sassy is relapsing. – Page 6 – Second Chance AIHA Dogs

Keymaster

Alyssa,
Good to hear about the platelets, it worked as I expected it would. Now you have bought some time.

If this is babesiosis, then the organisms are still inside some of the red blood cells. The immune system is going to keep targeting those cells in an effort to destroy the “invader.” The spleen is the organ most involved in this activity and can rapidly destroy many red blood cells. In fact many humans and dogs can completely fight off and recover from babesiosis without any treatments. Did you ask your vet to palpate the spleen? It should be quite enlarged if this is babesiosis.

In addition, many ticks carry more than one disease and will infect a human or dog with more than one disease. If this is the case and they didn’t do a SNAP 4 DX+ , then you should have them perform this test. While ehrlichiosis will respond somewhat to Imazol, the other tick diseases respond best only to doxycycline. Can you tell me if they started any other treatment along with the Imazol?

Each tick disease has a different mode of attack on the body and symptoms can be different with each disease. Although, in general, anemia and autoimmune destruction of red blood cells is common to some of them. Another tick disease also impacts the white blood cells. Easier global travel and warmer climates are allowing ticks to spread multiple diseases to areas that never even had tick populations and this definitely increases the risk of multiple infections.

When a dog has one or more tick diseases that cause the immune system to attack red blood cells it is a tricky treatment. The vet must quiet the immune system to stop the autoimmune attack on the red blood cells (and platelets) and prednisone is the first line of defense for this job.

But additionally, suppressing the immune system with high doses of immunosuppressant drugs to stop the hemolysis (and most especially the spleen which plays an very large role in the immune system) weakens it’s ability to fight the invading tick disease. It is a fine line a vet walks in doing this. Your vet is highly challenged right now and is trying to balance these two things carefully. The tick disease must be destroyed but the immune system also needs to stop attacking “self.”

So I understand completely how confused and lost you feel. You want to know what is the best thing to do to save Sassy. Your vet is the key to this. He or she knows how complex this treatment is right now and is hoping that the Imazol will do it’s job ASAP. A second shot may be necessary as well and is generally given in most cases. But your vet can’t stop suppressing the immune system yet because it is still destroying red blood cells. You say you think she is rejecting the transfusion and in reality that is what the spleen is probably doing. It is on high alert.

Stabilizing her is very important because she can fight this herself as well. That comes down to excellent nursing care, not only medically at the clinic, but also by you. And with dogs, a very critical part of their treatment is to not feel stressed out. She needs her family around her acting happy and relaxed as though no one had a care in the world. Any sign of unhappiness from you signals to her something is wrong. This will go a long way in reducing her stress.

I’ve been involved with a tick forum since 2007, 9 years now. I have seen many owners in the same kind of situation you find yourself in. Often in the past, the vets were the hardest part of saving a dog’s life. They were not up to speed on recognizing and treating tick diseases. To this day some vets categorically deny that ticks are an issue “in our location.” They don’t test routinely for tick diseases and fail to recognize the signs until it is too late. It has been frustrating for me. Your vet seems different and willing to do all the right things.

Let’s see what the PCR shows Monday morning. The results are not always absolutely correct, there can be several ways that the test can fail to identify the situation correctly. Again, Gil Ash has explained this in a way that is easy to understand. You can read about the PCR tests here, on this page.
https://sites.google.com/site/tickbornediseaseindogs/tests

Gil has been devoted to providing tick education to dog owners for a very long time, longer than I have been on Tick-L. She is a consummate researcher and I trust every word she has written. The answers you seek are on her website.

If you want to talk to the “Dr. Dodds” of the tick world then your vet, or yourself for that matter, can contact Dr. Holland by phone at her lab Prota Tek Laboratories. See this page for contact information.
https://sites.google.com/site/tickbornediseaseindogs/testlaboratories
I called her in 2007 when I thought Chance had a tick disease as the cause of his non-regenerative anemia and she talked with me on the phone for quite a while.
my best
patrice

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Patrice

Keymaster

Alyssa,
I am sorry you are having so much trouble finding blood. You probably know the issue with fresh whole blood is that it should be typed and matched, each subsequent transfusion adds to the risk of a reaction to a different blood type. Dogs have essentially 11 bloods types, but there are certain dog breeds that have blood that is “universal” such as the Greyhounds that Dr. Dodds uses. Many local vets do keep a donor dog, perhaps a family pet, who is like this. So a fresh whole blood transfusion is actually a good thing for Sassy it if can be done safely. You are not going to kill her with another whole blood transfusion. The vets in charge understand the details and will only perform one if they are certain that the risks are low.

The small PCV jump is significant. Many dogs survive with a PCV of 17%. I am also glad to hear that she had a clear pee. This indicates that the kidneys are doing their job correctly. The poops are clearing the bilirubin that was processed by the liver. Yes this is a part of a damaged red blood cell that is normally processed by the liver, but not to the extent that has been the case for several days now.

Eggs are an excellent food for sick dogs, that is what I use in my household. Please get a small can of plain pumpkin and give her a tsp or two a few times a day, this will help firm up her poop. Make her extremely easy meals to digest. A good choice for very sick dogs with diarrhea is rice congee. Our website has a reciprocal relationship with Mary Straus’s DogAware website. Mary has extensive information on how to care for a dog with diarrhea. She has numerous suggestions on this page. Here is the link that will explain how to make rice congee.
http://www.dogaware.com/health/digestive.html#diarrhea

It’s good to hear that she is regenerative, very positive.

Ok, so no tick disease. When you wrote it sounded like the vet was sure he had seen this in a red blood cell. He must have been sure enough to use Imizol? No, do not use doxycycline. It is a very harsh drug and is meant for dogs that have a positive diagnosis for tick disease.

ITP is like this, it hits very hard in some dogs, after they have previously recovered from AIHA or IMHA. I am never completely positive that these cases are idiopathic, I think that they do have triggers, but perhaps it is very difficult to actually make a diagnosis in this case. And it may be a cluster of triggers that are very hard to define. In most cases of ITP, if the vet can get the dog past the initial crisis period, there is recovery. That’s from Dr. Dodds literature.

However, I would still like to see some level of exploration of the spleen. This organ is very active in this current destruction. It should be evaluated by an ultrasound if possible. Chance’s original problems began with a very enlarged spleen with an enormous growth on it. Dog’s spleen’s tend to have these kinds of problems and in fact, dogs are very prone to developing hemangiosarcomas of the spleen, as well as benign accessory spleens. Humans rarely experience this same condition. In Chance’s case it was benign.

You are doing everything you can. And the most important thing is that you are with Sassy, that’s what matters to her, she has a vague notion she isn’t well, but dogs cannot imagine a future, only live in the present. They do not ruminate about death but live in the moment. Be with her in that moment and reassure her how much you love her.
my best
patrice

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