Help and advice – Experience with Acute Respiratory Syndrom in AIHA dog – Page 5

Anne

Guest

Hello everyone,

First of all, sorry for the delayed reply to all your kind words and good wishes. I must confess that since Bilbo’s extended stay at the veterinary hospital, I did not have the focus I needed to work. Now that he’s back home, I need to catch up on so many things – I’m teaching and the fall semester is starting soon (too soon!). So please, be assured that you were al in my mind, and that I really appreciated your time and help. So here are the latest news.

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Bilbo’s first week back home was good. His breathing has stabilized, and is now eating – hello prednisone!! We monitor his food intake, but since he needed to gain some weight, we could be more lenient this past week. :-)

David has elaborated a “pill schedule” (he needs to take 8 a day) based on a table the vet prepared (very kind of her!)_And so far, it’s working well. Thanks for offering to send me your chart, Vally: we’d certainly be happy to have a copy – it might be better than what we have in hand.

Thank you also, Sheena, Patrice and Mary for taking the time to look at Bilbo’s last test results. I did not have the time to write a proper thoughtful reply, but I really appreciated it. I might not write regularly, but be assured that I do take the time to read all your messages, and that I will respond at some point!!

Bilbo had his first follow up visit at the vet yesterday, and his RBC was at 28,5, and he’s still regenerative, yay! The vetforgot to give me a copy of his results though, so I’ll ask for it again next Monday. I’ll submit to you guys again, if you want. The pattern on his lung is now also back to what it was before his illness, so this was reassuring. However, he now has a small heart murmur (which developed when he was hospitalized, and they notified us then) and his white cell count was higher than the last time, which is now causing some concerns. Anybody else here have experienced that?

Sheena mentioned that a blood smear might be necessary, and we’re going back next Monday to do one. My understanding is that it t could be the anemia causing this inflammatory reaction, an infection, leukemia… I guess you all have learned to deal with this state of indecision or uncertaint, but it’s scary. We were so close to losing Bilbo a mere week ago, dealing with possible other dangerous issues is frightening.

I’ll send you the results from Monday’s testing and next week’s too, so that you can tell me what you think. The white cells things now worries me, but I try to stay positive, given that we were so lucky that Bilbo has come out of his ordeal alibe.

But besides this, Bilbo was happy to be back home. He doesn’t have that much energy, but his strength is improving. We’re not allowed to walk him, so he ventures in the backyard, walk around a bit, and then sleeps inside. Penny and Sam cuddle with him, but mostly let him be, as I believe they can feel that he needs all his energy for himself. I’ve attached a picture I took this weekend.

Thank you also for the suggested reading, Sheena, it was very useful. I asked the vet to double check for ticks as possible cause,but he tested negative for Lyme, Anaplasmosis et Erlichiosis. However, he received his shots a month before the disease started. Could it be related or would he have reacted to shots sooner?

Regarding his medication, here is what he has been on since he is out:

– Baytril 75 mg PO SID,
– Clavaseptin 187.5 mg PO BID,
– Lasix 15 mg PO BID,
– Aspirin 8 mg PO SID,
– Prednisone 25 mg PO SID,
– Atopica 75 mg PO BID,
– Immuran 25 mg POSID

We saw the vet yesterday. She said to reduce the Immuran to 25g (half a pill) every two days, and give Bilbo 3/4 of a 15g pill now instead of a full pill.

The vet said we would probably stop the Baytril and Clavaseptin onnce the prescription is over (I think we have it for a month, but I’d have to double check).

Anyway, I hope you are not too upset at this delayed reply: you’ve all been generous of your time, and all replied so quickly. I’m swamped with work, and because Bilbo is more stable now, I leave a bit more to David. I’ll keep you updated, but in the meantime, lots of good thoughts and love to you all!

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Keymaster

Hi Anne-Marie

LOVE the photos – Bilbo is adorable – that nice tummy just invites a rub!

Don’t worry about the delay – everyone understands completely how busy life is. Don’t worry too much about the white cells – it is common to see this & it is also easy to think the worst! It could be an automatic counting error in the machine (mistaking baby red cells for WBCs) or just a bit high because of the drugs. A blood smear would determine that actually. What is really important is that his PCV is improving & he is regenerative – fantastic. Also wonderful news about Bilbo’s lungs – clever boy.

I’m relieved to see anti-clotting meds there (I am the resident nag on here about vets missing this – it’s so important). I’m not sure about how quickly vaccinations can trigger the disease personally, but we know they definitely do cause it. What I can say is that Worzel had a vaccination when he was already under the weather (stupid idiot I am – even though the vet wasn’t worried, I now know I made a big mistake) and he went downhill after it. I am convinced it sent completely him over the edge as he was already fighting off an infection (most likely ehrlichiosis).

Heart murmurs are common in dogs (certain breeds are predisposed) & easily treated these days. It is not as serious as it is in humans. Worzel has a murmur (mitral valve prolapse) & has been treated for 5 years or more with pimobendane & prilactone. Some murmurs do not require treatment at all. Ollie also has a murmur & he is fine without medication – I suspect it’s because he’s incredibly lazy! Bizarrely, the severity of the murmur doesn’t actually equate to them having symptoms! Some can have quite a lot of leakage & be fine. Others have a minor murmur & be quite ill – Worzel had tachycardia (very fast heartbeat) of 200 beats per minute and was not good at all, even though his prolapse is low grade. The pimobendane worked within a couple of hours & his ECG was back to normal the next day. The vet who did the echographie (ultrasound) was kissed by my sweet dog constantly as she put the painful clamps on Worzel’s skin – she immediately fell in love with him, of course. The only problem is the cost of the drugs – about 100 euros a month for him. Murmurs can cause AIHA too – if the prolapse is severe, the blood can form a kind of whirlpool (like water coming off the edge of a weir & cycling in a spiral & trapping the canoeist in a death roll) which may cause cell damage as the blood cells are trapped within the heart. That was why we had the echographie & it was repeated when Worzel was diagnosed just to be sure. The specialist said this is a very rare occurrence, but he wanted to check everything out.

Just a little comment on the pred dose SID once per day? It is normally given twice a day, 12 hours apart. It is the half life of the drugs (how long they remain in the body) that determines dosage. During pred reduction, this is lowered to once a day, but it’s early days for Bilbo. Would you humour me & check this out? I am not overly worried as Bilbo is doing pretty well, but we are all paranoid on here about correct pred dosage & reduction.

You might see a slow down in the rise of the PCV now as he’s gone over the 25 mark. The kidneys monitor oxygenation levels in the blood & will slow down the production of EPO (erythropoeitin – RBC production stimulant) around this level, so don’t worry if you don’t see such a quick rise as you have had before.

Try & get some rest & relaxation – this is really hard work! It’s nice that David can help out now too and I bet your daughter is a great help with the cuddling. You are ALL doing an amazing job of getting Bilbo better – he couldn’t have a more loving family around him.

Love, cuddles & best wishes from all of us to all of you
Sheena, Worzel & Ollie xxx

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