AIHA-Just Diagnosed

[michael]

another test

[Wendy Gonzalez]

Hello everyone,

As Sheena mentioned, I did post that Frank has a skin infection. I went to the vet today and she told me that the sores/pimples did have bacteria, but she wanted to see him in a week, to see if the shampoo she gave me would work. She believes that it may be due to the side effects of Atopica.

Sheena was kind enough to email me and I have washed all of his things with hot water. I will be staying from work all week, since I work with kids and do not want him near anyone at this time.

I will be using a carpet cleaner that I own to clean up the rug from my office. I will also be washing all of the items that he has been on at work.

One thing that I am wondering…well a couple…

1) What medications did the vet prescribed for antibiotics? One of the things that she is concerned about is that Frank had the parvovirus when he was 2-3 months old…..she wants to make sure what medication they had him on and which one he possibly reacted negatively too (hence the emergency right shoulder surgery)…

2) Frank’s PCV was at 34%, went up 1% from last week. Vet wanted to reduce his pred from 1 1/2 tablets to just one (twice a day). However, I thought that was too big of a jump and went with 1 1/4 tablets, twice a day. I am then going to do one tablet after a week or so. But do you think it as too much of her to ask for such a jump on medication when his PCV is still not in normal range?

3) She also wanted to remove the sucralfate out of the his medication? I thought the sucralfate was a protective layer for his stomach? She also mentioned something about removing the famotidine? Is it too much too soon to have so many medications potentially removed ? I need any advice I can get.

I will ask for a print out of his blood work tomorrow when I pick up his pred and upload it. I completely forgot, it has been one of those long days at work and taking care of my baby boy.

[Vally]

Hey Wendy,

I’ll bet its a staph infection. What is the shampoo you’ve been given?

Sorry Wendy, I don’t understand your first question. Are you asking what the vet used this time around. There’s a list of antibiotics in the glossary which should always be avoided as they are possible triggers for AIHA:
https://www.secondchanceaihadogs.com/AIHA_Terms/drugsantibiotics-can-trigger-aiha/ I now carry a list of this with me. Locum vet suggested an antibiotic injection for Bingo who had had diarrhear for a while. She suggested Penicillin. I pulled out my list and said NO.

The prednisone reduction, I’d still wait a bit. He’s not quite in the normal range yet. Ideally he should be stable in the normal range before reducing. Now having said that, Bingo sat for quite a while under normal, so we decided to start reducing. The idea was that perhaps he would always have a lower PCV. In fact we did reduce and he stayed stable there and in fact started increasing after a little bit. The reduction, when it’s time, I would probably do it your way, but maybe do 1 1/2 in the morning and 1 at night. As you’re reducing, and still dosing twice a day, it’s usually better to have the higher dose in the morning. But certainly 1 1/4 twice a day is good.

The sucralfate and famotidine, I’d leave in place.

Congratulations on that beautiful PCV!!!

Vally & Bingo
xxx

[admin]

Hi Wendy. You are so on top of all this!! Way to go.

I hope in infection clears with the Shampoo. Yes, what is the name of the shampoo?

I agree with Vally about holding on the weaning for the moment. Sadie just hit 38% and we started the weaning. I’m glad she was up, because the weaning helped with the incontinence. So, yes, these drugs get to them. But do get him to a low normal, which with a few more points upward, will be perfect.

I would not stop the Sucralfate. Frank is still on high doses of the immune suppressants and his tummy is still in need of protection. I don’t get the vets reasoning for stopping…..

Sadie is on Doxycycline (antibiotic). Her urinealysis and culture actually came back negative, but we’re continuing with the antibiotics (thank you Auntie Sheena and Auntie Vally for your input!!!), because we, quite honestly, don’t trust the results. And she has had little to no side effects from it. So, I understand your caution on what to give him with his history. But find out which one was given that caused so much trouble (that’s terrible!) and use the shampoo and go from there. So sorry you’re dealing with all this. You are a super fur-mom!!!!

Sending love and huge atta-girl and atta-boy hugs!

Linda and Sadie

[Wendy Gonzalez]

My vet gave me Novalan/Nolovan Solution (spelling?), which we are suppose to use when we bath him twice a week and leave for 5-10 minutes before rinsing.

I also read that povidone iodine solution could help his infection, which I am going to purchase for him and use twice a day.

I am going to print out the list of the medications in which Frank should not take. I am also taking a copy of the paperwork I received from when I adopted Frank from the pound with the list of medications he received while in their care.

I also don’t understand why she wants me to stop the sucralfate. I am going to discuss this with her that I would like to continue it until we reduce his medications. I don’t want to have other issues arise, which more than likely will occur if I listen to her. Luckily, famotidine I can purchase over the counter, which I will continue to do so.

I will keep everyone updated on how my meeting goes with the vet today. Hopefully she listens to reason, if not, I will have to transition to another vet.

Gonzalez-Borg Pack

[Trish]

Hi Wendy! I can only speak from my experience with Max. Our regular vet tried to wean him down very quickly off the prednisone, and this is what prompted us to consult with the specialist that we are now working with, and that has seen us through Max’s recovery (so far, so good, knock on wood!). He not only did not wean him when our regular vet tried to (he was FAR from the normal range), he increased his pred, added the mycophenolate, and then did not decrease the prednisone until Max got into the low-normal range (39). We have been doing a slow wean on the pred since then (have not changed his mycophenolate dosage) and this week Max is at 44, which we are very grateful for. He was previously on Prilosec, and I have been giving him slippery elm (just slippery elm, not the “cocktail” others have touted, he didn’t care for it). The specialist said we could discontinue the Prilosec, but I know how sensitive Max’s tummy is, so instead I asked if we can give him regular Pepcid, and he said that was fine. I haven’t tried the sucralfate, but if he wasn’t doing well already, I definitely would. I won’t be stopping any tummy protectants until he is well weaned off the harsher meds, because I know how he is. You have to trust your instincts as well, which you seem really good at doing already. :) Sorry Frank is going through the skin issue!

[admin]

Hi Wendy

I think the shampoo is called Nolvasan which is great as it contains chlorhexadine. That should do the trick nicely & you can avoid the need for antibiotics, which is good. Don’t use the povidone iodine as well – apparently the chlorhexadine & iodine cancel each other’s good effects out (my vet told me that when Ollie had ringworm).

Good on you for keeping the tummy protectant going – we carried on with it until Worzel was off the pred as that is the safest way. I prefer sucralfate, but it’s awkward if they are refusing to prescribe it. We can’t get it without a prescription here either.

Cephalosporin is often prescribed for BAD cases of staph infections – it is on our list of antibiotics you should ideally avoid though. Some of our IMHA pups have had to take it – no choice in bad cases of course. If you can possibly avoid antibiotics, that would be better. In view of Frank’s parvo history & the IMHA, you need to be extra careful what you give him & I’m really happy you’re getting a copy of what he had at the rescue place that made him ill.

Lastly the pred – I wish they would just leave Frank on the same dose until he has had a normal, stable PCV for a while. It needs to be a bit higher – but he’s getting there nicely! Well done, supermum – you are fighting Frank’s corner magnificently.

Lots of love

Sheena xxxxx

[admin]

Hey Wendy

Good to hear that Frank is continuing to do well, although I am sorry to hear about the skin infection. Fingers crossed the shampoo will do the trick and you won’t need to give antibiotics.

I agree with what everyone has said – I think it might be a bit soon to start tapering, and I would also continue with the sucralfate for now.

Well done Wendy. You are doing an awesome job with beautiful Frank!

Mary and Mable x