Fairly new to the IMHA “family”

[Tim]

Hello all. This is a place where obviously, I never hoped to post in. But I want to share our experiences and see how they compare with others.

On March 8, 2021, we took our Molly (pointer/border collie mix primarily) to our vet with sluggishness and lack of desire to eat or drink. They did blood work and an autoagglutination test, and diagnosed IMHA, recommending we go to the ER (nearest one is 65 miles away).

We did that and they confirmed the diagnosis, and that her PCV was at 20%. After almost 48 hours they released her with a number of medications — doxycycline for 10 days in case there was an infection involved, 20 mg of prednisone twice a day, and mycophenolate at 250 mg also twice a day (she’s about 50 pounds).

Three weeks later, she had a PCV of 40%. We cut her prednisone from 40 mg a day to 30 mg a day (full 20 mg pill in the morning, half a pill in the evening).

Since then, her blood work has been very stable, but still a little concerning. Her HCT has been consistently 39-40%, and RBC has been consistently just below normal range, about 5.6. All other blood work is solidly normal. So all in all, I guess things could be a LOT worse. Because RBCs have been a little below normal, we’ve not yet tapered the pred down again.

I think our vet wants to stop the mycophenolate soon, but he wants to wait until she’s been on it for 8 weeks. And I’m fine with that. I don’t know that it’s helping, and I don’t know that he thought it was ever necessary in her case; in the hospital her PCV bottomed out at 20% and she didn’t need a transfusion (thankfully). I’ve also heard that on occasion, ironically, a side effect of myco can be…. anemia. I don’t suspect it here, but you never know if it’s reducing her ability to get well into normal. The diarrhea from it, we do know, though it’s getting better. I think he intends to stop the myco before cutting the prednisone, thinking it’s not a good idea to cut multiple medications at once.

We’re cautiously optimistic at this point.

[Vally]

Hi Tim, and welcome, although as you said, it’s not a place you really want to visit.

Molly sounds as though she is really rallying and I suspect she will do even better as the meds are reduced. Totally agree, never reduce two meds at once.

Mycophenolate is not one of my favourites, but more and more vets seem to be going that way now. Yes, ironically, it can cause bone marrow suppression which reduces production of red blood cells.

Good luck with your girl. Any queries, don’t hesitate to ask.

My very best wishes.

[Tim]

Thanks for the welcome. PCV up to 46% today! In a couple of days we will be cutting her myco in half (once a day instead of twice) and recheck seven days after that. Hopefully this is the start of getting her off of the stuff, and if that works, hopefully begin to reduce the prednisone, too.

[Vally]

Great news Tim. Good luck with the reduction.

Vally