My 13 yr old just diagnosed – Page 8 – Second Chance AIHA Dogs

Keymaster

Terri,
I am glad to see that you were able to get into your vet office.

You know, when Chance was on these drugs, (and so too with all dogs on prednisone) his liver enzymes were very high and he was in a lot of pain. What does this mean?

Drugs must be metabolized in the body to be useful. In the case of some of these drugs we use to treat AIHA, IMHA and non-regenerative anemia, the liver is the organ that metabolizes these drugs. Each time you give prednisone, for instance, the liver is the organ that breaks down the drug and makes it available to the body. And each time this happens, some of the liver cells are damaged. They release enzymes into the blood which are markers of this damage. The chem screen monitors Alkaline phosphatase (ALKP) and Alanine aminotransferase (ALT), among others. These values can become very high in our dogs during treatment.

We can’t avoid this situation, unfortunately, because this treatment is necessary to save their lives. However, this inflammation can be darn uncomfortable for a dog. The liver can be extremely swollen and tender. And this was the case with Chance. His ALKP was many many thousands of times higher than normal for instance. I noticed him groaning and having trouble laying down. He no longer wanted to get on anything soft like the couch or bed. I asked Dr. Dodds about this and she told me he is in pain because of his swollen liver.

I am betting that this is the case with Koda. Take a look at the most recent chem screen test results and tell me what the ALKP and ALT are. I bet they are very high. But before you worry, the liver is a very regenerative organ and can survive severe insults. If there was no organic disease before now, then most likely once you decrease the prednisone the liver will recover.

What do you do right now to make him more comfortable? Well, here is what Dr. Dodds had me do. I used a supplement called Denamarin, which is a veterinary blend of silybin and Sam-e. That supplement is known to assist the regeneration of liver cells very well. Once I started him on that his liver enzymes began to drop FAST.

The other thing that Dr. Dodds recommends is her liver cleansing diet. It generally consists of some type of white fish and some vegetables like green beans and white potatoes or yams. Why does this work?

The liver has the job of processing many things, including the old worn out red blood cells in our body (and in AIHA, all the destroyed cells). It does have to work to do this. So the thought is to reduce the work load of the liver by also removing all red blood cells from the diet. When we eat meat those RBC must be processed too. So thus we change the protein to a food that doesn’t contain RBC.

I, too, am a little uncertain about the aspirin. The risk is giving it to him if his platelets are low which can hamper is ability to clot internally. Do you know what value is last test showed for this? PLT.

However, any dog that is currently still actively destroying red blood cells, via the autoimmune destruction, is at risk of developing certain conditions in their vessels that make them at high risk for abnormal clotting. That’s what the aspirin is given for, to reduce that risk of abnormal dangerous clots. We are all worried about this condition called DIC disseminated intravascular coagulation.

Your vet needs to work closely with you to determine what his risk is for this, vs what his risk of low platelets is. We are all sitting on the edge of our seats right now for you.

Do dogs survive this? Of course they do, we are happy to always say that. I have seen some amazing recoveries, beyond belief. Owners play a large role in these recoveries, their home nursing care is so important.
my best
patrice

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