Just Diagnosed and starting treatment

[kristal]

Hi friends,

First I want to express my sincere gratitude for all of the support and guidance. It is remarkable at how kind and informed everyone is and I really believe that Shelby would not be getting the as much of the right care if it weren’t your suggestions that are guiding my discussions with the dr’s that we are working with. And thankfully they have been open to my feedback and recommendations!

So Shelby is at home now and she is doing well. After the transfusion her PCV level was t 23% and at 8:00 this morning her PCV level 27% and the file notes that there was some jaundice – up to this point she was jaundiced although her Bilirubin levels were elevated in her blood test (I will upload her blood test from Wed night in the urgent care area).

They discontinued the AventiClav – however I did discuss with the Dr about the use of Doxycycline and they have written us a prescription. I haven’t started it with Shelby yet because I was looking for your feedback based on Shelby’s blood work if I should. We will be going back to her regular Dr. tomorrow and I am asking for a Tick Panel completed. They haven’t completed one at this time because on April 26th she had her tick borne 4DX and it was negative but I think I need to rule out a tick borne disease via a Tick Panel. The dr. prescribed the Doxycycline due to the elevated white blood cells and as a precautionary measure.

I also asked for Shelby to be placed on the blot clot medication. She is now on Clopidogrel . Again that was due to your recommendations!

So in addition to the above noted medications she is also on something to protect her tummy Sulcrate) , the prednisone and the Azathioprine, and the thyro tabs.

I should also mention that the vet’s notes before the transfusion tat her blood typing – grossly visible auto agglutination = poor prognosis indicator and the Blood Smea 1-2 spherocytes/hpf.

We have been transferred back to our regular vet and tomorrow I will take Shelby in for a PCV test to see how the transfusion progress is holding up. I read on a previous forum post that it is normal for the levels to drop after a blood transfusion. Can you comment on what that normal level of “drop” would be?
On Tuesday or vet is back in the office and I am going to have a flood blood work done up on Shelby again. In addition, I am thinking of leaning toward a referral to an internal medicine specialist. The closest to us is either in Michigan or in Guelph On, either way I am thinking that because of Shelby’s condition that I should escalate her care. I would appreciate your thoughts on whether or not I should wait to see a specialist based on how Shelby starts to respond to her current medicines or if I shouldn’t delay.

I can’t emphasize enough at how thankful I am!!! I really don’t know what would have happened to Shelby without your support and guidance in enabling to be Shelby’s best advocate. This site and all of you made all of this so much easier and our entire family are overwhelmed with your kindness.

THANK YOU!

[Amy E]

So happy to hear she is home. Glad you are feeling more secure in your ability to care for and advocate for her. It is our pleasure to help in any way we can. Even if it just checking in on how you are doing. I hope the rest of your day is quiet. As always I will continue to pray.
XOXO,
Amy & Coal

[kristal]

Hi – I am also concerned about Shelby’s jaundice. if you see from my post a few hours ago the vet did record that she was showing jaundice when she left their care. I have noticed that whites of her eyes are yellow and her now light pink gums are tinged yellow. Her pee is also dark. Should I be concerned at this point or is this common after a transfusion?

[Sheena]

Hiya Kristal

So happy Shelby is back home & has anti-clotting clopidogrel (very much needed ) & sucralfate for her stomach too. We got your blood work through, not entirely complete for me to read it all, but enough to see her neutrophils are sky high which is a huge indicator for infection – she does need the doxycycline for sure – start it straight away please. Good idea to persevere with finding the infection as you are doing. You can also do PCR testing if your vets can organise that if the Snap test is negative again.

Shelby is low thyroid, so great to hear thyroxine started. All good! The best news is that this is regenerative anaemia – please feel really happy about this – regenerative is one of our favourite words!

You have been brilliant Kristal – the high bilirubin/jaundice is always seen when they destroy their own blood cells – or even the transfused cells -we have all experienced this – & this will drop as the drugs kick in. If she needs another transfusion, so be it -as long as it is fully cross-matched, that’s fine. I can’t be exact on what drop you might see after transfusion – guesstimate 5-7 approx. But some dogs DO take a while to respond to the drugs & another transfusion(s) is not uncommon – every single dog differs.

You know you can always consult with Dr Jean Dodds via our website:

https://www.secondchanceaihadogs.com/hemopetresources/

I did consult her myself & continue to do so as I trust her implicitly (many of us do regularly ask her advice) & think she really is the most knowledgeable person about this disease, plus hypothyroidism & so many other disorders, plus she is always happy to work with other vets. She has always been my lifeline for Worzel. Our dogs will always be special & cannot be treated or vaccinated in the same way as other dogs are, sadly. We must be ultra-careful!

Azathioprine must ALWAYS be given with food – very important – and use gloves : please read these carefully so you know what to look out for in case of pancreatitis:

https://www.secondchanceaihadogs.com/AIHA_Terms/azathioprine/

https://www.secondchanceaihadogs.com/AIHA_Terms/pancreatitis/

Keep her diet low fat & high protein- fat aggravates the pancreas. It’s no problem to help you with advice on diet if you want. Also Vally does the best drug charts in the world – I know she’d love to help. Juggling the pills with food/ empty stomach, away from other drugs …. nightmare!

Kristal, you are so sweet thanking us- the biggest way to thank us is to get Shelby better & to tell us how she is doing. Send anything via the urgent advice so we can see what’s happening – thank YOU for the detailed info. Ask anything. We need to talk about liver health as soon as possible, but get Shelby settled at home for now.

Sheena, Worzel & Ollie xxxx

[kristal]

Hi Shenna – I have scanned the blood test – let me know if that is a better copy. After such a thorough response, the only 2 questions I have at this time is what if Shelby isn’t eating. I was able to give her a was a few teaspoons of the “urgent care” Hills brand of food given to us from the vet today. Otherwise she hasn’t eaten since Friday. She is drinking and today she was eating grass (although she vomited after). I am assuming that I should still give her the Azathioprine despite having a full stomach?

I would very much appreciate any feedback about the approach to giving Shelby her meds. Right now the only rule that I am following is with the Sulcrate Plus 2 hours before or 1/2 after other medications. Otherwise I am giving the medications all at the same time and it does seem very excessive to me.

Any diet advice would be great, although for now we are lucky if she will take a bite for us.

[kristal]

p.s for some reason the scan version of her test is not uploading via the urgent advice section so I will send another email :)

[kristal]

p.s for some reason the scan version of her test is not uploading via the urgent advice section so I will send another email :)

 

[Vally]

Kristal, I’ll email you about a chart. The thyroid medication should be given AWAY from food – 1 hour before or 3 hours after. Azathioprine and prednisone, instead must be given with food. Sucralfate, yes, actually 2 hours before AND after is better.

Feeding is hard when you know they need to eat with the drugs, but they’re not willing to eat. Try different things. I think we’ve all discussed no dog turns its nose up at roast chicken. Bingo is embarrassing when there’s roast chicken in the house. Keep it low fat – very important with the azathioprine.

Vally & Embarrassed
xxx