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- Camilla, AIHA-dog from Italy
hello sheen! thanks for your response, especially for the indication on antibiotics because I was not aware. regarding vaccines, agree with our vet, camilla will not make vaccines for this year. in the future only if necessary/required by law. Unfortunately here in Italy we have heartworm and leishmaniasis so she will do the prophylaxis for heartworm taking some tablets called “cardotek” (it’s not a vaccine but a pesticide). For the leishmaniasis Camilla has always led the collar Scalibor (another pesticide) for the whole year, changing it every 4 months. agree with our vet she will take it only from May to October, that is when it is easy to be bitten by an infected mosquito. and surely I will do like you: a blood count monitoring every three months for all her life.
Sheena, can you explain me the difference between autoimmune anemia and immune-mediated anemia? i think i don’t understand it…. at the beginning i thought they are synonymous, instead they aren’t. so i thought the autoimmune anemia is always “primary”, not dependent on other causes like tick disease etc, and the immuno-mediated is always secondary, dependent on another cause, instead not….i remember i’ve read that both could be primary or secondary. so, what the difference? maybe if there are antibodies against the RBC is autoimmune and if there aren’t is immuno-mediated? i ask this because the first diagnosis for Camilla was “autoimmune anemia”, but after one months and a half when in her blood there aren’t antibodies against RBC the hematologist used the term “immune-mediated anemia”. Thanks
Hi Eleonora
I understand about vaccinations required by law, but I have heard most countries give you an option to get a certificate of some sorts explaing why you dog should be exempt. I’m sorry I don’t know much about this as it doesn’t apply here in France or in th UK where I used to live – you do not have to vaccinate at all by lae, but here in France you have to carry vaccination documents with you whilst travelling.
Heartworm is awful – you have to do something – most folks on here use Dr Dodds protocol & reduce the heartworm medication to a less frequent number of times per year – she recommends every 45 days instead of every 30 days:
http://drjeandoddspethealthresource.tumblr.com/post/46289883129/dodds-heartworm-preventives#.VrDrUPkrKUk
First thing to say is that AIHA or auto-immune haemolytic anaemia is an “older term” still widely used, but more often referred to nowadays as IMHA Immune Mediated Haemolytic anaemia, Vets use either term these days.
Any auto-immune disease is where the body attacks it’s own cells, tissues or organs because it no longer recognises them as belonging to the body – it thinks they are foreign invaders & will attack them just like it would if infected by a bacteria for example.
There is a lot of intellectual difference on some of these things so I am explaining this in my very simple way! Sometimes there is no known reason why this happens – Primary -with current technology it is impossible to say, but it is possible something has gone wrong within the body, for example that a cell line may become damaged or faulty, as in MS Muscular Schlerosis which is a good example. A line of cells has a defect through poor replication & proliferates, making the body attacks the myelin sheath that covers & protects the nerves, & also can attack the brain & covering too. These days, there is stem cell therapy available on a trial basis for now – they extract stem cells from the patient’s blood by giving a growth hormone to encourage the marrow to make loads of stem cells & harvesting them. Then they kill off the entire bone marrow & replace the stem cells with the non-faulty harvested ones – these new stem cells replicate properly, without the inherited fault & this is considered to be a cure or remission. This form of auto-immune disease would have been considered primary in the past as there was no “known” cause. Now we know the cause is genetic mutation, but I think it is still classed as primary! Things like asthma & Hashimoto’s disease (body attacks it’s own thyroid), Sjogren’s disease & others have no “known” cause. I am convinced that there is a cause of all these things – we may be born like this of course – will be studied in the future & a cause will be found. But they are of course considered primary because nothing has triggered or caused it to happen that we know of.
Secondary: Sometimes an auto-immune reaction is triggered by something like a vaccine, an infection or virus, or even a drug, and is called secondary, i.e. something has caused the immune system to go haywire & we know what it is. In Worzel’s case, he had ehrlichiosis & a vaccination, so that would be considered secondary. It caused his system to kill off anything & everything indiscrimantly. So that is secondary.
Can I ask you to go through the videos Patrice has put on here – they are really good & seeing things may help you understand things too:
https://www.secondchanceaihadogs.com/aiha-video-library/aiha-introductory-videos/
At the end of the day the treatment for all these things is immuno-suppressant treatment & eliminating the cause if there is one. Now you can see why eliminating the cause is such an essential thing to do. Quite often, we do not ever find out why it happened because current medicine is not looking at molecular or genetic level. One day, maybe we’ll know everything????
Does this make any sense? I hope it does & wasn’t too boring either.
To read more, see our glossary terms
https://www.secondchanceaihadogs.com/AIHA_Terms/aiha/
https://www.secondchanceaihadogs.com/AIHA_Terms/imha/
Love Sheena xxxxx
thanks sheena, i understand! in camilla’s case the vets didn’t find what has caused the auto-immune reaction…blood tests and stool did not reveal anything …. nothing diseases flea or tick, no intestinal parasite …. camilla had only a very high level of C-reactive protein, but i don’t know if it depended on some inflammatory process not well identified (the hematologist thinks so) or it was a direct consequence of the autoimmune reaction. I would rather find a tick disease or something else that would explain the anemia,…..so this day I don’t know if her immune problem is primary or secondary and this make me fell very worried :( thanks so much!
Hi Eleonora
C-reactive protein in high levels is seen in many, many things. For example heart attacks, influenza, anything that causes huge inflammation. So you can assume Camilla did have something that caused inflammation – what? Not possible to say really. I will look at her early blood tests again tomorrow.
Do not worry – primary or secondary, the trick is to keep watching closely for anything untoward, especially illness, infection or ticks. If Worzel is not quite right, I’m afraid he goes to the vet! I will never lose my paranoia & neither will you. That means we are always vigilant & that is a GOOD thing. Vally always says “welcome to the crazy paranoid world of IMHA” – so a big welcome, Eleonora, to our world! We are all the same, I promise.
Love Sheena xxxxx
Eleonora
I went through Camilla’s tests etc & what you wrote. My best guess is that this WAS in infection – I wrote it on the early tests – high neutrophils is a pretty good indicator AND she was treated with antibiotics too. What was it? We will never know! Of course, we can never be absolutely sure.
Worzel had ehrlichiosis testing – it came back negative (took a week to get it). But the Specialist said you can have 5 tests for this horrible thing & 4 will come back negative because this nasty little bug hides in organs & bone marrow & may not be visible in the blood stream. So Worzel was diagnosed through symptoms only. Educated guesses are usually correct if you look at symptoms! Before I even saww the Specialist, I went to the local vets & told them I was 99% sure from the many obvious symptoms that this was was it was, so I insisted we put him on antibiotics there & then. He must have had the infection for a long time as he became ill slowly. Long story of a million vet visits. The Specialist in Bordeaux agreed with me 100%, on ehrlichiosis being the most likely cause, thank goodness, so he was treated for many weeks with doxycycline to kill the nasty thing off. This infection. coupled with a vaccination would definitely cause his bone marrow failure.
I am pretty sure this was some kind of infection in Camilla’s case and it looks like your original vets thought the same. It was probably enough to trigger an immune system problem. So that is my best guess! High neutrophils, plus band & segmented neutrophils are in important indicator of infection. No use worrying about the past – the future is looking good because Camilla is doing amazingly well. That’s what matters!
Love Sheena xxxxx