Do some dogs not respond to treatment for regenerative IMHA

[Patrice]

Darbi,
I am so glad you have been doing some follow up on your own. You are probably correct then, this is an old infection, (common), recurring. These cases can be more difficult to treat, as you have probably already read on Gil’s site. She does not take any of this lightly, neither do I.

No, if the test selected was babesiosis then it does not necessarily follow that they tested for co-infections. Another incredibly stupid move by vets, not understanding co-infections. They can account for other signs and symptoms in many cases.

You drive the bus. This is your dog and she relies on you for your advocacy. I also advise owners that you don’t burn your bridges. You do want to be part of a team that treats her, not a helpless owner in the waiting room hoping the vet knows the right things to do.

If this were me I would do two things, one of which I have already done years ago that saved Chance’s life, I got a consultation with Dr. Dodds and she saved his life. You can find all the links for Dr. Dodds on this page, just click on the pictures to go to her site, find the owner consultation page. If you have trouble paying for the $150 for the consultation we can help you.https://www.secondchanceaihadogs.com/hemopetresources/

The second thing is to call and try to talk to Dr. Holland directly. Be very specific about what you need from her, no panicky chatter, be gracious and polite. Tell her the brief history, with all the details about tests done, medications dispensed and a brief current condition. Ask her how you should test her now to get the most effective treatment started. She will tell you what the most effective protocol is going to be right now. She does this every day, all year long.

I suggest you ask for 125mg every 12 hours for 8 weeks. You are going to need to protect her stomach for this, doxy is very hard on the stomach. Dogs can lose their appetite. Even if you still don’t have hard test results right now, I am sure Dr. Dodds would agree with me that you start the treatment.

I just finished a prophylactic doxy treatment on one of my Giants after being exposed to one tick bite. My vet does NOT mess around with these tick diseases. I don’t even have to go in, I just call and they dispense it. Then I follow up after 6 weeks with a SNAP 4DX+ test to ensure that I cleared the disease with this dosage.

So, for optimism sake, let’s hope I am really wrong. No harm is done by treating until you know for sure. That’s the cool thing about veterinary medicine, you can treat without a clear diagnosis, just based on suspicion.
my best
patrice

[Vally]

Darbi, your Middy is such a beautiful girl, and she’s lucky to have such a great mum.

Vally

[Darbi Martin]

Vally,
Thank you – we think she is pretty special!

Patrice,
I sent all of Middy’s bloodwork to Dr. Dodds yesterday, but she is in Italy, so they indicated it will be 24-72 hours before I get a response.

I will call Dr. Holland this morning. I have printed out all of the information you provided, and a form for ProtaTek Intl to take into my appointment tomorrow so that I can have a sample sent to her lab and determine level of infection. The more I think about it, I am confident this all started last summer with the UTI and high PH, soft stools, swollen lymph node, depression at times, etc. I am so upset that I did not know more about this at that time.

I am hoping that my vet is open to Dr. Dodd’s recommendations. So far, she has worked with me as I have requested additional tests, etc. She also increased the prednisone per my urging – all though I am not sure what level she should be on if she is fighting a tick disease as well. Hoping Dr. Dodds can help answer all of this!

Thank you!

[Darbi Martin]

Update:

I heard from Dr. Dodds yesterday. She indicated that I should start test thyroid, take thyroxine regardless of results, and potentially add mycophenoloate.

I also reached out to Dr. Holland but did not hear back.

Met with my vet specialist today. PCV is still at 20% (was same on Monday). She did another ultrasound and did fine needle aspirate of her liver and spleen. She said the pronounced node near her pancreas was not visible this time around.
She sent blood antigen titer (per my request following Dr. Holland’s paper) to a lab, took a coombs test, and sent blood away for thyroid.
She will not put her on Thyroxine unless her level is low because she feels that with all of Middy’s medications it could interact…?!
We are starting mycophenoloate tomorrow evening as we had to send it off to a compound lab to make proper dosage. We will give her one pill a day at first to see how she does as apparently the gastro side effects are pretty bad.
She is very tired, her tummy is making lots of noises. She had kind of soft stools and a little (very small amount) of blood in her stool.
When she eats, she is kind of doing a weird tongue thing where she is spitting some of the rice out – I can’t tell if she is having a hard time swallowing, or if she just didn’t like the Balancit nutrient power I put on top. She ate pieces of liver just fine, so I think it is the powder. I will stop putting it on her food (waiting on Pet-Tinic to arrive – no clue when that will be)…She seems more down today then she has. I am so worried. I really need some prayers for my sweet girl, please.

[Vally]

Darbi, how is Middy?

Vally

[Darbi]

Vally,

Middy has been really good this weekend. Alert, happy, even chased a squirrel up a tree before I could stop her.

Her gums are still super pale though. There have only been two times that her gums have seemed pinker to me this whole month, once when she was at 23% and once over the weekend before we were at 20%. They were paler at 25% than at 23%. How does that work?
At what pcv did you all notice pinker gums?
Also, is she just adjusting to life at 20% or is this likely improvement?
I’m so traumatized by our visits to the vet and the bad new each time, as I know she hates the blood draws as well.
I pray we get good news this week…and from now on!

[Vally]

More prayers from me too Darby.

When Middy is lying around, it’s not a good time to check her gums. They will always be paler. It’s all to do with the spleen. When the dog responds to something, it releases its blood supply and so you would expect then to see pink gums. So maybe have a look when she’s watching out for that squirrel or those moments when she’s a bit more active.

When does she get checked next?

Vally
xxx