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- My dog just diagnosed
My dog Maggie was recently diagnosed with AIHA.
She weighs 24lbs and is on 50mg azathioprine, 100mg cyclosporine, 20mg pred, 20mg leflunomid, & 100 mg doxicycline. Also, 10 mg Pepcid ac 2x per day.
I will upload her results soon. Her last transfusion was 9/14 & her RBCcount got up to 34. She ‘a had 4 transfusions in a week & each time the count drops down after a few days. How often should she be checked?
Hi Jen, great you’ve posted – you’re very welcome here.
What did the PCV drop down to when needing a new transfusion? Usually blood is transfused up to a PCV of about 25 and not over, otherwise the body thinks it doesn’t need to make any new blood and gets lazy. You can read the item on transfusions in AIHA Terms at the top, or this is the link
https://www.secondchanceaihadogs.com/AIHA_Terms/transfusion/
In the early days, Bingo had his PCV checked 3 times a week until stable.
It would be great to do a consult with Dr Jean Dodds, she is the very best in this field. hemopet.com.au
Is there any mention of thyroxine being given. That is often used, whether they are hypothyroid or not, to help the marrow start to producing red blood. Also the pred dose looks a little low to me, it’s usually 1mg per pound, and the cyclopsorine seems high. Others may comment on that. Also the cyclosporine takes a little while to kick in, it’s slower to work than the prednisone but it’s great stuff in that it targets the actual problem, whereas the prednisone targets everything.
They are terrible drugs and the prednisone, in particular, has horrible side effects, but they are life savers.
My very best,
Vally & Bingo
Jen, I’m so sorry you need us but since you do I’m glad you’re here. This group is wonderful. Maggie is a darling girl.
Where are you located? Are you seeing an internal medicine specialist? Did they check for tick borne diseases? Sorry — we have so many questions to make sure that all the bases are being covered.
This disease is rare and most vets never see a case. You do not want someone learning with your dog. Even some specialists only see a couple cases. I am fortunate to now be with a specialist that has treated many cases – I did need to change specialists as I was not happy with our first internist.
I agree with Vally, the pred dose seems low unless Maggie couldn’t tolerate it for some reason. I’m also surprised to see her on so many immunosuppressants so quickly, but again, this could be for a reason specific to Maggie. Typically we see dogs put on pred (at 1 – 1.5 mg/lb) and one other immunosuppressant initially. Another immunosuppressant may be added after a couple weeks, as it takes some time for these drugs to take effect. That is what the transfusions are for, to buy us time for the drugs to kick in.
In my Ashki’s case, we did not transfuse until his PCV fell to 15, but also he coped pretty well in the teens. It took quite a long time for him to turn around, almost 10 weeks, and we did add another immunosuppressant after about 2 1/2 weeks. He started on pred and cyclosporine, and we added mycophenolate later. We also checked PCV 3 times a week for several weeks.
I agree, a consult with Jean Dodds would be helpful, she has consulted on hundreds of cases of IMHA and is very knowledgeable. The drugs and treatment are expensive. I found I could save about 50% by getting the meds at Costco if you have that available to you.
The best thing you can do is learn as much as you can, educate yourself so that you are an informed owner when you go into the vet office and can ask educated questions. This takes some time, there is a lot to learn, but it will pay off for you and for sweet Maggie.
We’ll continue to ask questions and to help you formulate questions to ask so you can learn more about Maggie’s IMHA — this disease does take different forms in different dogs, and that can make a big difference in treatment.
Sending you big hugs — I know this is so scary.
tamara and ashki
diagnosed 4/30/2014 latest PCV 32
Thank you for responding. I feel like I’m on an island!
I am located in MA. I saw specialist who just assumed cancer so I’ve opted to stick with my reg vet ( his cocker spaniel had this 25 yrs ago).
He treats others with this disease as well. I’m also working with an emergency vet center who have been awesome to Maggie!
When she collapsed her RBC was 12 & platlets @ 30,000. Her 4th transfusion got her count up to 34 & platlets 375000 but I haven’t tested her since Sunday- plan to today. It costs $125 per test so things have been pretty expensive ( not that I’m complaining). Does that rate seem about right in your experience? In 11 days we ‘be spent $4000 so I’m nervous we may run out of money but of course I just want to help her!
will ask for copies of test results so I can contact Dr Dodds.
She has been on 75mg cyclosporine for allergies for years so maybe that’s why dosage seems high. Not sure about pred or any other dosages. I’m just doing what they say. I will ask about aspirin for clots.
Hi Jen. I sent you an e-mail but writing here too. Maggie is just adorable. I hope she’s continuing to climb in her PCV.
As I wrote in my e-mail to you, my cocker spaniel, Sadie, at onset was 32 lbs, larger than you precious little Maggie. She gained quite a bit of weight on the prednisone and I jokingly referred to her as a football on toothpicks, but with the weaning (finally!) she is slimming down and getting her girlish figure back.
I agree with Vally and Tamara about the doses and the number of auto immune surprises ants. Sadie, at her 32lb onset, was put on 40mg of prednisone daily and 50mg of cyclosporine (Atopica). Both. Seem high for Maggie and the additional surprises ants are a question to me also.
Do you have any idea what brought on the onset of her AIHA/IMHA? We think Sadie’s was pesticides sprayed for foliage on our pond. It contained copper, highly toxic to pets. She had played and ran to the shoreline which is where it was sprayed from, and most likely either sniffed or absorbed through her paws. Just a freak thing. She collapsed two days later. We also had fish dying by the truckloads too, it was really sad.
Is that cost for a PCV or full CBC? Sadie’s PCV alone usually runs around $35.00. But I bought a discount program called PetAssure and that cut the cost of all procedures and meds at vet by 25% – it adds up as you know. It continues to pay for itself. The vet has to be sighed up to give the discount. You might check it out. Just google Pet Assure.
I also buy Sadie drugs from COSTCO. They too, will discount pet (AND human) prescriptions if there is no insurance. They know me from being there so often and ask how Sadie is doing each time I go in – so nice. I have saved much on the Atopica (cyclosporine) alone.
Stay with us. You are not alone. We are here for you – we know what you’re going through as we’ve been right where you are now. It’s mind boggling and so confusing. Hang in here with us. Let’s get Magpie well. :)
Love and hugs,
Linda and Sadie
Hi Jen
I hope you got my e-mail OK – a big welcome to you & Maggie.
Oh. what a beautiful little girl Maggie is – she loves her cuddly toy very much too! I’m so sorry this has happened to her & I know how worrying this is for you. Everyone has covered the drug treatment – you can look up prednisone on our site here
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone/
The dose Maggie is on is not too much lower than the recommended level, but I would discuss maybe adding another 5mg per day with your vets, unless there is some reason why she can’t have it.
I am hoping your vet has covered clotting risks – this is a serious problem with most dogs with AIHA/IMHA & cannot be ignored – it is serious. The main risks are destruction of large amounts of red cells, agglutination (cells sticking together forming clumps) & transfusions can also cause problems. You can read about the risks on here:
https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/
In very rare cases of bone marrow failure where anti-clotting medications are not needed, transfusions can still trigger clotting issues.
I do appreciate that Maggie also has low platelets (Evans), so this needs to be carefully considered too as this puts her at risk of bleeding. Platelets are produced quicker than red cells, by the way – they don’t take as long to mature, so you might see a rise in these first. Please have a chat with your vets about the clotting though – they will probably have done some blood smears. Some of us can help you with blood test results too – you are welcome to post anything on here, and of course anything that is worrying you, just ask.
Many vets do forget about the PCV of 25 level not being exceeded with transfusions because of the rarity of the disease – this is very important. As Vally says, this is the approximate level where the kidneys (who monitor oxygenation levels) slow their production of the bone marrow stimulating hormone EPO
https://www.secondchanceaihadogs.com/AIHA_Terms/erythropoietin/
This is obviously not what you want to do as Maggie will be relying on the transfused blood – what you want to see is her producing her own cells as soon as possible. Thyroxine (soloxine) is also good for stimulating blood cell production & I agree with Tamara & Vally that you should discuss this with your vet too. It is not unusual to see a drop in PCV after transfusions because Maggie’s body is destroying some of the transfused red cells, so don’t worry too much.
I am assuming the doxycycline means your vet suspects an infection? Tick disease maybe? I am glad all the ultrasounds etc have been done & all is well. Your local vets sound very good.
Personally, I would not hesitate to contact Dr Dodds of Hemopet. She can be contacted through the Hemopet resource page & you can consult via the internet with her.
https://www.secondchanceaihadogs.com/hemopetresources/
Dr Dodds is the most lovely person who has helped many of us on here – I cannot speak more highly of both her knowledge of this disease & her compassion.
Please know we are all here to help & to try & take your worries away a little. I would describe my experience of this disease with my sweet Worzel as going to hell & back and I know everyone else feels the same. It is a truly frightening experience, mainly because most of us had never heard of this evil thing before. As Tamara said, the more information you have, the more you can help Maggie.
Sending you & Maggie big cuddles from all of us here in France
Love Sheena, Worzel & Ollie xxxx
Me again – be careful in choosing anti-clotting meds with the platelet problem – there are different kinds for different clotting problems & with the low platelet issue, your vet needs to be careful which one they use. This is a human site, but is the best explanation I’ve found on the different drug actions;
http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/HealthyLivingAfterStroke/ManagingMedicines/Anti-Clotting-Agents-Explained_UCM_310452_Article.jsp
Also should have said you can get all different types of transfusion blood components from Hemopet, for example packed red cells, platelets
Love Sheena x
![bingo-14-5_1200x775](https://www.secondchanceaihadogs.com/wp-content/gallery/aiha-dogs_2/bingo-14-5_1200x775.jpg "Vally\'s Bingo \\"Smile\\"")
![Brigitte_Cleo_Ripley_Enzo_4](https://www.secondchanceaihadogs.com/wp-content/gallery/aiha-dogs_2/Brigitte_Cleo_Ripley_Enzo_4.jpg "Brigitte\'s Cleo, Ripley, Enzo and Guest \\"Rockin\\"")
