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Kelly is a 10 year old spayed female Cocker Spaniel owned by Michelle and Scott of Plantation FL. Kelly was diagnosed with autoimmune hemolytic anemia on January 20, 2007.
When Michelle was asked to comment on Kelly’s symptoms prior to her AIHA diagnosis she replied, “The onset of the disease came on very quickly. We had always described Kelly as the puppy that never grew up. She didn't know how to walk, since she galloped everywhere. She was the dog who always seemed to have a smile on her face and loved to make people laugh. Just prior to Kelly’s AIHA diagnosis, it appeared as if her energy was completely drained. This dog, who so loved life, seemed barely alive. She didn't want anything to do with food (this from a dog who normally loved food so much she scarcely chewed it, because she wanted it so badly!) and she could barely stand or lift her head. This behavior was such a sudden and shocking change from her usual happy, energetic, and mischievous demeanor. Kelly had gotten into the garbage the day before we noticed any symptoms so, when she was sluggish and would not eat, we thought she just had an upset tummy from the garbage. But when this lasted a second day and she started to vomit, we took her to the veterinarian. Our biggest worry, at the time, was that she had swallowed a chicken bone and it had caused internal damage. Blood work at our regular veterinarian’s office revealed a PCV of 8. Based on that in-office blood test we were urged to rush Kelly to an ER animal hospital.
”Upon admission to the emergency care hospital, Kelly had a PCV of 7 and was autoagglutinating. Kelly was given a blood transfusion, which she rejected, and was started on subcutaneous fluids, prednisone, antibiotics, antiemetics (drugs effective against vomiting and nausea) as well as drugs to prevent GI distress. When we did not see any improvement in Kelly after 5 days, we transferred her (with IV’s still attached) to Coral Springs Animal Hospital. We had learned that Dr. Rebecca Seaman at this hospital was a very good internal medicine/oncologist who had had some success with AIHA. Heparin injections as well as other antibiotics were added to the treatment regimen at this hospital. On January 29, when Kelly’s PCV had climbed to 18 and her appetite had improved, she was released from the hospital on the following medications: ½ tab Carafate dissolved in water every 8 hours, one hour before Pepcid; 25 mg Imuran, once daily; 50 mg Cytotec, every 8 hours; 10 mg Pepcid AC, every 12 hours; 125 mg Ciprofloxacin, once daily; 15 mg prednisone, every 12 hours; 5 mg Reglan, every 8 hours and 1.3ml Heparin, subcutaneously for 2 days.
”Blood testing on February 2, 2007 revealed Kelly’s PCV had risen to 20 and there was no autoagglutination. The Carafate, Reglan, Ciprofloxacin and Heparin were discontinued at this time. Over the next several months, as Kelly’s PCV continued to rise, we slowly lowered the prednisone dosage. When Kelly’s PCV reached 44 on August 15, 2007 the prednisone was discontinued. The Imuran dosage remained at 25 mg once per day. Over the next couple of months we lowered the Imuran dosage, until it was stopped on October 30, 2007. On that date, Kelly’s PCV was 51 and her slide agglutination test was negative. When Kelly had blood work done 6 weeks later, her PCV was 43 and her slide agglutination continued to be negative. At the present time we are doing blood work every 3 months. As a result of her illness, Kelly will no longer receive any vaccinations.”
When Michelle was asked to comment on the current state of Kelly’s health she replied, “Kelly is in excellent condition and continues to be a 10 year old puppy. Her PCV at her last blood check on June 28, 2008 was 45. Her tongue is a dark pink and her gums are a good color. Her appetite is insatiable and she is as mischievous and curious as before her illness. She is really back to being Kelly. It is almost as though she had never been ill. She lives every moment to the fullest. Kelly is back to being the loving, silly, funny, impish, adorable little bean that she was prior to AIHA. It's sometimes hard to believe that our littlest one was on the verge of death, but Kelly proved that her love for life and for her family was stronger than any disease. It's as though by sheer stubbornness and
will power Kelly stayed with us. She is a tough little girl with a heart that just won't quit.”
Casie is a 15 year old spayed female Cocker Spaniel/Retriever mix owned by Jennifer and Trent of Cincinnati OH. Casie was diagnosed with autoimmune hemolytic anemia, at the age of 6, on September 18, 1999.
When Jennifer was asked to describe Casie’s symptoms prior to her AIHA diagnosis she replied, “Casie had always been a dog who was very full of energy and who loved the outdoors. The onset of her illness appeared to have come on very quickly. Casie had all the classic AIHA/IMHA symptoms including lethargy and pale gums. She was very tired and unresponsive for two days and then on the third day she could not even walk. We immediately took Casie to the veterinarian where blood testing revealed a PCV of 12. The Coombs test was negative but Casie had severe autoagglutination. Casie was given a transfusion of whole blood and as well as 50 mg IV Dexamethasone Sodium Phosphate and was started on 25 mg Azathioprine (Imuran), once per day; 20 mg prednisone, twice per day and 100 mg Tagamet twice per day.
”Over the next two years Casie’s medications were reduced very slowly. When her veterinarian felt she was clear of the disease, all medications were discontinued. Shortly after these medications were stopped Casie received several vaccinations that had been put on hold during her illness. This was a big mistake since two months later she had an AIHA relapse. Casie was immediately started back on prednisone and Azathioprine and, thankfully, she once again recovered quite well. Casie has not been vaccinated again since that relapse. At the current time Casie takes 25 mg Imuran every other day, 20 mg prednisone every other day (on the days the Imuran is not given) as well as 0.3 mg Soloxine twice per day for thyroid supplementation.”
When Jennifer was asked to comment on the current state of Casie’s heath she replied, “Her PCV at her last blood check on June 27, 2008 was 36.8 and her AIHA appears to continue to be in remission. Casie just celebrated her 15th birthday. She tends to relax more often, which is totally understandable, since her age in human terms is over 100! A few years ago, Casie developed a thyroid condition that requires medication (Soloxine). This is nothing serious. Recently, however, she was diagnosed with a cancerous tumor on her leg. We first noticed this tumor while giving her a bath. Thankfully the tumor does not seem to inhibit her ability to walk. The veterinarian gave us the option of amputation or surgery with chemotherapy. Considering Casie’s age of 15, we have made the decision to do neither. We feel that it would not be fair for a 15 year old dog to adjust to having only 3 legs. We also fear the risk of putting her under anesthetic and chemotherapy at such an advanced age. Currently Casie is so lovable and affectionate, one would not even know her tumor exists. She is enjoying life and has been doing so in spite of her AIHA diagnosis 9 years ago. We were told that Casie would be lucky to make it two years past her AIHA diagnosis but we never gave up hope. Here it is 9 years later and she is still ready for each new day. For a dog to be diagnosed with AIHA at 6 years of age and still to be living at 15 years old is true miracle. Casie has overcome many obstacles and we want to tell others who have a dog diagnosed with AIHA/IMHA to never give up hope! ”
Casie Update, November 2008
I recently received the following Casie update from Jennifer.
”We are following up on Casie's October 2008 AIHA Success Story. Last Wednesday, November 19th, Casie died at the age of 15 ½ due to complications of the cancerous tumor on her leg. When this tumor began to break through her skin, our veterinarian advised us that Casie was not in any pain at that moment, but that she would be in tremendous pain within the next few days. My husband and I made the difficult decision to euthanize her before the pain began. Up until the day of her death, Casie was still a happy dog, full of love and a huge appetite! On the morning Casie was euthanized, we gave her four waffles with syrup (her favorite)! The entire decision was bittersweet. On one hand, our dog was living her last day to the fullest with tons of love and without any pain. On the other hand, it was so heart-wrenching to see her jump in the backseat of our car and actually walk into the vet on a leash to be euthanized. We are so thankful for Casie’s long life and that ultimately, auto immune hemolytic anemia was not the cause of her death.”
Sonny is a 6 year old neutered male Border Collie, born of working parents, owned by Vida of Portreath, Cornwall UK. Sonny was diagnosed with immune-mediated hemolytic anemia in November, 2005 shortly after his 4th birthday.
When Vida was asked to comment on Sonny’s symptoms prior to his IMHA diagnosis she replied, “Sonny had a very sudden and acute onset of the disease. His mucous membranes were white/grey with a yellow tinge, he refused food and hid under the bed for a full day. Looking back I recall that Sonny had been unwell for 2-3 days following a booster vaccination, but recovered. It was six to seven weeks later that he became so ill.
”I took Sonny to an Emergency Veterinary Clinic where blood testing revealed a PCV of 10. He was immediately given an unmatched blood transfusion and started on steroid therapy. The second day after his blood transfusion, blood test results showed Sonny’s PCV had plummeted to 8. This was a disaster since the vet could find no more donor dogs that day. In desperation, she used blood from one of her own dogs (for which I will be eternally grateful to her) for a second transfusion. Azathioprine was added to the treatment regime at this time as well. Sonny was hospitalized for 16 days and when he was discharged from the veterinary hospital I was instructed to give him 50 mg Azathioprine once per day as well as 35 mg prednisolone (divided into two doses) per day. Sonny was very weak after his discharge from the Veterinary Clinic but we were so delighted that he had actually survived that it was a real pleasure to have him home. Over the next 10 months, as Sonny’s PCV rose and he became stronger, his medications were changed. The Azathioprine was discontinued and the prednisolone was reduced monthly by 50%.
”About two weeks after all medications for the treatment of Sonny’s IMHA had been discontinued, blood testing showed that his platelets had decreased. We continued to do blood testing on a regular basis and each test indicated Sonny’s platelets were decreasing. After one of the blood tests the vet rang me at work to tell me that Sonny had a platelet count of less then 4 and was in ‘grave danger of bleeding.’ Sonny was diagnosed with Immune- mediated thrombocytopenia and was once again started on 50 mg Azathioprine once per day and 35 mg prednisolone (divided into two doses) per day. The Azathioprine was discontinued after six months while the prednisolone was decreased at a much slower rate then it had been during the episode of IMHA. From the onset of the thrombocytopenia diagnosis, the veterinary practice was in close contact with the UK South West University Veterinary Hospital for guidance in the management of Sonny’s case. They recommended that when Sonny was stabilized the prednisolone be reduced at half the rate it was during the IMHA episode.”
When Vida was asked to comment on the current state of Sonny’s health she replied, “Sonny is doing well, both his PCV and platelet count are currently in the normal range and his last liver function test indicated that it is nearly in the range of normality, which was not the case a few months ago. Sonny has not been vaccinated since his IMHA diagnosis nor will he be vaccinated in the future. Sonny currently takes 5 mg prednisolone twice per day and probably will remain on this maintenance dose of that drug for the foreseeable future. He also take 450 mg of milk thistle daily and 2 Destolit tabs per day to improve his liver function. Sonny, is, perhaps, not quite as active as a normal 6 year old Border Collie, but we still walk 2-3 miles a day and he still runs his circuits and laps around the woods. Last year we adopted a new Border Collie puppy and Sonny’s first impression was that this puppy was the most awful thing he had ever seen, however, now he loves and accepts the ‘new recruit’. Sonny’s very much the ‘Boss Dog’ and the puppy has given a real boost to his life. I believe we all have lessons to learn in life and the very big lesson I learned from Sonny’s illness was to take every day as it happens and to love Sonny each day and be thankful for every minute he is with me.”
Bertie is a 3½ year old neutered male Maltese/Bichon mix owned by Lisa of Western Australia. Bertie was diagnosed with immune-mediated hemolytic anemia on December 11, 2005 at the age of 7 months.
When Lisa was asked to comment on Bertie’s symptoms prior to his IMHA diagnosis she replied, “Bertie followed me everywhere and had always been a very playful puppy. He loved his toys and having his ball thrown. Overnight, he pretty much, went from being a playful puppy to one that wouldn’t/couldn’t get up. Bertie had very pale gums and his eyes looked strange as well. A friend that went to the park with us that morning asked what was wrong with Bertie and also commented on the fact that Bertie looked different. When I called the veterinarian to tell him that Bertie didn’t seem well, he said that if Bertie did not improve within a couple of hours I should bring him in. I had to go to a family lunch and when I returned home Bertie was so weak he appeared to fall over, it was at that point that I took him straight to the veterinarian.
”Upon admittance to the veterinary hospital, blood testing revealed a PCV of 18. Bertie was immediately started on prednisolone with Imuran being added the next day. When Bertie’s PCV dropped into the low teens on December 12, he was given a blood transfusion. After the transfusion his PCV rose to 20 and remained there for the next day and a half. By late afternoon on December 14 Bertie’s PCV dropped to 15. He was given a second blood transfusion, which raised his PCV to 28. Heparin was given with the transfusions. Bertie remained in the veterinary hospital from December 11 to December 19 at which time the veterinarian told me to come and get him as he was not responding, even though his PCV remained stable. I will never forget the shock I felt when the veterinarian said, ‘Bertie is not responding, there is nothing more we can do for him.’ I asked for a referral to a Veterinary Specialty hospital and immediately took Bertie there where he was hospitalized for 4 days. Bertie remained on prednisolone and Imuran with ranitidine and sucralfate being added to the treatment regimen. Even though Bertie’s PCV remained stable, he was not regenerating new red blood cells. Finally after 5 weeks we saw his PCV jump from 30 to 38. As Bertie’s PCV continued to rise and remain stable his medications were very slowly reduced and then discontinued.”
When Lisa was asked to comment on the current state of Bertie’s health she replied, “Bertie is in excellent health. His PCV at his last blood check was 50. That was a little high but we feel he may have been a bit dehydrated. His PCV at his previous blood check had been 46. He is currently on no medications for the treatment of IMHA and has received no vaccinations since his IMHA diagnosis. I had a vaccine titer test performed on him and was told his immunity levels were very high. I was also told that he may not need vaccinations again, but to redo the titers testing every 3 years. You would never know by looking at Bertie that he had been so sick at 7 months of age. He loves to play with his ball and ropes and plays for hours even after a long walk. At our last vet visit, the vet was very impressed with Bertie’s progress and was pleased with all his test results. Bertie’s gums are lovely and pink and I still check them a couple of times a day. I just say ‘gums’ and he turns his head for me to lift and have a look…. I think he knows how important it is for me to check them. I learned there is no quick fix for this disease and even though I will never know what caused Bertie’s illness, I’m more informed and prepared for anything else that comes along. The most important thing is always to be aware of your little mates moods and do the little checks regularly on them. When Bertie got sick, I found it really important to keep a diary of his moods, heart rate, gum colour and later on his medications. Since the disease took its toll on me, this diary helped me to remember what I needed to do. Bertie is so precious to me and I cherish each day I have with him.”
Bertie Update, January 2010
I recently received the following
Bertie update from Lisa.
”Bertie is doing really great. He still has his puppy streak in him, even thought he will be 5 years of age in April. I continue to check his gums often and he gets regular vet checkups. Bertie is not on any medication for the treatment of IMHA nor does he receive any vaccinations or flea or heart worm preventives. Over all you would never know he had been so sick. My thoughts and prayers are with anyone who goes through this with their furry friends.”
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