Staffie X Tiger Diagnosed with AIHA – Page 7

Keymaster

Hi Adam

I am sorry to hear about this scare you have had with Tiger’s PCV, although I am very glad it was “just” a scare and not an actual drop. Thankfully your specialist was on the ball and picked this up quickly. I totally agree with Patrice and Sheena though – the vet needs to get this sorted so that it doesn’t happen again, as Tiger’s treatment relies on accurate results.

How is the diarrhoea? From what I remember of my visit to Australia many moons ago, you guys eat pumpkin a lot so hopefully it’s easy to get there (it’s a nightmare to find in the UK). I do hope it’s eased up. I was a bit alarmed by the rapid decrease of medications, although I wonder if he has been on a loading dose as Patrice suggested, and if Patrice and your specialist are happy for you to lower it, then I’d go with that! My personal preference – and I am not a vet – would be to reduce one drug at a time. That way, if Tiger were to suffer a relapse, you would know which drug it was related to.

Re: freezing cyclosporine. If the manufacturer’s instructions say not to, I wouldn’t. It may only say this because it hasn’t been tested after freezing, but some medications are affected by extremes of temperature (e.g. vaccines) and therefore I wouldn’t risk it.

Re: skin lesions. Is the cefalexin helping? I’m not sure if you have it in Australia, but there is a liquid chlorhexidine surgical soap here called Hibiscrub which I have used on my cats. It cost a fortune from the vet, but I was able to buy it for half the price in a pharmacy. Do check it’s safe for dogs, but that might be one to consider. If not, I am sure there will be something similar there.

You are not needy Adam. I am not surprised you are feeling upset. You have had a huge shock and a lot to come to terms with in a short space of time, not to mention this latest blip with the results. I know that Tiger’s PCV is a little lower than it was before, but I think that this is not uncommon with a reduction in medication (others – please correct me if I am wrong!) and that sometimes a drop of a few percent is seen when meds are reduced. As others have said, see how Tiger is in himself. This is such an important indicator of what is going on. Some people use the “capillary refill time” as an indicator – press lightly on the gum with your finger for around 5 seconds and quickly release. It will be white where your finger was. The pink colour should return to that white area within 2 seconds. That’s a good little thing to try if you are feeling nervous.

As has been said, Tiger’s gums will look slightly paler when he has been resting. This is normal and healthy, as long as the colour improves once he starts moving around. I check Mable’s gums (a cat who has not had IMHA) and the same happens with her. She ended up having a PCV which was right at the top end of high. So you see, you are not needy. This disease affects us all and makes us a little paranoid. You are still in the thick of it and I think you are coping remarkably well. Have faith in yourself and please know that you are always welcome to come here and ask questions, or simply let us know you are having a difficult day. I promise we will understand.

Please give that beautiful boy a big cuddle from me. I can see why he is called Tiger! I hope you’ve managed to have a nice Easter and that Tiger is feeling well in himself.

Mary and Mable x

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Patrice

Keymaster

Adam,
That is really super news! 34 is excellent, just a few points away from low normal: 38%. Nothing to worry about here.

Lowering the dose of prednisone has been responsible for reducing many negative side effects. They will still continue to exist until he has completely reduced and stopped the prednisone. He will have fat and fluid redistribution and there will be continued muscle wasting / atrophy. These account for the bloated tummy look and a general de-conditioning.

Lowering the dose of cyclosporine helped reduce the diarrhea. I think you can safely try giving this about 2 hours before a meal on an empty stomach now, which allows for maximum absorption.

Hmm. All clinics should be taking a full CBC complete blood count and chem screen to monitor his condition. This is always the first step in diagnosis. I am surprised they have not done this. It is really very important. Automated analyzers are used widely because they can not only perform the test quickly, they also provide a wide range of diagnostic information that used to be quite labor intensive to obtain.

I can’t image how you could make a mistake with a spun PCV. There is nothing to calibrate. It’s simply a small tube of blood, spun in a centrifuge, and held up against a chart. PCV’s were used, though spun by hand, in WWI during the later 2 years of the war on the battlefield when they began attempting transfusions!

A chemistry panel tests kidney function, liver function, electrolyte levels, glucose levels, pancreatic enzymes, etc. It tells us essentially how healthy he is. This is usually where we see the negative effects of prednisone, liver enzymes can be greatly increased for instance or there can be signs of it bothering the pancreas.

You can view a short introductory video on the CBC here:
https://www.secondchanceaihadogs.com/aiha-video-library/aiha-introductory-videos/

The CBC shows relationships between the variety of cell types in the blood. For instance an important value that is missed when you only monitor the PCV is the platelets. In autoimmune disease, these can also be low. I don’t think that is the case with Tiger but it would have been very important in the first few days to find that out. The CBC also provides values for the white blood cells, for instance looking for infection.

Here are the guidelines for reducing prednisone:
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone-dose-reduction/

It is usually wise to reduce only the prednisone for a period of time to begin getting rid of the annoying side effects, which are numerous. Some of these, like muscle wasting, will take months to recover from. But they eventually do go away!

Reducing the cyclosporine can follow once he has reached a clinically good HCT and has remained stable for a period of time. This drug has fewer side effects and these tend to go away very soon after discontinuing it, generally with no lasting effects.

We’ll be here to help you through these steps, don’t worry!

I’m so glad to hear he is more himself this week! Good work Dad!
my best
patrice

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