Camilla, AIHA-dog from Italy

[eleonora]

thanks Sheena. Camilla eats Regal adult bites (it’s an holistic dog food with 15% rice, 23,5% turkish and chicken…it contains 22% protein, 13% fat…maybe you know it) and on the advice of the vet she also eats 100 grams of fresh minced meat (beef) per meal. I hide prednisone and gastroprotective in fresh meat (as a trojan horse ahahaha!) otherwise she wouldn’t take it. do you think her diet is too rich in fats?

[eleonora]

P.S. i’ve uploaded a picture of Camilla…. i took it the day she was discharged from the clinic

[eleonora]

the medicine for ulcer is Ranitidine Ratiopharm (ranitidine hydrochloride). in her stool today i found a lot of white dots maybe worms (intestinal parasites), so i went again to the vet with a stool sample.I’m waiting for the result of the analysis of stool…and we must understand if the blood in the stool depends on an ulcer or on intestinal parasites….aaaaargh!!!!there is always something wrong :/

[Sheena]

Hi again!

Lovely photo, Eleonora – she is adorable!

Sorry to repeat & insist but Camilla does need Sucralfate. Great to see the ranitidine or cemetidine, which are very similar & do the same as famotidone, so that’s good. Is it possible for you to send copies of Camilla’s blood tests? You can put them on the urgent advice page:

https://www.secondchanceaihadogs.com/urgent-advice/

I am also suspicious this has been a tick or parasite problem and I think you are too. This could (I can’t be sure yet) mean Camilla doesn’t strictly have AIHA, but a severe form of anaemia caused by infection – that would be good news & I would be so happy if this was the case. My neighbour’s dog had the same thing. And Camilla is getting better! Very good news. We use the PCV & HCT, also haemoglobin levels, plus red cell count to monitor our dogs – here is a website which is wonderful for comparing blood results:
http://www.2ndchance.info/normaldogandcatbloodvalues.htm
Don’t worry about understanding everything – we can help you.

Please tell us what happens with the stool sample & how Camilla is doing – she is BEAUTIFUL – I love the photo.

Please, please get some sucralfate as soon as possible – I promise it is essential for prednisone side effects.

Sending best wishes
Sheena, Worzel & Ollie
Xxxx

[eleonora]

Hi Sheena! thanks, yes Camilla is beautiful but not only….she’s a great dog: she’s very clever, she always knows how to behave in every situation (she comes with us everywhere, in the restaurant, in the shops, on the beach…. everywhere!), we did not ever take a lesson from a dog trainer and she is our first dog. for us she is like a daughter (but i think it’s the same for you and your dog). i’ve just called the lab and they said me that the stool sample doesn’t show intestinal parasites. i’ve asked about white dots and they told that are probably proglottids of the tapeworm, so our vet will give us something to eradicate tapeworms. unfortunately Camilla eats everything, also other animal’s stool so it’s possible that she has contracted tapeworms by eating infected stool.I hope every day to find a cause to her anemia different from the AIHA, but really 1 and a half month ago her anemia was too severe to be caused from intestinal parasites (and there weren’t withe dots in her stool) and blood tests showed there weren’t trick disease. when she was hospitalized in clinic her body destroyed a million red blood cells a day. the vet said me that hypothyroidism can cause autoimmune diseases such as anemia but she can’t do the test for hypothyroidism as long as she is under prednisone because the result would surely be altered. what a mess!!!!!! I will be happy to send you camilla’s blood tests but I must scan them and I can only do it from my office (I haven’t a scanner at home), so I think I’ll send them to you on Monday. if you want i can send you the first blood count (November 6, the day she was hospitalized), the worst blood count (November 9, the day of transfusion) and the last blood count currently in my possession.I can send even the blood smear of 6 November.unfortunately we could not take the coombs test because when she arrived at the clinic was Friday night and the test must be performed on the day of the levy but the lab was already closed at that hour. Do the coombs test the following Monday would be useless because she was already under prednisone which would distort the result. Thanks for your advices. Have a nice week-end!

[Sheena]

Hi Eleonora

Camilla sounds like a real sweetie & I bet everyone loves her. It is an absolute pleasure to help – we ALL want her to get better as quickly as possible. Did you get the sucralfate? It is very important for her to have that – if her tummy is ulcerated or inflamed, she won’t be absorbing all those lovely vitamins she needs to get better. Vitamin B12 can be a problem if the gut is inflamed – it can only be absorbed in one particular area & if that is not working properly, you will not get enough B12 into the bloodstream. Worzel had a really bad tummy upset (infection) & his B12 levels went bananas. We have dogs on here who needs B12 injections as they can’t get enough B12 to make new red cells & recover.

I can tell you that a near neighbour of ours thought her dog (she breeds Leonbergers) had the same as Worzel & came rushing to see me – I & the vets reassured her it was not the same – not an auto-immune problem, but a disease infecting the red cells, making the dog kill his own red cells for that reason – they were infected & it is normal for the body to kill something infected. It is not normal to kill healthy cells indicrimninantly – that means an auto-immune immune system problem. I really hope that a parasite or infection might be the case with Camilla. Her dog didn’t have AIHA, he had acute, severe, life threatening anemia due to a tick infection – he recovered very quickly with just antibiotics & prednisolone only. Dogs with AIHA/IMHA don’t usually respond this quickly on just pred – they almost always need a second long acting immuno-suppressant such as cyclosporine or azathioprine. Personally, I would not worry about doing Coombs Test now – it is not 100% accurate & a simple blood smear will reveal much more information anyway – you can sometimes even find the cause or trigger! Very interesting & something I have studied in detail. I am a bit of an amateur detective with blood smears & blood work, but of course I’m not a vet. You vet could be right, it could be AIHA – not seeing any tests results yet, I am taking a educated/ experienced guess! I hope I’m right as it would be lovely to tell you Camilla doesn’t have this disease. Looking forward to seeing the blood results – very, very useful to see if there are any clotting risks, signs of blood parasites or signs of another cause of anaemia. I can’t promise to find the “cause” but you never know – something may be obvious.

For now. let’s assume she definitely does. It is always recommended to get a full thyroid panel done with this disease – being hypothyroid (often an auto-immune disease common in dogs & Golden Retrievers are a breed that is susceptible to this) can trigger this disease & you would need to add thyroxine to Camilla’s treatment. Dr Dodds always adds thyroxine to ALL our dogs treatments unless they are hyper already of course – never come across that so far, but she probably has. There is a good reason – thyroxine encourages haematopoeisis or blood cell production. Humans & animals with hypothyroidism are often anaemic. We have found our dogs recover much more quickly with thyroxine. Also, prednisolone does dampen thyroid hormone production, so if she was hypothyroid before, she will probably be worse now. Some dogs on here have really struggled to recover – very slow – adding thyroxine has made a HUGE difference to their recovery – I promise it is very important to get the test done. She may even need to take thyroxine forever, but you will need to monitor her levels as you reduce the pred & alter the dose accordingly.

Here is a more detailed article from our glossary:
https://www.secondchanceaihadogs.com/AIHA_Terms/hypothyroidism/

Dr Dodds states 20-60% percent of hypothyroid dogs have some kind of anaemia! That is a lot. Her protocol for treating AIHA includes giving & I quote from her paper “0.1mg of thyroxine per 12-15lbs of optimum body weight twice a day to stimulate hematopoeisis, or if patient is hypothyroid” It also helps platelets. You can read one of her articles on hypothyroidism here if you want to (it’s quite long):
http://www.homevet.com/browse-articles/item/336-thyroid-disease-and-autoimmune-thyroiditis-with-dr-dodds

I hope I’ve explained this all properly – if it doesn’t make sense, please ask me anything you like again. I know, it’s complicated!

Have a peaceful weekend cuddling Camilla

Love & hugs
Sheena, Worzel & Ollie xxx

[Linda]

Dear Eleonora and Camilla, I am so sorry to be late responding. We are at our 7th child’s college graduation.

Your precious Camilla is beautiful. My fist thought seeing her picture was – lovely pink tongue!!!!

Both Sheena and Vally are incredible and literally helped save my pup, Sadie. Their advice is right on target. Please listen to all their advice.

TUMMY: A MUST protection. My pup is a unique case and has been through onset and relapse now for the 4th time (onset and three relapses). This is rare. But without ALL the protections (TUMMY, LIVER AND ANTI-CLOTTING) along with the life-saving drugs – with Sadie it is Prednisone AND Atopica), Sadie would not be here today. Every day is a gift. But what I would like to reiterate is that it is imparitive to keep Camilla on tummy protection (Sucralfate, twice a day). Without it ulcers can, and will likely, form.

Sadie will start licking her mouth, smacking her lips and moving around, as if she can not get comfortable. When she does this, I know she is feeling pain and it is usually her tummy. I stay with the Sucralfate twice a day, but when it gets bad, I will open a slippery elm capsule and put a bit in some plain Greek yogurt. It helps. If you do the slippery elm, be sure to give it AWAY from any other medicines and/or food. But first and foremost important is the Sucralfate.

And PLEASE keep Camilla on either milk thistle (and SAM-e) or if you can get it, Nutramax’s Denamarin (now in chewable form, Amazon and many other sites). Also, for anti-clotting, Sadie has been and remains on Plavix (generic: Colopdogrel).

You are doing an amazing job. The fact that you found us (forum) and are so diligent with her medical care and continued support and love is incredible AND commendable. KEEP UO THE AWESOME WORK YOU TWO (pup and fur-mom).

Will be checking in. Sending much love and huge, hang in there hugs,

Linda and Sadie

[Brigitte]

Buona sera Eleonora e Camilla!
That is about how far my written Italian goes even though my mother was Italian. I speak a little bit, but certainly not about AIHA. Camilla e molto bella, mi piace tanto! Eleonora your English is fantastic, I wish my Italian were as good.
I am late posting, it is just such a busy time for everybody. All the others were so great at still finding time to help you, they are the greatest! I think that everything important has been covered already so I am not going to repeat what has been said. One thing that I don’t think was covered, I am pretty sure that worms, even tapeworms would not cause AIHA. Worming your dog is really not a big issue, but I am not sure if it would be a good idea to do it now. It is very easy to do a stool sample and have that checked out. Your vet would know if it is ok to deworm at this time. I would certainly not do it if there is no sign of worms. I am pretty sure that you would know if Camilla would have tapeworms. They are pretty gross and big so I am sure you would eventually notice.
Just a couple of points I want to repeat, even though I said I would not. I am being short and to the point. Adding thyroxine turned my dog around to build more RBCs. Even if the prednisone influences the test, if the test comes back low it is still low. I can almost guarantee you that Camilla is hypothyroid. Sucralfate is VERY important to protect the intestines! Milkthistle and Sam-E are also very important to keep the liver healthy.
I don’t like commercial food very much and prefer to make my own dog food. Many of us have had success with the liver cleansing diet of Dr. Dodds. Maybe you have a good source of fish and that would be a possibility?
http://www.nutriscan.org/knowledge-center/cleansing-diets.html?utm_source=tumblr&utm_medium=post&utm_campaign=20121211%20kidney
I miei migliori auguri,
Brigitte