Aspirin and Rectal Bleeding

[Rebecca]

Hi, all:

I’ve been lurking for a bit, my dog Obie was just diagnosed with idiopathic IMHA last Wed the 29th March with a crit of 8%. He was transfused with PRBC’s and his PCVcame up to about 30%. He came back home on Thursday the 30th. Monday the 3rd of April he had another PCV and it was still 30%, with agglutination continuing. It was decided to start him on Azathioprine at that time, his first dose was on Mon night. His IMHA is regenerative and the doc also thinks it is extra-vascular. He is blowing off bilirubin in stool but not urine. No icterus or jaundice. Appetite decent (considering) and he is drinking like mad.

We have been dosing 30mg pred twice daily along with omeprazole and added 1/6th of an 81mg aspirin once per day against our vets advice (dog is 25kilos). I’m a registered nurse and so I tend to dive into research head on with any type of pathology and based on everything I am seeing with published material, anti-thrombotics are absolutely mandatory- so I took matters into my own hands. I have not received an answer that is satisfactory as to why this practice does not recommend aspirin. All I get from them is the bleeding risk.

Obie has been doing as well as can be expected aside from the medication side effects and fatigue. Yesterday (Wed the 5th) he had diarrhea in the house with a quarter sized drop of bright red blood. A couple of hours later he had incontinence with two more drops. I decided to take him in again to have another PCV check and brief exam. His PCV has come up to 33% from 30% in two days, and the doc thinks that the bleeding is minimal, lower bowel, and related to all of these meds and dietary changes (I agree). He started him on metronidazole which relieved me because I have been questioning whether he should have been put on an antibiotic right at the beginning of this, even though he had no objective evidence of infection.

So, to my question:

Because of this bleeding, I held aspirin last night. However, I do not want to hold it indefinitely. My feeling is that it is such a tiny amount that the bleeding risk is fairly minimal when weighed against the risk for thrombi. I was thinking of planning to continue the hold for 24 hours and restart tomorrow night *unless* the bleeding resumes. We have not seen any more bleeding last night or this morning.

So, what would all of you smart IMHA experienced folks do?

Thanks so much, Rebecca

[Vally]

Hi Rebecca, welcome to the forum.

Obie sounds as though he is doing well with a nice smart PCV of 33%.

I think you are definately right in having used the aspirin, especially with agglutination. The risk of clotting is the biggest killer with this miserable disease.

Bright red blood as the vet has said is lower bowel bleeding. Has Obie been constipated or had diarrhea before you noticed the blood?

I’ll bet the appetite becomes ferocious pretty soon with the prednisone and yes, he’ll drink heaps too.

Is Obie on stomach protection? Ideally Sucralfate is the best, but must be dosed 2 hours away from meds.

Let us know how Obie is going.

Vally

[Rebecca]

Thanks, Vally!

He has had very loose stool since all of this started, I reckon it’s from the dietary change and has been exacerbated by the pred. When we adopted him last June he struggled with adapting to a new diet as well. When he began acting lethargic last Wed before we took him in, I switched him from dry kibble to baked chicken, beef heart, Liver</h4>The liver (hepar) is a large & highly important organ, performing over 1,000 known functions, and is essential & necessary for life. The liver has an amazing ability to recover & regenerate itself, even after quite severe injury or damage from disease. The liver is responsible for producing(…) Term details” class=”glossaryLink ” target=”_blank” >liver, rice, and pumpkin to get him to eat and he has been loose ever since. Now we are doing baked chicken, rice and 1 can of hills prescription digestive care daily. No more diarrhea yet today.

I will ask about the Carafate</h4>Carafate is a brand name for Sucralfate.<br /><br />Please see glossary term Sucralfate for further information.” class=”glossaryLink ” target=”_blank” >Carafate at his next PCV check and earlier if this digestive issue continues. It’s a pretty innocuous drug to bring to the party I think.

What’s your opinion on resuming aspirin?

Thankful this forum exists!

[Rebecca]

Thanks, Vally!
He has had very loose stool since all of this started, I reckon it’s from the dietary change and has been exacerbated by the pred. When we adopted him last June he struggled with adapting to a new diet as well. When he began acting lethargic last Wed before we took him in, I switched him from dry kibble to baked chicken, beef heart, liver, rice, and pumpkin to get him to eat and he has been loose ever since. Now we are doing baked chicken, rice and 1 can of hills prescription digestive care daily. No more diarrhea yet today.
I will ask about the carafe at his next PCV check and earlier if this digestive issue continues. It’s a pretty innocuous drug to bring to the party I think.
What’s your opinion on resuming aspirin?
Thankful this forum exists!

• This reply was modified 7 years, 8 months ago by Vally.

[Vally]

Rebecca, I don’t know if you’d like to consult Dr Jean Dodds. She is an expert in this disease. That would give you another source to go to, who is an expert. If you do a consult with her, send a copy of all your reports (send as 1 attachment) and she responds very quickly. The cost of the report is $150 US, and with that you can email her back any questions and she’ll answer. It’s a one-off donation fee. It’s not just for a one-off answer.

Because your vets are against it, despite there still being agglutination, I feel it better to get an expert opinion on it. My thinking is stay on the aspirin, but with the blood, it’s puts a question mark on it. There is no sign of bleeding on the skin is there? Just the red blood in the poo?

Vally

[Vally]

And here’s the link. It’s the second box on eh page.
https://www.secondchanceaihadogs.com/hemopetresources/

[AmyE]

I am so very sorry your pup is sick. I am glad you posted and I hope we are able to help. My suggestion would be to trash the hills go back to what you were feeding him except the pumpkin and add sweet potato. It is better to stopping loose stool than pumpkin. The canned food is crap and is not helping his immune system. Also stop the organ meats until he is feeling a little better. Boiled chicken is better than baked and you can use the broth in his food as well. So boiled chicken with the broth ,rice and sweet potato is the best diet for awhile. Then slowly add in his kibble. Again I hate to say it but dump that canned food into the trash. I look forward to getting to know you and your pup better. Please pots a picture of sweet Obie if you get a moment.
Warmly,
Amy and “the girls” ( Vidia Coal and Leia)