Poppy, the yellow Lab

[Vally]

Suba is Poppy’s mum and she wrote:

Had one transfusion last week, took it well (this was a week after being diagnosed with IMHA and being put on prednisone).

Blood count stabilized at around 20 and she started eating again. Four days later she lost appetite gradually, had diarrhea etc so we took her back. She had another transfusion yesterday, blood count stabilized at 23. Also had an immunoglobulin? Shot (1200$ for one).

Now the vet called saying she had a ton of fluid around her lungs and chest cavity so they took out most of it. They’ll keep monitoring to see how it goes. I’m army wits end. Have you heard of this?

[Vally]

Hi Suba,

I’ve very sorry you’ve had to come looking for us, but I’m glad you’ve found us. None of us are vets, but we’ve all had dogs and cats that have gone through this, so between us, we have a lot of information.

Can you give us a bit more information about your dog –

What is his name and weight?
What drugs is he on now?
Is he home with you?

If you have a copy of blood test results, attach them to an Urgent Advice email, as you’ve done. The email goes out to the administrators only. There are some people here who are very clever at understanding the results and can help to explain them to you. I’m not one of them though.

With the drugs, you only mention prednisone. In most cases a second immunosuppresent is needed, such as cyclosproine. Also, I’m wondering about the fluid, whether this could be caused by a blood clot but see what others say. Is your dog on blood thinners? This is often vital with this disease and clots can be a bigger risk than the low bloods. Also stomach protection medicine.

Please write back, we’d all love to help.

Also you can post on the form and we encourage people to do that. Go to the bottom of the forum page and you’ll see Create a New Topic. If you have any problems, let me know and I can start it for you. The forum is better in that it will be seen by more people. Your email information is safe on the forum as it’s not displayed.

My very best, Vally

 

Edited to say ….. Ooooops I turned Poppy into a boy :O

[Vally]

Sheena answered:

Hiya Suba

Really glad you’ve contacted us too – a BIG welcome. As Vally says, we’ve all been through this horrible, evil disease & love to help others who are as scared & overwhelmed as we were. If you could send us any blood tests, blood smears & any other tests results, I can help you by having a good look at them & I will try to explain anything you don’t understand. I used to be a nurse (many years ago) & have studied a lot of haemotology books & papers because my dog Worzel developed bone marrow failure, due to ehrlichiosis (a nasty tick disease) & having a vaccination while he was under the weather.

You will find everyone extremely supportive & kind – we would like to know all about what happened so we can help you as much as possible. As Vally has suggested, please give us details of every single drug & dosage, your dog’s weight & any other details you think would help. Don’t worry if you do a very long message – the more info we have, the better.

Vally has quite rightly mentioned that our dogs are at great risk from blood clots & it is important tha your vet does a blood smear to see if your dog is at risk. Most dogs need an anticoagulent, such as aspirin, plavix, clopidogrel. This is something I am very good at nagging everyone about because I have looked at much research on this subject & it is proven to save lives. You can read about it on the website

https://www.secondchanceaihadogs.com/AIHA_Terms/abnormal-clotting/
At the bottom, there are links to the research that you can show your vet if necessary. I know there is a lot to take in!

Just to mention tummy protection as well – these drugs are very harsh on tummies & we recommend sucralfate for protection against ulceration. This medication must be given at least 2 hours before or after any other medications because it will stop them being absorbed properly, which you don’t want to happen as they need the full effects of the medications for sure. Bearing in mind your dog’s tummy troubles, this would be a good idea. You can read more about it here if your want to:

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

I have heard of dogs having immunoglobulin – oooohhhhhh – expensive! It is not used very often, but I’m sure it works – it certainly does with humans with immune diseases. However, the usual treatment would be cyclosporine (an immuno-suppressant) plus high dose prednisone to start with.

How is her diarrhoea now? Do you know if she has an infection? Is she on antibiotics? My dog also gradually lost his appetite – it’s really worrying, I know. I was absolutely at my wits end trying to get him to eat something, so I sympathise.

Sometimes dogs do get fluid build up on their chests – there are several reasons for this & I can’t really answer why this has happened without more information. When that happens, it is also usual for them to drain it off &/or to give them diuretics (water pills). I think an x-ray & ultrasound of her chest is advisable as you must find out what is causing the fluid build up. Is she with a specialist? Do they have experience of this disease? I can’t emphasise how important it is to get the right help from the right vet – many of us have had to look around for someone who has experience. We can also put you in contact with a world renowned expert called Dr Jean Dodds – a wonderful lady who probably knows more about this disease than anyone else! My specialist thinks she is fantastic & was very happy to work with her. Let me know what you think.

I’m sorry to bombard you with so much infomation – but I hope I’ve helped a little. Her PCV is not in the dangerously low area – it’s amazing how well they cope actually. I must mention that transfusions should be small – do not take the PCV higher than 25 otherwise they won’t make as many new red blood cells as they should. Complicated!

Sending you supporting hugs at this difficult time. We are all in this together – anything we can do, just ask, anytime. We are world wide, so someone is usually awake!

Take good care

Sheena, Worzel (diagnosed Dec 2012 – in remission) & Ollie too xxxxx

[Vally]

Suba wrote:

Hi Vally,

The part that breaks my heart is I am traveling for work and not even home in Austin where all of this is going on with my fur baby. It’s really sad. My husband and others are taking care of her.

She is Poppy, a yellow lab who was 63 pounds before all this started and seems to have not lost a ton or anything, but lost some weight to look at.

Prednisone for sure, and they recently started her on something that apparently helps re-generate RBCs and takes a week to kick in.
Immunoglobulin shot (one-time)
2 blood transfusions
Peptacid (does this thin blood?)

I’ll ask the vet to email me a copy of all her history for the past two weeks.

She is currently in the hospital and under their observation and care, which I am grateful for given her new problems daily. She was at home with us between the first and second transfusion.

I am on mobile now and tried but couldn’t create a thread on the forum. I would greatly appreciate any help from you!

Thanks a million!
Suba

[Vally]

Linda wrote:

Hi Suba. My name is Linda and I have an AIHA pup, named Sadie. I am actually at the hospital with her now, getting her second transfusion in 24 hours.

I am so sorry you are going through this. It’s a horrible disease, but it CAN be beat. Sheena and Vally are the best and their advise in spot on target.

I am so glad you reached out to the forum. We all have been (literally, me tonight) where you are and trust me, I was the infamous deer in the headlights – I had never heard of this stinking disease. This forum and these wonderful and knowledgeable people saved Sadie’s life and my sanity. And, as you can imagine, are doing it again tonight as I write to you.

So, excuse my hurry – hang in here with us. You will not be alone.

Sending much love and supportive hugs to you, your family and Poppy,

Linda and Sadie

[admin]

Hi Suba

How are you & Poppy doing?

Peptacid? Do you mean Pepcid AC? If so, it is a tummy protector. It’s not an anti-coagulant.

Sounds like your vet might be giving her another type of immuno-suppressant – they take a while to kick in as you mentioned – just guessing for now – let us know when you find out what it is!

I’m really sorry you are away from home – it’s horrible not being able to be beside them – you must be frantic with worry. You know you can count on us for help any time.

Love & hugs
Sheena x

[Suba]

Hi All,
Firstly, thank-you for your incredible kindness and support during this tough time for us. I have been delayed in responding because Poppy has been progressively getting worse. I have asked the specialty hospital to email me all her details so I can share here, but since I am currently out of the country, it has been a lot of phone and email coordination. At this point, I am desperate to kiss her one last time and hold her in my lap one last time. The shortened version of the latest is that 24 hours after her 2nd blood transfusion and an immunoglobulin shot, she was up to 22 (red blood count) but breathing hard so they took a chest xray, saw a ton of fluid and took out almost a liter (per the vet). They had to repeat it over night to make her comfortable and again the next day. They saw blood in her fluids the next day, her red blood count had dropped to 17 again and the platelet count was really low too. Plus the % of blood in her fluid was high. After a bunch of tests including for coagulation factor and not finding anything off, and consulting other vets, her vet told me they suspect a tumor somewhere in her lungs. At this point the latest is that doing a chest surgery will be worse on her and she may not be able to take it. So we have the option of waiting and watching – to see if she magically pulls through (while they keep trying to make her comfortable) or “coming to a euthanizing decision.”
Please bear with me and my sporadic/incomplete updates as I get all this sorted and wrap my head around it.
The vet suspects it was the cancer that likely triggered an immune response in the first place and lead to IMHA but can’t confirm it.
Please pray for us and Poppy.

She’s on prednisone and danazol and they were supposed to start cyclo sporine today.

[admin]

Hi Suba

Thank you for keeping us in touch with what is happening, despite you having so little time. I sincerely hope the news on Poppy will be better tomorrow – I’m sorry you are faced with all this whilst abroad. I pray she will respond to the danazol quickly, but as your vet said, is does take a while to work fully. My thoughts are with you, Suba.

All my best wishes
Sheena