The Meisha's Hope Bandanna
Meisha, a lab, terrier, spaniel mix was 3 years old when she was diagnosed with autoimmune hemolytic anemia (AIHA) on January 21, 1992. We had noticed for several days that she was not her usual energetic self and when on this morning she would not eat or drink water and later she was too weak to climb the stairs, we made a immediate call to the veterinarian.
Upon presentation, Meisha had a temp of 103.6, pale gums and dark colored urine. The veterinarian suspected at once that it was AIHA and started her on prednisone and antibiotics, while he waited for the results of the blood tests. Meisha was started on high doses of prednisone, as is the normal treatment for this disease and over the next few weeks the dosage was decreased and then completely stopped. By the end of May, 1992 Meisha had been on and off the prednisone a couple of times. Each time she was taken off the drug she would relapse. We now believe the relapses were probably caused by the prednisone being reduced too quickly.
At Meisha's checkup on May 26, 1992 we did a thyroid test to determine if the disease had caused the thyroid gland to be under functioning. She was off the prednisone at this time and overall appeared to be doing well. The results of the thyroid test indicated that her thyroid function was borderline normal so she was put on thyroid medication. Meisha was to remain on the thyroid medication until July of 1995.
On August 4, 1992 Meisha suffered another relapse. Once again we started her on prednisone and antibiotics. We also started her on Pettabs +, a multivitamin tab, and prescription dog food. It was at this point that it became apparent that Meisha probably would not be able to live without the prednisone. We knew that we would have to find a dosage that would keep the disease in check without doing damage to her liver and other organs. We decreased the dosage over time to 10mg every other day (eod) and decided to try to keep her on this dosage for as long as possible. As long as possible turned out to be over 2 years.
Meisha continued to do very well on 10 mg prednisone eod but her checkup on March 7, 1995 indicated the alkaline phosphatse (liver enzyme) was very high. We were concerned that the prednisone could possibly be doing damage to her liver so the prednisone was lowered to 5mg eod. Meisha's doctor did not believe that 5 mg eod would keep the disease under control. He also believed that even this small of a dosage could continue the alkaline phosphate rise and do possible liver damage. After consulting with other doctors, on May 1, 1995, he decided that we would take her off the prednisone once again. Meisha continued to do well all through the summer and fall of 1995 and we were beginning to think that maybe she would be able to live without medication. On October 30, 1995 Meisha had one of her best checkups ever and we were very encouraged. She had now been off all medication for 6 months.
On November 17, 1995, Meisha started having a mild nose bleed and sneezing blood. No one believed that she could relapse so quickly after having such a great checkup only 2 ½ weeks before, so instead of running blood tests, it was concluded she had a mild sinus infection. We put her on antibiotics and took a wait and see attitude. Hindsight, now indicates this was the incorrect thing to do. The mild nose bleeding continued and after a couple of days we ran all blood tests including the Coombs test. The PCV was her lowest ever and the Coombs test was positive. We knew the disease had once again returned. Meisha was started on 60 mg of prednisone per day and she remained on the antibiotics for several more days. After this relapse, we knew we could never take Meisha off the prednisone again. As before Meisha responded well to the prednisone and within a short time we were able to decrease the dosage. Meisha was to continue on 5 mg of prednisone eod for nearly 6 years.
Over the years we implemented vitamin therapy into Meisha's total care program. Near the end of her life she was taking 1150 mg of vitamin C, 400 IU's of vitamin E , a brewers yeast and garlic tab, a pet tab+ vitamin tab as well as 1500 mg Glucosamine and 1200 mg Chondroitin per day for arthritis relief. The Glucosamine/Chondroitin formula eliminated the need for any other arthritis drug.
Early on, we became concerned about the part that vaccinations might have on Meisha's condition, so we never gave her more then one vaccination at a time. We would space them out with at least a month in between each shot. As Meisha became older we became even more concerned about the role vaccines might have on her already weakened immune system. Because we felt she was at almost no risk for the rabies disease we eliminated that vaccine in 1996. Her veterinarian wrote a rabies waver for us to give to our city officials so we were still able to license Meisha. As we continued to research the vaccination issue we became more and more concerned about the part vaccines might play in a potential relapse for Meisha. In the spring of 1998, after consulting with many veterinarians we decided that Meisha would not receive any vaccinations whatsoever in the future.
After the relapse in November, 1995 we were to have 6 more good years with Meisha, all relapse free. She did have a couple of infections during this time but they were quickly remedied with antibiotics. Like all senior dogs, Meisha had good and bad days. So when she had a few more bad days, I attributed it to old age. Monday, October 29th, 2001, Meisha seemed better then she had been for some time. She was full of energy and guests to our home that day commented on how well she seemed. The next day she was good as well, still trying to get her nonplayful canine sister, Margo, to play with her. However on October 31st Meisha nearly fell down the stairs. When I presented her with her food she turned up her nose and refused to eat even a bite. Just the day before she had eaten it very normally. When I took her temp it was nearly 104. We took her to the vet immediately and ran the blood work, all numbers on the CBC were in the normal range. Most of the chemistry profile looked as it had at our last visit in late March. We did x-rays, and saw no problems. We also did a urinalysis and started antibiotics since we felt that perhaps we were dealing with a urinary track infection (UTI). The urine culture later came back negative for a UTI.
On November 4th, when we felt things were getting worse we made a return trip to the vet and ran the blood work again. It continued to tell us we were dealing with neither AIHA or ITP. Many of Meisha's symptoms now led us to believe we are dealing with another autoimmune disease called Systemic Lupus Erythematosis (SLE) and we began treating Meisha as though that is what she had. When she would not drink water and started becoming dehydrated we started her on IV fluids at the vet clinic and learned how to give them at home as well. The antibiotics brought down Meisha's temperature and she once again started to eat & drink. We became cautiously optimistic that she might once again recover as she had done so many times in the past.
November 15th we did blood testing again. Meisha's PCV was now 32.8, down from 41.0 on November 4th. However the November 4th number may have been bit high as the result of dehydration. The prednisone was raised from 50 mg to 75 mg per day and 50 mg of Imuran per day was added.
Testing on November 21st revealed the PCV had dropped to 31.3 In addition the hemoglobin was down, the WBC was up and most other counts were out of line. The chemistry profile also had many values that were out of line as well. Meisha was starting to become dehydrated and losing gum color. We talked to our vet twice later that day with strict instructions to call him Friday morning to reevaluate the situation, or sooner if need be. We spent a quiet Thanksgiving with Meisha. She was eating & drinking less and we were becoming certain that the end for her was coming close.
Friday morning, November, 23rd , Meisha seemed weaker and would not eat at all . She also was starting to have labored breathing. We decided it was time to let her go. We called our vet and made an appointment to have her euthanized at noon. We had a couple of hours to spend with her before it was time to leave for the vet. We took good advantage of that time, by sitting on the floor with her, hugging her and telling her how much we loved her. When we let her outside before leaving for the vet, her stool was almost like water.
At approximately 12:30 PM, central time on November 23, 2001 Meisha was tranquilized and then given the final shot that would end her suffering. She went very peacefully. We had made arrangements with her vet to do a visual as well as tissue autopsy. Late in the day Meisha's vet called to say the visual autopsy showed her liver had started to leak blood and Meisha was only hours away from being in "real distress" with the possibility of bleeding to death or going into DIC. The results of the tissue autopsy revealed that Meisha died from Amyloidosis, probably caused by the long-standing AIHA.
Meisha was only 8 days short of her 13th birthday at the time of her death. She had lived for 9 years and 10 months after her AIHA diagnosis. In spite of the AIHA, Meisha lived most of those years as a happy, healthy, normal dog. She had an indomitable spirit and an overwhelming desire to live. It is our hope, indeed, "Meisha's Hope" that her story will give you the hope you need to keep on fighting AIHA. Meisha was proof that the disease can be survived. If her illness has helped even one dog and their family in the AIHA fight then it has been worth it all.
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This page was last updated on January 9, 2013.
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