Zhenya and immune-mediated hemolytic anemia

[Francesca]

Goodmorning everyone! My dog ​​Zhenya, female, 4 years old (a Bernese mother, a Belgian shepherd father) was diagnosed with immune-mediated hemolytic anemia on November 20, 2019 without a cause, out of nowhere.
The day before she was a perfectly normal dog and on the morning of 20 November she was not celebrating anyone and she didn’t want to eat and had gums and tongue as white as his teeth. I take it to the vet and these are the various tests.
We also gave her a transfusion that allowed us to keep her alive and to wait for cortisone to take effect.
Initially she took two high dose cortisone stings (33 kg) and after a week we started to decrease it until we get to the tablets. Currently she takes 2 tablets of Prednicortone (20mg) a day and 1 tablet of Azafor. She also takes Zantadine for the stomach.
But a few days ago she suddenly lost weight (now weighs 29 kg) and her head, legs and rib cage are bony, she looks like another dog! When I cuddle it I feel only bone and I am very worried.
sorry for my bad english!

https://drive.google.com/open?id=1_-JIGOJRgpGM1SpTJeSLyBS0-c4J0E9C

These are his exams

[Vally]

Hi Francesca, I’m sorry Zhenya is not well right now.

How is Zhenya eating? The high dose prednisone does have a lots of serious side effects, incuding loss of muscle mass, but right the drug is very important.

Here is the glossary item on prednisone
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone

Feed her good quality high protein (low fat) foods. We recommend Dr Jean’s liver cleansing diet. See the first article here:
https://www.secondchanceaihadogs.com/nutrition-resources

I’ll ask Patrice, the site owner to have a look at the test results. She’s very good at understanding and explaining them.

Ask anything.

Vally

[Francesca]

The vet didn’t tell me anything about his diet but I noticed that giving it just dog food doesn’t improve. I had started giving her when she was sick and she didn’t want to eat minced meat, brown rice, carrots and some mandarin slices. (Read online)
But the vet really, despite my questions about what to feed her didn’t tell me anything :(

She loves to eat meat, vegetables and fruit: D

[Vally]

Is she eating okay now?

[Francesca]

From today, after the analysis I started giving her beef / pork, boiled potatoes, carrots and brown rice but I don’t know if I’m doing well.
She has always been very greedy so she has always eaten everything, chewing it. During the treatment with high-dose cortisone, even the walls of the house were eaten! And he didn’t chew anymore, he swallowed like he didn’t have teeth. Now chew.

In addition to the food I make for her, I leave her croquettes in the bowl she eats during the day calmly.

I read the diet you recommended, I’ll buy things tomorrow.

The thing that worries me is that for example today it was difficult to jump in the car, as if the muscles had no strength while when she had no anemia she jumped into the circle like a lion and ran to take the wooden sticks and balls .

[Vally]

Francesca, this is all normal. Prednisone gives them a huge appetite and they drink heaps of water. They absolutely do lose muscle mass though, so that’s why she has trouble jumping in the car. It’s better to keep her a bit quiet too for now.

When the prednisone is reduced (and do it slowly), you’ll see that her appetite will go back to normal and she’ll slowly start to put back on the muscle she’s lost.

In the early days, they look so very terrible and this is the drugs, but they are necessary.

[Francesca]

Thanks Vally, we have already started reducing Prednisone and for a few days now it seems to have a “normal” appetite and chews food well. He drinks a lot of water but I know it’s normal.
Until yesterday he was taking one tablet and 1/4 of Prednisone twice a day. Today we did the analysis and its values ​​went down :( Although the vet has gone down, he has lowered the dose because he is really losing a lot of muscle and his head, legs and chest are very dug so from today he takes only one tablet twice a day I am worried because I do not know if it is “normal” that it has fallen and I do not know if he will be able to make his red blood cells rise with less medicine. :(

I searched a lot online in Italy but I didn’t find anything until by chance someone put the link of your site!
It seems that many dogs in Italy have not been able to save themselves from this disease and this scares me a lot :(

[Vally]

Francesca, can you confirm the prednisone dosage, before today, how much prednisone was she on. I understand 1 and 1/4 tablets twice a day, and today, 1 tablet twice a day? So 25% reduction? This is good – no more than 25% reduction at a time, and never reduce two different tablets at once.

I used to always find that my dog, Bingo, red bloods dropped down a little bit after a reduction, but the next time he usually picked up again. I think it was his body reacting to the change in the dosage.

I think if the disease is treated quickly, you have the best chance, so Francesca, you have done the best thing for Zhenya in getting her treated quickly.

Vally