AIHA or IMHA

Cyclosporine Reaction -

Did research.  I knew in my gut a dog which never displayed any signs of Arthritis could not go this lame (unable to walk) this quickly.  Turns out that this is a side effect of Cyclosporine.  I have halted it.  Nothing I can do tonight.  Tomorrow I will get an Rx of Azathiaprine and consult the doctor about increasing her pred until it has time to take effect.

 I knew the generic cyclosporine was too good to be true.  

yikes... don't halt it without vet guidance.... sudden removal of ANY of these immune suppressors even if they haven't kicked in totally yet can send the dog into another overblown immune reaction or a different sort of immune problem. I know the side effects are scary, but if you want to treat this make sure you don't halt drugs without talking to a vet. I had to do the same... the drugs were killing Snickers but with the sudden removal... you know the rest of the story.

thinking about you.. good luck... i'm so sorry you have to deal with this.

He's actually on his way to the vet NOW (I was just coming over here from email to ask for good thots and prayers for them and he's already been here! Rah!).  He had a TCVM appt with Dr. Baker today (and this TCVM vet actually happens to be a new addition to the vet clinic he was already going to so it's a perfect situation for him).

Knowing my own personal reaction to prednisone, I'm not surprised (since this is just another weirdo version of a steroid and how the body reacts to them when it reacts badly).  But given how cyclosporine works in the body (it's the absorbed levels of it rather than just this dose or that dose) so he should be ok with what he's done.  If it's locked up her muscles like *that* then she's at risk in other ways too -- she won't be able to release her bladder or sphincter muscles, etc. 

He's more prepared this time for the azathiaprine.  He HAS milk thistle, he's been using it and can crank it up to protect her liver.  She's already got it in her system.  And because of the specific type of IMHA she's dealing with, it should make this do-able.  She's already switched drugs twice

 I'm so sorry Cyclops is lame. I hope it's a reaction to the cyclosporine and that the IMHA isn't making her weaker. I'll be praying for her.

outdoorschik

 

yikes... don't halt it without vet guidance.... sudden removal of ANY of these immune suppressors even if they haven't kicked in totally yet can send the dog into another overblown immune reaction or a different sort of immune problem. I know the side effects are scary, but if you want to treat this make sure you don't halt drugs without talking to a vet. I had to do the same... the drugs were killing Snickers but with the sudden removal... you know the rest of the story.

thinking about you.. good luck... i'm so sorry you have to deal with this.

 You are right outdoorschik -  Anyone reading this - think twice before doing things on your own. Outdoorschik is correct and I shouldn't have halted the Cyclosporine.  Of course you have to listen to your gut.  I had never seen Cyclops have arthritis before.  I read about lameness as a side effect of the Cyclosporine and kind of reacted.  

I had 2 vets plus consult with teaching hospital and everyone seems to think that its not the Cyclosporine causing the lameness.  With the help of Callie and something she said about how Glucosimine and Condroiten wear off really fast if they are not given daily plus the doctor who did a really good exam on Cyclops it turns out that it may have been just this extreme cold combined with how her Glucosamine/Condroiten was stopped last month while she didn't have an appetite.  Also the rapid decrease in Pred may have had something to do with it too. 

The TCMV manipulated her hind legs and showed me how one side was bothering her.  He did accupuncture and gave vitamin B shots.  Callie emailed me some good info on some other things I can do for arthritis and I am going to follow up on that. 

The doctor did take my concerns about the Cyclosporine seriously and he explained how when they list side effects they report everything that happens to any dog in the study regardless if it had anything to do with the Cyclosporine or not.  He suggested that I give Cyclops her next dose and see if the lameness returned.  I am happy to report that the lameness did not return.  She is a little stiff but once she is up and moving she seems to be doing well.  The weather is not so cold either and it is suppose to be in the mid 50's tomorrow.  

I can believe it either way ... but I like this guy's procedure.  It's a good way of diagnosing. 

We'll talk about more arthritis stuff tomorrow on the phone.  I can teach you a few things about finding problem spots.  Sorry I missed your call tonight -- we'll talk tomorrow.

 Cyclops' CBC showed a Hemocrit of 23.7.  This is the in-house machine which was 25.0 last week.  The same sample was sent to an outside lab and came back 30.0.  But each machine is different and comparing the same machine Cyclops was down 1.3 from last Friday. 

The TCVM vet and my regular vet talked and decided to put Cyclops back on 15mg pred/day.  Then we'll recheck the CBC next week and see if we are falling or maintaining or hopefully increasing.  Basically what this means is that Cyclops had stayed within 20-25 since Dec 26.  Her numbers at OSU would be 21, 23, 22, 24.. ect.  Raising or lowering 1 or 2 points but not going below 20 or higher than 25.  Same thing since we've been back home.  

I am hoping that the herbs we are going to start next week might help raise her numbers.  Cyclops' liver functions were improved.  I've been giving Cyclops 1500mg of Milk Thistle.  500mg spread out 3x a day. 

So Jessies_Mom we're not thinking she is weak because of IMHA.  But in terms of the IMHA we are not seeing any progress.  But things could be worse we could be crashing and I am thankful we are not.  I'll take stable over falling any day.  Just hoping to see some increases.  

Cyclops did well with the acupuncture.  She was very relaxed and although she didn't fall asleep she went into a really relaxed state and she didn't bother any of the needles, even the ones in her front paws/legs area.  

So thanks to Callie, Cyclops has been given direct input from Dr Dodds on the Western Medicine front and Dr Xie on the TCM.  People from coast to coast have now heard of Cyclops.  

Everyone who meets Cyclops has told me that they understand why I'd want to save this dog.  They all seem to think she is really sweet and special.  

calliecritturs

I can believe it either way ... but I like this guy's procedure.  It's a good way of diagnosing. 

We'll talk about more arthritis stuff tomorrow on the phone.  I can teach you a few things about finding problem spots.  Sorry I missed your call tonight -- we'll talk tomorrow.

 Dr Baker seems to be very down to earth and seems to not favor Chinese or Western - but a balance between the two.  So he was a pleasure to work with and he spent a ton of time with me.  

I am back to where I was with the Cyclosporine.  Neither vet here was in any hurry to switch her back to the Azathiaprine.. mainly because of the risk of what could happen to her immune system.  They are looking into maybe running both drugs together for a time and then slow her off the Cyclosporine.  The vet at OSU is strongly in favor of the Cyclosporine over the Azathiaprine.  The reason why is because she has had much success with the drug.  The vets here at home Dr Baker and Dr Wright both seem to have no problems with the Azathiaprine but I can tell that if we are going to switch it is only going to happen if I really push the issue.  

Her hemocrit was holding well from Dec 26 to Jan 5 on Azathiaprine/Pred. Her hemocrit hasn't really changed from Jan 5 - Jan 16 on Cyclosporine/Pred.  So I am not sure I see a medical advantage.  But I can't argue the fact that Billy came through with Cyclosporine.  I wonder if there are any cases where a dog made it on Azathiaprine?  If there is no difference then maybe the switch should be made so more resources could go to accupuncture and herbs.  Mainly I feel hesitant to do anything because if something goes wrong I'll be the cause of it.  No vet is making a case on switching so I know it will be me who has to push it.

I am thinking of emailing Dr Dodds and if she gives the blessing then make the switch.  If she says to stay then I'll stay.  I know thats letting someone else make the decisions.  I am usually good at listening to all sides and making a sound decision but this disease has played with my head in a way that has made me question everything I do or don't do.

GratefulDawg

I am thinking of emailing Dr Dodds and if she gives the blessing then make the switch.  If she says to stay then I'll stay.  I know thats letting someone else make the decisions.  I am usually good at listening to all sides and making a sound decision but this disease has played with my head in a way that has made me question everything I do or don't do.

  That's the nature of this disease; if I were in your place, I'd do the same. I'm so glad the IMHA wasn't worse and her count is holding. It will probably come up very slowly; I think that's the way it was with Billy. Still keeping you in my prayers.

GratefulDawg

If there is no difference then maybe the switch should be made so more resources could go to accupuncture and herbs.

Mike go check out the other forum, lots of dogs are on Azathiaprine there.  I don't know how good or bad they've done but the posters there definately have some experience with it.

Willow never used it so I just can't offer anything on it.  But, we are thinking of Cyclops every day and hoping she continues to get better.

I wasn't able to connect with him today, but left him a message -- they may elect to switch drugs LATER but right now I would just go with the flow because she's not stable *yet*.  That's probably job#1. 

You folks rock -- it helps SOOOOO much when you jump on here when you have a sick animal to SEE all the support!! **GROUPHUG**

I got a message from Dr. Dodds: 

"Dear Michael: Cyclosporine is a better imunosuppressant than azathioprine, so I wouldn't change anything now.     Jean"

 So there you have it.  Doctors at OSU were following Dr Dodds so I should have known but I can't tell you how much it means to have that input from her.  That took away my nagging doubt of maybe we are wasting money on a drug that is no different from the other. 

It is blowing my mind that Cyclops is getting help from everyone on this board and from the top vets in Western and Chinese Medicine.  

Cyclops' arthritis is so much better today.  Is it from the acupuncture or because it got to 53 degrees today vs 10 degrees Thurs and Friday?  A lot of times its hard to tell cause/effect.  Just like I went blaming Cyclosporine just because I had never seen Cyclops have an attack of arthritis before.  

Dr. Dodd SOOOOO rocks!!  She is just **the** nicest lady and man, she is so awesome just about consulting with other vets (for nothing I might add -- I can't tell you how many times she's talked with Dr. D about Billy).

The change in arthritis?  It's going to be several things but the acupuncture brings quite a lasting change for days.

DO get started on the Knox NutraJoint tho -- because the overall thing that IS worsening the arthritis isn't the weather -- it's the pred. 

That will change the foods you give her too -- no spinach, mustard greens, swiss chard, beet greens (too much oxalic acid - I can't eat them either).  You *can* use kale, turnip greens, etc. 

Hi everyone,

I am so sorry for what everyone on this board is going through because we are going through the same thing.  It is a very long story so I won't go all the way into it.  This is very hard on us right now because we just put our little boy to sleep in Dec and then one of our other dogs was diagnosed with this and now the doctor is saying that the meds are not working and we might have to make a decision very shortly.  Taz was diagnosed Dec 10th and had a blood transfusion and put on heavy meds.  This past week she started to go down hill fast would not eat and was throwing up.  On Wed she had her weekly blood test which showed she dropped from 32 to 30, but her white blood cell count was very high.  She was also diagnosed with a mammory gland staph infection.  The doc gave her a shot of anitbotics because of all the other meds she was on.

He also put her back to 100 mg of Atopica (50 mg in morning and 50 mg at night), cut her pred to 15 mg a day spread into 2, he then added Azathioprine 15 mg for the first 2 days and then every other day.  She is on Carafate for her stomach.  Right now she can not get up, once we lift her to her feet she walks very slow and wobbles quite a bit.  She won't eat anything so we have shot some yogurt into her, she is still drinking quite a bit.  She has lost so much weight since this all started and is just skin and bones.

 Taz is a mini schnauzer almost 12 years old and is our first pet - we are at our wits-end because neither one of us wants to make this decision especially since it is so close to having put our boy to sleep.  Any little advice or words would be great.

Thank you so much for listening,
Jennifer

I don't have the right words but I am so sorry for what you are going through.