AIHA or IMHA

Thank you!  I'll ask our vet about it.

Thank you so much for your suggestions!  I really switched to the prilosec because it was easier to get down with food, now that we have to "pill" her with everything, we might as well switch back, but I was told they are basically the same.  We are a bit gunshy to try the Cyclosporine again but it's funny you say that because I was just thinking that after looking at all of my notes regarding when she would and wouldn't eat and which new meds we had recently introduced.  Problem was, there were always multiple new drugs at at time, so hard to pinpoint, but she did get Pancreatitis RIGHT after we introduced the Azathioprine.  My vet just told me that she spoke to the surgeon and he told her he wasn't concerned about the amount of Prednisone she is on and would do the surgery, so now we have to consider these options.  Thanks so much for the feedback it is much appreciated Mike!

 Alyson

Alyson -- try this

Get meat baby food and some veggies and/or fruit baby food.  You can start with just the meat (beef, veal, lamb, chicken, turkey) -- you can take a small spoon of the meat, mush the pill in it and usually get them to take it that way (rather than pilling them.  It's not fatty -- and if you can use a small airtight container and mix a jar of baby food meat with one of veg or even fruit (all baby food -- no lumps, and it's easy to get down them) -- you should eventually get her to take her pills that way -- low fat, and actually very nutritious.

Pilosec is FINE -- Billy was on it the whole 18 months he had to take the drugs -- it's actually stronger to help the gut than the Pepcid.

ARe you going to a specialty vet or a university vet?  I know they do a splenectomy sometimes but like you said it's risky. 

Another thing you might want to try is my slippery elm cocktail receipe -- that can really help heal the stomach.

1 -- half a cup of boiling water.

2 -- add 1 rounded tsp. of ground slippery elm

3 -- let cool totally

4 -- add 1/8 c. + 2 tablespoons of aloe juice

5 -- add 10 drops of chlorophyll

6 -- Add 2-3 capsules (open the caps) of acidolpholus

That will keep in the fridge for 3-4 days.  Give a baby medicine syringe FULL about 1/2 hr before a meal -- it may well improve the appetite. 

Hold the jaw loosely shut -- park the tip of the syringe behind the canine tooth and just squirt slowly so she can swallow as you squirt in the mouth.  It will help calm down the stomach.

The pred could well be the problem -- the cyclosporine is a better drug for this.  The pred is definitely what's causing the arthritis.

Try a topical rub of peppermint and/or wintergreen essential oils (not food flavoring -- you get these at a health store).  You can even use the green alcohol you get at a pharmacy and just add more wintergreen or peppermint oil to it if you'd rather.  But use it as a massage liniment -- it really HELPS the stiffness.

Prednisone messes with the viscosity of the joint tissue and breaks it down.  One of the things I recommended many times on here is Knox Nutra Joint -- it's just a powder you can mix in the food once she starts eating a bit.

The big conundrum with this disease is the fact that you gotta keep them eating.  They must eat to tolerate the drugs.  But try the baby food meat - it IS helpful.

Try beef heart -- often that is really tasty to them -- you can saute it in just a spray of Pam so there's no fat (and it's very low fat anyway).

The other HUGE suggestion is milk thistle.  I know - it's one more thing to 'give' BUT it can help so much because the liver can add to the general toxicity (and makes them feel like they are sick to their stomach when they really aren't -- the toxins shunt to the brain).

You can literally stir the powdered milk thistle into any food -- it's not at all bitter or bad tasting. 

Try using the baby food and the b.f. meat combined with veg -- it IS food and at the same time it makes giving the meds much easier.  I've posted "how" to do that before -- if you can't find it I can do it again.

Good luck -- I've BEEN there, trust me.

Thank you, thank you, thank you!  It's heartbreaking to pill her as well of course since she already seems so miserable, so I will try the baby food, great tip thank you!  We actually got her to eat the science diet dry food tonight, go figure.  I'm thinking the other stuff is turning her off now for some reason? I'll let you know how it goes with these tips. Thanks so much for taking the time to share with me, I really appreciate it!

Alyson

Thank you JackieG!

Please everyone do not change the name of the thread.  

I've had it stickied and it will mess with people being able to find it. 

Thanks!!

Kiypies,

Welcome to this thread. I'm new here, too, and I can tell you everyone is willing to help and answer questions. I am so sorry Kiya is feeling so crummy!

Kiypies

She has been on prednisone since the beginning, but has had SEVERE muscle loss

Frisby is having a hard time with the prednisone and the muscle loss right now, too. The high humidity/heat really seems to make it a lot worse--especially the panting. She's going to the vet tomorrow and we're going to see if there are any options. Her appetite came back when we started the pred, so I'm not sure what to offer except to read Callie's and others' ideas. The vets did give me a medication for Frisby to stimulate her appetite (Mirtazapine)  in case she didn't start eating.  

Our beloved Jazz needs help and prayers.

Last Friday Jazz didn't eat and seemed to want to be left alone.  We were housesitting a friend's dog, so we had three dogs with us in all.  It was hot and I assumed she was tired from all of the running and playing she had been doing with her friend and brother.

On Sat. morning, she was still drinking, but not eating.  I thought maybe she had an upset stomach.  She did not play with her brother or friend, but she was alert and seemed happy.  Sat. afternoon, I told my husband I was concerned, and would he please take her for a walk.  During the walk she slightly limped on her left back leg, but was curious, sniffed around, ect., and urinated in all the usual places.  

We're remodeling our back yard, and I assumed she must have rough played and briused her hip or something.  We bought her a rotiseree checkin, mixed it with broth, and she seemed to enjoy this quite a bit.  Then, we let her rest....  It was about 3p.m.

At 6:30, we called her to come into the backyard.  Jazz would do anyhting to please us, and has NEVER not come when called.  No response.  We oppened the sliding glass door to see what was going on, and to our horror was our beloved Jazz, desperately trying to walk, taking steps then falling and trying to get up again.  Her head was frozen to the right.  We swept her up and took her to emergency room.  Our thought was that our dog had been poisoned.

Jazz was diagnosed with IMHA.  Her blood count was 10.  We were shocked to see for the first time her yellow gums and eyes.  How could we have missed what is now blatently stating us in the face?

She had a blood transfution on Sat. night.  On Sun. night her number again dropped and she required a second trasfusion.  The second transfusion has brougt her up to 28.  her numbers have remained at 26 and 27 since.

She has been on iv fluids, Doxycycline, Nitrofuran Monohyd Macro, Prednisone, Cyclosporine and Famotidine (to protect her stomach).  They have performed numerious Tox. screens and blood tests for possible cuases.  She has had x-rays and ultrasounds.  She got to come home to us yesterday.  Her gums are still pale, but no longer yellow.  She will eat shredded chicken with a bit or rice, cottage cheese.  She is drinking water.  She is up a bit, and will walk outside to use the bathroom. 

Mostly, she wants me to pet her and gently massage her, especially rubbing her belly.  Her little brother follows her, but is keeping his distance from her. 

I began to read through all of the discussions, but became quickly overwhelmed.  My daughter is also sick, and we had to take her to the ER yesterday because she was becoming dehydrated (she's much better now).  My head is numb, and I can't concentrate.  I think I'm dehydrated from crying so much.

She's only 2 1/2 years old.

Does anything with Jazz's current treatment stand out as problematic?  Is there something missing?  What more should we consider doing?

 I've never posted to a forum, so I'm not sure if I did this right.  If not, I'm sorry.  Please copy and paste me to where I should be.

We hope Jazz is feeling better. It sounds like you were very on top of things as soon as you saw something wasn't right. This is so good. This disease hits fast and hard. I have added Pet-Tinnic, a liquid vitamin to Frisby's routine. Dr. Dodds recommended it. (I emailed her after reading how she helped others on this dicussion board. She emailed me back and was very helpful! She's at hemopet.org  I used the contact email there.) I also do the milk thistle, per Callie's recommendation. I'm sure others will be by and can offer a lot more good advice--they've been dealing with this a lot longer than I have.

Thinking of all of you!

Best of luck, I'm so sorry you are going through this, it is just awful.  Do email Dr. Dodds today hemopet@hotmail.com as she is leaving tomorrow for Calgary, she gave me some great advice and responded so quickly thanks to Mike for referring me to her!  Good luck with Jazz!!!

Hi -- Again I'm changing the name of the thread back to AIHA or IMHA (otherwise people can't 'find' it fast) -- this thread goes on for SEVENTY ages now (*shaking my head*)

don't worry -- we'll help you (everbuddy is a "newbie" at some point). 

 Is she being seen by just your regular vet or by a vet school or specialty hospital?  Honestly -- this truly seems BEST done at a vet school.  They are simply more cutting edge AND CHEAPER very often. 

 I've got some questions --

1.  Why do they have her on doxycycline?  Do they suspect tick disease?  (that's typical -- but doxycycline also tends to BOOST the immune system and the whole point of what you do in IMHA is try to slow the immune system down.)

2.  What is the Monohyd Macro -- that's another antibiotic - and it seems like they've got her on a ton of drugs, and to a degree you usually have to get the IMHA under control at least to some degree *first*. 

.The huge deal is to keep them eating -- because they have to eat to tolerate the drugs.

The yellow is from jaundice -- but it doesn't seem like they have her on anything to help the liver.  Milk thistle is a HUGE gigantic deal (and it's not something many vets think of).  It helps protect the liver and helps with detoxing it. 

As far as food -- you will do **better** to use beef (particularly beef heart if you can get it) -- but RED meat because part of the problem is her body is starved for iron (and chicken has little nutrition in it anyway actually - particulalry white meat chicken).  Even meat baby food can come in really handy.

 Don't use cottage cheese -- it's dairy and it's been my experience that dairy can inhibit the absorption of the cyclosporine.  At least that's what we found with Billy.  Try plain bland mashed potato if you want something bland.  Hummus is another super good thing (chick peas are really high in iron actually) and a lot of dogs love it.

Please feel free to give me a call -- it really does help a lot.  We're all here to give you all the support we can. 

Thank you for your well wishes. I truly appreciate your kindness.  We send prayers to you as well for Frisby, as well as all of the animals I have been reading about today who are stricken with this terrible illness.

As for staying on top of things, I really don't know how we missed how sick she was.  I guess we should have checked her gums, but we thought she had twisted her leg.  Knowing now that she was near death has been very unsettling for us.  Every time she gets up, I am now checking her gums, as well as her brother's.  There is a lot of guilt with this disease, and while I don't blame myself, there should be more awareness in the animal community to inform pet owners to check their gums when their dogs seem like they are not feeling well.  The lack of a cause has also been unsettling.  If she pulls through, how do I prevent a relapse or keep her brother from her fate?   

As far as an upside, Jazz discovered roast beef today, and I was able to mix it with rice and get her to eat quite a bit. 

I will look into both the Pet Tinnic and the Milk Thistle.  I called my Vet today to ask about the Milk Thistle and he said it was a good idea, and that they sell it in the vet store, but I think it's combined with other ingredients.  I also asked about Asprin, but he said no.  We have an appointment in the morning to check her bloodwork.  I plan on creating a list tonight - based on the research that I was finally able to do today and on any feedback from others tonight.

 So far:

Pet Tinnic

Asprin

Milk Thisle

Good luck at the vet tomorrow Jazz

Your friends

Lori and Willow

amsten

I will look into both the Pet Tinnic and the Milk Thistle. 

I got the Pet Tinnic from entirelypets.com  They had the 4 oz bottles and they got it here super quick. I started giving about 1/2 what is recommended, just to make sure she could tolerate it. (It was a bit hard to find; my vet didn't have it in stock. He did have the vitamin tablets (Pet-Tabs, I think), but they don't have nearly as much iron. My milk thistle comes from mountainroseherbs.com (an herbalist friend keeps it in stock and I got it from her. It's organic and is available in power form. (My friend prepares Frisby's for her, but I would just order the power if Grace weren't around.) I think at least one other store has been recommended on this site, too. I also get beef liver (gag!), cook it up with just bit of Pam, then freeze the slices. Then, I cut of a little bit while it's still frozen, cube it, and serve it as a cooling treat. (I let it sit for about 5 min. before I give it to Frisby so it's not a total ice cube!)

I think this disease can go from 0 to 100 in less than a day--Frisby's blood work had looked OK for a long time while we were treating a tick disease, and then bam! she crashed hard really fast.

Kiypies

Thank you so much for your suggestions!

Alyson,

Your welcome. 

I may have misunderstood about the stomach protectant.  I didn't know you had tried Famotidine (Pepcid AC) before and then switched.  

If you are having good luck with what you're using stick with it.  I said PepcidAC because thats what I've had experience with and thats what the teaching hospitals are using (the ones in Oklahoma and Colorado). 

Hopefully, with a doctors advice on Cyclosporine dosage you can try again using Callies food suggestions and see what happens.  With that much Prednisone, you know that she must feel lousy, as my dog was a raging food maniac while she was on Prednisone.  

Anything I can do, don't hesitate to ask.

Mike