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- Rocky — IMHA, day 16
Hi Everyone!
I have been reading this forum and I hope that I can get some advice from you.
Our 7 year old Lab, Rocky, because ill on Saturday April 26th. I was out of town and my husband noticed that he was fairly lethargic. On Sunday, I got a call at 7:00am that he had collapsed and my husband was bringing him to our Emergency Vet in town. His Hematocrit was 19, platelets 100,000, but not jaundice at this point. We were told that his diagnosis was Thrombocytopenia, he was given a dexamethasone shot, doxycycline and a follow up with our usual vet in the morning. We were very naive at that moment as to what would lie ahead in the next couple days.
After returning home that night with Rocky, he did seem slightly perkier, and was interested in eating treats and drinking water, but not much else. He would struggle to get up to go outside, and almost immediately collapse while trying to use the bathroom. We made it through the night, and were the first people at the vet the next morning. When our usual vet got there, she did more blood work which revealed that the PCV was 18, and his platelets had dropped to 85,000. We were sent immediately back to the vet hospital, where Rocky was met at our car with a gurney and the internal medicine team of doctors began assessing him. The next couple days were a blur. His PCV ranged from 12-17, and he received 1 blood transfusion and 1 IVIG infusion. After the infusion, he had started to rise into the 20’s, only for the roller coaster to continue to drop us back down to a PCV of 17.
Finally, after adding Azathoprine, he started to rise and stay up. We left the Hospital after 1 week at a PCV of 24.
Rocky has continued to improve slightly, but not as fast as they had hoped. Every test has come back negative.
As of yesterday, our platelets are normal, PCV 28, and reticulocytes 166,000. His bilirubin is at 0.4.
He is currently on Azathoprine 50mg every other day, Prednisone 20mg two times a day, 1/4 tablet of Aspirin and an acid pill every day. We are adding 100mg cyclosporin twice a day, starting today.
Any thoughts would be very much appreciated. Does anyone have any suggestions about diet, supplements or anything like that???
Thank you for reading,
Lauren
Dear Lauren
Welcome to the site. I am glad you have found us, although so sorry to read what a difficult time you and Rocky are going through. This is a difficult disease for sure, but it sounds like Rocky is now at least more stable. Am I right in thinking you have an internal medicine specialist?
Pleased to hear that he is going to start Cyclosporine, which is usually the drug of choice with AIHA alongside prednisolone. It is also excellent and very important that he is receiving his anti-clotting medication (the aspirin) and stomach protection.
I am the resident cat owner here, but the others are all dog owners and can help advise you on supplements and nutrition. I know that several members here use slippery elm and milk thistle, so those might be worth looking into. PCV of 28 – has this risen on its own from the 17%, or did he need a further transfusion for this? Some of the members here are very good at interpreting blood results and I am sure will give their opinions on his results when they see your post. If you look at the AIHA terms tab, there is a lot of useful information there too.
Another idea might be to contact Dr Dodds from Hemopet who is an expert in this disease, to see if she has any specific recommendations.
Anyway, welcome again and I wish little Rocky every luck with his treatment. Do keep us posted.
Mary and Mable x
Hi Lauren
Welcome to the site. I too am sorry you and Rocky are going through this.
First of all, it seems as though your vet team have been very pro-active, which is great. Rocky has responded so far and a PCV of 28 means he’s not in danger. So that’s fabulous news.
I am 100% certain the cyclosporine did the trick with Bingo but it takes a little bit of time to kick in so crossing fingers, toes and paws that that will work and bump up the numbers to where they should be.
The acid pill, is that to reduce acid? Personally, I think stomach protection is better because the prednisone can do some damage. Bingo ended up with stomach ulcers. The drug of choice for this is sucralfate, but must be given away from other drugs as it stops absorption.
How is Rocky going with food? Once the pred is in their system, there’s usually no stopping them. Food food food. Try and avoid the high fat foods but other than that. Pumpkin is a good filler.
Supplements, a good one to add is a product called PetTinic which has iron and other vitamins. I know Dr Dodds does recommend this and most of us here use it.
Ask anything, someone here has been through it.
If you’d like to post a photo of Rocky, please do. We’d all love to see him. Use the “Upload Your Photo” on the right.
My very best,
Vally & Bingo (diag Nov 2011, in remission)
Hi Lauren,
I am so sorry you had the need to find us, but glad you did. It looks like Rocky is slowly getting better. I have been told that this disease is not a sprint but a marathon, so be ready for some endurance here:)
For supplements Dr. Dodds recommends petinic which contains vitamin B12, iron and folic acid. It is also a good idea to give milk thistle to protect and cleanse the liver from all the harsh medications. The intestines also take a beating and it is good to protect them with sucralfate/carafate. These coating medications have to be given away from all the other drugs so they don’t interfere with absorbtion.
How is Rocky eating? Does he have an appetite? What are you feeding him? Please keep it fairly lean because the prednisone makes them more vulnerable for pancreatitis also a result of fatty foods. The less complications of the sort you have the better:)
It looks like Rocky is on the right path to get better, be patient, let him rest a lot, he is tired and needs to heal. Have always lots of fresh water for him,he will be drinking like crazy. Of course everything that goes in will have to come out:) So sometimes accidents do happen. But they usually don’t last long. This is all I can think of for the moment.
Take care and best wishes,
Brigitte
Hi Lauren. You and your husbands’ persistence saved Rocky’s life – way to stay with it.
We all here have been through this nightmare roller coaster and are here for you all the way. Everyone pretty much covered ‘first things’ needed. I’m really glad about the cyclosporine. As mentioned, it will take some time to kick in, so it’s hurry up and wait. Patience.
It sounds like he’s stabilizing and you mentioned reticulocytes, which is great – it’s going forward instead of backward – good going Rocky!
On top of the milk thistle, I use CellFood (brand) liquid SAM-e for liver protection. Denamarin is a commonly used liver protection, but the beautiful blue color and fillers prompted me to replicate the ingredients in a more natural form, being milk thistle (I use HerbPharm liquid milk thistle – the alcohol helps with absorption) and CellFood SAM-e – twice a day in her food – along with the PetTinic (great stuff) and slippery elm (cocktail) in addition to Pepcid for tummy.
Just remember, anything that costs the stomach – slippery elm, Peocid, Sucrslfate
Sorry – hit submit too early by mistake.
As all have said too, it sounds like you have a worthy team for Rocky. That is key.
Please stay with us and post his entire blood work. I did and have learned much about this horrid disease.
Will check in tomorrow. Keep up the great work!!! Thinking of you and your
Wonderful Rocky.
Linda and Sadie
![bingo-14-5_1200x775](https://www.secondchanceaihadogs.com/wp-content/gallery/aiha-dogs_2/bingo-14-5_1200x775.jpg "Vally\'s Bingo \\"Smile\\"")
![Brigitte_Cleo_Ripley_Enzo_4](https://www.secondchanceaihadogs.com/wp-content/gallery/aiha-dogs_2/Brigitte_Cleo_Ripley_Enzo_4.jpg "Brigitte\'s Cleo, Ripley, Enzo and Guest \\"Rockin\\"")
