This is for Judah "ElisHope" (man, I love that login name!!). Your questions above were good ones -- why do they think "anemia" on one hand and keep checking for other stuff? What "kinds" of things trigger it? How does a vet look at a dog and *know* what's wrong.
I think THE coolest thing about having taken Billy up to the University of Florida at Gainesville (Go Gators!!) was seeing how they diagnose this stuff. It's pretty awesome.
ElisHope
We always bathed him in Adams Flea Shampoo and it has chemicals in it. I hope that is not why he got sick. He never had fleas because we use a monthly flea drop but we used that shampoo because it made his coat so nice. I can't think of why this happened.
Judah, I wanted to reply to this a bit more when I had time. It is a *very* good thing to try and figure out what the "trigger" for the IMHA may be. If you listen to the vets at the university you will learn *much* about how vet schools TEACH their students to diagnose things.
I can't get this to let me to a real outline -- I can't get it to paragraph right even copying from Word. grrrr
My point is it's really sort of how vets are taught to think. They take a broad symptom like "Doesn't want to play" and they think of ALL the things that might cause that. But when they examine the dog there are certain things they look for that might make that happen.
When a dog comes in with the general complaint "Not acting normal, doesn't want to play" -- they're going to look at several things first that cause "weakness" - and the general term "Lethargic" (slow, sleepy, does nothing in a hurry). Honestly there can be TONS of things that may cause that.
One of the FIRST things the vet will do is check the gums to see if they are pale or to see if the "capillary refill time" is slow. The "pale" you can just see if the gums aren't pink (like yours). Capillary refill is when the vet takes the tip of their finger and presses hard against the gum for a couple of seconds and then releases it - the gum will go pale where you press, but the color should snap right back when you release it. (Go try that on yourself in the mirror and see what I mean.)
Between those two they can show "anemia" (which can be lack of blood generally or lack of red blood cells IN the blood). IF the vet sees external signs of anemia (like pale gums or poor capillary refill time, or just if the vet strongly suspects anemia they may just plain do bloodwork which tells a ton of stuff but the hematacrit will show low red blood cells and other things that fall into the category of anemia.
With Billy his gums WERE pink and his capillary refill time was great ... but we did bloodwork *just* because I suggested it. (I was worried about that danged tick that had bitten him.)Ok - here goes our "outline"
:Anemia - potential causes
I. Injury or general loss of blood
==== External injury (usually easy to see)
=====Internal (bleeding inside the body)
??Is there blood in the stool.(poop)? take a fecal sample - is it black and tarry? That means bleeding high up in the intestinal process - large or small intestine or stomach bleeding passing INTO the intestine --- OR did owner notice bleeding in the stool that was bright red? That would indicate bleeding near the rectum
II. Tick Disease - from there the vet may ask questions like what tick protection is the dog on? Noticed any ticks? Etc.
- If tick disease is possible do a tick test
- If tick test is inconclusive, and if dog is unresponsive a further tick "panel" should be done - it's expensive and takes about 3 weeks to come back
III. IMHA
Treat for IMHA even if #2 or #4 are possibles because the initial treatment (prednisone) is usually the same and it will save time.
Try to further determine and rule out possible things like internal injury, tick disease or cancer, etc. - there is some process of elimination there.
Talk to owner about "triggers" to see if likely triggers present:
Recent vaccines (1-3 months)
Recent illnesses or exposure to illness
Recent medicines taken (there's a whole list of drugs that can trigger auto-immune stuff)
Recent exposure to chemicals LIKE:
flea/tick preparations (new? New formula? 1st time this year? New application of something used long term?)
fertilizer/garden chemicals
household chemicals
city spraying (fogging) for mosquitoes, etc
Recent stresses LIKE:
++major household changes in schedule
++loss of loved one
++loss of animal companion
++loss of "friend"
Various other diseases that can cause internal bleeding.(like cancer)
Honestly Judah, each one of those things has LOTS of other things under it - but this will begin the list for you. But vets have to go thru a similar process like this to determine any sickness - so just having a low hematacrit doesn't make a dog have IMHA because there are other things that can cause it.
Try to make a list for the vet of anything you or the family can think of that Eli might have been near that was unusual -- have you seen him eat anything outside? licking at something? bitten by something (or even playing with an animal he shouldn't be? He's a herder -- he's going to be around other animals IF he can!)
If you have had him to a dogpark, or with you somewhere and maybe he was eating grass - see if you can find out if they had sprayed for pests recently, etc.Why? You may never know or never be able to figure it out - but generally, they believe (as in "the vets who study this";) that if you can figure out the ‘trigger' you have a better chance of getting the dog off the meds *eventually* completely. Some dogs have to stay on the drugs for a long, long time (like forever) and some don't. You've probably read in this long, long thread that we thought Billy had tick disease (he HAD been bitten by a tick). His body actually had built antibodies to the tick disease and his immune system (which has never been good) saw the antibodies and thought *they* were the bad guys in the blood and started killing those. But if you have had even a little biology you know that antibodies are what the body forms in the blood to fight specific infections so the body never getst THAT disease again. So antibodies are actually the *good guys* but Billy's body didn't know that. Once the body killed those, it began to think ALL of his blood was "bad" so it started killing all of his blood.So a "sick" tick probably triggered Billy's IMHA.
Other auto-immune stuff-
There are other auto-immune diseases that can be a problem - and some of the folks who post on this thread (like Willow and Pirate's Mom [slr2meg]) have dogs who have had a disease SIMILAR to IMHA. "auto-immune" or "immune-mediated" simply means that the body begins to turn around and attack itself - that something in the body is a ‘bad' thing and the body begins to attack itself.
Some affect the blood (like thrombocytopenia or pancytopenia like Willow and Pirate had) and some affect other parts of the body (like psoriasis or other skin problems, rheumatoid arthritis in humans, and tons of other things).
Sometimes it can just be big huge infections.
But when Eli comes home you're good at watching when he does something "not normal" and Eli's lucky to have you. Just noticing that he didn't want to play? Honestly Judah, that's HUGE. Because you got your folks to get help for Eli before it got really bad - and man, that is soo awesome.