact with Dr. Dodds and her team. They have recommended I go see Dr. Feldman at VCA in West Hollywood – he’s known for these types of refractive cases and they have 24 hour care vs. Dr. Dodds (they only do clinic hours). I have an appointment later today.

[Vally]

Vera, good luck with the appointment today. Let us know how Lola is, when you can. Crossing everything for you.

Vally