Suggestions/Information

[Coco’s Mom]

After almost a full year of battling IMHA, I am grateful that my beloved Chihuahua Coco has a clean bill of health. I have to suggestions that you may find helpful. After receiving the diagnosis I read everything I could but my emotions overwhelmed me and my “6th sense.” Coco’s blood tests improved and my vet began tapering her Prednisone and Azathiaprine. My 6th sense told me it was too much too fast but I was exhausted and conceded. Soon after Coco was very ill again. I went to a veterinary specialist, and indeed my 6th sense was right. Her meds were reduced too quickly and her Azathiaprine dosage was too low all along. Coco’s meds were reduced then discontinued over 6 1/2 months. Prednisone was reduced thendiscontinued first then Az. Please see a veterinary specialist, if possible. Lastly, I always have a puppy pad down and darkened urine on a puppy pad was the first indication of illness and again the second time. If you have a large dog you might want to consider walking with a puppy pad and scoot it under your dog when it urinates outside. Utilizing puppy pads was a way for me to confidently monitor between blood tests. I purchase adult incontinence pads in the pharmacy area at Sam’s Club. You can get a big bag of them that lasts a long time for around $25. Much cheaper than actual puppy pads at the big box pet supply stores. I wish good health and all the best for you and your fur baby

[Sheena]

Hi Coco’s Mum!

So sorry to hear about Coco’s relapse, but very happy that Coco is now just fine. I hope everyone will read carefully what you have written – we constantly emphasise to owners the importance of correct weaning on here, but for some reason vets often do withdraw the drugs much too quickly & our dogs relapse. I think it is maybe because pred is given for other less serious diseases & can safely be reduced quickly. This is NOT the case with our IMHA/AIHA dogs – it must be done slowly & correctly – here is what we recommend to everyone in the AIHA Terms section:
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone-dose-reduction/
and this is also reiterated in our information on pred:
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone/
We also recommend that pred is reduced first to the minimum dose possible – usually none at all thankfully – and only then to reduce the longer acting immunosuppressant – in your case the azathioprine – afterwards. I wonder if it is also that vets don’t know enough about this very rare disease – very sad as there is so much information available online about correct treatment. I am eternally grateful that my specialist was very well informed & I am eternally grateful for the help I received from other people on here too. You cannot beat personal experience either!

I cannot stress enough how important it is to follow these rules. The chances of a relapse are miniscule if you follow the correct protocol. If you don’t you really are asking for trouble. And what you are saying about finding the right vet is spot on. I hate hearing stories on here about vets who are not following the correct protocols – finding the right vet can save your dog’s life for sure. It is often difficult for owners to accept that their vet is not really up-to-speed on protocol because they may have a long standing relationship with them, but sometimes you have to be brave & take matters into you own hands & change vets if you are in any doubt. I would in an instant if I thought my dog was not getting the right help.

Thank you very much for bringing this up – it is something I also feel strongly about & I hope everyone who is in the process of treating their dog will take heed of what happened to you & Coco.

Best wishes to you both – keep well, Coco! It’s a shame you didn’t find us earlier when Coco was first diagnosed, but I’m so glad you are here now.
Sheena x

[Vally]

Absolutely agree with you Coco’s mum. This is not a simple disease to treat. It needs to be treated aggressively to start with. As Sheena said, I think many vets who have not treated it use the usual protocol in reducing prednisone, which is basically 50% reductions over a few weeks and whilst that’s fine for allergies or inflammation for injury, it just doesn’t work with AIHA.

Yes, agree on the specialist too.

Can I add one further thing though, that if a specialist is not available due to distance or money issues, have the vet consult with Dr Dodds.

Thanks Coco’s mum. The more that suggest this the more will see it.

Very best to you and Coco.

Vally & Bingo (diag Nov 2011, in remission)

[Sheena]

I agree completely Vally – I should also have said that Dr Dodds is always the best person to help, She can be contacted via the Hemopet Resources on here, so distance is no object!
Sheena x