My dog Lucy was diagnosed with IMHA/IMT on July 23rd. She has been up and down with this, but after her second blood transfusion last Monday (and adding cyclosporine in addition to danazol and preds), her blood work was the best it has ever been yesterday (PCV had barely changed from following the transfusion - near 40%, and her platelets were up to 161,000). Her liver enzymes (the ones that show that her liver is being damaged (ALT?) were still high, but were down to half of what they were prior to her second transfusion (down from 1157 to 731). If her numbers were still good at the end of the week, we were going to begin a gradual reduction of her prednisone starting Sunday (but leave her on the cyclosporine).
When she was diagnosed, her PCV was 15% and her platelets were 17,000 (they put her on pred and azathioprine to treat it). Three days after she was diagnosed, her PCV had gone down to slightly under 12%, so they gave her a transfusion, and it went up to 36%, but eventually fell down to 28%. Even though her PCV was holding steady at 28%/platelets went up to 80,000, and it appeared the high dose of preds and aza were working, I could tell she was feeling crappy. Her blood tests revealed her liver values (whichever one it is that shows her liver is being damaged...I think it's ALT) were extremely high and possibly causing her to feel bad. They then discontinued the aza, and added danazol. They also put her on some fluids to try to flush out the liver toxins. She seemed to feel better. However, the next Wednesday, her PCV had dropped down to 20%, and her platelets to 40,000. Her liver values were even higher than what they were. She doubled the danazol dose. Then late that Sunday night, I noticed she fell over two or three times (the same type of collapse that she had when I first took her to the emergency clinic and we found out she had this god awful disease). Next day her PCV was at 15%, and they decided to do another transfusion. Her PCV went up to 40%. They also kept her on the same dose of danazol, but reduced her prednisone and added on cyclosporine. Aside from the Cushing's type symptoms from the pred, she has felt the best I have seen her feel since this all began.
I live in Alabama (so we have a lot of mosquitos). Yesterday, she was a week late taking her Trifexis (I haven't wanted to give it to her until she was more stable). I asked my vet if she thought it would be okay to take, and she told me yes, and that she would hate for Lucy to have gone through all of this and then get diagnosed with heartworms in 5 or 6 months. So I gave it to her.
She
has been feeling so well for the past week and was still feeling so
good yesterday. Today, I've noticed she's been sleeping a lot more, and
is not the same Lucy that I've been seeing over the last week (she had
been following me around everywhere, and desperately scavenging from
food from the preds...not today).
Her color still looks pink (not
as pink as yesterday though). I was worried she was maybe getting a
fever or an infection, so I took her temp and her temp was normal. She
has a glazed over look in her eyes, which is always indicative to me
when she's not feeling well. She's not wagging her tail like she was or
anything. She also was breathing really hard whenever she walks
anywhere, and is a lot more wobbly when walking. She ate today (she
never has stopped eating since this whole ordeal began). My BIGGEST
concern is when I was holding her to take her temperature, her chest
felt swollen, and her heartbeat felt funny (not like the anemic heartbeat, but not normal either). It felt like she was swollen
with fluids in her chest (does that make sense?). She's had pred belly for a while now,
but her stomach is now even more swollen tonight, and feels tightly
swollen with fluids.
I wasn't thinking anything, but then I remembered I gave her the damn trifexis yesterday. Has anyone had any negative effects from
this???? I am SO MAD I gave it to her now. I'm calling my vet first
thing in the morning to take her in, but I wanted to hear from other
people to see if anyone has any advice concerning this.
Thank you for any advice/help/suggestions, etc.