AIHA or IMHA

Sometimes my chutzpah astounds even me.  I emailed Dr. Dodds for him (ON Christmas, no less, and asked for a "quick reply";) and SHE DID. 

She said all 3 vet schools were excellent, and actually gave him a 4th option AND sent her IMHA protocols that have just been published.  So I forwarded it to him.

Jackie -- I'm the same way - I can't get Cyclops off my mind and heart. 

 But I tell you folks -- having a renowned vet like Dr. Dodds take time on her Holiday to help like this -- that just plain ROCKS.  Now let's hope and pray that the Alpha of all Alphas helps make this real and happen. 

Oh I am so glad you picked her up and took her home!  Will continue to pray for her.

 callie.. thanks so much.  i feel very honored to just know Dr Dodds took her time to reply to you.  feels like what it must be like to have your name mentioned by a favorite celebrity or TV or to meet a favorite sports player.  I have been reading about Dr Dodds everywhere since I got the diagnosis.  I'm glad to know she thinks any of the 3 would be a good choice.  I read a lot of good things about Colorado State University too but it would be a very long trip. 

I was leaning toward Kansas State but now that Dr Dodds mentioned Oklahoma State I may check with them first.

Wow.. a lot to think about.  Thanks again!

Wow -- and I just got a response from Dr. Dodds to send to him.

 Apparently they (Hemopet) just did work with Okalahoma's vet school.  So she suggested them because they're already used to working with her protocols. 

It's awesome that she took time from her Holiday to help.  And yeah, Mike -- I kinda feel like "Man, an email from Dr. Dodds in MY Inbox!! WHOA!!!!"

I'm just checking back in to see how Cyclops is feeling.  I'm hoping no news is good news.  We are with you in spirit either way. 

Lori & Willow

That's a BUNCH of us thinking of Mike and Cyclops and lifting them and their family up ... if they made the journey to Oklahoma they may just not be able to post in any event.  But prayers and good thots are never wasted and man, I've checked this 30 times this morning!!

I just found this site and started reading about your last few weeks. I know the pain that you must be in every time you look at Cyclopse. Reading this was like reliving the last few days of my life. I came home from work on Monday the 22nd and my 2 1/2 year old TsiTshu, Nikko, didn't seem to be her normal bouncy self. She had walked out into the snow about a week earlier and walked onto the pond. She cracked the ice and went under. She came right up and out but I'm sure she had to have swollowed some of the nasty water. I attributed that to her not feeling well and thought some bacteria got into her system and got the best of her. I went to work on Tuesday the 23rd (8:00am)and and called the vet's office as soon as they opened and they told me to bring her in. I went home immediately and by the time I got home (11:30am) Nikko was lethargic. Absolutely unbelievable that this could happen this quick. I rushed her to the vet and they said she was probably dehydrated they would start an IV, run some tests and call me after lunch. Nikko's red blood cell count was down to 7. She had IMHA. I had never even heard of IMHA. Her blood was already clotting. I was told all of the same stuff that you have heard about the transfusions and treatment and prognosis. I was also told the minimum price for the treatment and her odds. I was told that if I hadn't come home early that day to pick her up when I did there was a good chance that she would have passed away on her own. Nikko had Christmas gifts at home waiting for her. They said I couldn't bring her home in the condition she was in. By this time my head was spinning with the "odds" of a 1 in 4 chance of survival. I gathered her gifts and my daughter came and picked me up. I went and held my precious pup for 2 hours. She got her gifts early and we put her in a pair of pink thermols. She couldn't even pick her head up but she could move her eyes. It was one of the hardest things I've ever had to do but I didn't have the funds for the treatment with the odds against her the way they were. Now I wonder  why this happens and would the treatment have worked? I know I'm not alone in wondering nor am I alone in missing my Nikko Bo. I look back now and wonder if I had noticed 24 hours earlier would it have changed her odds? Is there something I could have done differently? People say that it's bad timing for this to happen with it being the Holidays. That doesn't matter, it NEVER would have been good timing.

I hope that they find a treatment that works for Cyclopse and I hope they find it soon. She sounds like she's a fighter. There needs to be more answers for IMHA because the "we're not sure" answer doesn't cut it. Cyclopse is lucky to have an owner that has gone the extra mile trying to find a cure for his best friend. Fight Cyclopse, fight. My thoughts are with both of you.

I'm so sorry to hear about your precious Nikko.  I can't imagine what you must be feeling, please forgive yourself for any guilt that may be hanging on.  You did every thing you could for Nikko and you loved her enough to let her go. 

Nikko Bo

I look back now and wonder if I had noticed 24 hours earlier would it have changed her odds? Is there something I could have done differently? People say that it's bad timing for this to happen with it being the Holidays. That doesn't matter, it NEVER would have been good timing.

Oh i am SO sorry.  No -- never ever -- and it just increases your guilt because you think "Did I not notice because I was so busy?? -- don't beat yourself up.

The smaller the dog the faster it can happen simply because a bigger dog has more blood volume.  There were times when Billy faded literally before our eyes.  It was as if we could see his tail wag slower and slower (and for us with Billy that was ***every time*** our cue that his pack cell was falling).

Don't beat yourself up.  Truly do NOT.  I have seen dogs "beat this" only to get slammed by it 2 years later.  We never *ever* will say "Billy is CURED" because he's not.  It's simply the whim of the immune system and how healthy you can get them after.  But very often the 2d recurrence is faster, harder and more often fatal. 

It rapidly becomes unbelievably expensive -- but it's also one of those things that literally changes your life because there is SO Much to their care and 'watching' - watching SO close for a relapse.

It's very difficult but I encourage folks who have experienced IMHA to make a list -- you may never know what 'triggered' the IMHA, but at least make a list of things you'll never do again.

IMHA can be tied to things like:

• vaccines -- annual vaccines?  extra vaccines? not good
• systemic pesticides - maybe more convenient but more dangerous - some folks won't use them all together
• certain antibiotics - sulpha and others
• tick disease (and not using stuff like Frontline/Advantage can expose your dogs to ticks - so you can't win there)
• other things

It's mind-boggling.  It's mind-numbing.  But that's one of the reasons why I try to help people -- because had it not been for the incredible support I got from the folks on here, I'm not sure I would have made it.

I am SO sorry for your loss.

calliecritturs

I am SO sorry for your loss.

Me too.  I'm sorry.

I am really sorry to hear what happened. You are really bringing to life what I was saying a few messages back about cost and the choices you have to make.  

You asked why it happens.. the short answer is no one really knows what triggers it most of the time.  Your dog's age and sex are prime target for IMHA.  For some reason it seems to hit young female dogs more than either males or older dogs.  But my dog Cyclops is 10 and it still hit her.  You pretty much said it all - there are many people who want answers.  

Would the treatment have worked?  Maybe.  Your dog is a very small dog and that means that it might not be able to survive some of the things a bigger dog can just because a bigger dog has more resources to draw upon.  I am wondering what they quoted you to give her 1 transfusion and start her on meds?  It would be helpful to know because I have just been learning about the huge differences in costs between one vet and another.  One thing I have learned is that cost does not = quality of care.

Your biggest problem is that you just didn't have TIME on your side.  You can't put yourself and the rest of your family at risk by trying to do something you can't afford.  Think about some of the poor dogs out in the world with either no owner at all or terrible owners.  Dogs who are abused and neglected or made to fight for football players.  You gave your dog a good life. 

A doctor at the teaching hospital today told me a story - she just had a patient who died of IMHA.  The people who owned the dog had no issues with money whatsoever.  This dogs red cell count was a 6 and they would transfuse and the dog would go up to an 8 and within 10 hours would crash again.  The owners wanted to keep the dog alive but there literally was not enough blood to keep transfusing.  They would have had to do a transfusion every single day.  So even though money was no issue it didn't matter in this case.  

I was listening to the radio today NPR news and they had a vet on who wrote a book about dogs called "Tell me where it hurts" and I really want to get it and read it.  It talks about people like us on this forum who love our dogs and how hard it is knowing that most likely we'll outlive our dog. How we set ourselves up for heartbreak over and over.  

I know what you mean.  There is no good time for this to happen.  I hope you'll keep in touch.  I hope you have people around who can understand your loss and help you to remember the good times.

Take Care

when my golden retriever, hunter, was diasgnosed with aiha on oct. 9, 2003, i had never heard of this horrible disease.  We went over everything in the previous 2 months and the only thing different in Hunter's life was the Proheart6 injection.  my vet said when it came time for his next injection we were going back to the interceptor monthly pills.  i was to learn later that AIHA had been ddded to the warning label a few months before Hunter got his fatal injection.  And ironically, the DAY he got the injection, there had also been anohter label change listing death as a reaction.

 I started doing reasearch and just typed in Prohearet6 and the FIRST  story i found was by a klady in NC who had lost her shih tzu to AHA following PH6 injection.  The next per4son I found wqs one in Colorado who ha lost her 4 year old mix to AIHA and her 11 year ols "skipper4 key" to live damage----following PH6 injection, aqnd her 3rd dog, a shepherd/l;ab mix was being treated for n autoiommune disease.  All 3 had had gotten their PH6 injection the same day and in 2 m,opnths, 2 were dead, the ohter on meds.  Casey is still on meds 6 years later.  Many of us who lost or almost lost a do/dogs 6to PH6 are still in regular contact.  I was telling hunter's story all over the web and found or was fgound by about 45 whose dogs had developed AIHA following PH6 injections.  at that time, only 2 were still alibe, a buff cocker and a beagle.

None oif us had ever heard of this disease before our dogs were diagnosed.  i took Hunter in when i noticed pale gums.  Some actually didn't not notice anything wrong until their dog collapsed.  And many of us, in hind sight, realized things had not been qite right for a few days, or in my case about 2 weeks.  Hunter spent more time sitting on the patio watcvhing squirrels than chasing them.  He had tried his whole life to catch a squirrel like our older golden, gut had never got one.  We thought he must have learned from Buck how to stalk.  Just little things like that.  Jean had noticed Tasha didn't follow her upstears from the basement every tp and thought it was because it was cooller in the basement.  But after Tahsa collapsed and was diagnosed and Jean learned about the illness, she knew Tasahad not had the energy.  For so many of us it was such little things----like a jog saw puzzle.  one or two pieces do not mean a thing, but get enouigh together and yu see the puzzle.

 \My hunter was in ICU from the morningof the 9th til his death at 8:40 PM on the 16th.  he had had 2 transfusions, a ton of meds, blood work every day, x-rays and ultrasound, etc.  my bill was $2300.  The manufacture of theProHeart6 did pay almost half of it.  luckily my vet is great and was letting me pay it off a little at a time

 Hopefully this is a picture of my Hunter.

Update on Cyclops

First of all.. I want to thank Callie again for contacting Dr Dodds.  Dr Dodds made it easier for me to choose which of the 3 nearest hospitals would be the best to go to.  Although she said all 3 would be just fine, she had personal experience with Oklahoma State University. 

I had my vet fax records to OSU and we started on our way early Friday morning.  Cyclops favorite thing ever is road trips.  She even knows words like "rest area" and of course "park".  She is extremely thirsty because of the Pred so we stopped about 5 times on the way so she could get out and pee and have another drink.  When I let her out one time she was actually walking ahead of me on the leash.  We fed her chicken breasts that morning and then about half way there we stopped for some burgers and she ended up eating a good part of both mine and my wifes burger and i think she even had a few french fries too.  

We got to the hospital and was met by a very nice 4th Year Med Student.  She took a very complete history and she made sure to caution us not to get our hopes up.  She then told the story of the last IMHA patient they lost - which I mentioned in my last post.  Then she took cyclops into an exam room with an Intern and did a quick exam.  They noted that Cyclops's color was pretty good in her tounge and cheeks/gums.  On Christmas Eve they were white as a sheet.  They told me that someone would call me 2x a day every day she was in the hospital.  They took a 500.00 deposit which they thought would cover things from Friday night until Monday morning.  

I was only half way home when the phone rang.  It was a 3rd doctor that I hadn't met.  This doctor said she ran CBC and some other blood work and also re-did some X-rays.  She said that her PCV was 22.  That is the highest it has been.  Her past CBC's were: 10.6, 9, 10, 6, 20 and now 22.  22 being 48 hours after her last transfusion.  

Then came the ominous news:  Cyclops is not regenerating cells.  She is not making new baby cells.  This is something I didn't know before. On Monday an attending physician will be back from Christmas Break and they are going to put Cyclops under anethisia and take a sample of bone marrow.  Here is the part where I have to do some research.  The doctor on the phone said it may be IMHA/AIHA or (as she worded it) "this may not be a true IMHA".  I asked her what that meant and she said that the anemia might be caused by something like a  cancer or something else in the bone marrow that stopping it from creating baby red cells.  What I didn't think to ask at the time was if not auto immune then what is destroing all the red cells? Unless  its a combo of cancer and auto immune.  

The doctor had a positive tone and said that there are different meds they can try to get the bone marrow to start producing.  Said we'll know more after Monday.  

She has a heart murmor that was caused by the anemia.  If her red cell count gets to the normal range it may even resolve itself.  Her liver is slightly enlarged.  She said it was most likely from the heavy doses of steroids.  Her lungs appeared to be dry and clear which was good news.  No evidence of cancer on any of the organs.  She said her appetite was still good.  

Someone will call tomorrow for another update.

Also I asked about the liposomal clodronate - the med student said she was going to look into where the study was done and try to get all the info she could about it.  I asked her that if it came to the point where it didn't look like anything else was going to work if they'd try it on her - provided that it didn't cause any pain or undo suffering.  I appreciated the fact both doctors I talked to didn't just blow my suggestions off.  

They really respected Dr Dodds too and I brought my email from Dr Dodds and they thought it was very cool she took time on Christmas Day to send me a note and wish me good luck.  

Even if we lose Cyclops.. I feel like I've done all that can be reasonably done.   I am not going to be upset because of the money issue.  If I lose Cyclops I won't be saying I should have saved the money and had her put to sleep.   If she does recover then hopefully it can help others make the choice to try too.  The more experience the doctors get in treating this the better. 

To all of you.. it meant a lot to me to log in and see you thinking of Cyclops.  Tomorrow I am going to try to put some picture up on here.  The main thing is that she is the sweetest most gentle loving dog you'd ever want to meet.  And always been that way.  My only regret in her life is that I never took time to learn about how to get her in to visit people in hospitals or old age homes because nearly everyone I'd meet would tell me she was the perfect dog for that.  

Talk to you all soon.  Please.. if you have any info about the bone marrow draw and about non-regenerating cells let me know.  

in fact let me know anything that crosses your mind, i'd rather be told twice than not be told at all.