More on Billy -- this is getting really scarey

I am so sorry to hear about your trials and tribulations Billy dear!  Please know you are in my thoughts and prayers.  You too Callie and David.   LOL.
 
If there is anything I can do here in Jax please let me know.
 
Sending get well wishes and hope for a 'not too complicated' diagnose soon!
 

I am sorry to hear about Billy my thoughts and prayers will be with you.

I'm sending prayers and healing thoughts your way.  I'll light a candle tonite, too.

Callie, good thoughts and prayers are with you, David, and Billy.
 
{{hugs}}

As i was reading I thought "My God, that sounds like my Hunter" and then I get on down and see you mention the AIHA being possible.  Hunter's HCTdropped to 9.7 and my vet said he should have been died when it went below 11.  He was given two units of blood that day, and again 4 days later.  he was on such heavy doses of pred and then had to have the tagament for his stomach, plus was on heavy B complex and i don't even know what all else. 
 
You certainly have my prayers for not only Billy, but for you and your husband.  I know how hard this is to deal with.  One day Hunter's HCT  and red count would be up, the next day down.  It is just despressing not knowing and not really being able to do anything for them.  But don't let him know you are worried and depressed.  He needs all the good vibes he can get.  I would smile and laugh and hug Hunter and talk to him in a normal voice (3 times a day), then go sit in the car and cry.  I knew it was importmant to be up beat with him.  The best of thoughts and prayers coming your way.

I know I'm tired so I hope this makes sense.  I just got home and finally got online (provider problems) Again folks THANK you so much for your support:

I took Billy to Gainesville this morning (Mon. 6/19).  Actually I was at my regular vet (Dr. Bailey) at 9:00 when he got there.  And ... as I feared ... Billy's blood dropped way low again -- from 25 after the transfusion on Friday nite/Sat early morning it was down to 10 again this morning.  Dr. B really didn't want to transfuse him *again* and have that impede what the University might do so he asked me if I could just plain take off and take Billy to Gainesville NOW.  David and I talked and I took off with Billy.  Stopped at home and grabbed everything we'd need for overnight and zoomed to Gainesville (a roughly 2 1/2 - 3 hr trip)

When he started to 'crash' (act really sick like his blood was super low) this morning before we     got up to Dr. B's he crashed fast.  Honestly I wasn't sure he'd make it all the way to Gainesville (from playing like 'normal' yesterday).

He did.  My vet set it up and they brought him in as an emergency.  Wow.  they even came out to the car with a gurney so he didn't have to get all exhausted walking in.

To sum up more briefly than normal:

1.  The initial blood workup (a serious one) FINALLY showed a high white blood cell count (this IS typical of IMHA and is what's been 'missing' all along for a true diagnosis). 

2.  The ultrasound was FINE (rah - most of the rest of these tests are specifically looking for cancer so we WANT them to be fine).  x-rays fine.

3.  Took aspirates of liver and spleen -- those aren't back yet but because both liver and spleen LOOK good on the ultrasound this speeds diagnosis along.  IF those come back 'funky' then they have to consider a bone marrow aspirate (big deal -- he has to be anesthetized and it can be followed by a biopsy if they strongly suspect a problem).  If we can skip the bone marrow stuff I'll be happy -- even anesthetized it's more than I hope he has to go thru, and that would be something bad anyway.

4.  Took more blood for MORE tick tests.  Because that spectre of ehrlichia is still there they can't discount it, BUT they can more effectively treat it if they can nail it down more specifically.  But tick tests will be another week coming back.

5.  Once they got those definitive tests taken they could finish getting him ready for the transfusion.  The second is a big hairy deal -- they have to type and cross match the blood now.

6.  I saw Dr. Xie -- tomorrow once Billy has been transfused and they've run the tests they need to THEN he will start work and do daily acupuncture on Billy (RAH!! I didn't expect this). 

7.  The idea is that this is very likely IMHA -- either triggered by ehrlichiosis or "idiopathic" (without any clear cause but it's enough that he's a buffy coat cocker!) -- and the treatment will be more pred, but the addition of cyclosporin -- another steroid -- this one also a serious immune-supressant -- and yeah, they'll do both together.

I'm, of course, not thrilled about the steroids -- but it's that or lose him.  We MAY lose him.  Generous odds have it at 2 out of 3 "make it" thru IMHA.  That's "generous" because most of the dogs who don't make it are the infamous buffy coat cockers.  (buff = blonde).

But SOME buffy coats do make it.  And I told them "I want mine to be one of the ones who DO!"

These folks were great today -- in fact, they were so awesomely supportive and ENTHUSED that I'd been home cooking for him.  Because Billy is SO food motivated, and when his blood is half-decent he eats like a little horse, I went and got ricotta cheese for them to use to give his meds in (this dog is on a poop-load of meds NORMALLY, much less all they'll give him now).  Shoving this much medicine just down a dog's throat is traumatic and Billy takes it all SO easily this way. 

I also brought back about 8 cartons of yogurt (no Rockin Raspberry Billy -- that Publix had not much Stoneyfield at all! *sigh* But he'll  be FINE with mixed berry, boo-berry and strawr-berry!!! *grin*)

I took a big risk with this because MOST vet places would get mad if you had the gall to bring THEM such a thing as a "probiotic" (which most regular vets would shun anyway) OR ricotta cheese to facilitate giving meds. 

I'm THRILLED to report these folks were THRILLED with me!!  They were so happy to get stuff they'd know Billy will like and would keep him eating and happy.  They were cracking up that I'd even brought plastic spoons for him (and yeah, he eats his yogurt off a spoon -- *grin* AND his pills get shoved in a lob of ricotta and I just offer them to him on a spoon and he takes it.  *sigh* I guess I AM over the top, huh??).  But no one told me I was crazy, no one looked at me sideways for saying "probiotic".  In fact they told me I did everything RIGHT. 

IF he makes it, he's there for probably 4 nights -- MAYBE to come home Friday (little chance of earlier but a small one) and maybe thru the weekend. 

They encouraged me to come back and say goodbye to him and I did the whole "You're staying here 4 beddytimes" thing.

But I also told him he was gonna get a transfusion like the other night and it WOULD make him feel better fast. BUT that I wanted him to stay so they could really find out what was really, REALLY wrong. 

The vet watched this ... and honestly she's convinced (as I am ) that he DID understand.  She was pretty surprised and pleased. 

It helped a WHOLE lot that this vet and her student assignee totally and completely fell in love with my dog. 

I drove all the way home and didn't stay up there.  I expected him to stay overnight but I honestly wasn't expecting the 4 days thing.  So since I gotta go back up there I HOPE on Friday if this goes well, I couldn't see staying. 

I'm trying to think positive and pray strong.  Me and the Alpha of all Alphas had a LONG talk in the way home, and I think my head is straight at least.  The Alpha of all Alphas is in charge of this, cos He's my Alpha too.  But my boy is very loved -- and that counts for a lot. 

They promised to call me daily and as I hear stuff I'll tell you.

But again folks, thanks - your support means the world to me and to Billy.  Callie

Callie we're sending more thoughts and prayers for you and Billy. Here's hoping he comes home Friday - diagnosed and on the path to being better.

Wow, what a great place to be! It sounds like Billy will be very well taken care of, even though he has to be away from home. I'm glad they're getting everything figured out, so you can at least *know* what you're fighting against.

(((((((hugs))))))

Callie, I gotta tell you, the only two dogs i know of that survived PH6 induced AIHA was a beagle AND a BUFF COCKER named MIA.  So there is all the hope in the world for your Billy.  My vet was happy for me to bring in boiled chicken for Hunter 3 times a day also.  I had fed him piece by piece and he gobbled it.  One of the receptionist was new at the time and didn't know my name, but she called me The Chicken Lady because I took the fresh boiled chicken in for him 3 times a day.  My prayers are with you all.

Sending good thoughts and prayers for a speedy and COMPLETE recovery for Billy-boy!  Peace and comfort for you, David, and the rest of the crew. 

Callie, Rusty said to tell Billy that there are FAR too many buff colored cockers at the Bridge right now and he's just gonna have to get healthy and strong and WAIT until some of the others cross with their people. Rusty says its just flat not TIME for Billy to come to the Bridge.   I JUST read this this morning, yet last nite, I, who rarely remembers a dream had a doozy of Rusty coming back, sitting in front of me on the footrest of the recliner and telling me JUST EXACTLY that.  Totally bizarre.  But there was a REASON for that dream last nite.
 
You know without me saying it that you guys are in my thots and prayers.  And I'm sending you hugs throughout the day so I hope that you can feel them!!

 Callie my thoughts and prayers are with you and Billy; he is in great hands at the vet school. It helps that they're understanding and even enthused about the homecooking and the probiotics; that relieves some of your stress load. When the dermatologist at Purdue asked what I fed Jessie and I told her "Eagle Pack Holistic" to my surprise she named several holistic brands and said she thought companies like those made good foods. Jessie's nails were a little long when I took her for a recheck and when the dermatologist brought her out I noticed her nails had been trimmed; she had used a Dremmel.  You may get more than one update a day; one of our cats spent a few days at Purdue because they amputated his leg after they diagnosed bone cancer. We would get a call from the student assigned to his case during the day and another call from the student assigned to his case at night. Billy is getting the best possible care ; hopefully he'll be coming home this weekend.

Oh Sandra, thank you so much.  First, altho I knew Hunter's death was caused by ProHeart 6, I really didn't realize it was ultimately AIHA (which apparently they are now calling immune-mediated, rather than 'auto immune' pretty much across the board in *anything* auto-immune).  Of course that has made you re-live it all over again.
 
In honesty, I have tried to kick myself 100 times in the past weeks because we DID find this so incredibly, unbelieveably 'early' simply because I'm so darned anal about "don't TELL me that the fact my dog doesn't get up on the waterbed for long anymore is *behavioral* -- <> know it's because he's feeling seasick and WHY!!!!"
 
I mean most vets (much less husbands) just wouldn't run a freakin blood panel over something so incredibly lame-sounding, or the fact that the dog urped clear thin mucous once!  And with me it just comes down to the look I see on their face more than anything else. 
 
So we've had him on pred for FIVE weeks and I'm thinking I'm truly nuts -- were we keeping the body from responding to the ehrlichia with the pred by trying to respond to two potential killers at the same time?? I've honestly torn myself up over this because the two treatments were literally fighting each other.
 
But the vet told me yesterday (not as a result of anything I said, but just a comment out of the blue) "Mrs. K ... in honestly most dogs give virtually NO outward symptoms that this is developing in the body and they crash and die in about 3 days.  By the time an owner even sees the first 'signs' and rushes the dog in often it's far too late and the blood too destroyed for the dog to respond.  The biggest two things Billy has going for him are his lusty appetite and the fact that he's been on PRED for 5 weeks and the body was beginning to be retrained to do something different.  This gave it a more gradual lead in, but it may save his life."
 
I only WISH I could be there the entire week.  I'd stuff his little face so full of homecooked food, yogurt and watermelon it wouldn't be funny. 
 
And Sandra -- you have helped people SO much in your reminder about PH6.  One of the reasons I'm so against a certain heartworm preventives (Revolution) is because there is so much similarity in how the two drugs stay in the body for an undetermined period of time IN THE BLOOD. 
 
ONce again you folks have been such a strong encouragement to me.  Every single ((hug)) is so meaningful.  Thanks guys.
 
Redbird, if I were up there with more leisure I'd be suggesting coffee but that won't work.  Thanks for the thot tho.

Im so glad to hear Billy is there getting the best care he can!  I will be praying and thinking of you guys.
 
I thinks its just great they liked your cheese and yogurt... your too right that many places would act like your crazy... too bad really.  But, Billy seems to be in the very best place for him now.  Hope you can pick him up Friday! 

Thanks so much for your kind words, Callie.  And let me tell you, DO NOT, repeat, DO NOT beat yourself over the head  for not realizing sooner what was going on.    I sometimes think hindsight is a not a good thing. 
 
That vet is so right about most not even knowing their dog is sick.  One who lost two of her 3 dogs to PH6 and posted on here, lost one to AIHA.  She didn't even realize the dog was sick until she collapsed.  In hindsight she realized her Tasha had not been acting quite right.  In hind sight, i realized Hunter had not been quite right for a couple of weeks.  He had spent more time sitting on the patio watching the squirrel rather than chasing them.  We thought he had FINALLY learned to stalk from Buck who caught  squirrels regularly.  Hunter never managed to get a single one.   Also, he would bring is ball for us to throw, but if one of the other dogs got a jump on him, he didn't go after it.  Again,  we thouight he had learned that from KayCee.  All her life, if one other dog got the jump on her, she didn't go after the ball..    It was not until later we realized that the AIHA had already set in and was starting to take it's toll on him.t.  I mean, he ate normal, he drank normal, he did bring his ball--tho as i said didn't go after it if one of the other dogs got a jump on him.
 
But that morning, Oct. 9, 2003 I was looking a teeth and saw the pale gums and made an appointment for later that morning.  Then a short time later he peed right off the patio (he usually went to back fence) and I saw the rusty colored urine.
 
I have his complete records, but i am going to post a few of the test resutls the day he was diagnosed
 
White Blood count   15     Normal 6-17
Red Blood count      2.6    Normal 5.50-8.50
Plate                         34     Normal 200-500
HCT                         20     Normal; 37-55   (for him normal was 49-50)
 
On day two it was marked in his records, NO PLT SEEN.  On day 4 his HCT dropped to 9.7 and the vet said he should have been dead when it went below 11 (the power of a love of a dog for his owner kept him alive, or so my vet thinks)  he got two units of blood that day.  Had he not also had the liver damage, I think he might have won the battle, but he just could not beat them both.
 
Not to scare anyone, but it appears AIHA is on the rise.  A woman on Dogster contacted me after reading Hunter's story.  She had lost her JRT to it in April.  She put me onto a forum that is all people who have lost a dog, has a dog sick right now, or people whose dogs are in remission.  When Hunter was diagnosed, my vet said he saw about on case of AIHA a year. it seems that was mostly the case, rare and far between.  BUT on this forum one in California whose dog is fighting it asked her vet and he said he is seeing 3-4 cases a week.  Others report their vets also saying they are seeing more of it.  Many believe it was vax that brought on their dogs AIHA.  To me this is all the more reason to vax as little as possible and still keep the dogs safe.
 
Oh, I was there this morning and one guy is celebrating that his dog has been off meds for 2 years now with no relapse.  It is never cured, just goes into remission.  Others are posting the number of months their dogs have "beat it".  So there is always, always hope and i do believe if Hunter had just had the AIHA, he would have won the fight.  I think liver damage was the leading adverse reaction to PH6.  probably Hunter's liver was damaged and that brought the AIHA on, or possiblity they came on together.    Many dogs died of one or the other, and in some cases, both.