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September 2001
Daisy Mae
Daisy Mae is an 9 year spayed female terrier mix owned by Heather of Fort Collins CO. Daisy was diagnosed with autoimmune hemolytic anemia on March 5th 1999.
When Heather was asked to comment on the symptoms Daisy exhibited prior to her AIHA diagnosis she replied, " the disease came on very quickly-almost overnight. The symptoms Daisy exhibited at the initial diagnosis were white gums, fever/shaking with chills, not wanting to go outside, going into her crate and lack of appetite."
Daisy was taken to her vet where testing revealed a PCV of 23. A Coombs test was done which came back negative, however the vet was able to see great deal of agglutination on the blood slide. Daisy was diagnosed with autoimmune hemolytic anemia and started on Solu-Delta Cortef (a rapidly-absorbed, rapid- acting injectable Prednisolone Sodium Succinate widely used for dogs in shock and immune crisis) and then switched to 10 mg prednisone twice per day. She was also started on 50 mg Doxycycline twice per day and Carafate for stomach protection. Daisy spent 6 days in the veterinary hospital. After Daisy was sent home she was gradually weaned off all drugs. On November 11, 1999 Daisy had an AIHA relapse. Her PCV at the time of the relapse was 9. She was once again started on Solu-Delta Cortef, prednisone and this time Imuran was added at a dosage of 25 mg per day, Tagamet and Carafate were given for stomach protection. Daisy was also given 2 Oxyglobin transfusions. Because Daisy's vet did not feel comfortable leaving Daisy unattended at night while she was in such critical condition, each evening Heather would take Daisy to the Animal Emergency Services Clinic to spend the night. Each morning Heather would take Daisy back to her regular vet for the day.
Heather noted, "After the initial diagnosis we weaned Daisy off of all drugs. She was off drugs for about 5 months before she relapsed. We know that we will never be able to take her off the prednisone and Imuran entirely without risking a fatal relapse." Daisy currently takes 10 mg prednisone per day and 25 mg Imuran three times per week. In addition she takes 1 tablet Thytrophin PMG, a dietary supplement to stimulate her thyroid, as well as ½ of a mulitivitamin, a herbal liver maintenance supplement and a probiotic tab daily. Daisy has not been vaccinated for approximately 3 years. She has the titers test done for Parvovirus, Distemper and Rabies on an annual basis. According to Heather, "no flea preventative is needed at the altitude at which we live." Daisy takes Filaribits as a heartworm preventative.
When Heather was asked to comment on the current state of Daisy's health, she replied, " Daisy is doing very well. She is back to her old self! Recent blood work confirms that she continues to be in good health. Her last blood test on June 4th, 2001 revealed a PCV of 43.5. Daisy maintains a normal energy level for a dog her age and still loves going to obedience class, where we are working on utility. She is an excellent obedience dog. She has her U-CDX, and has been High in Trial dog. She is queen of the house, and keeps her brothers (the boy dogs) in line. Her favorite activities continue to be eating, looking out the window, patrolling the floor for crumbs, napping in a cool spot, enjoying a good belly scratching and chewing on her bones. She is a playful dog, a happy worker and still approaches life with gusto."
Daisy Mae Update, March 2007
Heather recently wrote with the following Daisy Mae update:
”I thought that I would email you to let you know that Daisy Mae passed away last month, at the age of 14 years and seven months. She lived for nearly eight years after her AIHA diagnosis. Daisy’s death wasn’t directly related to her AIHA. She had an undiagnosed tumor in her intestine, it perforated her intestinal wall, and she got septic and went downhill very quickly.
“We took Daisy in to the veterinarian on Feb 2nd to have a growth taken off of her eyelid. The pre-op blood work showed that her albumin was low – but nothing else pointed to an immune crisis. They also found a heart murmur at that point, and decided not to go ahead with the surgery. The evening of Feb 6th, Daisy was suddenly not well. It was a very clear difference – one minute she was fine, the next she was not. I thought it was an immune crisis, and took her to the Emergency Clinic. Her PCV tested at 40, they retested and it was 42 – clearly not an immune crisis. But her protein was still low and her membranes were pale. They put her in an oxygen cage overnight and also took x-rays which showed nothing. The next morning I took her to the Colorado State University Veterinary Teaching Hospital, and they did an abdominal ultrasound and an echocardiogram. That is how they diagnosed the tumor in her intestine, and free gas in her abdomen from the perforation. If they were to go in and try to resect the tumor, her prognosis was poor, especially with a septic belly and her heart disease. We decided that euthanasia was the right choice. Daisy died on February 7, 2007 with Bill and me at her side. She had a great life and we are grateful the end for her happened quickly and with a minimum of suffering on her part.
”I remember how comforting it was to find the Meisha’s Hope Web site when Daisy was first diagnosed. Thank you for the good work that you do. Also, thank you for starting the Meisha’s Hope AIHA/IMHA Fund #338 at Morris Animal Foundation. We will continue to support it In Memory of Daisy as we did in her Honor when she was alive.”
October 2001
Missy
Missy is a 5 ½ year old spayed female Standard Poodle owned by Sheila of Horseshoe Bay TX. Missy was diagnosed with immune mediated hemolytic anemia on September 25, 1999.
When Sheila was asked about Missy's symptoms prior to her IMHA diagnosis she commented, " Missy became quite ill quite fast. The disease happened nearly overnight. One day she was her normal self, two days later she was urinating blood and very jaundiced. Other symptoms Missy exhibited were lack of appetite and loss of energy. When Missy would not eat (regular food or treats) for two days, I made an appointment with the local veterinarian."
Missy was taken to her local veterinarian on September 21, 1999 where she was given a series of tests which included urinalysis, chemistry profile, complete blood count, Coombs test, X-rays and more. Sheila noted, "my regular vet could not determine what was the matter with this normally healthy dog that suddenly started urinating blood and becoming very jaundiced. He thought she had been poisoned but I knew that was impossible. She is a house dog and in a fenced yard and not allowed to roam free. After two days at the local vet I asked him to refer me to Texas A&M - if they couldn't get her well - no one could." On September 25, 1999, Missy was transferred to the intensive care unit at Texas A&M University, College Station, TX.
Upon presentation at Texas A&M, Missy had a PCV of 13. She was quickly diagnosed with immune-mediated hemolytic anemia and started on high doses of prednisone and azathioprine (Imuran) as well as Doxycycline, Famotidine, and Pet Tinic, a vitamin- mineral supplement. When Missy was discharged from Texas A&M on September 28th, Sheila was instructed that Missy must be kept quiet and have limited activity. Missy was to continue on the prednisone, azathioprine, Doxycycline, Famotidine, and Pet Tinic at home. Sheila remarked, "after Missy returned home from A&M her paw pad became ulcerated and bled - it was the start of an infection. A red streak was observed extending from the foot up the leg (her legs had been shaved for the IV's so the streak was visible.) Missy was put on antibiotics by her local veterinarian. Because of the high doses of prednisone the wound took about 3 months to heal. She looked pitiful walking around with a stocking on her leg but it was the only way to keep a dressing on it." As Missy continued to recover from her bout with IMHA, she was gradually weaned off her medications. Six months after her discharge from Texas A&M she was off all drugs.
When Sheila was asked to comment on the current state of Missy's health she replied, "I am happy to say Missy is fully recovered and back to her old self, even chasing squirrels again. She takes Sentinel for heartworms and that is all the medication she gets. I got her a new friend, a black Standard Poodle we call Raven and he keeps her hopping. She gets good exercise trying to keep up with him. I keep a sharp eye on her for any variations or signs of lethargy, appetite suppression and so forth. The disease was nearly fatal for Missy. After the local vet could not determine what was wrong with her (other then severe anemia) I decided to go to the ultimate source of vet care-Texas A&M small animal clinic. We were very fortunate that Missy responded well to the meds and care given her there. After a course of high doses of meds, she was gradually tapered to no meds at present. Although many people told me her time had come, I never gave up on my girl and with a good vet like Dr. Sophie Grundy and lots of love she is flourishing."
To read an excerpt from an article on IMHA written by Dr. Claudia Barton & Dr. Sophie Grundy, (who treated Missy while she was at Texas A&M) which appeared in the February 15, 2001 issue of the Journal of the American Veterinary Medical Association Click Here
November 2001
Hershey
Hershey is a 14 year spayed female Border Collie & Lab mix owned by Kathy of Chantilly, VA. Hershey was diagnosed with autoimmune hemolytic anemia in March of 1997.
When Kathy was asked about the onset of Hershey's AIHA she relied, "I had just moved from the Chicago, IL area to northern Virginia when I noticed, about two weeks after moving, that Hershey was getting lethargic and seemed to have some blood in her urine. She also had difficulty getting oriented when she got up to walk plus she had lost her appetite and refused to eat. I came home one evening to find her extremely ill and my carpets stained with dark bloody urine. I was extremely lucky to have a vet office about a mile from my apartment so I rushed her there. The doctor examined her and explained to me, that from the symptoms he saw, he was relatively sure that Hershey was suffering from AIHA. I had never heard of AIHA much less understood the magnitude of what this disease could do to a dog. Hershey was immediately hospitalized and put on IV's to combat the dehydration she was experiencing. She was also given a blood transfusion and started on prednisone. When Hershey's PCV continued to drop and fell as low as 12, she was given a second blood transfusion. After the second transfusion, the PCV stabilized and began to rise. Imuran was then added to the treatment regimen. The doctor told me that the prognosis was usually not good for dogs with AIHA and that it was especially serious considering that Hershey was older when she contracted the disease. Hershey was hospitalized for a week before she got stable enough to come home with me. The doctor told me that her prognosis was probably a year or so at the best." When Kathy inquired of her vet if there was a possible cause for Hershey's AIHA, he told her only "that some breeds get it more then others". Later Kathy learned that Hershey's mother also had been diagnosed AIHA.
When Kathy was asked to comment on the current state of Hershey's health, she responded, "She has good and bad days. I guess that is allowed when you reach the ripe old dog age of 14, but she is always "up" for her daily walks with her daddy, mommy and her canine brother, Baxter. She is a joy to be with and I thank God everyday that she has survived this disease. She takes her medicine religiously and has come to understand that she needs blood tests taken on a frequent basis to ensure she is doing okay. When her blood count starts to go down, the doctor increases her prednisone for a short time and then when it seems to get to an acceptable level, we drop it down to a small dose -- just to keep her in a safe range. Hershey is currently taking 5 mg prednisone and 50 mg Imuran given on alternating days." Hershey's last blood work was done in June, 2001 when she had a PCV of 36.
Kathy continued, "I can truly identify with those individuals that have dogs with AIHA and the only thing I can say it to find a great vet and let your dog know that you love them -- most of all, be there for them. I went to the hospital every evening and sat on the floor, cried and held Hershey's head. She would look up at me as if to say, "Don't cry mommy, I'm going to be alright." While I know my time with Hershey will eventually come to an end, I know that I owe the last few years I've had with her to the great work the doctors have done in treating her AIHA. An angel has been looking over her for the last four years. She is my miracle dog. She is a testament to the fact that dogs can and do survive AIHA. For all owners out there who have dogs diagnosed with AIHA, Keep the faith!!"
A footnote to Hershey's story is the fact that Kathy works in the nation's Capitol at the House of Representatives. When speaking about the September 11, 2001 attack on Washington DC, Kathy noted, "I work at the House of Reps and we were evacuated immediately from the Capitol complex after the second attack that hit the Pentagon. However, I could see the Pentagon burning from my office window when the plane crashed into the building. It has been very interesting that since this has happened my husband and I have noticed that Hershey and Baxter have become very protective of us. It's a constant contest between Hershey and Baxter to see who can get the closest to mommy and daddy. They appear even more happy to see us each evening than they previously were."
Hershey Update, November 2002
I recently received the following email from Kathy.
“On Thursday, November 19, 2002 we made the extremely difficult decision to let Hershey go. She had been doing so well with her AIHA until early October, 2002. In August, she started having nose bleeds that were hard to stop and she seemed to be getting more and more lethargic. We took her to our vet and she did some x-rays of the nose. Since a dog’s nose is extremely dense, it is difficult to tell much from an x-ray. Because of Hershey’s age (she turned 15 on October 6) we didn’t want to put her through any anesthesia to have it checked more thoroughly. The vet thought there was a dense area in her nose which was probably some type of tumor. We made the decision to watch her closely and continue treatments for AIHA but not put her through any additional treatments which could cause her trauma. She had good days and bad days but it late October the good days seemed to be getting fewer and fewer. She started falling down the steps in our home and urinating in the house. On occasion, she seemed disoriented and confused and one day she fell in the back yard and I had to carry her into the house. My husband and I decided it was time to take her to the vet and have her assist us in determining the best avenue to take. We wrapped her in her blanket and drove to the vet where it was determined there was nothing else we could do, so we made the difficult decision to allow her to die with dignity. Hershey went to sleep at 6:20 P.M. on November 19, 2002 while the vet and my husband and I held her.
Hershey was a true fighter and a wonderful example of what good veterinary medicine can do for dogs suffering from this disease. Hershey was diagnosed with AIHA when she was over 9 years old. She lived with AIHA from March 1997 until November 2002. She was referred to by all the veterinarians at our clinic as their ‘Miracle Dog”. Our household is sad this Thanksgiving, but ever so grateful for the gifts Hershey gave us over the last 15 years”.
December 2001
Murphy
Murphy is a 10 year old neutered-male mixed breed owned by Darci & Mike of Sheboygan, WI. Murphy was diagnosed with autoimmune hemolytic anemia in June, 1999.
When Darci was asked to comment about the onset of Murphy's AIHA, she replied, "the disease seemed to come on very slowly over a period of about 1 ½ to 2 weeks. Murphy became very lethargic and wouldn't eat. He also began to vomit and have a runny stool. When I brought Murphy into the veterinarian he thought it was an infection and prescribed an antibiotic called Dicural. Three days later Murphy was still very lethargic and his stool looked bloody. That same day, he collapsed while attempting to get up. I immediately brought him back into the vet where blood testing was done which resulted in him being diagnosed with AIHA. Murphy's PCV at the time of his AIHA diagnosis was 14.4."
Murphy was started on large doses of prednisone and hospitalized at the veterinary clinic for 5 days. Over time, Murphy's prednisone was very slowly reduced. Currently, he remains on 10 mg of prednisone every other day. Although the veterinarian was not able to give Darci any reason for Murphy's illness, it is noteworthy that he had his 3 years Rabies
vaccination a short time before the onset of the AIHA.
When asked about the current state of Murphy's health, Darci commented, "he's doing great. His last blood test was on November 19, 2001. His PCV at that time was 41. He has gained some weight and his skin/fur is a bit dryer. I believe those are side effects of the prednisone. He has had one infection which we treated with antibiotics. Our vet told us Murphy will be a bit more susceptible to infections."
Darci continued, " Murphy has always been very much a "people-person". He loves company and sitting on the sofa with my husband, Mike or me. He's very playful and will let us know by begging with both paws waving in the air when he wants to play. He'll also roll around on his back (again with both front paws waving) when he's happy. He always gives us a huge welcome when we get home from work. In addition, he takes really long walks with his "grandpa" (my retired father-in-law) every day. All in all, he's doing really well, back to his normal goofy self."
January 2002
Editors note: When Meisha became ill with AIHA, I had no idea the number of decisions I would have to make in regard to her care. Everything from "is what I am seeing now serious enough to warrant a call to the vet" to decisions regarding vaccinations and finally the ultimate decision of all, deciding when it was time to let her go. In a similar manner, when I started the success stories page, I had no idea the number of decisions I would have to make there, from scheduling the stories, to the length of the stories and more. When one of the success story dogs died, I had to make a decision on how to handle these deaths. I decided to update the success stories to reflect the deaths. Similarly when a dog who was on the success stories schedule died prior to being on the page, I had to decide how to handle that situation. My first thought was to eliminate the story and merely "bump up" all the dogs on the schedule a month. But on closer reflection, I realized that this dog had lived long enough to fulfill the requirements I had set forth for being on the page. There is no "magic" associated with the one year requirement for being on the success stories page. The one year requirement was set forth based on what I had been told by many vets, that once a dog survived the first year, the chances of long term survival increased, and the fact that I had to set up some sort of criteria for the page. Having reflected on all that I decided to go ahead with "Molly's story" as planned. Every AIHA dog who survives a day, a month or a year, is in my opinion a "success" and their owners are nothing short of heroes. In the uncertain world, we now live in, each and every day is something to be cherished. That it is how it is when one lives with AIHA as well. So without further ado here is "Molly's story", who even though she is no longer with her family, is indeed a success story. As with all the other success stories, may Molly's story give you HOPE!!
Molly
Molly was a spayed female chocolate Lab owned by Lori of Gurnee, IL. Molly was 8 years old when she diagnosed with autoimmune hemolytic anemia on August 26, 2000.
When Lori was asked to comment on the symptoms Molly exhibited prior to her AIHA diagnosis, she replied, "her symptoms were very subtle. I brought her into the vet for lack of appetite and weight loss, but the vet also saw signs of anemia. I thought that her lack of appetite was an emotional response to my new boyfriend (now my husband) and his two dogs. Dan loved her dearly but she was not used to sharing me like that. I was quite surprised that her weight had dropped to 62 pounds from her normal weight of 69 pounds. The AIHA came on very slowly. Molly started picking at her food the last week of June 2000 (12 days after her annual vaccinations) but it was almost two months later that I scheduled the vet visit and Molly was diagnosed with AIHA."
Upon presentation at the vet's office Molly had an elevated temperature, and a PCV of 30. The vet gave Lori a tentative diagnosis of "anemia" (Lori believes the vet meant AIHA, but at that time he did not give her the full name). Molly was started on prednisone and the antibiotic Clavamox. She also had chest & abdominal x-rays which appeared to be normal.
Lori continued, "we went to another vet on August 30, where we did further blood work including a urine test and a Coombs test (which was negative), along with an ultrasound of Molly's abdomen. The PCV was then 21. The vet was very concerned about the sharp drop in PCV while on the prednisone, especially with the holiday weekend approaching and limited veterinary services available over the weekend.
Molly's blood work showed normal counts on reticulocytes but low counts on mature red blood cells, which indicated that she was producing red blood cells normally but losing them (through internal bleeding or some other destruction). Urine and stool tests appeared normal and were negative for blood. The ultrasound showed no abnormalities except a slightly enlarged spleen. The internist actually suspected an intestinal tumor of some sort, but AIHA was never ruled out.
Once all the blood work came back, on Thursday, August 31, the vet recommended that Molly go in for exploratory surgery the next day. The clinic's blood donor dog was prepared in case a transfusion was necessary. Samples of Molly's intestine were taken for biopsy, and the vet decided to remove her slightly enlarged spleen. One day after the surgery, her PCV was approximately 32, and she held that level through the weekend. Biopsies on her intestine were negative, and tests of her spleen revealed a diagnosis of AIHA.
Molly rebounded so quickly from her surgery that we knew in our hearts that she had AIHA, even before the lab work came back. She was sent home four days after surgery with strict instructions to stay quiet, but all she wanted to do was bounce around the house and run in the yard. I know that a splenectomy is considered extreme and a last resort in the treatment of AIHA, but based on our outcome, I'd do it the same way all over again. It can take a while to stabilize the dog on medications, and you risk losing them in the meantime. Molly was in pain for a few days from the surgery, but her quality of life was completely restored within a week of the surgery. For over a year after the surgery she continued to be the same old girl she was before she got sick. Molly was a flower girl in our June 2001 wedding, although she got removed
from the ceremony when she recognized me and started whining and singing! She loved her new Daddy and enjoyed the company of our other two rescued Labs.
On October 13, 2001, I took Molly into the vet for a routine checkup, including blood work. All blood work was normal except for the PCV, which had dropped to 17.6. We were very surprised at this turn of events because Molly had been showing no AIHA symptoms. The vet suggested that she might have been declining so slowly her body was adjusting to it. Molly was started back on prednisone at a dosage of 80 mg per day. On October 25, Molly's PCV was up to 23.5, but the white blood count was high at 29,000 so Amoxicillin was added to the treatment regimen.
When Dan returned from a trip to NYC (ground zero - he's a fireman) at about 10:30 PM on Friday, October 26, Molly was doing OK. She greeted him normally, and went to lay down in her beanbag. We both gave her some cuddle time and she followed us upstairs to get ready for bed. Later, Sugar one of our other dogs, was jumping on me. I told her to go back to bed but she wouldn't relent, so I got up to let her out. Dan also got up and called to me that Molly had thrown up. She then collapsed on the floor, panting heavily. I could see that her abdomen was much more swollen. We immediately made the decision to take her to the emergency vet. She was status-quo on the 15 minute drive to the vet, although deep down, I knew that she wouldn't be coming home with us. We were moved into emergency mode as soon as they saw Molly - initial diagnosis was that she was in shock. She was put on fluids and oxygen. The cause of the shock was likely the fluid in her abdomen, which was clear with some blood upon aspiration. An x-ray gave little information, except that she didn't appear to be in heart failure. Her PCV was still at about 24. After an hour of fluids and oxygen, we were allowed to see her. She was not responding to this treatment, and was still in shock. Despite this, she thumped her tail and clearly recognized us, even through the oxygen mask. The vet suspected some form of abdominal cancer, and said that we could take her to a specialist on Monday for further testing. When questioned, however, the vet had little confidence that she could get Molly through the weekend or even through the night. Since Molly was always happiest at my side, I couldn't see leaving her that night, especially not knowing if she would make it through the night. Her long-term prognosis was very poor. It was a difficult decision, but it was clearly the right one. The kindest thing was to stay by her side and let her leave peacefully and painlessly, in our arms."
Later after doing research Lori came to believe that perhaps Molly died of hemangiosarcoma. Lori noted, "Although an autopsy was never done, we don't believe Molly died of AIHA-we believe it was hemangiosarcoma , which can be misdiagnosed as an AIHA relapse."
Lori continued , "I rescued Molly through the Labrador Retriever Rescue of Indiana. She will always be my girl and my "heart dog" - few bonds are stronger than those between a rescued dog and her rescuer. However, as dearly as I loved my dog, my top priority was restoring her quality of life; I was not content to just extend her life. The thing that bothered me most, once Molly was in the clear, was the lack of education surrounding reactions to vaccines. In all my years of dog ownership and rescue work, I've never had a vet tell me to watch for anything after annual vaccines. I still believe strongly in vaccinations, and our other two dogs are fully vaccinated, but I feel that it is important for people to know that if their dog loses his appetite or starts acting lethargic shortly after receiving vaccinations, then the dog needs medical attention.
Molly had 14 WONDERFUL months following her AIHA diagnosis and that is important for people to hear. Although I miss her terribly, I am tremendously grateful that I had that extra time with her."
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