New to this

[Bethany]

Hey all… we are newbies to the community of AIHA/IMHA. My 12 year old mix breed dog has been fighting back from a 10% RBC since Thursday 10/3. Tuesday I took her back in because she wasn’t eating and we got her to eat some special wet food and on Wednesday she threw it all up; the vet didn’t think she’d make the night based on the inclination of end of life behaviors. It is now Saturday night and we continue the fight. She is currently taking 80mg of prednisone a day, iron supplements, and her antibiotics as she can tolerate. I’ve had a difficult time getting her to eat and have finally found some things that work (making her food watered down enough that she can lap it up like water, adding sardines 🤮, and incorporating yogurt often). She has not pooped since Tuesday and this is becoming a concern despite her not eating much. Today is the most she has eaten since her symptoms onset and she was taken to the vet. I am grateful for the glimmers of hope, but still very concerned about the future. Today was a good day and I will celebrate the win, but this rollercoaster isn’t fun and I wish I wasn’t tall enough to ride it. I’ve decided I’m gonna fight for my girl as long as she fights and the moment she is in pain or acts like she wants to give up… she’s a fighter and I have to honor that. She shouldn’t be alive per her blood work and yet- here she is… I am hopeful we have better numbers on the blood work, but for now- I am just cherishing every day I get with her. 🩷

[Vally]

Hey Bethany

I’m so sorry to hear about your girl. This disease can be treated and a lot of vets seem to know how to treat it nowadays. Don’t worry about her not pooping at this stage. As you said, she’s not eating much just yet. Keep up the fluids with food, that’s a great idea.

The prednisone may also be upsetting her stomach. It might be an idea to ask for stomach protection.

Let us know how her bloods go.

My very best.
Vally

[Patrice]

Hi Bethany,
I am sorry to read about your 12 year old.

I think that your “RBC 10%” is really Hematocrit 10%. That is the most important measurement of the seriousness of the anemia. This value is very low and she should be in the hospital. Have they discussed a transfusion yet? I think at this point that should have been on the list of things your vet discussed.

Please remove the Iron supplement. I’ve never seen a case in many years that the cause of the anemia was low iron. That applies more to humans that can have a type of anemia due to low blood iron. Dogs do need some iron and that is stored in the liver, but too much can be toxic and lead to serious illness or death. I fear that this is part of the reason she feels so ill.

Prednisone is a very strong medicine. Dog’s stomach acid is much more acidic than humans. If a dog has a prednisone pill in the stomach, the high acid can eventually cause ulcers in the stomach lining. To reduce this risk, always give with food. Also to reduce the risk even more, buy some soft white bread and prepare this to hold the prednisone into a “sandwich.” Prednisone pills are bitter so you must be careful not to handle it directly while doing this. Take the white bread and make a smallish cavity, put something tasty and smelly in the bread like peanut butter or cheese and carefully stuff the pill inside. Rinse your hand and then squeeze the bread tightly. Take a second piece and just add another bit of cheese or pb. Offer the second piece first so she will smell it and take it. Then right after that give her the other ball with the prednisone inside. Prednisone ulcers can lead to pancreatitis as well, which may also cause a poor appetite and extreme pain. I am suspicious that she already has ulcers and maybe even pancreatitis.

To heal this ask your vet for a bottle of Sucralfate tablets or search on line for it. This is not a medication. It is like a thick “bandage” that coats the esophagus and stomach lining. Humans use this as well. It heals and protects from ulcers. The sooner you get it the quicker it will heal any existing ulcers and prevent new ones. Only give this to her at bedtime for an overnight fast. It does interfere with the digestion of medications and nutrition of food. Give one a day at bedtime.

In addition the high prednisone dosage can cause many organs to have severe difficulties. The liver for instance is the organ that processes the prednisone. It can become highly inflamed doing this work. It has to sacrifice liver cells to process the prednisone. We will see several organs showing high enzymes on the vet’s chemical screen, that will make her feel very sick. We recommend that you use Denamarin. You can go to this page on the website and read about it, it’s not a drug, but it will help the liver heal. https://www.secondchanceaihadogs.com/second-chance-resources/supplement-resources

You note that the link I just sent to you also points to many other resources. Hover over the Second Chance Resources and click on one of many pages that explain many different parts of the treatment.

Has your vet discussed going onto any other immuno-suppressants? I am afraid that long treatments with just prednisone are going to diminish her health further. 80mg is a very high dose. On this page the top three drugs are discussed that can be used to help a dog recover. https://www.secondchanceaihadogs.com/medication-resources

If your vet has not discussed this with you do you have another vet source where you are? An emergency veterinary hospital might be a better choice. Please check with us before you chose to move her to a different vet. But do call them and ask if they can help you better.

Vally can help you with your medication chart so you are timing (and properly giving) your meds. She can also point you to the page and explain how to provide a liver sparing diet at home. It’s important to keep the diet very simple.
My best Patrice