Shih Tzu Diagnosed With AIHA

[Susie]

Thanks Vally,

Actually, she’s had her best week in almost 3 months so I was just hoping she was either holding at or surpassing her last check. I think the last couple of drops have me a bit nervous about her continuing to go in the wrong direction (plus, I was hoping for a reduction in the Prednisone today ).

It helps alot to know that all of you have gone through the same ups and downs with their pets. Its not that I’m glad that you had to experience this, but it’s encouraging to get these pep-talks from those who have been there and know that it does go up and down and then it gets better.
♡Susie and Emily

[Susie]

Hello All,

Just a quick update and a question. Today marks the 3 month anniversary of Emily’s diagnosis. She is better everyday. Yesterday she remembered that she loves toys!! She’s chewing on them, picking them up and shaking them and acting like our crazy, naughty little girl again! She’s decided to rummage through trash cans, grab napkins from tables and shred them on my bed, steal and chew up whatever she can get a hold of. She stole my grandson’s plate of fruit the other night. He tried to defend her, but I’m pretty sure from the smell of her breath and her swollen belly that she’s up to her old antics again. That’s a really good thing!

I’m so humbled as I’m reading through everyone’s posts and seeing how critically ill their pets have been. We’ve been through it to be sure, but honestly, nothing like some of you have been. Thank you to everyone who has shared their experience with us. It gives such hope when you feel like all is lost.

My question is to our team of experts : as I’ve read everyone’s stories I’ve seen a repeat of clotting issues. At 3 months in, should I bring up clotting problems to the vet again or do you feel we’re out of danger at this point?

Thanks for your help!
♡ Susie

[Vally]

Susie, I’m not certain about this one. When they do a blood test, the platelets should be between 200 and 500. See the Glossary item which explains this:
https://www.secondchanceaihadogs.com/AIHA_Terms/wbc-white-blood-cell-2/

Also I think if they do a blood smear, they can see what the cells looks like and can tell from that if they are clotting too much.

Wait for the experts though.

Vally & Bingo
xxx

[admin]

Hi Susie

Vally is right about the platelets – the danger is when they start to get very high – climbing to 1,000,000 or over is a big red flag for sure. A blood smear will show if Emily is still at risk from clotting issues. Print this item off & take it to the vets with you:
https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/

So what you need to ask if Emily currently has agglutination, spherocytes, clumping (including platelet clumping) or haemolysis still – I would be extremely surprised after such a long time & a good recovery if she has any risks now, even though she may have to start with – most dogs do – but it’s always good to check. My local vets were told by the specialist to do a smear every time, up until Worzel was off the pred completely – it only takes a few extra minutes – I always preferred to be very cautious. You can catch any potential problems that way.

I would personally like to know if Emily has ever had any of these issues, but if finding out she did have risks in the past would upset you, don’t even bother asking – it’s not worth getting stressed out about at this late stage & I wouldn’t upset you for the world. I’ll leave that up to you.

Can I please remind you to get an amylase test as well – each time you have a check-up – this is because there is always a risk of pancreatitis & Emily has already had a bout of it, poor baby. If her amylase test is high, they should then proceed to do the more detailed tests for pancreatitis as in the following article under the “Pancreatitis Diagnosis” section:

https://www.secondchanceaihadogs.com/AIHA_Terms/pancreatitis/

I always have an amylase test even now as Worzel still takes 1 x 50mg azathioprine per week – again the specialist said to do this to be on the safe side. I like being on the safe side, as you know! Nipping things in the bud before they become a big problem makes life so much easier in my opinion.

Hope this helps. If there’s anything you’re not sure about or I haven’t explained it properly, just ask.

Love & hugs to both of you
Sheena xxxxx

[Susie]

Thanks Vally & Sheena,

I will ask our vet to check those things. Sheena, you can always remind me of the things I need to ask for!
I trust you to steer me in the right direction.

Emily’s next check up is in one week. If she’s doing well do you think it’s okay to reduce her prednisone from 7.5 to 5? Shall we wait and see how her pancreas is doing and decide from there? I kinda want to know before going in because a couple of times I did the reductions (both pred. and cyclo) different than I was instructioned to and forgot to tell the vet.
Thanks ♡ Susie

[admin]

Hi Susie

Let’s see her PCV & CBC results, but that does sound fine to me as long as the last reduction was 2-3 weeks ago – I can’t remember exactly when you last dropped the pred – please remind me! Her pancreas is actually a good reason to reduce the pred – to lessen the risks of pancreatitis of course. So, don’t rush, but get it down safely. Again, a reduction of 25-33% every 2-3 weeks is “conservative” & safe, as long as Emily’s PCV is holding steady in the normal range (i.e. 38 or above).

Love to you & dear Emily
Sheena & the boys xxxxx

[Susie]

Hi Sheena,

Emily’s last reduction was 25% (10 down 7.5) and I believe that was on June 28th. We’re anxious to get the Prednisone down a bit more because she is so stinkin’ skinny. My husband is really bothered by it. ( I guess my concern is more about her organs right now). I’m glad she’s a Shih tzu so that her skull isn’t showing. Her little feet and legs feel so fragile. I can’t imagine how thin your boy must have looked!

I was able to purchase organic potatoes and organic sweet potatoes yesterday and I’m in the process of making Emily the liver cleansing diet. I was looking online for a pancreas diet and came up with nothing until last night. I was reading a link about pancreatitis and found Dr. Dodds being quoted in the article recommending the liver cleansing diet for the pancreas :-) Yay!

Love to you and the boys
♡ Suse & Em

[admin]

Hi Susie

That proposed reduction sounds great in that case!

I agree – Dr Dodds liver cleansing diet would be fine – very good idea. The main thing that aggravates the pancreas is fat – so keep the fat reasonably low for now. Keep protein high, using the meats Jean recommends, to try & retain muscle (but it’s impossible not to lose some muscle). I promise all these horrible side effects do go – it amazes me how quickly they get back to normal when the pred is reduced, actually. I find it a bit sad & shocking looking at Worzel’s photos when he was ill, but I look at him now & you would never know he’d been through this traumatic treatment. All our friends who were very upset with how he looked during his illness are so happy when they see him now. Tell your lovely husband not to worry – Emily will gradually get back to her old self.

Love & hugs as always
Sheena & the boys xxxxx