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February 2002

Snowy

Snowy is a 7 year old neutered male mixed breed (part Cocker spaniel & part Lhasa apso) owned by Marlene & Gary of Princeton Junction, NJ. Snowy was diagnosed with autoimmune hemolytic anemia on August 30, 2000.

When Marlene was asked to comment on Snowy's symptoms prior to his AIHA diagnosis she replied, "Snowy has always been on the quiet side. About 4-5 days before the AIHA diagnosis, he seemed depressed and his appetite was poor. I attributed this to the death of our 20 year old cat that Snowy loved. He was with her when she was dying and I thought maybe he was just sad. I finally took Snowy to the vet when he started vomiting. At that point he had become so weak he couldn't even stand up on his own. In addition, he had pale mucous membranes and his usually pink-spotted nose was very pale."

On presentation at the veterinarian's office, Snowy had increased heart and respiratory rates and his urine was very dark. Blood testing revealed a PCV of 10. A blood smear showed marked spherocytosis and evidence of regeneration. Snowy was diagnosed with AIHA and because of his low PCV was given a blood transfusion. He was started on 25 mg prednisone per day, 25 mg Imuran daily for 5 days, then 25 mg every other day, 200 mg Amoxicillin twice per day and 10 mg Pepcid AC, daily. Over time Snowy's prednisone and Imuran was decreased very slowly. At the present time he remains on 1.25 mg prednisone twice per week and 25 mg Imuran twice per week. He also receives Heartgard chewables for heartworm prevention. At the onset of Snowy's illness, he went for weekly blood checks, later blood checks every other week, then monthly blood checks. At the present time Snowy has blood checks every 3-4 months. Since the AIHA diagnosis, Snowy has had his rabies vaccine and other vaccinations without incident.

When Marlene was asked to comment on the current state of Snowy's health, she replied, "he is doing great!. His last blood work as done on December 3, 2001. At that time his PCV was 42 and all other results were within normal limits. Snowy is playful, happy and healthy once again. My husband, daughters and I have learned a valuable lesson from this disease. We have learned how important it is to enjoy each and every day and to spend the time to let those we love, human and furry, know how very much they mean to us. Although the battle against AIHA is extremely difficult, in some ways it has helped to make me a better person. It has taught me to never take anything or anyone for granted. Every day that we have with Snowy is a gift, and it is a gift that we truly treasure!"

Snowy Update, July 2003

Marlene wrote recently with the following Snowy update:

"In mid November 2002, Snowy suffered a relapse of AIHA. He was exhibiting the same symptoms of lethargy and loss of appetite that he had exhibited during his initial onset of AIHA. I rushed him to a nearby vet. At re-diagnosis, his PCV dropped to a low of 15. He received a full blood transfusion and was once again started on drugs for AIHA. Over the next month his PCV slowly climbed to the low 30's. He seemed very tired and weak during this period, but no more so than he had during his initial battle.

On December 23rd, Snowy was breathing a bit heavier than normal. He was rushed to his regular vet where testing revealed that his PCV was still 32. We were distraught when Snowy died while the veterinarian was examining him.

Although we feel blessed to have had Snowy during his life on earth, and to have had him for over two years from the time of his initial AIHA diagnosis, we were still not at all prepared to lose him. He would have celebrated his 8th birthday on January 30th, 2003, but it was not to be. We all miss him terribly, more than words can adequately express, and he will always hold a special place in our hearts."

March 2002

Casey

Casey is a 5 year old spayed female English Labrador Retriever owned by Cara & Paul of New York, NY. Casey was diagnosed with autoimmune hemolytic anemia on August 27, 2000.

When Cara was asked to comment on Casey's symptoms prior to the AIHA diagnosis she replied, "Casey was very lethargic, not hungry, had labored breathing and no interest in anything." Cara continued, " Casey is a sweet, gentle, lumbering type of dog, very mellow and loves to swim. When we first noticed she wasn't herself was when we were in the park and she stopped swimming and just laid down on the ground. I usually feed her after her exercise and when I brought her home and she wouldn't eat, which is unheard of with Casey, I knew there was something wrong. She grew more and more lethargic. Something in her whole face changed, she started gasping for air and her breathing was severely labored."

Casey was taken to her local veterinarian where she was diagnosed with Rocky Mountain spotted fever, although no tick was ever found on her and no blood testing was done. She was put on antibiotics and sent home. Cara was told to bring Casey back to the veterinarian in two weeks. During the next two weeks, Casey's condition continued to worsen. When Casey returned to the local veterinarian she was diagnosed with AIHA and started on a very low dose of prednisone. Casey was put back on antibiotics and hospitalized for 4 days over the Labor day holiday weekend. Cara was told not to visit Casey during the hospitalization, to just "let her rest". When Cara awoke one night during Casey's hospitalization, something told her to go to the clinic and see Casey. Cara was shocked and distressed to find out that only a lab technician was attending to Casey and that Casey's condition was continuing to worsen. Cara immediately called the New York Animal Medical Center and was told to bring Casey right over, they would have a room waiting for her. Casey was carried out of the local veterinarians office on a stretcher, placed in the car and taken to AMC.

Upon admittance to AMC, Casey was given a blood transfusion since her PVC had dropped to 7. She was started on 80 mg prednisone, and 40 mg Imuran. During her stay at AMC, besides the initial blood transfusion, Casey had two Oxyglobin transfusions and one round of Cytoxan. She was also given the antibiotic, Clavamox. Casey remained on Clavamox throughout the 7 months she was on prednisone to combat the side effects of the prednisone which according to Cara included "weight gain and massive hunger attacks to the point where Casey would cry. She also had severe bed sores on her hind quarters that were filled with pus and oozed blood all the time because she was actually sitting on the raw bone. We put diaper rash cream and doggy diapers on her sores for 9 months so she could sit more comfortably. She had sores along the outside of her mouth that would not heal either. Also her hair fell out, basically she had none on her tail for a while. Once the prednisone was reduced lot of these things cleared themselves up." Over time Casey's medications were very slowly reduced and then stopped. At the present time Casey is on no AIHA medications whatsoever. Casey continues to see her veterinarian on a monthly basis for blood checks. Each time a blood test is done another special blood test called Bio Nutritional Analysis (BNA) is done as well. Based on the results of this test, special nutritional supplements are created specifically for Casey. When Cara was asked to comment on these supplements she replied, " I believe strongly that these supplements contributed just as much as traditional medicine to Casey's recovery." Cara also adds 1000 mg of a glucosamine/chondroitin supplement daily to Casey's food. Since Casey's AIHA diagnosis, she has had no vaccinations but does use Frontline for flea protection during the hotter summer months and Heartgard for heartworm protection.

When asked to comment on the current state of Casey's health, Cara replied, "Casey shows no symptoms of the AIHA. She is actually more energetic and alert then before. Her last blood check was on February 23, 2002 and her PCV at that time was 41. Casey is a truly special puppy! From the time she came to me, I knew she was going to be my best friend for life. She was well-behaved and sweet from 9 weeks old. She is the only dog I know that has to be bribed to go out and take a walk- no aimless exercise for her! The day Casey got sick, I knew something was wrong- you just know your dog so well when you spend a lot of time with them. Now she has returned to her previous self. Casey is the most precious thing in our lives and we would do anything to see her healthy and I am happy to see that she is! We are enjoying every moment with her. It is hard to believe that she came back from this dreaded illness- animals are amazing! It was torture to see her suffer but I knew she was on the way back and I wasn't giving up."

April 2002

Lucky

Lucky Boy, is a 14 year old neutered male Dalmatian owned by Kathy of Perkiomenville, PA. Lucky was diagnosed with autoimmune hemolytic anemia on September 28, 2000.

According to Kathy, "Lucky was always a pretty healthy dog, until he was diagnosed with Rocky Mountain spotted fever and Lyme disease in the fall of 1999. He was started on a course of Doxycycline and appeared to recover well. In April 2000, Lucky received a Lyme vaccination. He had a severe reaction to this vaccine. When his whole face became swollen, I took him to an emergency clinic. He ended up having his submandibular lymph node removed & biopsied. Lucky was again placed on antibiotics for a period of time and he seemed fine until the day after Labor day, 2000 when he collapsed while running outdoors and sustained back injuries. Lucky was hospitalized and had back surgery to remove 2 herniated discs. Two weeks after the back surgery, Lucky developed pneumonia. He stopped eating and was hospitalized again. When testing revealed both a low PCV and platelet count, Lucky was diagnosed with autoimmune hemolytic anemia. The vets also said he still had Rocky Mountain spotted fever. Lucky was started on prednisone and Doxycycline. When Lucky's liver became enlarged from the prednisone, it was decreased to 5 mg per day and 100 mg Cyclosporine was added to the treatment regimen. Lucky saw his vet every week for blood checks for a number of months and as the PCV rose, the drugs used to treat the AIHA were decreased and then later completely stopped."

According to Kathy, "my regular vet didn't see the need for all the medications. He thought the anemia was drug induced or perhaps from the Lyme disease or Rocky Mountain spotted fever. So even though Lucky was diagnosed with autoimmune hemolytic anemia by one vet I am not sure if he really had it or not."

Kathy continued, "Lucky has recently been diagnosed with several heart problems including aortic & mitral valve leaks, arrhythmia and high blood pressure. He is currently taking 3 medications for those heart problems as well as several dietary supplements. In June, 2001 Lucky was due for his distemper vaccination. We decided to do the titers test first, which indicated he still had distemper protection from his last vaccination. Because of the titers results, we chose not to revaccinate at that time. Lucky also takes Heartgard for heartworm prevention."

When asked to comment on the current state of Lucky's health, Kathy replied, " Lucky is doing good. He has good and bad days. If he does too much on one day, he might be weaker the next. He's better at different times of the day because of his heart meds. Lucky is always good at meal time though. The most important thing is, that he's still trying. He barks when I come home from work and brings me one of his toys . He still wants to ride in his Jeep and put his head out the window with his ears flapping . Lucky still enjoys walks in the park and keeping his kitty's in line. He's the boss! For a 14 year old Dalmatian, he is doing well. Despite all Lucky's health problems in the past couple of years, he still keeps his spirit and has the will to do. As long as that continues and I know he's not suffering, I'll go to any lengths to keep him happy. All we can do is take it day by day. We make every day count."

Editors note: Even though there is some disagreement among Lucky's vets as to whether or not Lucky actually had autoimmune hemolytic anemia, I decided to do his story for the success stories page at Meisha's Hope. Lucky's story points out that AIHA can sometimes be very difficult to diagnose. The symptoms of AIHA can be confused with many other diseases including Rocky Mountain spotted fever. To learn more about Rocky Mountain fever Click Here

May 2002

Metku

Metku is an 11 ˝ year old spayed, female Bearded Collie owned by Pia Backlund and Vesa Kanninen of Vantaa, Finland. Metku was diagnosed with autoimmune hemolytic anemia on November 26, 1997.

When Vesa was asked to comment about Metku's symptoms prior to her AIHA diagnosis, he replied, "Metku was tired, weak and apathetic. Her gums were very pale with bleeding. In addition, she had a temperature of 104." Vesa continued, "Two years before the initial AIHA diagnosis, Metku had "weak spells" for a few days, losing consciousness once just walking on the lawn, another time running along a path, and generally having to sit down every now and then. In between she'd be as fine as ever. Addison's disease was suspected but not confirmed. At that time her PCV was as high as 50%, and she had mild uremia. An EKG and ultrasound were done on Metku's heart. It appeared somewhat enlarged, but otherwise, was fine. Did this have something to do with her AIHA? Probably not, but who can tell for sure - most certainly it was a sign of her body reacting to something in a quite drastic way."

After displaying the AIHA symptoms Metku was taken to her veterinarian where according to Vesa, "she walked into the vets waving her tail. Once inside, she had used most of her strength, and after a while would not even lift her head. We were lucky enough to have an expert vet who knew a lot about AIHA and actually diagnosed Metku even before blood tests were conducted." Metku was given a Dexafort (Dexamethasone in the USA) injection and started on antibiotics. The next day she was started on prednisone at a dosage of 2mg/kg per day and additional antibiotics. She was also give a blood transfusion. According to Vesa, "When she was in transfusion and at her weakest, our vet gave Metku "a slight chance" if she would react to the medication properly." Over the next few weeks, lab reports revealed that new red blood cells were forming and the PCV began to increase. The prednisone was slowly decreased until by spring 1998, it was down to 0.5mg every other day (eod).

In late November, 1998 when Metku was in heat, lab reports and symptoms indicated an AIHA relapse. Prednisone was again started. Imurel (Imuran in the USA) was started at a dosage of 50 mg per day. By January 1999, the prednisone had been reduced to 10 mg per day and Imurel was at 25 mg per day. On April 7, 1999 Metku suffered another AIHA relapse. The Coombs test was positive. Prednisone was increased to 40 mg per day and Imurel was increased to 50 mg per day. When Imurel caused Metku to start vomiting, it was decreased to 25 mg per day on April 21. Once again Metku responded well to the drugs and by June 24, 1999, the prednisone dosage was down to 0.5 mg per day and Imurel was discontinued. According to Vesa, "Now that she had recovered, we decided that she would be best off if she was spayed, and her spleen removed as a precaution. This was in line with what her vet had been saying since day one, that at some point this might be worth considering. This way we could see if the spleen had anything to do with the disease." The spay surgery and splenectomy were done on July 23, 1999. Metku recovered well from the surgery, however lab work on August 5, 1999 indicated an "IMHA relapse, early stage." Vesa continued, "After the operation there was a hernia in the wound, the trauma of which probably contributed to the relapse in August - and the prednisone had, so said the operating vets, made her muscular tissue remarkably fragile. After this relapse, her prednisone which had been kept at 10 mg eod was raised to 20mg/day, and dropped within three weeks back to 10 mg eod. She remains on 10 mg prednisone eod at the present time." Metku goes for blood checks 3-4 times per year and her PCV remains in the normal range. Because there is no risk of heartworm in Finland and fleas are quite rare, Metku receives no heartworm or flea protection. She does, however continue to receive vaccinations from her breeder on an annual basis.

When Vesa was asked to comment on the current state of Metku's health, he replied, "clinically as well as mentally, she's fine for a gal going on 12. Her age is starting to show a bit, but she keeps up with our other two younger Beardies quite fine and they surely keep her in good shape by offering plenty of exercise. They go for walks totaling up to 10 kilometers per day. It is notable that after the '99 spring & summer of down-and-ups (since it felt like "we" barely reached an acceptable condition and relapsed again, and started again..) Metku has been in "excellent" clinical condition for 2.5 years. Whether the operations have caused this or not is impossible to prove, but it seems likely they did help. The vet has suggested trying to drop the prednisone dosage, but since she seems to cope well with the current dosage we have decided not to risk another relapse at her age. Knowing that her body might "give up" because of the medication makes it a difficult call to make, but we feel that the high doses needed in case a relapse would occur might be even more harmful in the long run The only setback from AIHA is the immense appetite caused by the cortisone treatment: left unattended, Metku will "clean up" anything resembling food from the tables and lower shelves. But that is nothing compared to the joy of her just being there! We are so very happy to still have her with us. It was a long time after the initial diagnosis and recovery until we realized how close we came to losing her! Now, every day with her is a new miracle to us."

Metku Update, September 2002

I received the following Metku update from Vesa.

”On June 7, 2002 Metku was diagnosed with lymphatic cancer. Her lymph nodes became swollen to the point she had difficulty sleeping. The prognosis was 4-8 weeks with no treatment and up to 6 months with chemotherapy. We started her on Vincristine and Cyclophosphamide as well as a third medication and her condition stabilized. However, the treatments did not make the nodes smaller, a clear indication that the treatment was not really effective. During July, new drug combinations were tested but it appeared that none of them were effective. Metku’s general condition was good, except for intermittent sleep, due to nodes in her neck applying pressure to the trachea, when she was lying down. On July 31st Metku started vomiting, she would eat as usual but nothing stayed down. On the morning of August 1, I took her to the College of Veterinary Medicine at the University of Helsinki, where she had previously been treated. After a discussion with the vets there and consulting with one by phone in Austria, I made the decision to have our dear gal euthanized. We decided to act so Metku would not suffer in the days ahead. We continue to think of Metku and miss her a great deal, she was THE dog for us in so many ways."

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