Diagnosed in July, looking for support

[Kim]

Thank you for all of the info Patrice. Sorry for the delay in my response, I had a very busy week. I don’t have a recent chemistry screen for Lily. The last one that was done was back when she was first diagnosed, so before any of the meds were started. Since then they have only been doing CBCs.

Lily’s mood has been great this week. She has been excited to see guests when they have visited and she was very interested in all of the birds on our walk today. I have been giving the sucralfate at bedtime. I sure hope this reduction in the Azathioprine helps.

[Mel]

Hi Kim I was just reading your thread and saw that you’re worried about the heavy breathing. My Kingston also breathes quite heavy (but never pants). I’m in a Facebook imha support group and they are also all the same. It is from the pred!

[Patrice]

Kim,
Good news about Lily! I usually tell owners to monitor their dogs by how they behave, not necessarily by what their tests are showing.

Even if tests might show a reduced HTC PCV, dogs adjust to overall lower levels of oxygen over time as a survival mechanism.

Heavy breathing is a response by the body to increase oxygen levels to the body cells, anemia is defined by not enough oxygen going to the body cells. There would be increased breathing rates with anemia whether or not prednisone is being used. Elderly adults can develop reductions in kidney function which leads to less stimulation to the bone marrow to make more RBC. This leads to chronic anemia ans subsequent breathing patterns.

The role prednisone does play is that it is similar to the bodies own natural cortisol but it is dosed in excess of our needs. Similar to when we are in a stressful situation such as a car accident, the body prepares us to “fight or flight” by shutting down unnecessary processes (digestion for instance) and enhancing those systems that would be necessary to “fight or flight.” Increasing blood flow and oxygen delivery would be high on the list. Our bodies cortisol is usually the stimulus that starts this process and is provided by the adrenal glands. When using high doses of prednisone we put the body in a constant state of “fight or flight.” The adrenal glands have stopped working and essentially shrink when there are high levels of prednisone (cortisol) in the body. Because of anemia, the body simply can’t respond with more oxygen properly. The body will try to stimulate an increased heart rate and increased breathing rate to make this happen but the results are still inadequate to deliver enough O2 to the body cells.

This could be considered a “transfusion trigger” that a vet would use to determine if there is a need for transfusion during treatment for AIHA IMHA.

Merck manual states:
“The decision to transfuse RBCs is determined by clinical signs, not by any pre-selected PCV. Animals with acute anemia show signs of weakness, tachycardia, and tachypnea at a higher PCV than animals with chronic anemia. The amount of RBCs required to relieve clinical signs will generally increase the PCV above 20%.”

So Merck recognizes that acute anemia responses are increased heart and breathing rates. As time goes by, chronic anemia, dogs adjust to lower PCV’s and their symptoms are less apparent.

In addition stressful conditions can increase heart and breathing rate. During treatment many dogs develop enlarged and inflamed livers. This is quite painful and can increase a dog’s stress level significantly. Some dogs develop pancreatitis and this too is very painful.

So the changes we see in our dogs during treatment for anemia can be due to a variety of reasons. Thus the need to reduce stressful events in their lives while they are in treatment. Even something as simple as the doorbell ringing is an overly stressful event to a dog.
my best, patrice