PREVIOUS SUCCESS STORIES

September 2006

Missy

Lilswee’s Mischievous Poop AX NAP MXJ NJP, known to her friends and family as Missy (aka Poop), is a 7 year old intact female Maltese owned by Mary and Steve of Houston, TX. Missy was diagnosed with immune mediated hemolytic anemia on April 9, 2003.

When Mary was asked to comment on the onset of Missy’s IMHA she replied, “Missy’s symptoms included lethargy, vomiting, lack of appetite and pale gums. These symptoms appeared to develop over a week or more when Missy was staying with a friend while I was on an extended business trip. My friend thought Missy had just a ‘bug’. When I went to pick Missy up, I thought perhaps she was depressed from us being apart, but I soon realized that something else was wrong. I immediately took her to the veterinarian where blood testing revealed a positive Coombs test and PCV of 14, which lead to her IMHA diagnosis. Since I had lost my 11 year old Cocker, Tanner, to IMHA in November 2001 I knew what a serious disease we were dealing with. Missy was given an Oxyglobin infusion, and Dexamethasone, and then started on 5 mg prednisone twice per day. As Missy’s PCV rose, we slowly decreased the prednisone every two to three months until it was completely discontinued in January 2004. By late April 2004 Missy had a PCV of 45.

”Over the next several months Missy appeared fine, however, on Sunday August 22, 2004 I noticed her stool was orange and her gums seemed lighter. I had read on the Meisha’s Hope Web site that an orange colored stool could indicate the shedding of red blood cells. The next day we took Missy to the veterinarian where blood testing indicated a PCV of 30. The veterinarian said to wait a couple of days and then bring her back for a recheck. That evening Missy started vomiting, was lethargic and had no appetite. We took her back to the veterinarian the next morning where blood testing revealed a PCV of 20. She was given 2cc Dexamethasone, and received 9cc of whole blood from a donor dog as well as 1.55cc ACD (an anticoagulant solution used for collection of blood for purposes of storage and transfusion). Missy was again started on 5 mg prednisone twice per day as well as 10 mg Metoclopramide twice per day, for 3 days for her gastric problems. Her PCV dropped to 16 before it started to rise. Thankfully by September 21, her PCV was back to 45. In October 2005, Missy started showing signs of thyroid problems. She was started on thyroid medication in early October 2005 and currently takes 0.1 mg Soloxine twice per day for her low thyroid function as well as 2.5 mg prednisone once per day for IMHA. We hope, at some point, to be able to reduce the prednisone even further. Missy also takes a daily multivitamin and SynoviG3 (a glucosamine supplement) because she does agility. She takes Sentinel for heartworm and flea prevention. Missy has not been vaccinated since her initial IMHA diagnosis.”

When Mary was asked to comment on the current state of Missy’s health she replied, “Overall Missy is doing great. Her PCV continues to remain stable. It was 45 on July 25, 2006 and her activity level is up. At one point Missy had lost most of her coat due to her Thyroid/Cushing’s symptoms and looked like a Crested. When the thyroid medication kicked in, this past spring, her coat came back nicely. On July 30, 2006 Missy got her MXJ title and also a Double Q (which are hard for most of us to get since it only takes one minor mistake to blow it) at a San Antonio agility competition. Although we have some conditioning/confidence building to do, Missy is enjoying getting back into agility. My goals have changed from winning to having us enjoying just running with each other. I always enjoyed agility, but prior to Missy’s IMHA, I really wanted to win and get better. I still want to be a better handler but now I realize how lucky I am to have my partner to run and cuddle with, so each course is now a joy whether we make mistakes or whether we run fast or slow. I am so thankful for Missy’s two great veterinarians, Dr. Mccoy and Dr. Braley, who worked with us through both the initial IMHA episode and relapse. The specialist, Dr Braley, did the original transfusion and work-up and let me take Missy home each night instead of leaving her at the clinic. I picked her up at 10 pm after her transfusion and took her back daily for tests. Our regular veterinarian, Dr. Mccoy, treated Missy during her relapse and has been patient about listening to my ideas. During Missy’s initial IMHA episode my husband and I were always very confident about her recovery, however, during her relapse her energy level was lower and it was really ‘touch and go’. My husband stayed up all night with her watching her and making sure she was still breathing since I was on a business trip for the first few days of the relapse. My husband is convinced that Missy started improving when I got home and made it through because I came home. I want to urge others to keep fighting the disease and not to underestimate the power of them being there to help their canine friend fight to get through the rough part and then to let the medicines take effect. We are so very thankful for Missy’s recovery from both the initial episode and relapse. Each day, for us, is now a miracle."

October 2006

Kobi

Kobi is an 8 year old neutered male Golden Retriever owned by Brett and Miel of Nassau, New York. Kobi was diagnosed with autoimmune hemolytic anemia on March 23, 2004.

When Brett was asked to comment on Kobi’s symptoms prior to his AIHA diagnosis he replied, “We had no idea that Kobi was sick when we took him to the vet to have a small wart on his lip checked. While the vet was checking the wart, which turned out to be nothing, she noticed that Kobi's gums were extremely pale. A Complete Blood Count (CBC) was done which revealed a PCV of 18. Other testing revealed an ANA positive at 1:400, a negative Coombs test, and Rocky Mountain Spotted Fever testing weakly positive. At that time, Kobi had no signs of weakness despite being profoundly anemic, which suggested to our vet that his red blood cells were being gradually destroyed. She immediately suspected AIHA and started Kobi on 70 mg prednisone and 350 mg Doxycycline. When Kobi did not respond to prednisone within 48 hours, and it was determined that the anemia was non-regenerative, 100 mg Cyclosporine twice per day was added to the treatment regimen. On March 27, we took Kobi to the Animal Medical Center (AMC) in New York City. A number of tests were run to confirm the AIHA diagnosis as well as to rule out cancer. We were told that Kobi had something called pure red cell aplasia (PRCA), which meant that the immune-mediated red cell destruction was occurring in the bone marrow. We were also told that dogs with PRCA take a longer time to respond to immunosuppressive therapy then dogs with other forms of AIHA.

"Over the next week, Kobi began to show more obvious signs of weakness. On April 2, 2004 he received his first blood transfusion, which raised his PCV from 13 to 22. His energy level increased slightly, however, over the next few days his appetite started to decrease, his abdomen became distended, and his breathing became labored. An abdominal ultrasound confirmed that his liver and spleen were very large, and that he had fluid in his abdomen. His liver enzymes were also very high. We were less than 3 weeks into the treatment, and Kobi was already suffering from multiple secondary problems. Unfortunately, the situation would get worse. On April 11, Kobi was very weak and was unable to stand up without help. Late that night, I could actually hear the beating of his heart from across the room! The next morning, we took him back to the vet, where we learned that his PCV had dropped to 11. He received a second blood transfusion, which bumped his PCV back up to 22. Unfortunately, he continued to develop additional secondary problems over the next week. His urine was now dark orange with ammonium biurate crystals and he had almost no appetite. We consulted with the specialist from AMC, who told us that the prognosis was worse because of all of the secondary problems. With some encouragement from our local veterinarian, we decided to take Kobi to Cornell Veterinary Hospital for another opinion.

"Kobi was admitted to Cornell’s intensive care unit on April 20, 2004 with a PCV of 15, and a long list of secondary problems. The doctors at Cornell added 75 mg Azathioprine every other day and 15 mg aspirin every day to the treatment regimen and replaced the prednisone with 4 mg Dexamethasone every other day. Kobi received another blood transfusion that night, however, the next morning he was still having trouble breathing and did not appear any better. A x-ray revealed evidence of pulmonary edema and thromboembolism. Based on his condition, the vet called to tell us that Kobi probably had another day or two at the most, and that there was nothing else that they could do. Deeply saddened, we returned to Cornell, hoping that we would make it in time so that Kobi wouldn't die scared and alone in the cage. After Kobi’s discharge from Cornell, we got a hotel room, comforted him for a while, and went to sleep at 4 AM, not knowing whether or not he would be alive in the morning, and being completely unaware that his recovery had already begun earlier that day. We drove home the next morning. To our surprise, Kobi actually seemed to be looking a little better. His was eating a little food, his breathing seemed to be a little better, and the fluid in his abdomen seemed to be going away. We were afraid to start hoping again, but Kobi hung on and over the next few days, it became obvious that he was looking better and better. On April 26, his PCV was 18.6 (down from the last check), but four days later, it jumped to 22! Finally, Kobi was starting to regenerate new red blood cells. Over the next few months, Kobi's PCV would gradually rise, but with many, many ups and downs. However, every time the PCV went down, it went up by a little more the next time. By July 2004, Kobi’s PCV had climbed into the 30s, and we began to gradually taper the medications. Despite the ups and downs during the first few months of recovery, Kobi’s PCV has been above 35 since August 2004."

When Brett was asked to comment on the current state of Kobi’s health he replied, “Kobi is doing extremely well and shows no signs of ever having been sick. Since his AIHA diagnosis he has had a few other problems (epilepsy, borderline hypothyroidism, lipomas, and occasional back or leg pain), however, these problems are most likely unrelated to AIHA. Kobi recently turned eight and he has as much energy as when he was two. His PCV at his last blood check on August 31, 2006 was 48. Kobi continues to take 50 mg Azathioprine every other day, 3/4 grain Phenobarbital twice per day (for the treatment of epilepsy) as well as 0.8 mg Thryrozine (thyroid medication) twice per day. He takes Heartgard for heartworm protection and we use Frontline every 4-6 weeks for flea/tick prevention. In regard to vaccinations, our veterinarian consulted with a specialist who indicated that the rabies vaccine is among the most potent to the immune system, therefore, we have chosen to no longer vaccinate Kobi for rabies or any other diseases. He has received no vaccinations since his AIHA diagnosis.

“There are at least three important things that I hope other AIHA/IMHA dog owner/caregivers learn from Kobi's story: (1) It is important to determine whether or not your dog has red cell aplasia. Only a small percentage of AIHA/IMHA dogs do, but if your dog is one of those few, it is important to give him or her time for the treatment to work. Dogs with red cell aplasia take a long time to respond to immunosuppressive therapy. In one study, the average time to increase the PCV by 5% was 38 days, and the average time to return to normal was over 100 days. However, many of those dogs responded completely in the long-term. (2) Kobi nearly died from the secondary problems that were most likely caused by a reaction to high doses of prednisone. Don't overlook the significance of secondary problems that arise while treating the primary problem (i.e., anemia), and find a specialist who has experience managing those problems. In our case, the switch from prednisone to Dexamethasone eliminated many of the secondary problems, which gave us enough time for the treatment to work. (3) Don't give up. When Kobi was really sick, I kept telling myself that somewhere there is a dog that was once a lot more ill than Kobi, who eventually did recover. Kobi is a deeply loved member of our family and we are thankful each day for his miraculous recovery. We look forward to many more years with him.”

Editor's Note: For more information on the study on pure red cell aplasia that is mentioned in the above Success Story Click Here

Kobi Update, June 2008

Brett wrote recently with the following Kobi update.

”Kobi is doing very well. It has now been over four years since his AIHA diagnosis. He continues to take Azathioprine, but thankfully has not had any AIHA reoccurrences. We will celebrate his 10th birthday in July!”

November 2006

Hershey

Hershey is an 11 year old neutered male Chocolate Standard Poodle owned by Rick and Dennis of West Sacramento, CA. Hershey was diagnosed with immune-mediated hemolytic on October 8, 2004.

When Rick was asked to comment on Hershey’s symptoms prior to his IMHA diagnosis he replied, “On Tuesday morning October 5, 2004, Dennis called me at work and told me that Hershey had had a seizure. Since Hershey had never had a seizure before, I was certain something was terribly wrong. Just as I arrived home that evening, he had another seizure. It lasted about 15 seconds and involved him lying down and spreading out all four legs as far as he could and then bobbing his head around. He then flipped from one side to the other, all the while trying to raise his head and stand up. As I comforted him, he calmed down and seemed to come out of it. We counted a total of eight seizures of this nature before we got him in to see a veterinarian on Thursday, October 7. The veterinarian who examined him recommended hospitalization and 24-hour care. Since 24-hour care was not available at that clinic, it was recommended that we take Hershey to Sacramento Veterinary Surgical Services (SVSS) where around the clock care was available. This pet hospital is probably one of the best in the Sacramento area since most, if not all, of the vets there have been educated at the University of California, Davis, a premier veterinary school on the West coast. Upon exiting the veterinary clinic, Hershey had seizure number nine, which lasted only about three seconds. We immediately took him to SVSS and received the same dreaded news that Hershey was a very sick dog. They pointed to his very pale, nearly white, gums as well as his weak demeanor and recommended immediate hospitalization and a full work up. The vets were not sure what was causing this condition, but stated it could be a tumor causing a secondary problem of some type. With 24-hour care, Hershey’s seizures could be monitored and tests done to obtain a diagnosis.

”The first test information came back the next morning. Hershey had experienced no seizures overnight, but his blood work indicated he was extremely anemic, with a PCV of 12 and an elevated white cell count, indicating an infection. He was started on an antibiotic and additional blood work was performed. Every vet we spoke with said that Hershey was very ill and may not survive much longer. We were not willing to give up since he had been so healthy and energetic just the weekend before. By Sunday, every test that could be administered by the vets at this facility had been completed. The only test that could not be performed at SVSS was a CT (brain) Scan. We were told that Hershey had IMHA. We were also told that IMHA is common in Poodles as a primary condition but that it can also be a secondary condition, possibly caused by cancer. Since Hershey had had no more seizures since being hospitalized and testing revealed Hershey had no tumors, it was felt these were positive signs that he did not have a brain tumor. The vet and I went over the exact nature of Hershey’s seizures. We concluded that they were not seizures at all, but that he was simply trying to keep from blacking out. His red blood cell count was so low and his hemoglobin level so depleted that it was difficult for him to maintain consciousness. Hershey was started on 60 mg prednisone twice per day to try to suppress his immune system and stop the red blood cell destruction.

”Against the Veterinarian’s advice, we brought Hershey home on Monday evening, October 11. Since Hershey’s PCV was only up to 18, the doctors were concerned that if he ‘crashed’ in the night he might die without immediate medical care and a blood transfusion. I told them that I’d rather he die at home with me than in a cage in a hospital. I also told them that there is positive therapy to having him home where he is happiest. I agreed to bring him back daily for blood tests and continue his oral medications at home, which included prednisone and an anti nausea medication. By Friday Hershey’s PCV had risen to 24 and the next Monday it was up to 30. The next week his PCV was up to 36! During this time he was suffering horrible diarrhea, and I was concerned that he could not go on like that. One of the doctors at the hospital said the diarrhea may be a result of Hershey’s bland diet. We were feeding him chicken, rice, broth and cottage cheese. The doctor indicated that chicken is hard for dogs to digest and that his old diet of lamb and rice would be better. Hershey had previously been on a dry lamb and rice diet so we gradually returned him to that food and the diarrhea went away. As Hershey’s PCV continued to slowly but steadily rise his prednisone was slowly reduced and then after several months completely discontinued.

“Hershey did well for several months and then in December, 2005 we noticed that he had a dark growth on his face under his left eye. We took him back to SVSS where removal and biopsy of this growth confirmed it to be Melanoma. The surgeon said that there was a clear area about 2 centimeters around the tissue. They did more blood work, a chest x-ray and an ultrasound on his abdomen. All tests showed that the cancer had not metastasized.”

When Rick was asked to comment on the current state of Hershey’s health he replied, “He is healthy, happy and seems to be doing well for an old man of 11, who will turn 12 on December 28. His PCV remains in a range from 40-45 and he is currently on no medications for the treatment of IMHA. Hershey receives no heartworm or flea/tick preventative and on the advice of his doctor has received no vaccinations since his IMHA diagnosis. Hershey is full of energy and loves to run and play in the house and yard. He enjoys getting up on the sofa next to me where I can pet him as well as pull back his lips and check his gums which now are always nice and pink. Everyday is a blessing and we are so thankful that Hershey recovered so well. Every day with him is a gift.”

Hershey Update, August 2007

Rick wrote recently with the following Hershey update.

”Over the past 3-4 months Hershey lost weight, quite a few pounds in fact. His blood counts were normal and a chest x-ray showed no growths. His energy level was good and he was still very playful. However we were very concerned about the weight loss. We changed his diet to try to get his weight up and he responded well to the diet change, but did not gain much weight.

”On July 25, 2007 Hershey was energetic. He ate 2 big bowls of food and everything was fine. On July 26, he would not eat. That evening his head was down as was his tail and his breathing was a bit labored. When he was not better on July 27, we decided to take him back to the Sacramento Valley Surgical Services. Testing revealed Hershey had a high fever, pneumonia, and was vomiting bile. His lungs were completely congested so a tube was placed in his nose for oxygen. After reviewing alternatives with his primary Dr., we decided it was either euthanize or treat aggressively for the next 48 hours and see if he would respond. I decided that I could not endure leaving Hershey in a cage for any time, whatsoever, especially since he was so critically ill, and had so many other health issues in his life. So the decision to euthanize was made. I stayed with Hershey and petted and kissed his face while he was put to sleep.

”After Hershey was diagnosed with IMHA, and attained remission, he had over 2 ˝ more years of happy life. I am very grateful for those years and they are what I choose to focus on. Hershey was such a miracle dog and everyday with him was a precious gift and blessing.”

December 2006

Logan

Logan is a 12 ˝ year old neutered male Italian Greyhound owned by Michelle and Frank of Tacoma WA. Logan was diagnosed with autoimmune hemolytic anemia on January 3, 2004.

When Michelle was asked to comment on Logan’s symptoms prior to his AIHA diagnosis she replied, "Logan and his two Italian Greyhound brothers, Ripley and Sebastian were being boarded in a 24-hour veterinary clinic while Frank and I were on our annual Christmas trip to Mazatlan, Mexico. I had called several times to check on them and each time was told that our dogs were fine. Unfortunately, when we returned to pick them up, we realized something was terribly wrong with Logan. He didn’t get up to greet me and was very listless and cold feeling. He seemed extremely weak and could barely sit up or stand. After we arrived home we noticed he was getting weaker and appeared pale in color. We immediately rushed him back to the veterinary clinic for emergency medical care. The veterinarians put Logan in an oxygen cage and after numerous medical tests, diagnosed him with AIHA. We were told his condition was extremely critical since his PCV had slipped to 6. It appeared he was only hours away from certain death. Logan received two Oxyglobin infusions, was started on prednisone and Azathioprine (Imuran) and remained at the veterinary hospital in critical care for almost eight days. When Logan slowly began to recover, we were finally allowed to take him home. My husband and I traded taking days off from work to stay home to care for Logan and nurture him back to health.

"Three weeks after Logan came home from the veterinary hospital, his PCV had risen to 21. However, we noticed the forearm joint on his right front leg, which had been deformed from an injury early in his life and then later broken, was beginning to swell to the size of a golf ball. We took him to the vet who advised us to soak the leg in Epson salts to relieve the swelling and inflammation. We soaked the leg twice a day and then followed up by wrapping the joint, hoping that would further reduce the swelling. Within a few days the leg was swinging freely and was even more swollen. The vet x-rayed Logan’s leg and determined one of the screws in the metal plate bonding his leg together (from an orthopedic surgery Logan had to repair an injury to his leg while living with his previous owner) had come loose. Heartbroken, we were faced with two choices; repair the damaged leg with a new plate, or amputate it. After some long and careful thought, sorting through the options and consequences of each, we decided to have the leg amputated. We couldn't justify putting Logan through more surgeries and several months of painful recuperation in another cast since we realized if we were to repair the leg, there was no guarantee it would be successful. Our greatest fear was jeopardizing Logan’s immune system since his AIHA was still very serious. Thankfully the surgery went well and Logan healed quickly, in spite of all the medical problems he was experiencing. It was very heart wrenching to see our little Logan go through all this but we knew the leg was causing his health to fail and we believed this was our best chance at saving his life. Logan began to adjust quickly to having only three legs. Several months later the vet determined Logan’s AIHA was probably caused by his leg being infected by bacteria growing on the plate.

"By July 2004, Logan’s PCV had risen to 38. However, during this time we noticed he had a persistent cough. An x-ray and echocardiogram revealed he had early Dilated Cardiomyopathy (heart disease). Logan was started on Enalapril, an ACE Inhibitor drug. In addition, his triglycerides, ALT/ALP (liver enzymes) and lipase levels were climbing which were additional concerns to us. Logan was put on a modified protein diet for one month to help decrease these levels, however, he began to have severe diarrhea because of all the rice and vegetables he was eating. The vet decided to stop all medications, vitamins, and the modified protein diet. Two weeks later we tested again and the results indicated Logan was in the close to normal range for all values, except the ALP. Hormone testing done at the University indicated high androgen levels with estrogen levels nearly normal. The vet believed this problem was due to a pituitary imbalance and put Logan on 2 mg of Melatonin per day. At this point things were going well and Logan was progressing satisfactorily.

"Logan started having seizures in September 2004. Testing revealed he was experiencing focal motor seizures. Fortunately, the seizures were determined to be mild and not require medication. However, we would need to continue monitoring Logan's progress carefully through regular blood panels, CBC’s and other medical tests.

"In January 2005, Logan started coughing again. At first we thought he might have allergies but soon found out he was suffering from congestive heart failure (CHF). His lungs were full of fluid and he was placed on the diuretic, Lasix. After a few days the fluid drained out of his lungs and his breathing returned to normal with only a mild irregular cough.

"After we adopted Logan, in April 2002, he had to have six teeth removed as a result of poor dental health (a common problem with IG's) and we knew we would need to take good care of his remaining teeth. We took Logan into the vet’s office in March 2005 to have the vet examine his teeth because we noticed Logan had really bad breath, which can be a precursor to dental infection. Logan had been experiencing dental problems for the past few months and we were concerned that if his teeth were infected they could be causing or aggravating some of his health problems. The dental examination revealed that Logan had several infected teeth and most, if not all would need to be removed. We were concerned that surgery would be dangerous for him because of the anesthesia. To provide us with a better measure of safety, we decided to have the surgery done by a team of vets, which included a specialist from Canada to do the actual extractions. To our amazement Logan went through the surgery very well and was able to keep six of his teeth. The vet indicted that there was a possibility that Logan's liver problems were related to his bad teeth because a month later his ALP level dropped considerably.

"At the current time Logan’s health is maintained by a regiment of medications consisting of 12.5 mg Lasix once per day, 2.5 mg Enalapril twice per day, 60 mg Ursodiol once per day and 2 mg melatonin before bed. Logan has regular check ups, which include echocardiograms as well as CBC’s and blood panels to make ensure his body systems are functioning correctly. His seizures have disappeared and his liver enzymes (ALP and ALT) have returned to the high normal range which indicates to our vet that Logan is stable. Logan receives no heartworm or flea/tick preventative and upon the advice of our veterinarian, will no longer be vaccinated."

When Michelle as asked to comment on the current state of Logan’s health she replied, "Logan has been through a lot of health problems and has been a trooper through it all. He is a really tough and courageous dog and a true inspiration to so many. His PCV now remains in a range between 36-40 and was 38 when his last blood work was done. Even though Logan has only three legs, he plays with toys and chases his canine brothers and sister. Logan never stops wagging his tail and he is the most loving lap dog. He is my best friend and companion. It is amazing to think of all the health issues he has been though yet he has so much courage and strength and when things get tough he gets tougher!! Logan is a real treasure and we love him dearly We were blessed to be able to rescue him that day in April, 2002 and in the end, Logan rescued us - for our lives are forever enriched for having him as our beloved pet."

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