Forum Replies Created
Hi Adam
So happy Tiger is home – I bet you missed him like crazy. Being highly regenerative is wonderful news & he is certainly doing really well. Good to know it wasn’t rat poison after all. Things are looking really good, Adam.
The drugs (prednisolone in particular) make them very tired, as does the anaemia. When they don’t have enough red blood cells (which carry oxygen), they can’t get enough oxygen circulating around to be active, so it’s no wonder they feel a bit lethargic! They also breath more quickly to try to get more oxygen into their system. Tiger is improving on the PCV front & you will see he becomes more active as his levels gradually come up to normal.
We always find they have much bigger appetites with the prednisone & get very greedy! They need more food than usual, so you will have to up the quantity. Your vet’s advice on low fat is given to people on these steroids too – a very good idea.
Tiger will drink a lot more too – they need to drink loads to keep hydrated. Of course that means more toilet breaks & more peeing. Don’t be surprised if you have to let him out more during the night. We all suffered from sleep deprivation at this stage!
I presume the vets don’t have a definite idea of what triggered this? Some owners never do find out I’m afraid.
Did your vet explain that you need to give the Losec (tummy protector) at least 2 hours away from any other drugs? That is very important because the Losec prevents absorption of other drugs & that is not what you want. Hope that helps.
Most of us have also given sucralfate as a tummy protector – a 1g dose twice per day, the last dose being last thing at night. I would chat about this with your vet as it is really good stuff & helped my dog a lot more than the losec-type protector. Sucralfate is unique because it forms a lovely “mucousy” protecting layer in the GI tract, preventing irritation & healing any ulceration already present. Again, the sucralfate must be given at least two hours away from other drugs. These things make drug timings a right pain to organise. Working out drug charts is Vally’s forte – I’m sure she would love to help you on that.
I read in your that you’re a bit concerned about looking out for a clot – did they look into this & tell you anything? Did they do a blood smear? This & a blood test would instantly tell you if Tiger is at risk from abnormal clotting.
So don’t you worry that Tiger is a bit on the tired side & breathing a bit faster – perfectly normal. He needs lots of rest, keeping nice & calm – & a lot of cuddles of course! You are doing a fantastic job – you need to get some rest & look after yourself too.
Keep us updated whenever you get a chance
Love Sheena, Worzel & Ollie x
Hi Adam
I am so sorry to hear about what you and Tiger are going through, although I am glad you have found us. All of us have been through this and completely understand how shocking and devastating it is. As you can see above, there is hope for many animals with the right treatment, and I am so pleased to read that Tiger is seeing a specialist and holding his own. It’s great news that he appears well in himself too. That’s so important.
If you could get us a list of medications, and if possible Tiger’s blood results, that would be really helpful. As has been said, there are other medications which are used alongside the immunosuppressants which are really important to counteract the side effects of the drugs and the effects of the disease (e.g. abnormal clotting). From what your vet has said, it sounds as though Tiger may have intravascular haemolysis, although I am not certain on this. Sheena has explained reticulocytes, and that is also important and something to ask the vet about. This will help you to find out whether Tiger has regenerative or non-regenerative IMHA.
I understand your frustration waiting for his PCV to rise. It is so hard waiting and waiting, but hang in there. These drugs do take time to work and hopefully Tiger’s transfusion has stabilised him so that he is able to maintain his PCV whilst the drugs take effect. The length of time it takes for response varies according to the drug used, and also to the individual dog. You are doing an amazing job getting him the right treatment.
In answer to your question about getting ready to bring him home – well, I’m the only cat owner here, so I am sure the dog owners will have some handy hints here for you, but I would suggest you get in plenty of food, both for you and for Tiger. If he is on prednisolone, which is likely, he will probably become very hungry. I think the others can help with advice on what to feed him. He will also drink and pee a lot with the prednisolone, and some dogs have “accidents” so perhaps just make sure you are prepared for that with some clean towels etc. I would also suggest making him up somewhere cosy to sleep which is near to his food and water, so that he doesn’t have to use too much energy to get up. He is likely to feel pretty tired for a while.Perhaps consider whether you will want to sleep near to him too. Some people do, some don’t, and either way is fine, but if you are likely to want to stay close to him, you might want to make yourself up somewhere to sleep too!
As much as you can, try to stay positive around him too. This is devastating for you, but Tiger will pick up on your emotions and it will help him if you are positive and things at home are as normal as possible.
One more important point – don’t forget to look after yourself. You need to stay strong for Tiger, so eat well, sleep well and make sure to ask for help from others if you need it.
Keeping everything crossed that Tiger is soon home with you and feeling much better.
All best wishes,
Mary and Mable x
Hi Susie
I understand you worrying about what triggered this illness. Sometimes we are able to find the cause, and sometimes not. Many cases of IMHA are classified as “idiopathic”, meaning the cause is not known. Whether there is a cause that we are yet to discover remains to be seen. Some animals appear to have a genetic predisposition to immune problems. I think this was the case with my Molly, and I wonder if it could be with Emily too, since she has allergies. Please don’t torture yourself with it though. Whatever has kicked this off, it is not your fault.
I think all of us would admit that going through this has made us paranoid, so please don’t feel you are alone in waking up to check her breathing, as Vally said. I’m sorry to hear about the ibuprofen incident. I’ve lost count of the number of times I’ve had to call the vet because one of my cats has eaten something they shouldn’t.
Vally is amazing with her medication charts. Do you know any more about the Reglan? I am not familiar with its use in animals. It seems that the Baytril possibly interacts with some “antacids” (reducing absorption of the Baytril) so it might be worth checking this. Sucralfate certainly seems to reduce absorption, but I know Vally is well aware of that and how it needs to be spaced. I’m just not sure if Reglan has the same interaction. From what I can tell, both Reglan and Baytril seem to have some interactions with Cyclosporine, so please do check with your vet that these are safe if you change.
Vitamin K always worries me with this disease and whilst I understand why some vets initiate it, it seems to me that it is likely to increase the risk of abnormal clotting, which is already a great risk in most IMHA dogs. Am I right in thinking Emily is not on any anti-clotting medication? Hopefully the blood results will give some indication as to whether this is needed. I’m sorry to bombard you with all this when I know you must be frazzled. Please don’t feel you need to reply in a hurry. It’s much more important to be spending time with your lovely girl.
All best wishes and I hope Emily is doing well today.
Mary and Mable x
Hi Adam – I have been off the website for a bit due to work pressure, so just came back today. So very sorry to hear about Tiger – you must be worried sick; it is a truly awful disease. But the transfusion will help for now while the immune suppressing drugs kick in – and it is promising that he is looking OK and not tired. And yes, you need to check out his reticulocytes. If they are regenerating, that is good, but if not, then there are dogs who can pull through it (Sheena’s Worzel is an example). It sounds like he has got good veterinary care – and above all, he has you. Your love for him will have a huge effect: never doubt that.
Keep us all posted about his progress. And take care of yourself
Sending love
Lynda B.
Hi Susie
Yes – Linda is spot on – the two tummy protectors are needed – sensitive tummies need looking after. Sucralfate is amazing because it forms a protective coating – ulcers will actually heal because they are “covered”.
I am delighted you are going to cyclosporine – small dogs do much better on it.
Susie – you are a star – you are doing the best possible job for your little sweetheart.
Love Sheena xxxxx
Hi Susie – sending every possible best wish for the visit.
Yes please – in addition to your great questions:
Blood test (s)/ any test result copies.
Sucralfate prescription.
Ask about the clotting risks.
Ask if they know the exact cause now.
Bossy old thing, aren’t I?
Love & a big hug, Sheena x
Oh Adam – you are having a rotten time. So glad you’ve found us in the end. Lets start with all the good stuff – if Tiger is more active & happy, that is the best news& actually very positive at this early stage of treatment. It is not unusual for the PCV to drop after transfusions in these early stages because the drugs haven’t had a chance to suppress the immune system properly yet. Give them time. I totally understand you are worried sick – the vets have done a good job and so have you – getting Tiger to the hospital so quickly has made a big difference. Are the vets still saying this is definitely rat poisoning? Blood tests again would help a diagnosis. Rat poison is very nasty stuff & should be used with more care to stop animals being able to accidentally ingest it – poor you having the worry of that.
You can read about reticulocytes here https://www.secondchanceaihadogs.com/AIHA_Terms/reticulocytes/
and reticulocytosis here
https://www.secondchanceaihadogs.com/AIHA_Terms/reticulocytosis/
Basically, reticulocytes are baby red cells that have just come out of the bone marrow – they are immature & will develop into nice red blood cells in normal circumstances. If Tiger is producing lots of reticulocytes, that means she is making lots of new red blood cells – exactly what should be happening – to replace the ones her body has “accidentally” destroyed. This is called regenerative. A blood test will show this. If for some reason Tiger is NOT producing reticulocytes it is called non-regenerative & means that for some reason the bone marrow has been affected. Do not panic if this is the case – my Worzel had a rare form of the disease which meant he had no reticulocytes getting into his bloodstream whatsoever. I was as scared as you are, believe me. He was given immuno-suppressant treatment (prednisone & longer acting azathioprine) & treatment of the cause or trigger of the disease (antibiotics for ehrlichiosis), plus stomach protectors to prevent the drugs damaging the GI tract. Slowly he recovered- he is in remission now, over 2 years after the diagnosis. It was a horrible time. Bone marrow failure is much more rare & can take various forms. Let’s not worry about that until we know about the reticulocyte levels on Tiger’s blood tests. It is more likely to be destruction of cells in the blood stream – this is called intravascular haemolysis. Does that help explain things a bit?
If you would like us to look at any tests & help you with the results, you can scan & send them as attachments on the Urgent Advice page:
https://www.secondchanceaihadogs.com/urgent-advice/
It would help us to help you if you can give us exact details of what drugs Tiger is on. With this disease, there is often a risk of abnormal clotting when intravascular haemolysis takes place. Anti-clotting medication is needed when any of the following are present:
1. Large scale hemolysis
2. Spherocytes seen on blood smear
3. Very high platelet count – over 1,000,000
4. Auto-agglutination
5. Transfusion
Obviously if anticoagulent rat poison IS the cause, the initial worry is bleeding & I see Vit K has been given.
I imagine your vets have already investigated these things – they sound very good indeed, but it is vitally important to be aware of clotting risks.
You can read more about this here: https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/
You are more than welcome to print anything you want to from the site glossary & take it to the vets with you if that helps.
Whe you get Tiger home – let’s hope that will be very soon as he is making progress on the PCV front – you will need tummy protectors – famotidine & sucralfate are excellent for this. Again, this is important as you don’t want the drugs to irritate or ulcerate the GI tract.
Anything else you’d like to ask?
Sending you & Tiger all my very best wishes – give him a gentle hug from me when you visit. This disease can be beaten with the right treatment & you must keep focused on all the positives, even though it’s hard when you see them so poorly.
You will get wonderful support from everyone on here – we have ridden that roller coaster too. The rarity of this disease means we all need to lean on each other. Please let us know how Tiger is whenever you can.
Sheena, Worzel & Ollie xxxxx
Vally – chart looks superb – you are just too good – we need to check this Vit K problem out as soon as possible though.
Emily – did they not give you sucralfate? It’s a good tummy protector – again worth mentioning to your vet. It needs to be given at least 2 hours from any other drugs though. I found it brilliant, stopping Worzel’s terrible tummy ache very quickly. Dogs with tummy ache sometimes eat weird & horrible things to try & lessen the pain – I know she has “slight tendency” (!!!!) to steal stuff.
Love Sheena x
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