AIHA or IMHA

Kassie -

I wish I would have seen you post sooner.  I've been affected by the ice storm and by work. 

I'm sorry about  Meeka.  This disease is cruel beyond belief.  I am on my way to Weddington tomorrow myself.  I'm hoping Dr. Wright is there.  When I saw your first post and the Cyclosporine dose I was floored.  My dog is sick from Cyclosporine she finally got used to the 150mg 2x/day and the upped it to 200mg 2x/day.  We started her on the higher dose on Friday and on Saturday night she had a huge nose bleed.  Called the emergency number and Dr Herring said put an ice pack on it. 

Tonight she had another nose bleed.  Same nostril.  I'm not sure if its related to IMHA, if it is then we're probably done for.  I won't keep putting her through this and I know the only really good care is at OSU.  I'm not putting down Weddington, I love the people there but they lack the ICU and the sophisticated equipment they have at OSU.  

I used to live in Fayetteville before I got married and got a house here in Bella Vista.  I really wish I could have seen your message the day you posted - I just don't know what to say.  

When they crash it happens so fast. I'm just bummed out - logged on bummed out about my dog but then saw your first message and was grateful to find you and then saw your last message and it really shattered me.  

Mike

Oh, God, I hope Cloppy isn't having low platelets as well as the IMHA.  I'm praying for her!

 Glad to hear about Emma and see a dog making it past a few months.  Callies dog Billy is about the only success story long term I've seen until Emma.  Seems like most of the stories here are heartbreakers.  Thanks for your database.  Someday if I ever get the time I'd love to make a site with forms where all this could be entered and have some type of stats. 

 I know what you mean about vacs I'll never do it again.  

Willow is a long term survivor too although not the same exact disease.  Glad Willow is still with us!

 I'm not sure whats going on.  Its been very cold and everyone's had dry skin lately.  Her nose has been very dry warm and cracked ever since the IMHA.  I was thinking maybe she needed moisture so I went to the drug store and got some saline nasal spray for babies and also some all natural lip balm made from coconut oil and not petrolium jelly (don't think its good for her to lick the vaseline which was my first thought). 

I'm not sure if its just me trying to find something good but both times it was the same nostil and right after she ate her kibble.  I am wondering if something got up her nose becase while she was eating she jerked her head away from the bowl once like she was in pain or startled.  

Appetite is good even though we've discontinued the Pred (which worries me) and increased the cyclosporine (which worries me more).  I've checked her urine (normal color) her stool (normal color) there isn't any bloating in her belly like she's bleeding out or anything.  No sound of fluid from her lungs and she has a normal temp.  

I'm thinking if she were hemmoraging the blood would come from both nostils.  I am really really hoping its just a local injury or maybe a sinus infection in one nostril (her immune system is compromised afterall).

These are just my ramblings and my hopes. The truth is I'm not sure what is going on and while I've had 2 weeks of smooth and stable sailing I'm back to where I was on Christmas Eve all over again.

We'll run that CBC tomorrow and I'll be sure to ask about platelets.

 

 I AM SO SORRY ABOUT MEEKA.   I HATE THIS DISEASE MORE AND MORE.  NO MATTER HOW MUCH YOU READ ABOUT IT, YOU CAN NOT IMAGINE WHAT IT DOES TO YOU UNTIL YOU HAVE YOUR DOG DIAGNOSED AND THE FIGHT FOR IT'S LIFE,  THE FEAR, THE WORRY STARTS.   ALL WE CAN DO IS HOPE THAT SOME DAY A TOTAL CURE, OR BETTER YET, A PREVENTION CAN BE FOUND.

 I DON'T REMEMBER ALL THE QUESTIONS YOU ASKED BUT HERE IS MY INOF.

 HUNTER WAS A GOLDEN RETRIEVER,  HE TURNED  ON AUG. 19, 2003.  ON THE MORNING OF OCT. 9 2003, I NOTICED HIS GUMS WERE VERY PALE AND I CALLED AND AE AN APOINTMENT TO GET HIM IN THAT MORNING.  A SHORT TIME LATER, HE "WENT" JUST OFF THE PATIO AND I NOTED HIS URINE WAS THE COLOR OF RUSTY WATER.     

GOT TO THE VET AND FOUND HE HAD LOST 9 POUNDS IN THE 5 WEEKS SINCE HIS PROHEART6  INJECTION.  FROM 78 TO 69 POUNDS.  HIS TEMP WAS 104.   I REALLY DON'T KNOW WHAT ALL OF THESE ARE,, JUST COPYING IT FROM MY FILES.  HIS WHITE BLOOD COUNT WAS  15 (NORM. 6.0-17.0)  HIS RED BLOOC COUNT WAS 2.6 (NORM 5.5--8.5) HIS HGB 6.7 (NORM 12,0--18.00)  HIS HCT WAS 20 (NORM37-55) PLT 34 (NORM 200-500)    MCV WAS 77,   (NORM 60--72,) MCH WAS 25,8  (NORM  19.5--24.5  MCHC WAS 33.6   (NORM 34--38)   RDW WAS 16.5  (NORM 12--16  MPV WAS 13.5  (NORM 6.1--10.1)

ON A CHART, HIS ALB WS VERY, VERY LOW HIS AML WQS MID LOW, HIS TP WAS MID LOW, HIS GUN WAS MID HIGH.  ALT WS VERY LOW NORMAL  AND HIS LKP WS VERY HIGH NORMAL.  THE REST WERE ALL MID NORMAL        

HUNTER HAD  BEEN A PERFECTLY HEALTHY DOG, WEIGHT 77 TO 79 POUNDS HIS ENTIRE ADULT LIFE.  HE HAD BEEN FULL OF ENERGY--WE CALLED HIM THE LONG LEAN PLAYING MACHINE BECAUSE HE WAS TALL AND LEAN AND LOVED TO PLAY.  HE ATE PURINA DOG FOOD  VERY OFTEN WITH FRESH CAUGHT & BAKED FISH ADDED.  HE WOULD NOT EAT THINGS LIKE CHIPS AND CANDY, JUST SNIFF AND WALK AWAY.  HE NEVER GOBBLED FOOD, ATE SLOWLY

HE WAS PUT IN ICU THAT DAY, OCT. 9, 2003. .  ON TH 12TH ULTRASOUND AND X-RAYS WERE DONE AND HE WAS GIVEN 2 UNITS OF BLOOD AS HIS HCT HAD DROPPED TO 9.7.  MY VET CONSIDERED REMOVING HIS SPLEEN THAT DAY, BUT CHANGED HIS MIND.  ON OCT. 15, WE KNEW THE PRED AND DOX (?) WERE NOT DOING THEIR JOB AND CYCLOSPORINE WAS ADDED.  HE WAS ALSO GETTING DURGS TO PREVENT HIS STOMACH FROM BEING TORN UP AND FOR HIS BLOOD CLOTTING FACTOR.  ON THE 16, HIS HCT PLUMMETED, HE WAS GIVEN 2 MORE UNITS OF BLOOD, BUT  BETWEEN THE LIVER DAMAGE (DRUG INDUCED NECROSIS OF THE LIVER ACCORDING TO THE HISTOPATH REPORT) AND THE AIHA, HE JUST COULDN'T FIGHT  HARD ENOUGH AND HE WENT INTO SEIZURE AND DIED AT 8":40 PM. 

IN HIND SIGHT WE REALIZED HE HAD NOT BEEN QUITE RIGHT FOR A COUPLE OF WEEKS.  HE SAT AND WATCHED SQUIRRELS INSTEAD OF CHASING THEM BEFORE THEY GOT DOWN THE  TREE.  i THOUGHT HE HAD LEARNED HOW TO STALK FROM OUR OLDER GOLDEN--WHO OFTEN CAUSHT SQUIRRELS.  HUNTER NEVER MANAGED TO GET A SINGLE ONE    AS HE ALAYS WENT AFTER THEM BY THE TIME THEY WERE HALF WAY DON THE TREE.  ALSO, HE WOULD BRING HIS BALL AND WE WOULD THROW IT,BUT IF ONE OF THE OTHER DOGS GOT A HEAD START, HE DID NOT GO AFTER IT.  HIS SISTER HAD ALWAYS BEEN LIKE THIS AND WE THOUGHT HE HAD FIGURED IT OUT .    OF COUSE LATER WE FIGURED OUT THAT AHA HAD SET IN AND WAS STARTING TO TAKE A TOLL ON HIM.  I TALKED TO A FEW OTHERS WHO LOST THEIR DOG TO AIAH FOLLOWING PROHEART6  WHO LIKE US, IN HIND SIGHT REALIZED THEIR DOG HAD NOT BEEN QUITE RIGHT FOR SEVERAL DAYS.  EACH TIME IT WAS LIKE A PUZZLE,  ECH PIECE ALONE MEANT NOTHING, BUT PUT TOGETHER MADE A PICTURE.                                                                                                         

 

Mike, is she bleeding "from", ie inside the nose or the cracked skin outside is bleeding?

If she is bleeding from inside the nose you need to get her a blood panel today not tomorrow.... I don't mean to freak you out but that's really important. Nose bleeds can be very platelet related, check the skin in between the fur all over, is there any bruising anywhere? How is the stool, is there any black tarry stuff coming out?

Please keep us updated, I'm worried about her and will be thinking about her.

Hi

I'm on my way to the vet today.  I checked her all over and I can't find anything.  Stool and Urine are both very normal.  Lips/Gums/Tounge are all pink.  Temp is normal.  Appetite is good.  

The bleeding is comming from inside her left nostril but not sure if its deep inside or just toward the outside.  Like I say her whole nose is dry and cracked but I've been keeping it moist now.  We'll see what the blood work says, if its normal (normal given her condition) I'll ask the doctor to use a scope and look and/or take an xray.  Her teeth and mouth are in good shape I was trying to see if she had an absess.  

 I called the vet the first time and the response was less than what I had hoped for.  "Put an icepack on it". 

Both nosebleeds happened at 6pm after her afternoon kibble.  I give her a little kibble in the morning and some chicken or turkey for lunch and then a little more kibble in the evening.  

I'll be back on this evening and let you all know what I found out.   I've been reading online and many times it seems these nosebleeds are never tracked down.  I hate it when more than one thing changes at a time.  Had the nosebleed happened last week it would be different because everything else would have remained the same.  But the fact that it happened as I am weaning her off the pred and increasing the cyclosporine by 50mg per dose makes me wonder. 

I had been walking her 2/10 of a mile per day.  1/10 mile one way and 1/10th back.  Its a very short distance only a few houses down.  But she wants to go so bad when I take the other dog out that its been hard for me to say no.  I've stopped her walk since the nose bleed though.  She was a daily walker up until the IMHA and then when she suddenly stopped moving and was in the kennel at the hospital for over a week I think it stiffened her up.  Since she started walking every day she has been getting up and down easier and moving much better.  But I'm going to keep her quiet for now just in case the increase in heart rate from the walk is making her hemmorage or something.  

I hate all the guessing, the second guessing and the not knowing.  I think I'm going to focus on her quality of life and let her do things she wants to do and then if she dies at least she died on her own terms.  In her mind there is nothing wrong with her.  That is what makes it so hard.  If she were in pain she'd understand but apparently she isn't in pain and she must be feeling ok because she's eating.. I guess the nosebleed isn't bothering her although my other dog is freaking out about it.  It was my other dog that alerted me the first time.  She kept sniffing Cyclops and staying right next to her and then I saw the drops of blood.

so nice to hear from you OC =)  thanks for being there.

Good luck with Cloppy today. Hopefully it's just the cold, dry weather drying her nose out. If everything checks out OK maybe a humidifier would help, like a person?

GratefulDawg

 I'm not sure whats going on.  Its been very cold and everyone's had dry skin lately.  Her nose has been very dry warm and cracked ever since the IMHA.  I was thinking maybe she needed moisture so I went to the drug store and got some saline nasal spray for babies and also some all natural lip balm made from coconut oil and not petrolium jelly (don't think its good for her to lick the vaseline which was my first thought). 

I'm not sure if its just me trying to find something good but both times it was the same nostil and right after she ate her kibble.  I am wondering if something got up her nose becase while she was eating she jerked her head away from the bowl once like she was in pain or startled.  

THIS IS NOT UNCOMMON!!!!!

All during the time Billy took cyclosporine periodically the edges of his lips (at the corners of is mouth) and his eyes and his nostrils would ALL get funny "hard' crack and bleed. 

Now -- this'll weird you out -- cyclosporine is the same stuff they use in the eye drops for the dogs with DRY EYE!!  Yes, in eyedrops it makes the eyes less dry!!! BUT in the mucus membranes it does truly weirdo stuff -- and he STILL gets skin funk on the edges of his lips near the corners of his mouth!! 

I'd imagine if you combined that with super dry winter air and heating that would likely make for a lot of bleeding.  The lip balm is a darned good idea.  Try even just olive oil! 

sl2crmeg

Good luck with Cloppy today. Hopefully it's just the cold, dry weather drying her nose out. If everything checks out OK maybe a humidifier would help, like a person?

 

Hope Cloppy is OK.  One of our old Labs would get deep cracks in her nose in the winter.  Our Vet suggested a humidifier and using Vitamin E cream, I found it in the grocery store and it did help a lot.  I hope it is just environmental and not a bleeding issue.  Sending you strong, healing vibes, Mike.

JackieG

sl2crmeg

Good luck with Cloppy today. Hopefully it's just the cold, dry weather drying her nose out. If everything checks out OK maybe a humidifier would help, like a person?

 

Hope Cloppy is OK.  One of our old Labs would get deep cracks in her nose in the winter.  Our Vet suggested a humidifier and using Vitamin E cream, I found it in the grocery store and it did help a lot.  I hope it is just environmental and not a bleeding issue.  Sending you strong, healing vibes, Mike.

 

ALL these things can help -- it's a side effect you cope with.  But when you think about the fact that one of the major things "Atopica" is supposed to do is that it's supposed to mess with the skin - these side effects do make some weird sort of sense.  And knowing that it's supposed to 'change' the amount of moisture in the eye??  yep -- same drug, invades different tissues in different amounts -- and it can have the opposite effect.  

GREAT suggestions

I'm back from the hospital.  Dr. Wright was there and she scoped Cyclops' nose.  Nothing was found.  I told her about the saline mist and the vaseline up the nose with a qtip and also the coconut oil balm.  She seemed fine with all that but I really like the Vitamin E idea. 

She was happy with Cyclops' color.  She checked all over for any signs of bruising or leaking of blood.  I told her I checked the urine and the stool.  She sent the blood off to the lab and the results will be in tomorrow so we'll know about the platlets and where the PCV stands tomorrow.  

 Right now her guess is that her nose is dry she dosen't think its due to the blood disorder although both bleeds happened just after her short walks.  I didn't take her for a walk today and today she didn't bleed.  I am thinking of cutting her already very short walk in half and take it even slower.  She wants to go so bad.  Doctor said her main concern was just the anemia making her tired and weak during her walk.  But once I told her how very short the walks were and how it keeps her "loose" she seemed to be on board.

 I mentioned Kassie's situation.  She really couldn't comment of course because of privacy issues but she did say how well Meeka was doing right before things went to hell.  Thats when I looked at her and told her thats why it never makes me feel better when she says how well Cyclops is doing.  Things can change in a second.

 Kassie if you're ou there I hope you're doing ok.  We're all thinking of you.

If you get back and read this I'd like to know if you had any vaccinations before Meeka got sick.  Or anything you can remember that happened before she got sick.  I was unable to come up with any conclusive cause, unlike some on here who got it from the Heartguard or from Vaccinations.  I told the doctor today no more vaccinations for Cyclops, ever.

 

Meeka's vaccinations were back in June so I can't imagine they had anything to do with it. There was nothing out of the ordinary in the time leading up to diagnosis. We do take our pack out hiking at Kings River Falls where there are tons of ticks, but we always comb them down afterwards to make certain they aren't bitten...and even then, since it is winter we haven't been down to the falls since August (I work at the university so don't get days off during the week once the semester starts and the falls tend to be busy on the weekends).

Meeka always crated when we were out of the house (an sometimes on her own while we were here...she was crazy for her crate), so she was never alone long enough to get into anything without us knowing. She just started to get lethargic and looking sad in the eyes...then things barreled down hill from there.

It is our belief that the high doses of cyclosporine did her in. She was wasting away...down to 80lbs, but even then the dose wasn't adjusted. We don't blame the clinic...no one knows enough about this disease...we can't blame them for that. We are very grateful for the care Dr. Herring and the techs at the clinic gave her.

I will say that even when Meeka was seeming so much better she still had no desire to go for walks anymore. She wanted to play with her brother and sister a bit...and she wanted to climb up on the couch and in bed with us...which was really a lot better than she was when she was first diagnosed. So I'd say Cyclops's desire to go out is a great sign. We would have been doing back flips if Meeka had shown any interest in normal activity. Don't let us get you disheartened. Also, Meeka's nose did the same thing. It got so cracked and dry and broken...it looked like asphalt. The vet looked at it every time we went in because we were worried about it, but she never did anything for it, and finally we just said "we have to do something about this." It was really starting to bother her. She was dragging it on the carpet and pawing at it. You could tell she was unhappy. At that point the vet gave us a gel called Kerasolv to rub on it. It drove her crazy when we put it on because it was kind of cold and she wasn't allowed to lick at it, but it always really soothed her once it soaked in and her nose had started to look a bit better after about a week. It wasn't terribly expensive...I think $10 for the tube.

We really appreciate all your guys' kind thoughts and messages. It has been one of the most difficult days of our lives and doesn't show signs of getting any easier. I know it will, it just doesn't feel that way right now. It is difficult being normal with our other pups. We know they wouldn't understand if we suddenly stopped walking or playing their daily favorites, so we're trying to stick to the norm for them. They know something is wrong, as we are so sad. They have been very clingy...I am sure trying to comfort us. I don't think they know yet that she is gone since she's been in and out so often throughout the last month.

Anyways. That is enough of that. I don't know that I'll stay on top of this terribly well. It is difficult. We do think about Cyclops often and hope that you don't have to hear the same news we did. Good luck.

 Frankly, the vets will tell you NO MORE *ever*.  It's S.O.P. for IMHA.  It was the first thing my *regular* vet said -- "This means NO MORE vaccines ever!"

My best guess is that the cold air likely makes the skin more fragile.  I would put something in the nose *before* the walk.  David and I were both sitting here remembering how very difficult the nose, mouth and eyes were.  Billy's nose, at one point, actually got HARD all the way around the nostrils -- you would have thought it was plastic!  White and almost 'scabby' looking.  And it was from the cyclosporine.  For sure.

don't forget to send me your address???  I've got Pepcid sitting here waiting to come to you!!

Kassie

We really appreciate all your guys' kind thoughts and messages. It has been one of the most difficult days of our lives and doesn't show signs of getting any easier. I know it will, it just doesn't feel that way right now. It is difficult being normal with our other pups. We know they wouldn't understand if we suddenly stopped walking or playing their daily favorites, so we're trying to stick to the norm for them. They know something is wrong, as we are so sad. They have been very clingy...I am sure trying to comfort us. I don't think they know yet that she is gone since she's been in and out so often throughout the last month.

 

They know more than you'd think -- because the smell that goes with this is incredible.  

I will never forget -- back when we had Muffin the Intrepid, and I was taking him to a specialty vet near us when he was in renal failure.  I had him on leash and was walking him before going in ... and he was sniffing for a "place" and SUDDENLY HE STOPPED.  He literally backpedalled.  He stood for a moment and LOOKED at this pile of poop.  Then ... very carefully he walked WAY *AROUND* it.  Like -- he never got closer than FOUR FEET to this pile of poop.  He walked a perfect semi-circle around it and then turned around and made a perfect line away from it.

 I thot "WOW -- whatever *that* dog had, Muffin wanted NOTHING to do with it!!  And when we came back out -- he did the same exact thing.  Man -- he wasn't coming CLOSE to that.

I thot then, the power of their nose is unreal ... and your other dogs truly understand more than you might think -- particularly since you and your husband are devastated.  But they want to *help* us process OUR grief -- and often that frustrates them.  

Kassie -- my thots and prayers are with you -- it is SO hard to lose them, particularly after you have tried SO hard with this disease.  *hugs*