PREVIOUS SUCCESS STORIES

March 1999

Sydney

Sydney

Sydney is an 8 year old spayed female Rottweiler, owned by Barbara of Toronto, Ontario, Canada.
Sydney’s first incidence of AIHA and ITP were diagnosed on August 16, 1993. The AIHA was extremely severe with the ITP being secondary. During the week prior to the diagnosis there was minimal change in Sydney’s overall well-being and attitude. Her appetite was somewhat less then usual and she was slightly more lethargic then normal. 24 hours prior to diagnosis, a urine specimen was wine-red and she presented moderately weak. This prompted veterinary attention. Upon Sydney’s admission to the hospital, blood tests showed she had a PCV of 12, a persistent soft weak cough, moderate wet inspiratory crackels, soft grade 2/6 hemic murmur, thrill on femoral pulse as well as very pale and mildly icteric mucous membranes. Sydney’s treatment consisted of intravenous dexamethasone and fluids, oral prednisone, and azathioprine. Sydney’s case was described as a "very aggressive immune disease". Because of severe clinical deterioration, she was given a whole blood transfusion. By August 12, 1993 Sydney was clinically improved although weak with a PCV of 17. She was released from the hospital at this time with the prospect of frequent checkups and blood tests ahead of her. Sydney continued to improve over time and was eventually weaned off all drugs.
Sydney’s second occurrence of AIHA and ITP occurred on October 28, 1997. This time the ITP was extremely severe with the AIHA being considered secondary. During this incidence of ITP, Sydney exhibited no clinical signs of the illness. She had been scheduled for cruciate repair and had passed the physical examination with an excellent report. It was only when the presurgical blood report came back that she was found to be in ITP crisis. The results of Sydney’s platelet count was 41 (normal = 200-500). The hospital concluded this low of a number must be due to a lab error since there were no clinical symptoms of illness. The following day, the platelet test was rerun and this time the count had dropped to 19. By October, 31, 1997 the platelet count had dropped to 14. Sydney was treated with intravenous vincristine bolus and oral prednisone. Abdominal ultrasound revealed 2 splenic nodules which were aspirated, with no significant findings. Sydney appeared unresponsive to treatment but as she presented no signs of bleeding or bruising she was released to go home, presumably to die in the confines of familiar surroundings. On November 3, 1997, Sydney was reevaluated and her platelet count had risen to 151. At this time it was recommended that the spleen be moved, on the speculation that the spleen is sometimes involved in AIHA/ITP problems. After considering all the factors, Barbara declined the suggestion of removal of the spleen and decided to take a more conservative approach. Sydney’s white blood count was also elevated at 31.3 (normal = 6-17). Treatment for this consisted of the antibiotics Metronidazole & Amoxicillen. These antibiotics were administered daily from Nov. 3, 1997 to Feb. 13, 1998 when the WBC finally fell into the normal range. The prednisone continued until April 1, 1998. In Nov. of 1997 a complete thyroid panel was run on Sydney and the results of the panel showed evidence of "moderate hypothyroidism". Sydney was put on .9 mg thyroxine (split AM and PM ) and currently continues on that dosage. Sydney sees her vet every 3 months for blood tests. The full thyroid panel is done every 6 months. She has received no vaccinations since November 1996. Sydney receives no heartworm prevention. Instead her owner, Barbara uses natural everyday methods such as Avon’s Skin-So-Soft, Citronella, and Tee Tree oil to discourage the mosquito population. Barbara essentially feeds Sydney a diet of raw and natural human grade foods such as protein meats, cereals, fruits, vegetables, yogurt, etc. along with Dr. Pitcairns recommended supplements. Sydney’s diet is also supplemented with GeriTabs ( multi Vitamin geriatric tabs) and EFA caps.
Syndey is currently in excellent health. According to her owner Barbara, "She is on a real high! She seems to be enjoying life immensely….always on the go. She looks good, eats well and is handling a bit of arthritis without any meds." She is in the St. John’s hospital therapy program anywhere up to 3 day a week, either visiting with patients herself or helping to show newer dogs "the therapy way".

Sydney Update, March 2001

When Barbara was asked to provide an update on Sydney, she responded with the following comments.
"Sydney celebrated her 10th birthday in August 2000. She continues to exhibit good health, a lovely and lively spirit and the genuine need to continue in her therapy work. All food, exercise and daily habits continue without change. She continues on a mixture of the Pitcairn and Billinghurst diets with no vaccinations, heartworm meds, flea collars or pesticide usage. Sydney's zest for life and sharing Rotti slobber are evidenced every day and her mother's insistence for gum checking continues unabated."
In June 2000, an article about Sydney and her therapy work appeared in the Toronto Star newspaper. To view that article Click Here

April 1999

Watson

Watson

Watson is a 10 year old, 29 lb. neutered male terrier cockapoo mix, owned by Leslie and Phil of San Francisco, California. Watson was 6 ½ years old when he had his first onset of AIHA in late August 1995. His first onset literally came on overnight. Saturday he was chasing balls in the park; the next night on his evening walk, he only made it across the street where he sat down and refused to go any farther. When morning came and he would not eat nor go on his walk, Watson was rushed to his veterinarian. He had pale gums, a PCV of 21.6 and was lethargic. Although the Coombs test was negative and splenic aspirations showed no abnormalities, he had spherocytes, high reticulocyte count, and reactive bone marrow. He was diagnosed with AIHA and was started on 30 mg of prednisone per day. Because he was not showing adequate improvement 6 days later, 25 mg of Cytoxan (cyclophosphamide) was prescribed 4 days per week. Over the next four months the prednisone was gradually reduced and the Cytoxan ended the first week of November. On December 1, Watson’s hematocrit was 39.5. By the end of December, his hematocrit was stable at 39 and the prednisone was reduced to 5 mg eod.
On January 12, 1996, Watson had his second onset of AIHA and it came on just as suddenly as did the first. Watson was bouncy on his morning walk and he seemed his usual self when he and Phil took Leslie to the airport for a day business trip. About three that afternoon, Phil saw Watson simply fade. Phil hurried him to the vet; his PCV was 14.5. The vet suggested that Watson be taken to University of California Veterinary Medical Teaching Hospital some two hours away.
Upon admission to U C Davis, Watson’s urine was "grossly red-brown" and he had moderate agglutination. This time Watson had a positive Coombs test. He was tested for cancer and tick borne disease as the underlying cause of the AIHA; both tests came back negative. His AIHA was diagnosed as idiopathic—of unknown origin. He was put on an IV for rehydration, heparin, prednisone, Imuran , dexamethasone Sodium phosphate (IV, once), sucralfate for GI protection, docyscyline to cover tick borne disease, ranitidine also by IV for GI protection. Two days later, his PCV dropped to 11.3 (his all time low). Watson was confined to strict cage rest in order to avoid a hypoxic crisis. On January 18th the PCV had risen only to 13; the vet noted that it was too soon to predict the outcome of the Imuran/prednisone therapy. His hematocrit rose to 23 on his discharge date, January 23rd.
Watson was grateful to be home and equally grateful that Phil who had recently retired was there to care for him. Watson was on the following medications when he returned home: prednisone 15 mg twice a day; Imuran 25 mg in the evening; cimetidine 1.2 cc orally 3 times a day and 1 hour after the Sucralfate and Sucralfate ½ gram tablet three times a day. In two weeks his hematocrit had climbed to only 23.4; two weeks later it was 24.4. Now in the hands of his specialist, Watson was also placed on Danocrine (danazol). On February 16, his PCV dropped to 23.2 and Cytoxan was substituted for the Imuran. The Danocrine was stopped when Watson suffered a major nosebleed and had to once again be hospitalized overnight. His PCV dropped to 23.1 then bounced to 26.6 and then dropped to 22.9. After 8 weeks on Cytoxan (the maximum amount of time it could be prescribed), his PCV was only at 29.4.
Watson was at a time of crisis. The Cytoxan had to be stopped and Watson’s hematocrit was not at an acceptable level. Neither the Cytoxan nor the Danocrine nor the Imuran had worked . He was still on 30 mg of prednisone every day. He had gained 10 pounds, his breathing was labored and there was no Watson-spark. His specialist next considered a splenectomy. To that end Watson had an ultrasound. However the ultrasound revealed that his spleen was of normal size. The concern now was that his liver had taken over the function of red blood cell destruction making him a poor candidate for a splenectomy. Moreover, because Leslie and Phil had been advised at Davis that splenectomies were not always recommended, they contacted Davis. Davis researchers were testing a then experimental drug, leflunomide, on canines with AIHA. Watson was invited to participate in the experiment.
In April Watson was placed on 50 mg of leflunomide eod. For the first time in 3 months his hematocrit started climbing steadily. In a week it was at 31.2; in two weeks it rose to 33.4; by June he was testing at 37.3 and in July he saw a small gain to 37.4. By fall Watson was testing at 41 to 43; a level he has maintained ever since. With the increase in red blood cells, little by little Watson returned to life: he started jumping on the furniture (allowed), running and barking when the doorbell rang and chasing his cat (not allowed). At the same time, Watson’s prednisone was very gradually reduced. In October 98 when Watson had been on a low dose—5 mg a week, his specialist decided to take him completely off of the prednisone. Watson has received no vaccinations since the onset of his AIHA. He is on Heartgard for heartworm protection and Advantage for flea control.
Watson is currently in excellent health. He has lost 9 of the 10 pounds he gained while on the prednisone. His wonderful personality is there in abundance. Watson takes daily beach walks of 1 to 2 miles, loves to go on trips, to dinner at friends’ homes and shopping on the weekend with Leslie. His 10th birthday was March 16 and he is very active, alert and happy.
Unfortunately the clinical trials of leflunomide at Davis have been suspended. The drug was released on the human market in September 1998 for rheumatoid arthritis and the drug manufacture at last report was not going to provide it for canine research. Leflunomide had no side effects for Watson; however, there can apparently be some GI problems associated with its use. Not all dogs in the trials have responded as well as Watson. Apparently leflunomide works if the red blood cell destruction mechanism is antibodies but not if the cells are being destroyed by another mechanism. Watson remains on 50 mg leflunomide eod and ½ baby aspirin eod; it is also likely, given Watson’s history that he will be on the drug for the remainder of his life.

Watson Update, March 2002

Six years after Watson's last occurrence of AIHA, he remains in a sustained AIHA remission with a PCV of 44.1 on January 29, 2002. During the past 3 years Watson's leflunomide dosage was slowly lowered from 50 mg every other day to 25 mg every 6th day and then totally discontinued in December, 2001. Watson is currently on no medication for AIHA.
According to Leslie, "Watson does have one problem which is not apparent to us. He has a heart murmur and what his specialist calls " a prominent heart". When Watson's heart murmur was first noticed a couple of years ago, we had a baseline x-ray done. Another x-ray and an ultrasound were done this past February."
The results of Watson's recent x-ray revealed, "mild to moderate left atrial enlargement consistent with mitral valve disease. No evidence of left sided heart failure. Mild shoulder osteoarthrosis." The ultrasound showed Conclusion: Mitral endocardiosis with significant mitral regurgitation. Mild pulmonic stenosis is also present."
Based on the results of the x-ray and ultrasound, Watson was started on 12.5 mg Lasix twice daily for 1 week. After the first week, the dosage was dropped to 12. 5 mg once per day. In addition Enalapril was started at a dosage of 5 mg daily, then increased to 5 mg twice per day. Watson remains on ½ baby aspirin every other day (originally started to prevent blood clots, but now continued for "aches & pains" according to Leslie) and .2 mg Soloxine per day for low thyroid function
According to Leslie, "It is hard to believe that Watson has heart problems, although he does sleep a lot. When he is out, he is still very bouncy-chasing his ball, going for walks and playing with a few select dogs. His last lab work was great. In light of that, his specialist says he is very optimistic that Watson will have a few more good years."

Watson Update, April 2006

Leslie wrote recently with the following Watson update.
"Watson died at home on Sunday October 10, 2005. He was 16 ½ years old at the time of his death and his AIHA was in complete remission. Watson had lived for over 10 years after his AIHA diagnosis. In his case, his heart valve problem led to congestive heart failure and his little heart simply gave out. Watson had a wonderful life and he looked terrific until the very end. No one could believe how old he was. We miss him like crazy."

May/June 1999

Remington

Remington

Remington is an almost 14 year old neutered male Lhasa Apso owned by Tamie of Austin Texas. Remington was diagnosed with autoimmune hemolytic anemia on September 18, 1996 when he was 11 years of age.
In Remington’s case, the disease appeared to come on slowly at first and then quickly. Tamie remembers thinking that Remington appeared to have aged about two years in just one month. Then over a weekend he became very depressed and lethargic. In addition to the depression and lethargy, Remington’s symptoms also included reduced appetite, pale gums, vomiting, and diarrhea. Tamie also noticed blood on the floor from an unknown source.
Upon presentation at the veterinarian, Remington was X- rayed and given an ultra sound to rule out cancer. He tested Coombs positive and had a PCV of 14.2. He was given a prednisone injection and then started on 20 mg prednisone twice a day as well as 125 mg Clavamox and 30 mg Baytril, both given twice per day. Remington’s first prednisone reduction came after 2 months. He was reduced to 20 mg prednisone once per day. The prednisone was tapered off very slowly until he was reduced to 20 mg twice per week. He was on this dosage for 1 ½ years. Remington was taken completely off the prednisone in November of 1998. He went back on 20 mg eod in January of 1999 as a preventative measure after vaccinations and is once again off the prednisone.
Remington is currently on Heartgard Plus for heartworm protection and prednisone only when a possible relapse could occur (i.e. after vaccinations and changes in behavior.) He then is put on 20 mg prednisone every other day for 2 weeks and then backed off the drug over a 4 week period. He has gone 4-5 months at a time without any prednisone. Because Tamie and her 3 daughters all volunteer at the local animal shelter there is concern that Remington may be exposed to disease, so Remington is vaccinated on a regular schedule. He receives DHLP-P, corona and rabies once a year and a 6 month parvo booster. Due to Remington’s advanced age Tamie is considering doing the titers test before vaccinating this year.
Remington is in good condition for a dog of his age. He is a very energetic dog who enjoys going for car rides and keeping track of Tamie. He has never had a major relapse. He has a small amount of arthritis, and one dry eye that needs ointment every day. He is almost completely deaf and has lost some sight. He can still use a doggy door to go outside and enjoys showing off for Tamie’s 3 daughters. Tamie is currently a foster mom to a golden cross puppy for Canine Companions for Independence. This puppy will be in Tamie’s home for about a year and then go back to the training center for formal training. Remington is delighted to be a big brother to this little gal and is gently helping her to learn the ropes of the household.

Remington Update, December 2001

When Tamie was asked to provide an update on Remington, she responded with the following comments.
"Since Remington was featured on the success stories page he continued in a complete AIHA remission. For the past 3 years, he had a tumor in the corner of his eye, about the size of a pea. The vet said it was too close to the eye to do anything with it. However when I put Optimmune (a form of cyclosporine) in his eye everyday, the tumor didn't seem to bother him. But in the beginning of June, 2001, the tumor began to grow rapidly. Within 2 weeks it was covering a third of his eye and he would literally scream when I had to clean his eye twice a day. I couldn't let him suffer with it any longer and put him to sleep in mid June, 2001, just 2 weeks before his 16th birthday. He was a wonderful dog. I miss him to this day. I was lucky he never had another AIHA episode."

July/August 1999

Amanda

Amanda

Amanda is a 8 year old spayed female Cocker Spaniel owned by Jan of Mount Vernon, Washington. Amanda was diagnosed with autoimmune hemolytic anemia in May of 1997.
On Saturday, May 17, 1997, just after Amanda was past her 6th birthday, she and Jan went to a friend’s house for dinner. Afterwards, Jan and her friend took the dogs for a walk around the golf course. Amanda seemed tired. When Jan and Amanda arrived home later that night, Amanda lay down on the grass and had a seizure. Amanda had suffered a couple of mild seizures leading up to that day, but Jan had always assumed she was mildly epileptic and her veterinarian had in the past thought the seizures were too infrequent to treat with Pheno Barbitol. The next morning when Jan lifted Amanda out of bed, she took a few steps before falling over and seizing again. Amanda’s eyes appeared jaundiced, she was very feverish and would not eat. Jan immediately called her vet. Since it was Sunday and the vet works on a strictly house call basis, Jan was warned the rates for a Sunday visit would be very high. Jan told him to come anyway.
When the veterinarian arrived, he took Amanda’s temperature. It was 105. By this time Amanda’s gums and tongue were pale pink, almost grayish. The veterinarian drew blood and took it home to his centrifuge. While awaiting results of the blood tests, Amanda was started on 20 mg of the antibiotic Baytril and 2 mg of Diazepam for the seizures. When the test results were read the PCV was 13 and the Coombs test was positive. At this point the veterinarian prescribed 20 mg of prednisone 3 times daily. The Baytril was discontinued after the AIHA diagnosis but all other medications stayed the same for several days. Amanda was tested daily for the first week. Her PCV went up gradually, 16, 19, 23, 25, 29 and 31. After a week the prednisone was reduced to 40 mg daily and the Diazepam was discontinued.. The seizures stopped after the first day. The veterinarian reasoned that Amanda’s seizure threshold was triggered by the fever. Amanda’s PCV continued to improve gradually, finally reaching a count of 42 within a couple of weeks. The prednisone was reduced to 30 mg a day the following week, then down to 20 mg. After 3 months she was down to 10 mg every other day. By the end of the 4th month Amanda was completely off the prednisone.
In September 1997, Jan and Amanda temporarily moved into Jan’s parents house. It was a two-story home and Amanda, overweight wasn’t used to stairs. One morning she ran up the stairs and promptly "seized" at the top. Jan immediately called the veterinarian and he came out. The first blood test showed a PCV of 9--- Amanda’s lowest count ever. A closer examination revealed pale gums and tongue. Amanda also had a temp of 103. Amanda was immediately put on 60 mg of prednisone per day. A blood test the next day showed a PCV of 14. This time the PCV seemed to crawl back very slowly. When the PCV had reached only 19 after 5 days the vet suggested using Cytoxan. Amanda’s blood counts rose more quickly after the introduction of Cytoxan into the treatment regime. She had a PCV of 34 after just a week, and 42 after 2 weeks. Two weeks after the second onset Amanda’s veterinarian switched Amanda from prednisone to a prednisone like drug called Medrol. Medrol is a drug from the methylprednisolone family. Methylprednisolone is a corticosteriod of the glucogenic type, having an anti-inflammatory action similar to that of prednisolone/prednisone. It was the vet’s feeling that the Medrol might help Amanda because she was eating voraciously and drinking profusely. Jan states the Medrol seemed to help Amanda with the drinking problem but did little to curb Amanda’s appetite. The Medrol dosage was reduced until by November it was down to 5 mg eod. Amanda was to remain of that dosage for 6 months.
Amanda is now completely free of any signs of AIHA. She continues to show healthy color in her gums and tongue and has not had a seizure since her last onset of the disease. Amanda sees her vet for blood checks every 6 months. Amanda no longer receives any vaccinations, whatsoever. Because Amanda lives in a part of the country where heartworm is not a problem she has never received any heartworm preventative.
According to Jan , "this dog is a fighter. She is my only dependent and my only companion, so I have free license to treat her like a child without raising too many eyebrows. My situation was different then most, in that I had a veterinarian who made house calls. But it is my gut feeling that having her own territory to recover in—and having me there around the clock to help her get through these bouts--- are what ultimately led to her recovery."

Amanda Update, August 2001

When Jan was asked to provide an update on Amanda, she responded with the following comments.
"Although I haven't had her PCV tested since January 1998 (when it was at 45), Amanda has not shown a single sign of an AIHA relapse. I pay close attention to her appetite, energy level, temperature and gum color, and she's doing just great so far.
Amanda has developed a tear-duct blockage in her right eye, though, and is no longer producing tears in that eye on her own. After about 6 weeks of acute infection, the eye is in pretty good shape and as long as she gets two treatments of Cyclosporine daily, she'll be okay.
Given the warnings I've heard about the potential for relapse following vaccinations, and the fact that she is almost never in contact with other animals, I no longer vaccinate Amanda for anything. We live in a region where heartworm is not prevalent so she has no need for a heartworm preventative.
Amanda turned 10 in May. She looks older and is getting arthritic, but still has the spirit of a puppy and an indescribable will to live -- which is, I'm sure, what allowed her to combat and survive AIHA in the first place. When I think about the fact that her AIHA battles were four years ago -- not much less than half her life -- I realize how lucky I am that they didn't take her life, because she's become even more bonded to me and I to her, and I can't imagine not having had her near me all of this time.

Amanda Update, May 2003

Jan wrote recently with the following Amanda update:
"After enduring two bouts of AIHA with Amanda when she was only six, I became rather protective of her health. I stopped all vaccinations and paid careful attention to the state of her appetite, the appearance of her gums and tongue. I also did everything possible to avoid emotional stress for her.
Amanda had always had arthritic problems that seemed to center on her back and hips. As the years went by, she seemed to have difficulty lying down and standing up. I started giving her glucosamine about two years ago, and that helped for a while. And then Amanda started showing signs of renal failure around Christmastime 2002.
When Amanda lost the use of her back legs and went into the late stages of renal failure in late December 2002, I knew I would have to let her go. She was euthanized on January 2, 2003.To the best of my knowledge, AIHA has played *NO* role in her demise. At least we can say she refused to yield to AIHA .
In the months since Amanda's death, I've moved, taken on a new job, and have worked out some of my grief by donating PR services to a local no-kill animal shelter. But I continue to wonder how it might be possible to adequately convey to the non-animal person how you can love someone with four legs so much. She was the light of my life, and she taught me patience and perspective. Losing her was painful, but having her was exquisite."
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