Wow -- a lot to respond to.
team Presley
Transfer factor: This one I really don`t understand as it enhances the immune system, Isn’t that what we’re trying to supress with the steroids? It sounds potentially counter productive?
First -- Bio Prep and Transfer Factor -- just **don't**. Both are a whole lot of marketing and inflated claims, but they are essentially algae and I honestly don't know any good holistic vets who are at all happy with it. I've seen it have some really negative effects to be honest -- there is a HUGE difference between "boosting" the immune system and "supporting" it. And both of those "boost" the immune system which is something you do NOT want to do. Rellasmom may have used it for a heartbeat but not at all later.
team Presley
Petinic: I think this is a multi vitamin to with vitamin c, vitamin b, and iron
Pet Tinic is made by the same people who make Pet Tabs -- it's a good companion supplement for a dog with IMHA -- it ehlps iwth iron and someo f the other things that IMHA saps out of the body.
team Presley
Presley`s last blood test March 19 has shown that Presley’s PCV is now at 45% (huge improvement from 12% march 2nd), however the pathologist has found she still has some irregular shaped eosinophil’s, meaning she`s still attacking her red cells a bit. Her bone marrow is thankfully doing what it should, producing new young red cells, but I`m still concerned.
Ok -- here is where I'm going to tell you to do a great big huge WHOA!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
I'm thrilled you like your vet -- but I can't emphasize to you enough IMHA is a HUGE disease and you will fight it for MANY MANY MANY MONTHS.
***Your dog is NOT stable yet***. I would be really unhappy if the vet was lowering ANY meds yet -- did I read this right that the vet is lowering the azathiaprine while the pred is not an immune-suppressive (10 mg for a cocker) dose?
I'ts NOT just the PCV or hematacrit. 45% is great -- but NOT NOT NOT if there is still destruction going on. *Particularly* since you had destruction going thru the kidneys at first. That's sort of a whole different type of IMHA ... very dangerous.
I can't quite get a feeling for all you're saying here.
Is your VET telling you to use Bio-Prep and Transfer factor?? That would be most unusual. But if your vet hasn't prescribed these STOP them. I fear you could be leading yourself down a merry path -- with the body making a ton of blood but still destroying blood at the same time. I've seen this before with both Bio-Prep and Transfer Factor -- they get the body making blood and the destruction gets ignored -- and then suddenly the dog crashes because not enough attention has been paid to STOPPING the destruction.
I hope I'm not over-reacting here -- your posts are a bit difficult to follow (gotta love that I-Pad!! *smile*)
team Presley
Presley is currently taking 10mg prednisolone 2x daily, azathioprine 25mg daily, and famotidine 10mg 2x daily, and omeg 3 pills.
Azathiaprene is one of the immune-suppressors. 10 mg of pred isn't really an immune-suppressive dose. BOTTOM LINE -- you don't want the vet to decrease *any* of the immune suppressors (unless there is serious cause because of kidney or stomach or liver problems or similar) until PPresley is STABLE.
stable means NO DESTRUCTION and regeneration is occurring. It's fine and great to have regeneration -- but STOPPING the destruction is the big huge mega deal for Presley right now. It's more than JUST the pcv --
I'm not sure how to say this -- The body can choose different ways to hurt itself. The red urine you saw at first meant that the body was killing the red blood but it was in conjunction with the kidneys. (red urine is DIFFERENT than seeing red blops of blood IN the urine). This isn't even the same as seeing destroyed red blood cells (spherocytes) in the blood -- I don't know a ton about this, but I do know that seeing red urine is literally a whole different way that the body is destroying red blood.
As long as the body is trying to hurt itself, there are a whole LEGION of ways the body can choose to do this -- destruction of red blood via the kidneys, destruction in the blood, OR the body attacking the blood in other ways -- like platelets being super low (alone that's called immune-mediated thrombocytopenia but it can also go hand in hand with IMHA and they call it Evan's syndrome).
My point is this -- you have to get the body stable **AND THEN** re-train the body to not attack itself. This can be the challenge today because a lot of vets want to get the dog off the drugs SO FAST (because they know how destructive these drugs are) but then the dog relapses (sometimes again and again -- and often a relapse can be fatal).
Hopefully the vet will use the azathiaprene as the biggest immune suppressor -- weaning off the pred first. Now often they use a big dose of pred initially and once you are getting good regeneration, they drop the pred quicker.
The famotidine -- it's one of 3 or 4 stomach protectants -- it's a fine one. STAY ON THEM. These drugs are UBER hard on the gut. I used several with Billy.
Omega 3? It's ok -- I gave Billy sardines. Be cautious -- it is VERY common to see Omega 3's be less than fresh. I've seen even human quality omega 3's be rancid. Omega 3's come under the heading of immune support -- but it's not your big priority now -- getting Pressley stable is. But make SURE it's a good viable product. These dogs are hugely immune suppressed so you don't want to be giving omega 3 tablets that are rancid (open one and SMELL of it -- if it's a pet product I'd use something else).
team Presley
reading of pages like meisha`s hope, to see if there`s anything I can be doing in addition to Presley’s current treatment to increase her odds. I`ve noticed that people often seem to use the additional holistic medications…
I think most of us started at Meisha's hope. Back when Billy was first diagnosed (5 years ago) there were only TWO buffy cockers I had found who had survived IMHA -- one was on Meisha's Hope -- and the other was ... Billy.
"people often seem to use the additional holistic medications"
Here you have it a bit wrong -- I'm not being snarky at all -- but let me just say you've kinda got the cart before the horse.
Meaning -- it's not so much "holistic medications" ... it's adding a holistic VET. Using Gui pi tang ALONE? Nope - you don't want to do that. Gui Pi is a blood mover/builder that is often used in Traditional Chinese Veterinary Medicine. It is one of MANY MANY MANY herbs used. Gui Pi has to do with not just the spleen but also the liver and manufacture of blood -- I've used TCVM vets for my dogs for almost 10 years now and know more than the average person about how they are used, but it's very very complicated and using the wrong herb for the job is beyond dangerous. I could sit here and list 15 different blends that Billy took at one point or another in the IMHA treatment -- and there would be 30 more that others might have used.
It's difficult to explain quickly -- but the exam a TCVM vet gives is completely different than any western exam. The vet will literally look inside the dog's mouth and carefully palpate the dog all over literally to compare how the blood is moving thru various pulse points on the body to diagnose where the weakness is **now** and what qi points need to be stimulated via acupuncture to help. The herbs then tend to come along with the acupuncture. Billy took Gui Pi but not early on. And then after a while on that, they moved him to others.
But it has to be specifically worked out what YOUR DOG needs. You don't just take a bottle of Gui Pi and use it. Gui Pi has more to do with the liver than just building the blood/moving the blood (both of which are huge concepts in the realm of TCVM).
My point is this -- using a SECOND vet who is well versed in TCVM (and the full range of TCVM - meaning they use acupuncture, and a myriad of herbs not only to help the body build blood but keep the blood *moving* to help avoid cancer. If you go to http://www.tcvm.com - there is a locator on the left and I'm happy to help you figure out which vet might be helpful to you.
It is a pretty big decision -- NOT ALL TCVMs are alike. You honestly do NOT want the TCVM vet who is the token "holistic" vet in a large urban practice. NOPE -- you want the one who is so convinced TCVM is the best way that they devote their entire practice to it.
But you really don't want to just pluck a TCVM herbal blend out of the sky and try to use it. That would be dangerous.
There are other modalities of holistic veterinary medicine that can be used -- it depends on what works for you and where you are located AND how severe your dog's IMHA is.
team Presley
I’ve noticed that some pets have had Spleen tumors and other problems after IMHA though.
Bio
The spleen is a holding place for blood in the body -- it's part of the body's process for making blood. One of the potentials is that IMHA may be caused by cancer in the spleen ... in fact, all during treatment for IMHA you can hear the horrific words "This could be cancer ...." when any new symptom comes up. The spleen is simply one of the areas where IMHA can originate. Again that's an over-simplification ... I've seen some vets treat IMHA by removing the spleen -- it's not typically done, but occasionally it works.
The way IMHA is treated literally changes day by day -- this is one of the many reasons why it is so difficult TO treat -- because treatment options are changing constantly -- vet schools all over the world are working to refine treatment. Dr. Jean Dodds is one of the premier vets in the world and she literally teaches all over the world to help vet schools develop protocol for treating IMHA.
team Presley
and have heard some vets can be un-trusting of holistic approaches. I`m not saying it will help her but if the vet says it can`t interfere with her current medications and treatment, I’m all for giving them to her if it has the slightest chance of increasing her odds of successful recovery, and minimising chances of relapse. I`m hoping there`s someone out there that could explain to me the benefits of these additional supplements, amounts I should be giving my dog, or how long these supplements should be administered (for the life of Presley or the duration of the treatment?) also if there`s any kind of documentation I could supply my vet with to help her make an informed decision, as well where can I acquire these supplements for Presley?
Most "regular" vets (meaning a vet who uses a typically Western/American/Canadian type of normal veterinary treatment) are extremely leery of anything alternative.
But that's why I made the big deal above about ADDING a TCVM vet, not replacing your vet with one who does TCVM. Most holistic vets honestly don't WANT to be your only vet - they don't want to do surgery or give vaccines or even state-mandated rabies shots -- some of them prefer one modality over another (like chiropractic, acupuncture, homeopathy, homotoxicology, TCVM, etc.) or they may use several in their practice.
You need a good primary vet for Pressley -- if you decide to ADD something like a TCVM vet - talk to me. There are ways of working with your regular vet that will offend them less and your dog can benefit hugely.
As far as "documentation" goes -- again, that's this huge chasm between the regular vet and the holistic vet. Regular vets are all about "tests and studies". And part of that is what makes many of them crazy about trying TO treat IMHA. Because the treatment for the disease changes SO FAST that there is no reliable written protocols. Various drugs have been studied -- but trying to help THIS dog survive IMHA without the side effects killing the dog is a big huge deal.
You talk about milk thistle -- you also, I believe, said that your dog is taking Denosyl.
Milk thistle is an herb. It does MANY things for the liver -- its best use is to PROTECT the liver. Literally to help protect the liver from the ravages from the drugs.
Second -- it also helps "facilitate" things -- literally milk thistle helps the liver function *better* so that in turn, the liver can then process the big drugs more efficiently. In other words -- addiing milk thistle not only helps protect the liver -- but it also helps the liver function **better**.
Denosyl -- Denosyl is made by Nutra Max Laboratories. Nutra Max also makes a product called "Marin" which is milk thistle that has been highly refined to the point where it has actually lost its status as an herb and it has officially become a pharmaceutical.
Denosyl is SAM-e. It is SAM-e (which is a detox for the liver) again refined to such a degree that it has become a pharmaceutical rather than merely a supplement.
Both Marin and Denosyl are good products HOWEVER, I prefer to stick with the milk thistle powder and/or tincture and SAM-e -- simply because you can give LOTS and LOTS of both of those, and you can't Marin nor Denosyl.
I suspect the vet is having you use Denosyl to help ward off the high liver values that can sometimes occur with azathiaprene.
The SAM-e that I used for Billy was CellFood SAM-e -- it's a supplement put out by the CellFood people -- but the huge advantage of it is that it's DROPS, not pills. You just put 12 - 15 drops in the dog's food twice a day. It's easier for the body to assimilate than the Denosyl. You can find CellFood SAM-e on Amazon and on E-bay. Vitamin Shoppe also carries it reliably.
team Presley
I`m hoping there`s someone out there that could explain to me the benefits of these additional supplements, amounts I should be giving my dog, or how long these supplements should be administered (for the life of Presley or the duration of the treatment?)
You are welcome to email me or I will also talk to you on the phone. i am NOT a vet ... merely a woman who loved an IMHA dog and saw him SURVIVE what was considered a deadly disease that he couldn't possibly overcome. I lost Billy a year ago ... NOT to IMHA. But to a simple but massive heart attack (the heart takes a HUGE hit with IMHA and Billy was a very old 12 by then).
I can tell you how much of most anything and I can tell you where to get the various things.
I can't find it now, but I recall in your first post above I think you said Pressley had "genetic IMHA".
Honestly? There is NO SUCH THING. There are some breeds (and cockers are definitely among them) that are more genetically pre-disposed to IMHA. But IMHA is not "genetic". Very often vets are not at all good at trying to help you determine what may have triggered Pressley's IMHA -- but that's another thing I'm happy to help you figure out.
See, if a vet labels IMHA "idiopathic" -- meaning no known cause - they often will recommend keeping the dog on some form of immune suppressor forever. OR, at the same time, they may simply yank the dog off immune suppressors absolutely at the first opportunity --
THAT is flawed logic I think. Again, I'm not a vet -- but part of what has to happen is the body has to RE-LEARN how not to hurt itself. That the next time the dog's immune system is exposed to something you don't want the body to JUMP to hurting itself again. This is something that will take MANY MANY MONTHS. You may or may not ever arrive at what you figure Pressley's trigger was. Then again you may.
They told me when Billy was first diagnosed that the advantage to figuring out WHAT triggered him, was that I had a better chance at getting him off the drugs totally. We did -- it took 18 months and a LOT of protecting of the stomach, liver, kidneys -- but after he got off the drugs we still had kidneys that functioned WELL and we had a liver that was a bit damaged but very viable. He did wind up with a grade 3 heart murmur after IMHA -- but we maintained it for a LONG time.
He's a cocker -- heart problems are massive in cockers (and I hold no illusions -- Billy was NOT well bred).
team Presley
Also I’m thinking of next vet visit asking my vet to run an thyroid test just to confirm there isn`t an underlying thyroid problem, does this sound reasonable?
That's a GREAT idea. However -- don't do just a regular thyroid panel. As your vet to send a thyroid panel either to Dr. Dodds at Hemopet or at the very least to Michigan State.
Both of those places will get you a thyroid panel that is ***BREED-SPECIFIC***. That's going to give you a FAR better result -- particularly since Pressley is a cocker. (and forgive me -- I know I've spelled Pressley's name wrong!! Please don't see that as a lack of respect -- rather I'm just plain tired!!)
OFTEN a vet won't do any sort of thyroid test at all while a dog is taking prednisone. It's well known and long established that most vets don't even TRY to test the thyroid when the dog is on pred. It's well known pred "skews" thyroid results. EXEPT both Michigan State and Dr. Dodds can and will interpret the results accurately in light of the use of prednisone. About 5 years ago, when Billy was first diagnosed, Michigan State did a huge study on the effects of pred on the thyroid.
Dr. Dodds is the one who set up Michigan's lab. She was head of endocrinology at MS for many years -- when she retired about 6 years ago she went into private practice (she retired to California? sounds good to me!) and jumped in to the whole auto-immune thing in addition to setting up Hemopet (which is a blood donor agency for dogs).
Both places will give you a breed-specific answer. Some vets seem to feel it is more palatable for them to send results to Michigan State rather than Dr. Dodds (they are used to dealing with vet schools -- it's a bit less threatening to them I think).
Sending blood to EITHER place means you have to package the blood in the specific quantities needed and put it on ice packs (you know that blue ice stuff people use on picnics??) to keep the blood viable for an overnight journey to either Hemopet or Michigan State.
But thyroid can have a lot to do with how regeneration occurs. Dr. Dodds is where I'd suggest you send Pressley's blood if for no other reason than to get Dr. Dodds input. Many of us owe our dog's lives to her. She just plain ROCKS. MS is a great place as well, but Dr. Jean Dodds is truly one of my heros (and I'm not the only one either!)
You may have already emailed me -- I know I have an email I haven't opened yet -- I was trying to get this typed. But holler at me and I'll help you any way I can. I hope I've answered most of your questions.