Page 86 – Second Chance AIHA Dogs

Forum Replies Created

Keymaster

Hi Debra

Please don’t feel silly or stupid – I can assure you we were all in the same boat & this is a very complicated disease to understand. Even though some of us have medical backgrounds, we knew virtually nothing about IMHA. I can see by your messages that you are a lovely, caring person & you must never worry about asking anything at all. To us, nothing is unimportant – the little things worry us all too. My goodness, you are certainly not rude – you are very polite indeed! We all know you are very concerned, that is what comes across.

The “something sticking together” could be platelets or red blood cells -it can also be called abnormal clotting, clumping or agglutination. I presume this is why your vet wants to add the the aspirin. This is very important as you want to avoid clotting & it is often seen with this disease. You can read about this here:
https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/

What a shame nothing certain has come up as the cause so far. Sometimes, you never do find out exactly what happened & it’s really frustrating. But the treatment carries on regardless. August vaccinations – I think that’s too long ago to be relevant. I don’t suppose you know what types of tick testing has been done – was it Snap4dx? We are always highly suspicious of tick diseases on here because they are a cause of IMHA – Worzel’s tests came back negative the first couple of times. Ehrlichia for example is very clever at hiding in the bone marrow itself & may not be readily be found in the bloodstream. This is what happened with Worzel, we suspect, and my Specialist here in France said treat it with doxycycline whatever the tests results are because he had so many obvious symptoms.

Regarding the spleen, it could be enlarged because it is working overtime trying to deal with the damaged blood cells, resulting in broken down blood components (haemolysis) & is in effect overwhelmed – it just can’t do this fast enough. The dark urine you saw is also the result of broken down blood components too. The liver also has to work hard at dealing with the components. When the prednisone & other drugs take effect properly, this breaking down of cells will slow down & the spleen might well go back to normal slowly. Removing the spleen is an absolute last resort unless it is diseased of course. More information if you want to read it here, but don’t get too hung up on the for now:
https://www.secondchanceaihadogs.com/AIHA_Terms/spleen/

The prednisone dose is not that high for Sadie’s weight-
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone/
The dose is normally 1mg per pound (2mg per kilo) per day & should be divided into in 2 equal doses, given 12 hours apart, so you could increase it to 20mg twice a day if your vet thinks it’s necessary. Sometimes, an even higher dose is needed if the PCV is very low.

The heinz bodies Patrice mentioned are something that would only be seen on a blood smear. I suspect spherocytes may also be present. These blood smears are very useful to us as they sometimes direct us to the cause of the problem. Has a blood smear been done, do you know? It would be handy for Dr Dodds & for us to help you with.

Contacting Dr Dodds – send her copies of everything you have & give her a concise version of exactly what has happened & any previous illnesses. Don’t miss anything out if you can help it (not easy). Also, a list of current medications will be needed. Most vets are more than happy to work alongside her & I’m sure your vet would be happy to give her anything they have. After all, getting Sadie better is number one priority & I am really impressed with how much your vets have done for Sadie so far – they have been brilliant. That is a huge bonus for you too. Here is the link if you need it to the online consultation
https://www.secondchanceaihadogs.com/hemopetresources/
She is incredibly busy, but usually gets back to you quite quickly. She lives up to all the wonderful things we say about her! Please get advice about transfusions from her too. PCV of 15 is borderline. Hemopet obviously provide blood products & you can order whatever is necessary – they have every possible variety according to need. I would stringly advise you use Hemopet as their blood products are rigorously tested, cross matched to your needs and will be fresh. Being fresh is very important as older blood products may make our dogs more ill.

I read about the electric fence – I presume it was for cattle or other animals? I have never heard of any ill effects from that type of fencing, but if it was higher voltage, it could of course have done some damage. Did she behave oddly or appear to be hurt afterwards? Poor Sadie – that’s a horrible experience. When I was a kid, we used to dare each other to touch the cattle fences – stupid or what?

Lastly for now (thank goodness you say!) I would go over to home cooked food if you possibly can. Sadie will need good food to use as the building blocks for making new blood cells. Personally, I stuck to broiled organic chicken, lamb mince, lean beef mince, steamed green beans, carrots – others will put some ideas to you on this. While haemolysis (red blood cell destruction) is in progress, Dr Dodds recommends avoiding red meat as their poor bodies cannot keep up with dealing with blood cell components as it is. Once the haemolysis stops, that’s a different matter. Also if you do have to use dried food, make sure you put plenty of water in it. Sadie will be wanting to drink loads of water & doing loads of pee-pees – that’s normal when taking prednisone. They can easily get dehydrated, so make sure there’s plenty of water available for her.

Is there anything I didn’t answer? I hope not – ask if I have. I live in France now, so it’s my evening – forgive us if we don’t always get back to you straight away because of the different time zones. However usually one or other of us is around if you need urgent help.

Sending big hugs – don’t be frightened, please. You have a good vet on your side & contacting Dr Dodds will put your mind at rest too. You will be in good hands with her & we are all here for you.
Sheena, Worzel & Ollie x

Details

admin

Keymaster

Hi Debra

First of all, I’m so glad you’ve found us, but very sorry poor Sadie is so unwell. I am also very sorry to hear about your Mum & you are wonderful to have taken Sadie in. She is really beautiful and I can see why you fell in love with her.

Patrice has given you loads of information which will help you understand what is happening a bit more. I would also recommend contacting Dr Dodds – I did. She is extremely knowledgeable, very kind & worth her weight in gold. She is happy to consult over the internet too.

I wanted to say we are all here to help you & will do our best to answer any questions you have – I had a million questions when this happened to Worzel & this great bunch of people on here kept me going with their tremendous support.

This is looks very similar to what happened to my dog Worzel who had ehrlichiosis, a tick borne disease – his baby red cells were being killed off in his bone marrow & they never got a chance to get into his bloodstream. He went downhill quite slowly & we didn’t know what was the matter. He was also classed as non-regenerative (bone marrow failure), like Sadie. As Patrice says, her other blood cells are low too, so whatever has caused this has affected those lines of cells as well. I saw on the blood tests that babesia had been written at the bottom by hand & they also mentioned tick diseases. Does this mean that Sadie was positive for babesia? Do you have any other test results at all?

What worked for Worzel was a high dose of doxycycline (5/6 weeks) and antibiotic to kill off the ehrlichiosis, high dose prednisone to stop him destroying his own cells in the short term & azathioprine to suppress his immune system in the longer term. I am glad to read that Sadie is on atopica (cyclosporine), which many vets prefer to give rather than azathioprine, and this will suppress her immune system (be patient – it takes time to take effect) & fingers crossed she will become regenerative. It is a waiting game, I’m afraid, and there are side effects to deal with.

Is Sadie on stomach protectant? This is very important. The prednisone can really irritate the tummy & cause ulceration, which can cause bleeding in the intestines – you don’t want any more of that precious red stuff being lost. We all like to warn everyone about this & get vets to add in famotidine & sucralfate. They must be given 2 hours away from the other medications, otherwise they can stop absorption of these important parts of the treatment.

It is so important to find the cause & treat it to eliminate it. I see your vets are on the ball, checking everything. I also see Sadie had an ultrasound – it says “may need operation”. Can you tell us any more about what they found? Also, what antibiotic was Sadie on? What was it for? I see she had a fever. Sorry to ask so many questions!

I’m really happy to read that Sadie is feeling better than she was & that the prednisone seems to have helped. I will be thinking about you & anything we can do to help, just ask.

In the meantime, I’m sending you & Sadie encouraging hugs – she can get through this .

Best wishes from us all
Sheena, Worzel & Ollie

Details