Patrice - 2. page

[Patrice]

Kat,
Oh dear I am so sorry to read this about Z.
I am not sure why the emergency hospital wants to transfer him back to your vet.

Call your vet office now and ask to speak to one of the vet techs. Be calm, polite and ask specific questions such as does the vet know the emergency hospital is transferring Z back, are they prepared to do a transfusion, can you come to the clinic and wait?

Do you remember Z ever needing a transfusion before? The vet needs to know this so they can use the proper blood type if he has.

We’ve seen dogs recover from very low PCV before, though you may need 1 or 2 more transfusions.

Ask if they will protect him from improper clotting. This is a risk right now that they should address immediately with some form of anticlotting medication such as low dose aspirin or heparin.

At all times be calm and polite. They know how upset you are, but they need to get their jobs done. If you remain quiet they will let you stay.

Let us know what is happening.
My best Patrice

[Patrice]

Jen,
It worked, I have the pdfs. No worries.

[Patrice]

Jen,
This website has been up for about 13 years, I lose track. Valley and myself both went through a terrifically difficult time with our dogs many years ago. So I developed this site to help owners to understand the medical information being thrown at them, educate them and help them make decisions without emotional influences. I disliked social media sites like FB because the information wasn’t always accurate, most of it is guesswork. I wanted to make sure everything I wrote was accurate.

So what you perceive, vet confusion, is something we are used to seeing. Its discouraging to us to this day. There are well known step by step protocols that focus on immediate treatment and doing proper diagnostics. The sooner a dog in emergency care gets the proper care, the better chance they have of surviving. In the first days the risk of uncontrolled improper clotting is very serious. There are protocols how to treat potential DIC, disseminated intravascular coagulation, which can lead to death. If we are able to intervene at that point we can provide advice what to specifically ask the vet to do.

Some vets don’t do proper diagnostics quickly. Not all hemolytic anemia cases are autoimmune, some are related to things dogs have swallowed, such as foods poisonous to dogs (onions for instance.) Tick diseases can cause IMHA. Treatment is doxycycline.

So in Cocos case we need to make sure your vet is actively researching those things they can test and treat. I am a firm believer in success if a dog is treated properly immediately.

But don’t sweat this, we can help you understand the things you need to care for Coco. Your job is to be calm and cheerful with Coco. We never can absolutely predict everything will be fine, but we do want to not worry around him. Dogs pick up on our emotions and will think something is wrong.

Please upload any testing paperwork to the Urgent Care page. Please try to keep the page size small but also readable. If you have trouble getting copies, tell them you need them for your book keeping. You paid for this, it belongs to you. Be polite but get it. Be gracious when working with the staff but also be determined that you drive the bus. You are an equal partner in Cocos care, you are the one giving him meds, feeding, monitoring etc at home.

We will look it over and help you understand what is happening and what to expect.
My best Patrice

[Patrice]

Jen,
I’m sorry to read about Coco. You had a difficult time getting care but you kept at it. Good job.
AIHA is an older term meaning autoimmune hemolytic anemia. Sometimes vets felt that the condition was caused by the immune system attacking the red blood cells without a credible reason.

IMHA means immune Mediated hemolytic anemia. The difference is that now there is more research and its most likely that the condition is caused by several cumulative triggers, some of which can be tested for and treated. Some triggers are breed related, as in a genetic predisposition.

The vet paperwork would help me look for testing that should have been done to look for triggers. It also highlights the dogs history that may have clues that led to this.

An example would be a cocker spaniel female that has a breed disposition. She may also be in heat, received multiple vaccines during a precheck for spay surgery and then there was unusual bleeding during the surgery.

So knowing Cocos history from your perspective is important. We are also looking for many triggers such as tick disease, foods or poisons, recent vaccines, spider or snake bites, medications, canine allergies, sensitive stomach from a young age. The list extensive, and something you probably know better than your vet.

Right now we also need to know each medication and the dosages and times they are administered. There is a routine protocol most clinics use no, along with any tests done such as a test for tick diseases. The vet may want to do an ultrasound in an older dog for unusual growths, as tumors can also be a trigger. Hypothyroidism is a very common contributor and a full thyroid panel should be done.

A PCV that wavers is normal after a transfusion. What we would look for now are signs of a continuing drop over time with no recovery. I dont see that from what you describe.
My best Patrice

[Patrice]

I am so sorry to read about this. This is somewhat complicated to explain but I do want you to have a lot of hope for survival. Please read this story of Chance, this site is up in memory of him. He survived from bone marrow failure and since we have had this site up, many other dogs have survived this condition. https://www.secondchanceaihadogs.com/our-stories/chance

If the vet is negative and suggests euthanasia, remember that you are the owner and you drive the bus. There are treatments that are very successful, Vally has pointed you to Dr. Dodds protocol.

I would also suggest that you also contact Dr. Dodds for a consultation, let’s call it a second opinion, because I believe this is a special instance where there may need to be treatment to attack the tick disease. Look here at the top of the page for the Owner Consultation Request. https://www.secondchanceaihadogs.com/hemopetresources

Anaplasmosis is a very serious tick disease and may very well still be in the body, causing havoc. Please read this page about Anaplasmosis carefully. https://sites.google.com/site/tickbornediseaseindogs/ehrlichiosis

There is a definite link to bone marrow failure from this tick disease.

Dogs with bone marrow failure are different from dogs with autoimmune hemolytic anemia. The damage to their red blood cells occurs inside the blood vessels, essentially causing them to break apart. Dogs with bone marrow failure have poor or no production of red blood cells. The ones that are in circulation are fine, but each day a small number of older red blood cells are destroyed normally. They just aren’t being replaced.

Dogs with bone marrow failure therefore slowly loose RBC which contains hemoglobin inside, this is called anemia, not enough hemoglobin to carry oxygen to the body cells. These dogs can adjust better to the slower loss of hemoglobin than a dog that loses a lot in just a few days. Transfusions are necessary over time for these dogs as the treatment progresses to resolve the bone marrow failure. I just want to make sure you vet understands that any transfusions after the first one needs to each be carefully typed and matched to avoid transfusion reactions.
My best Patrice

[Patrice]

Amanda,
I’m sorry to read this.
I’m going to suggest you try to take him to a specialty clinic if you have one nearby, for a second opinion. If you can find a board certified internist immediately it is important to determine if there is either internal bleeding or he has developed hemolytic anemia.

I don’t know every detail at this point but I do want you to get him somewhere safe so they can provide supportive care. At this point he belongs in emergency care, not at home. I am concerned also about inappropriate clotting that could be serious. We can talk more about at home treatment but he needs to be stabilized by a specialist very soon. Try to take a sample of stool and urine if you can collect some. But don’t waste time if thats too hard. I’ll check back in the morning and hopefully Vally will be on soon to check in as well.
My best Patrice

[Patrice]

Debbie,
I’m sorry to hear about Briar. This has been a long battle for both of you. I’m glad Dr. Dodds is helping you, she has a lot of experience with this condition.

We’ve had a few owners here who used anabolic steroids. You could search the forum using the search on the right side of this page.

I particularly remember Sway, whose owner had similar experiences for almost a year. He did use anabolic steroids and it seemed to hold her for quite awhile. But eventuality he discovered she had an undiagnosed liver shunt that was the ultimate cause for the severe anemia. Surgery was not advised.

In some particularly intractable cases some owners had moderate success. But in general, I believe that there may have been a yet undiagnosed condition that drove the anemia.

It would be helpful to know what tests and diagnostics that have been done to rule out conditions that may be contributing to this.

You can post a summary here but also upload some of your most recent tests, CBC and CHEM screen and the vets diagnosis. Look for the page Urgent Advice and use that form to upload these. Please, no more than 3 documents at a time. Start a new form if you have more.

The goal of using steroids is to boost the bone marrow to begin the process of regeneration. It can be stubborn due to a variety of reasons.

I assume that Dr. Dodds had you try cyclosporine at some point? And are you still using prednisone?

My best Patrice

[Patrice]

Lucy,
I’m so glad to hear that Jean advised you to do this! Not every vet will know of her and some will not believe her protocols. They tend to have difficulty understanding the supplementation of L-Thyroxine. Others think she is famous and admire her work.

We have seen some dogs on this forum who recover from ITP and don’t appear to have more problems. But there is a subset that do appear to have the risk of relapsing in the future. You should develop a comfortable relationship with your vet and ask them to let you keep a current prescription of prednisone at home for this. It’s not an expensive drug and it will give you a head start if this happens again.

Also it would be a good idea to get a routine checkup once a month for about the next 6 months if you can afford that. After that, do it about twice a year. Our dogs that come out of these conditions are a bit more fragile than when they started. Their immune systems may always remain a bit over alert.

So be cautious with exposing her to other dogs you don’t know, avoid exposing her to wild animals (especially due to rabies concerns.) The rabies vaccine is mandatory in most areas of the US and hopefully where you are should be on a 3 year cycle. Each state and locality has their own specific laws about rabies vaccines, exposure to wild animals and human bites. Find out exactly what they say.

When Chance recovered I had to agonize about giving his upcoming rabies vaccine a year after he had become sick. I talked at length with my vet and researched NYS rabies laws, plus my own locality.

It was pretty clear that if I failed to give it to him he would be considered “un-vaccinated” and not just elapsed. The law stated many things about this un-vaccinated state but the most concerning was that any dog not vaccinated could not be “at large.” That means never in public, on or off leash. If a dog that is un-vaccinated bites someone or has a tangle with wildlife, authorities are allowed to impound and quarantine any dog, for as long as 6 months. If there is a bite incident, they may prefer euthanizing the dog immediately to examine the brain. The health department is more concerned about human health than the dog’s health.

This wasn’t going to work with him, he was well and I wanted him to go back to a normal life. So I talked with the vet about a waiver. But she said she had tried many times to get a rabies vaccination wavers for her clients and was only given it once or twice for very old dogs with final stage cancer who were home bound. Chance was neither sick nor housebound. No enforcement officer is going to give one whit about this waiver paperwork, NYS makes it clear that they do no recognize it as a valid document if a dog is at large.

So Chance did have his vaccine and there were no ill effects. He lived three more years to the good age of 13 and passed from an unrelated heart condition.

This is an important discussion to have with the vet you trust the most. Avoiding the topic and hoping for the best isn’t the best option. If he remains un-vaccinated your vet is legally not allowed to treat him, they would lose their license to practice, again the community is more concerned about human health than pet’s health.

Be sure to update us now and then so we know he is ok. We worry about each dog when we hear nothing!
my best, patrice