Heaven knows I don't even want to post this. It's not dire ... yet, but I feel SO like I've been kicked in the gut today. And it's not that bad -- but... you'll get it as I explain so bear with me pretty please.
Most of you know Billy has IMHA. Immune-mediated hemolytic anemia. It's an auto-immune disease, meaning for various reasons the body decides to turn against itself and 'destroy' itself. In Billy's case, we *think* it started with a tick bite. It was apparently a 'sick' tick carrying a tick disease and altho I caught it 'quick' it HAD begun to feed.
Billy's body did what it should have done and it developed anti-bodies against the Ehrlichea.
BUT that's where it went wrong ... the body then generalized and decided that the *antibodies* were bad guys too -- so his body simply began to destroy it's own blood.
LONG story made short we caught the severe anemia on a routine blood exam, and my vet put him on prednisone (to suppress the immune system) and very slowly the body began to respond. We did all kinds of tick tests, etc. (knowing I'd found that darned tick) hoping it was tick disease and NOT "IMHA" at that point. Tick disease you can 'cure'.
The red blood cells were 'coming up' (his "pack cell volume" went from the low 20 to 29 in just a couple of weeks) So when we found a faint positive to tick disease the vet put him on Doxycycline (the usual drug of choice) in hopes that it would 'cure' the anemia as it killed the 'tick disease'. OOPS. He went from that 29 to TEN in literally two days. Talk about 'crashing'.
This is where most of you who have been around here a year or so know Billy wound up going thru SIX transfusions in a month last summer and man, I've never fought so hard to help a dog live. We had to go to mega major immune suppressants to get the immune system to lay off and stop killing the blood.
Eventually we found out that the body was triggered off by the antibiodies NOT real tick disease and it was when we took him off the Doxycycline that FINALLY the body began to respond and finally we began to get the IMHA under control.
MOST DOGS DIE. Most dogs just plain don't survive IMHA.
Soooo -ok -- most of you know Billy cos he LOVES to post. The one really nasty side effect (there are a lot of nasty side effects to cyclosporine but one REALLY nasty one) is the constant urinary tract infections. It was months before we could finally get them under control (remember -- one of the things that can majorly tick IMHAoff is all sorts of antibiotics).
All along we've used a combination of both regular veterinary medicine and alternative medicine ("TCVM" or traditional Chinese veterinary medicine -- acupuncture, Chinese herbals) -- and I've used a neutraceutical called D-Mannose along with Cranberry to keep most of the UTI's at bay and when they did crop up (every 3 weeks or so) I was given a particular Chinese herb to begin *immediately* when I saw symptoms).
So it's been going well and we've weaned him back to a much much lower dose of the cyclosporine (altho it's taken nearly a year).
But I've noticed in the past 2 or so months that I'm having a tougher time keeping the UTIs under control, so two weekends ago when we did a major blood/chem panel just before we reduced the cyclosporine again I also had them do a big culture and sensitivity urinalysis (that's where they take a 'sterile' urine draw by aspirate straight from the bladder with a needle), send it off to see if it will 'grow' bacteria, and THEN they treat that bacteria with all sorts of drugs to see what it is "sensitive" to -- i.e., what are the best drugs to kill it.
I was stressing because I wasn't getting the results back. Dr. B (my regular vet who is AWESOME) told me a week ago it was growing some weird sort of strep bacteria but he didn't have a 'final' on it yet. Well, I almost got ugly cos I thot the lab had forgotten us or screwed something up. (Yeah, can you imagine a Callie hissy-fit? NOT pretty folks!!)
Anyway -- I find out this morning the results are back. The 'culture' produced some weird 'new' kind of bacteria "Enterococcus Species" -- but the kicker is there is only one drug that it clearly shows it's not resistant to.
Doxycycline (excuse me while I go bawl again)
Yeah, the one d#$%^$(ed drug that caused the whole IMHA to blow out of the water a year ago. This stuff is resistant to nearly everything -- there are a couple of drugs it may be somewhat sensitive to, but oh man - I just can NOT risk giving him doxy.
The 'good' part of this is that it's not super severe. There wasn't a ton of this bacteria THERE and it's likely been there for a while -- it's probably been the thing lurking that has caused the UTI symptoms to come back with more frequency.
As soon as they took that specimen, I came right home and put Billy back on the Ba Zhang again (that Chinese herbal) and the holistic vet told me I could keep him on the 'big' dose of it far longer than she's wanted him to have it in the past. But one of the other herbs he takes will work 'with' this to allow his body to safely tolerate it.
My regular vet is working with the lab and doing research to find out what else we PERHAPS can try. My holistic vet is working with him -- she thinks that one of the less sensitive antibiotics WILL work done in concert with the Ba Zhang (especially since he's been on it to further have diminished it the last 10 days).
Folks, I'm asking please for those wonderful I-Dog good thots and prayers.
1. That the microbiologist can re-visit the culture to see what else this may be sensitive to (he's run the test several times with varying results) and find something other than doxy.
2. That Dr. B and Dr. D can get their heads together and find something that will work and NOT trigger off the IMHA.
I don't want to have to put the cyclosporine back up again -- his body has had all it should take of this nasty drug and I've worked SO hard to give him all the other stuff (massive quantities of milk thistle and all sorts of other things to help mitigate the damage from the cyclosporine) to keep him from damage. It's the cyclosporine that CAUSES the UTIs (and eventually this can all take a horrific toll on the kidneys and liver even with all we've tried to prevent that damage). So if the IMHA gets riled back up it's just all a really BAD BAD Thing.
3. me. -- I'll admit I reacted badly to this today -- I felt SO sucker-punched. I literally burst into tears at the mere mention of doxycycline. I rarely show my spiritual side on here but quite honestly this is just plain the 'enemy' trying to get me down. I know there is a bigger plan in all of this because we've been SO blessed in this whole thing. So I just plain need to get MY head on straight and not let this blow me away so badly. So somebuddy kick me in the butt please and help me get my attitude adjusted. We haven't come THIS far to fall apart now!!
Thanks folks - this has been long -- typically me. WE know with IMHA that it's always day to day. But boy I don't want to have to back step now and I just don't think I can contemplate giving him doxycycline. That would be like playing russian roulette with all the chambers loaded.
Thanks -- SO much.