PREVIOUS SUCCESS STORIES
January 2012
Topsy
Topsy Turvy is a 9 year old spayed female Boston Terrier owned by Linda and Jerry of Stockbridge GA. Topsy was diagnosed with autoimmune hemolytic anemia on September 20, 2010.
When Linda was asked to comment on Topsy’s symptoms prior to her AIHA diagnosis she replied, “After we lost our Boston Terrier in December 2004, I started checking adoption Web sites and found Topsy. She had been living with a small group of dogs, under a bridge, in Hattiesburg, MS when someone spotted her and took her to their veterinarian. She was heartworm positive, had mange as well as a terrible scar around her neck from a chocker chain that apparently had spikes. In spite of all this Topsy was very friendly and had a great personality. Because Topsy was overweight we walked her most days to help her lose weight as well as have some structured exercise. During the record heat wave of the summer of 2010 we walked as early in the morning as possible, yet we noticed that Topsy seemed to be walking slower and getting very tired. She even had to stop along the way to catch her breath. On the Sunday before Labor Day, I noticed some bumps on Topsy’s back which I thought might be hives or bites. When she still had these bumps on Thursday, my husband took her into the veterinarian. He also mentioned to the veterinarian that Topsy seemed more tired than the previous summer. When blood work revealed a PCV of 18, a strong tonic containing vitamins B12 and B6 was prescribed for Topsy. In addition Topsy received a vitamin B12 shot and we were told to return in one week for more blood work.
”The following week blood testing showed that Topsy’s PCV had dropped to 15 and her gums were very pale. A reticulocyte count revealed that Topsy possibly had a non-regenerative anemia. We were referred to the Georgia Veterinary Specialists (GVS) in Atlanta GA.
”At our first visit to GVS, on September 13, Topsy’s records were reviewed and the veterinarian explained what he felt was going on with her blood and how he would like to proceed. He ordered a PCV, CBC, reticulocyte count, x-rays, ultrasounds and a Coombs test. The results of these tests showed Topsy’s PCV was now 13, her white blood count was very high, her reticulocyte count was off the charts and the Coombs test was positive at 1:4. A bone marrow aspiration was suggested and we agreed to move forward with that as well. The veterinarian tried two bone marrow aspirations with no success, so he had to do a bone marrow biopsy. This left Topsy very sore and exhausted. When the veterinarian called the next day we were told the tests confirmed that the red blood cells were being produced at a greater rate than normal and it was possible Topsy might have myelofibrosis (a bone marrow disorder caused by scar tissue development). 30 mg Prednisone twice per day was prescribed for one week, after which we would redo blood testing.
”One week later, on September 20, Topsy was diagnosed with AIHA. Her PCV was 11 and her heart and respiration rates had greatly increased. After a blood transfusion Topsy’s PCV rose to 19. Liquid Cyclosporine, that had to be mixed specifically for Topsy at a compounding pharmacy, was added to the treatment regimen and we were told to continue the prednisone as previously instructed. Later that evening Topsy’s breathing became very labored and she could not catch her breath. At 1:30 AM I called the clinic and they said to bring her in. After she was examined and blood work revealed a PCV of 22 she was sent back home.
”Over the next few days we did blood work often and Topsy’s PCV finally started to slowly rise. When Topsy had problems with indigestion and terrible gas pains, I was told to give her ½ tablet of OTC Prilosec and Gas-X which really helped a great deal. As Topsy’s PCV continued to rise and stabilize we slowly reduced her medications.”
When Linda was asked to comment on the current state of Topsy’s health she replied, “Topsy is doing just wonderful. She is back to being a typical Boston Terrier and is so full of energy that it is hard to believe that she was ever sick. We are now walking 2 - 2 ½ miles per day and we tire before Topsy does. Her last blood work done on December 20, 2011 revealed a PCV of 36. Topsy is no longer on any medication for the treatment of AIHA, however she does take 5 mg Enalapril for a bad valve in her heart. Since we do not want to take the chance of vaccinations reactivating the disease, Topsy will no longer be vaccinated. We want to thank Dr. Ann Sullivan of Mallards Landing Veterinary Clinic for recognizing the severity of Topsy’s illness and referring us to GVS. Without this action on her part, Topsy probably would have died. Our appreciation also goes out to Dr. Derek Duval at GVS who treated Topsy and helped us to understand the disease. We are so thankful our dear Topsy is still with us and we cherish her all the more since we almost lost her. We consider her our miracle girl.”
February 2012
Chip
Chip is a 6 year old neutered male Cocker Spaniel owned by Lorrie of Red Bluff, CA. Chip was diagnosed with autoimmune hemolytic anemia on April 15, 2009.
When Lorrie was asked to comment on Chip’s symptoms prior to his AIHA diagnosis she replied, “Chip’s illness came on very quickly, within 24-48 hours. He went from being a very happy and active dog who loved to play with his toys to being very lethargic and shaky. Chip acted like he had a belly ache or a doggy flu and had no interest in his toys, whatsoever. Later his gums became pale and jaundice set in. He also had rust colored stools which meant he was passing blood.
”I became very alarmed at Chip’s worsening condition and rushed him to his veterinarian the morning of April 15th. Blood work revealed Chip had a PCV of 13. I was told Chip was near death and would need to be hospitalized. Chip was hospitalized for 3 days, during which time he received a blood transfusion, IV fluids and was started on 50 mg of prednisone as well as the stomach coater/protector, Sucralfate. When Chip was released from the veterinary hospital, I was given instructions of when and how to administer the Sucralfate and prednisone. From April 15, 2009, the day of Chip’s AIHA diagnosis, until July Chip remained on Sucralfate and varying dosages of prednisone. During this time, we visited the veterinarian once per week for blood testing. In July, despite my 24/7 watchful care and vigilant administering of medications, Chip took a turn for the worse. He once again had low energy and his PCV decreased by a few points. My spirits dropped to an all-time low and I wondered if Chip would survive. My veterinarian referred me to a neighboring veterinary clinic that was equipped with x-ray and ultrasound equipment to screen Chip for cancer. Thankfully, it was determined that Chip did not have cancer. This veterinarian agreed with my veterinarian that Chip was battling AIHA and needed to continue his regime of Sucralfate and prednisone. Since prednisone can be very hard on the liver, Chip was also given 200 mg per day of SAMe, a supplement for liver health, while on prednisone. On July 30, 2009 Chip’s PCV reached 34.5. When Chip’s PCV rose to 38.1 on August 6, the veterinarian decided it was time to add Imuran to the treatment regimen and slowly wean Chip off prednisone, which was taking its toll on him. Thankfully, Chip’s PCV continued to rise and in early October, he reached and maintained a PCV of 45. We continued weaning Chip off prednisone and started to reduce the Imuran. By November 20, Chip was off all medications for the treatment of AIHA. One month later, blood testing revealed a PCV of 47 and it was determined that Chip was in remission from the disease.”
When Lorrie was asked to comment on the current state of Chip’s health she replied, “Chip is looking and feeling great and has been off all medications for over 2 years now. His PCV at his last blood check was 45. Chip has not received any vaccinations since he was diagnosed with AIHA and will not be vaccinated again. Our veterinarian wrote a letter to the license office of our town telling them that Chip cannot be vaccinated ever again because of his bout with AIHA. Chip’s fur is once again soft and thick. It had been dry and dull while on medications. Chip is back to being a very active, happy, loving and loyal dog, and even more 'glued’ to my side since his battle with AIHA. He, and his canine sister, Dale, will be 7 years old on February 22, 2012. Chip’s continuing life is a gift and I do not take that gift for granted. This experience has taught me to be more grateful every day for Chip’s health, as well as many other things in my life. I am so thankful and grateful to our wonderful veterinarian, Dr. Sandra Flournoy of Antelope Veterinary Hospital and the entire staff there for their professional diagnosis, wonderful care, love and kindness shown to both Chip and me during the time he was so ill.”
March 2012
Daphne
Daphne is a 5 year old spayed female Shih Tzu owned by Amanda of Asheville, NC. Daphne was diagnosed with immune-mediated hemolytic anemia on October 7, 2010.
When Amanda was asked to comment on Daphne’s symptoms prior to her IMHA diagnosis she replied, “Daphne had always been active and loved playing with her canine brother, Beau. At the onset of her illness, she had no energy and wanted to sleep all the time. She would not eat and had a very pale tongue and gums. Since Daphne had appeared fine the previous evening, I was shocked at how quickly these symptoms appeared and immediately called the veterinary office for an appointment. I was told I would be able to get Daphne seen within the hour.
”After arriving at the veterinary clinic, Daphne underwent a number of tests including CBC, chem profile, urinalysis and x-rays. A blood sample was taken for a Coombs test to be sent out to another facility. When the veterinarian came in to talk with me, she told me Daphne had a PCV of 20.6 and was severely anemic. She thought Daphne had something called immune-mediated hemolytic anemia (IMHA) and would know for sure once the results of the Coombs test came back the next day. In the meantime, we would start to treat Daphne as if she had IMHA so she was started on prednisone, aspirin and Cyclosporine (Atopica). The next day Daphne’s PCV dropped to 16 and the Coombs test came back positive. The veterinarian was very honest with me when she told me that Daphne had a very small chance of surviving. She also said that if Daphne’s PCV dropped any lower she would need a blood transfusion.
”Blood work done on Saturday, October 9th revealed Daphne’s PCV had dropped to 13. I was told I needed to rush Daphne to the Emergency Clinic so she could have a blood transfusion. While we were on way, Daphne’s records were sent to the Emergency Clinic so the doctor would be ready for her. Once I arrived at the ER Clinic they put us in an exam room and the doctor came in to talk with me. He said they would get the transfusion going and that because of Daphne’s low PCV she may need a second transfusion. The blood transfusion started at about noon and ended at 4 p.m. After the transfusion Daphne’s PCV rose to 23, by Sunday morning it was 28 and on Sunday afternoon it was 25. Since Daphne’s PCV appeared to be stabilizing, the doctor said Daphne could go home on Sunday night. When we went to pick Daphne up we spoke with her doctor who told us to increase the prednisone dosage. He also instructed us to see our regular veterinarian the next day.
”On Monday I had to go back to work but I didn’t know what to do with Daphne. I did not want to leave her home alone when she was so ill. At 8 a.m. I took her to the veterinary hospital to have her PCV checked and it was 26. The veterinarian said that they could keep Daphne at the hospital all day so I could work. They checked her PCV again before I came to pick her up and it was still 26. I dropped Daphne off at the veterinary clinic each day and picked her up each evening for a whole week. During this time Daphne’s PCV held steady at about 27. The next week I felt confident enough about Daphne’s progress to leave her at home while I worked.
”In December Daphne began showing signs of latrogenic Cushings disease due to the prednisone. She was losing lots of hair and muscle mass, developing calcium deposits and was very weak. We continued tapering the prednisone to reverse the Cushings disease and started to decrease the Cyclosporine as well. On January 6, 2011 Daphne had a PCV of 45. At that time she was taking 5 mg prednisone twice per week and 25 mg Cyclosporine twice per day.
”Daphne was due for her three year rabies vaccine in January 2011. The recommendation from an internal medicine specialist was to use a non-adjuvented vaccine (Editor’s Note: an adjuvant is a pharmacological agent added to a drug to increase or aid its effect). However since none was available for dogs, it was recommended that Daphne be vaccinated with a one year vaccine with AIOH as the adjuvant vs. thiomersol. This was done on January 20, 2011 and Daphne had no side effects from this vaccine. We continued to taper the prednisone and Cyclosporine and at the present time Daphne is on no medications for the treatment of IMHA.”
When Amanda was asked to comment on the current state of Daphne’s health she replied, “Daphne is doing very well with no signs or symptoms of IMHA. Her PCV at her last blood check was 44. She currently has a bladder stone that we have been working to dissolve. We are trying to avoid surgery because of her medical history. Since Daphne did so well with the one year rabies vaccine last year, she received the same form of vaccine this year on February 11. Before Daphne’s illness, she was very independent, but since her bout with IMHA she is very attached to me. Other than the bladder stone, Daphne is a perfectly healthy, happy five-year-old little girl! I would have never thought at the beginning of Daphne's illness that she would recover and be even sweeter, happier, and more ‘spunky’ than before her illness but she is and for that I am so very thankful.”
April 2012
Lil Bit
Lil Bit is a spayed female American Cocker Spaniel of an unknown age owned by Mark and Ann of Athens GA. Lil Bit was diagnosed with immune-mediated hemolytic anemia in November, 2009.
When Mark was asked to comment on Lil Bit’s symptoms prior to her IMHA diagnosis he replied, “Lil Bit is a rescue dog who was abandoned in the middle of the night at our veterinarian’s office in January, 2008. She had laundry list of problems and needed a three part surgery to rid her of bladder stones, fix bilateral cherry eyes and spay her. We brought her home and soon noticed that she had an itch that would not stop. Food trials and anti-histamines were tried in an effort to bring her some relief but by October of 2008 it was decided that more specific medication would be needed. She was started on 50 mg Atopica (Cyclosporine) daily for one month then that dosage was reduced to every other day. This helped control her itchiness and kept her comfortable for many months.
“In July 2009, Lil Bit went in for a dental cleaning. Pre-operative blood work showed a significant drop in her PCV from her normal of 42 to 32. A cytological review did not show any abnormalities or significant regeneration of blood cells. A recheck one week later showed that her PCV was back to normal. At this time she was still receiving 50 mg Atopica on an every other day basis.
”Two months later blood work, at the ophthalmologist’s office prior to cataract surgery, showed Lil Bit’s PCV had dropped to 28. Since Cyclic anemia is very unusual in dogs, Lil Bit was referred to a veterinary internal medicine specialist for further diagnostics and treatment in November 2009. The abdominal ultrasound was normal and a diagnosis of immune-mediated hemolytic anemia was made at this time. Lil Bit’s unusual clinical presentation of IMHA was most likely due to the use of the immune modulating drug, Atopica for her skin condition. Imuran was added to Lil Bit’s treatment regimen and the Atopica dose was increased back to 50 mg daily.
“Over the next three months, the immunosuppressive drug dosages were lowered in an effort to find the lowest effective dose. Lil Bit continued to do well in regard to her IMHA, however she did struggle with painful viral warts secondary to her suppressed immune system. In July 2010, Lil Bit had a recurrence of a urinary tract infection. An injection of an antibiotic cured the infection but one week later Lil Bit was feeling poorly. A check of her blood showed that her PCV had again dropped to 29. What was especially worrisome was that although her cell counts were dropping, her bone marrow was not making any red or white cells. The Imuran was discontinued since it can lead to bone marrow suppression and the Atopica was increased. A bone marrow biopsy at the end of July, 2010 found a very healthy bone marrow that had responded well to the change in medications. Over the course of many months and multiple blood rechecks, Lil Bit has continued to do well. There were two occasions where her bone marrow had to really increase production of red cells and she teetered on the edge of needing an increase in medication. However, she has been able to stay on a relatively low dose of immune suppression medication without too many side effects.”
When Mark was asked to comment on the current state of Lil Bit’s health he replied. “Lil Bit is doing great. She is enjoying good health since all her chronic conditions such as IMHA, dry eyes, urinary stones/infections and dermatitis are now under control. Her PCV at her last blood check on February 12, 2012 was 50. Lil Bit takes 50 mg Atopica every other day. She also receives Cyclosporine drops in her eyes twice a day as result of having her tear ducts removed. Lil Bit is a trooper. She has had one issue right after another ever since we adopted her including cataract surgery in both eyes, bladder stone surgery, a flare-up of a disc problem, constant itching and IMHA. Through it all she has remained a happy, loving dog. We walk to our favorite coffee shop every day and because Lil Bit knows she’ll get a cookie, she loves the walk.
”Lil Bit has been an especially complicated case because she not only had IMHA but eye problems that have necessitated cataract surgery and lifelong applications of cyclosporine to combat dry eye. All that being said she is the happiest little dog you would want to know. She is a bit obsessed with food but that seems to be a common characteristic of her breed. She allows the twice daily application of eye drops without complaint and takes great joy in daily walks and just being with us and her pal Bohdi. It is our hope that the success we have had with Lil Bit can give hope and encouragement to others as they address this condition in their pet.”
Editor’s Note: A special Thank You to Dr. Linda Leavell of Mars Animal Hospital in Watkinsville, GA who provided much of the information for Lil Bit’s Success Story.
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