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Thankyou Vally, we are in England, and I will ask vet for prescription for drug cyclosporine, The vet has just contacted me Snoopys blood level has stayed the same and no more sickness and diareh which is really good news, its been on my mind all nite haven’t been able to sleep.I jhave appointment to see him at 12.15 to discuss next step, I did mention to him that I have found this site andneed to ask him some questions, I will be asking if snoopy can go on the drugs you lovely people have told me about, im feeling more posistive now ive got your advice , it means the world to me, thankyou, will up date when I get back from vets, with Snoopy!
Also vet has put Snoopy on Hills dog food for sensitive tummy, do you think this is ok? they have said they can do a scan to see if there is an ulcer there but hubby said if they treating it Snoopy for it anyway why do it?
hi just thought I remember the vet said he could try another autoimmune suppressant but the only thing isit takes time to work so im thinking hes probably talking about the cyclosporine?, he did say there is a newer one that acts faster and didn’t know which one to use? im worried now as didn’t realise cyclosporine took so long to work, does anybody know of this newer drug that actsquicker please?
sorry to keep leaving posts but thought I shloud mention Snoopy has been constantly searching for mud and stones to eat every chance he gets, also before he was diagnosed was trying to eat paper? the vet dosent seem to be worried about this but he never used to be like it before.
Jill, don’t apologise about the posts. Ask whenever something crops up or you think of something. Hopefully, you’ll hear from Mary, she’s in the UK. Mary had a cat that had AIHA.
You can go into the glossary under AIHA Terms https://www.secondchanceaihadogs.com/aiha_terms/
which has a lot of information. You can find the different drugs there too.
I think all of the immunosuppresents take a bit more time than the prednisone to kick in. That’s why high dose prednisone is thrown at them to get things under control.
Whilst Snoopy is on the prednisone, it will be very important to use the stomach protection. Sucralfate is the better choice. It needs to be taken 2 hours away from all medications but it lines and heals the stomach. Bingo had an ulcer and within a day after starting the Sucralfate, there was a difference.
I’m wondering the stones could be because of the ulcer. If Snoopy’s tummy is hurting, it could be an instinctive thing to eat. The other thing is prednisone, once it kicks in, has them eating their heads off. You usually find you just can’t feed them enough to keep them happy.
When you get your list of meds, post them here. I’d be happy to make up a chart for you. Also certain drugs need to be given with food (prednisone), others need to be kept away from food (cyclosporine). We’ll sort it out.
Would you like to post a photo of Snoopy? We’d love to see him. Use the link on the right “Upload your Photo”. It takes about a day to show up – that’s just to protect the site from scammers.
Love Vally & Bingo
Hi Jill
I didn’t realise you were a fellow “Brit”!!!! I moved to France about 9 years ago, but used to live near Oxford. It’s nice to be roughly in the same time zone as you, give or take an hour. I have a hairy lurcher called Ollie from the local dog rescue & Worzel the ex-racing greyhound from the Dogs Trust – he’s the one who had this disease 3 years ago. Snoopy sounds so beautiful – can we see a photo when you have time?
As Vally says, Snoopy could have a sore tummy, even ulceration, if he is trying to eat things like that, so that all important stomach protector – sucralfate needs to be added. I hope you can get that in the UK? I know you said about Snoopy having GI tract issues, including blood, so this could well be the problem.
There is also something called Pica – a craving for dirt, ice, coal & other bizarre things which is a symptom of anaemia – I saw it in humans when I was a nurse. My dog Worzel suffered this & licked everything in site, including himself obsessionally, when his was very anaemic. You can read about this here:
https://www.secondchanceaihadogs.com/AIHA_Terms/pica/
Please do not let your vet stray away from cyclosporine or azathioprine. Other immuno-suppressants are not well tested in dogs. We are very lucky to have a wonderful relationship with a reknowned vet haematologist called Dr Dodds at Hemopet. You can access her resources via this site:
https://www.secondchanceaihadogs.com/hemopetresources/
She has helped many of us on here & is in my opinion, fantastic. I consulted her via the internet & used my local vet & specialist vet who had incidentally trained in the USA – I was in great hands. Her protocol uses cyclosporine and sometimes aazthioprine as well. In rare cases where platelets are affected too, vincristine is used. I’m afraid you have to be patient for these drugs to start working – it does no happen overnight. My dog Worzel was an azathioprine – in hindsight, I would have preferred cyclosporine as it is safer, but the azathioprine did work well for him – he is in remission still. In my experience, Worzel did not respond to azathioprine treatment for about 10 days, maybe more, so the idea is to give high-dose prednisolone to hold them “steady” until the second immuno-suppressant kicks in.
Cyclosporine can cause a bit of upset tummy – diarrhoea & vomiting at high doses in the initial stages. This can be alleviated by giving a little food with the drug & usually resolves when the dose is lowered. So nothing too scary there.
Azathioprine can cause pancreatitis – this did not happen to me thank goodness – Worzel tolerated it very well. But that can happen, in which case you must stop the drug immediately & change to cyclosporine. Pancreatitis can be very serious, so you need to be aware of this & what to look for:
https://www.secondchanceaihadogs.com/AIHA_Terms/pancreatitis/
I promise I have studied this disease closely for the last 3 years since Worzel had bone marrow failure (for me, lots on the haematology side), and others on here have vast knowledge on it too – I ask you to please trust our advice. Many vets have never seen this disease & probably never will in their entire career. The rarity of it means that the treatment is often not done properly. I hope your vet will be open minded & trust our experience with this – it makes life much easier!
I’m sorry if I seem like I’m nagging, but please could you send us copies of test results – please could you get a blood smear done urgently if you haven’t already done that & ask that someone checks it carefully for abnormalities & reports what they see fully. They will know what we are looking for. We can then tell you a lot more about Snoopy’s problems, for example clotting, infection etc.
There is also the addition of thyroxine to Dr Dodds protocol which promotes red blood cell production. A thyroid function test would be a good thing to do anyway – hypothyroidism can cause this, as Vally so rightly says. You vet can always look at her protocols online, or I can e-mail them. She is generous in sharing her knowledge with us all.
Lastly for now, transfusions are a real life saver – in cases of anaemia, fully cross matched packed red cells are a good option. If platelets are affected, then a different scenario. Do not be afraid to use transfusions as necessary, but never transfuse to a PCV of 25 ish. If you go over this, the body will stop trying to produce new red cells. You can read more about this here when you have time:
https://www.secondchanceaihadogs.com/AIHA_Terms/transfusion/
I know this is a huge amount to take in – I have never felt so overwhelmed when this happened to Worzel. It’s horrible, full stop. If you want to talk to me on the phone, I can do that with pleasure. I have free calls to Europe, so no problem.
Good luck with the vet visit – please let us know how you get on. Your vet is welcome to look at any information in our glossary of course.
Number one priorities – get cyclosporine & sucralfate & check for clotting issues! And our wonderful Vally is the best drug chart maker in the world – she can help you with this. It did my head in trying to work out the timings for Worzel!
Hoping our lovely Mary from the UK will pop in & say a little word too – you are not alone – we are all ready to help you & Snoopy.
Big hugs
Sheena & the hounds xxxxx
Hello Jill
I’m so sorry to hear about what’s happening with your Snoopy. We’ve all been there and understand what a truly horrible time it is.
I’m also in the UK, and my cat Molly had AIHA. I’m afraid I am not sure about the price of cyclosporine over here, but chat with the vet about it. I would absolutely recommend Snoopy has a second immunosuppressant, alongside the prednisolone. For many animals, prednisolone alone is not enough (although it is essential). Your vet mentioned another immunosuppressant which is quicker acting, and I am sure I have also heard of something faster (help guys! was it MMF?) but I do not know how effective or safe it was. Cyclosporine is generally the treatment of choice (with pred).
Waiting is very, very hard. Remember that Snoopy can be ‘topped up’ with transfusions if necessary, until the drugs start to work (and great news that the PCV has not dropped further!). Bone marrow biopsy is an invasive procedure. We did it – I didn’t know there were other options at the time. I don’t think it should be ruled out, but I think it should be a last resort. There are other tests which can help to show the vets what is happening, which are less invasive (and less expensive).
My Molly also started eating strange things – in her case, clay cat litter. This is most likely Pica and is common with anaemia. Make sure he cant eat or lick anything which might be toxic or a risk for him to swallow. We had to rush about changing cat litter, as that can cause an obstruction.
It’s also so tough when they won’t eat. This will probably change when the pred kicks in and Snoopy will probably get very very hungry then. I think the chicken and rice is a good idea, but in general, lean protein and low fat is recommended. If he will eat the sensitive dog food, I would think that would be ok? I’m the cat person around here, but the lovely dog people will be able to give you some suggestions for food – lots of them cook for their dogs and are very knowledgeable about nutrition.
They also recommend pumpkin for dogs with diarrhoea. Now, we had an issue getting this in the UK, but we discovered you can buy 100% pure canned pumpkin in Tesco & Waitrose (maybe others), so mixing in a small spoonful of that might help his tummy a little. Vally also sent me some seeds, so later this year I hope to be in full production!
I think your vet is wise to be checking out the ulcer, even if it’s already being treated. It might give some further information as to what is going on. Stomach protection is really important, as is anti-clotting medication (in most cases).
I know you must feel shattered with all this, and there is so much information to take in. You can always print things out and show them to your vet if that is helpful. I also second the idea of contacting Dr Dodds. She usually replies very quickly and it can be hugely helpful to get another set of eyes and another opinion on the best course of treatment.
Hang in there Jill and Snoopy. This is a rollercoaster but you can get through it. Please ask anything you like. Someone will know or will know how to find out.
Much love to you and to Snoopy.
Mary and Mable x
Hi Jill,
You have gotten such great advice from Sheena and Vally. Please listen to them, between them they probably have more knowledge about this disease than your average vet.
I am not a big fan of Hills diet, actually not a big fan of commercial dog food at all. Especially for AIHA dogs I think you could do better. It will not be more expensive but of course more labor intensive than commercial food. Dr Dodds recommends her liver cleansing diet that is very easy to make and most dogs love it and do very well with it.
http://www.nutriscan.org/knowledge-center/cleansing-diets.html?utm_source=tumblr&utm_medium=post&utm_campaign=20121211%20kidney
Instead of the fish you could use lean chicken or turkey.
At the bottom you also see the dosage for Milk thistle. This would be an excellent supplement for Snoopy. There is a product called petinic that is great to add, it contains Vitamin B, folic acid and iron. This would also be a very good addition.
Best wishes,
Brigitte