AIHA or IMHA

Jackie, Callie, Jessie's Mom and sl2cmeg

Thanks for everyting =) 

Yes I got to talk to my vet at OSU and she was so impressed with all the research I did and how I caught the Pharmacy mistake about the Cyclosporine.  She said "no wonder her PCV didn't come up that whole month!"  She said she thought that the non-modified wasn't even on the market anymore.  I kind of hope that it still is so we'd have something to try in case Cyclops is sensitive to the carrier.

Anyway when she heard Calcinosis Cutis she said she had to do a Cushings test to rule it out.  I will be so happy if its negative.  We have her fasting right now and am taking her first thing in the morning.  

I ordered the special shampoos I mentioned earlier and we're just going to wait and see if it calms down.

You know.. another thing I was thinking and I know this is a long shot but it said that too much Calcium in the blood can cause this.  That Knox Nutrajoint has a lot of Calcium in it, she is getting a scoop per day which is something like 400mg.  Don't know if thats remotely possible but these things go through your mind..

We'll let you know tomorrow what the outcome is.

Thanks again!

Normal 0 false false false MicrosoftInternetExplorer4 Grateful Dawg - You've got our very best well wishes from HK too, hang in there!

For those curious here's an update on Poppy's condition:

She was 'recovering well' (i.e. energy levels up to 70% of before, wanted to play and eat, giving enthusiastic greetings etc) up until Weds late evening when she started throwing up 1 - 4 hours after eating meals (inc. meds).  We went to the vet on Thurs and they suspected her meds, which I was giving after each meal (wrapped in cheese), are causing burning in her stomach/throat hence the vomiting.

Since we are seeing encouraging results on the meds (established that both predisone and doxycline were prescribed as a safeguard from the first visit - so it seems they were also considering IMHA at the time), the vet wants to continue on them but gave us more (!) meds for her vomiting, prescribed a low protein diet made up of regular small meals and told us to give her water via a syringe after each pill (still to be wrapped in something) to ensure they are 'washed down' and not stuck in the throat as they dissolve. 

Of the 3 meals she has had since, Poppy has held down 1.  She's been eating small amounts of low protein treats and peanut butter between meals which have thankfully stayed down and drinking sugared water (I have been checking her gums obsessively!) 

The poor thing is now cautious of any food and has become rather picky about what she eats (especially if it is something she has had before and thrown up - she has even gone off cheese and ham!) but we can tell she is still interested in food which is a good sign.  So far what has worked best is inserting one half of a pill in a corn kennel and smothering the opening with peanut butter, and/or crushing the pills in some mashed banana but we’re thinking it’ll only be a matter of time before she goes off these foods...

It’s been hard emotionally but at least she has more energy during this latest episode (she barked at someone to say hello when she was being walked this morning, it's been a while!) vs. before going to the vet the first time.  But poor Poppy seems tired and sad from all the vomiting (poor thing looks so guilty afterwards!)

We're going to keep monitoring and if it gets worst will be back at the vet…has anyone been through this situation before and/or does anyone have any thoughts on how to make the pills go down easier?

That's it for now, thanks again for your thoughts and take care!

P.s. I checked her vaccination records and it was proheart that was given, not heartgard (good pick up on that!)

 Thanks for the update.  Are they giving her a stomach protectant?  "Pepcid AC" is what Cyclops takes and it really works well. GENERIC NAME: FAMOTIDINE 10MG - ORAL (fam-OH-tih-dine)

You said they are giving her meds for vomiting but I wonder if they are giving her anti-nausia instead of a stomach protectant.  Anti-nausia is treating the symptom but protecting the stomach would stop her tummy from feeling bad in the first place. 

What meds other than Prednisone is she on now?  You said doxycycline.  That antibiotic can make things worse if it is IMHA.

Please give us a list of every med she is on and please let us know the results of her CBC.  It would be a lot easier if we were not guessing about what is going on.  

Liverwurst is very good for hiding the pill in and it is slippery enough to get her to eat it.  Callie has said that dairy products may reduce the effectiveness of cyclosporine but if she isn't taking that then cream cheese is also a really good thing to use.  I have found it to be less messy than peanut butter. 

The main thing is to get her on the FAMOTIDINE or something similar because you have to get her to eat.  Also please let us know each drug she is on and what her PCV is at.

Poppalicious

has anyone been through this situation before and/or does anyone have any thoughts on how to make the pills go down easier?

The most important thing is to not try and 'trick' her into taking pills. It doesn't work, they can smell a billion times better than us. When Pirate was sick I sat down and explained every single pill to him and SHOWED him the schedule of when he needed pills. You can call me crazy if you want, but it worked. He was on doxy too and I think that's what makes them feel pukey-est. He lived off of minute rice, egg, and liverwurst for probably 3 weeks or so. I split it up into 6 meals when he was the sickest. He was getting pills three times a day so I would give one small meal before, and then one small meal after to make sure the pills got to his tummy.

Callie will tell you that her dogs know the difference between 'chew good!' and 'just swallow' -- Pirate does too. The easiest way I found to give pills it with liverwurst. Put the pill in a tiny meatball of liverwurst, and then get a nice big gob ready as well. Hold it over their nose so they have to tilt their head up and give them the one with the pill and say 'SWALLOW!' (or whatever). Before they even have a chance to spit it out I shove that big gob right in their mouth so one big gulp and it's done and over with.

 Clops never chews she literally inhales food like we've been starving her to death.  I wish I could get her to slow down and chew her food sometimes.  When it comes to taking pills though esp the cyclosporine where it is dangerous if its broken up it is a good thing she just swallows that liverwurst.

 You're right its nice to have an extra piece of liverwurst ready to go in your other hand so they are already looking forward to that before they know what hit them with the first one.  There is no hiding the pill though, I show her the pills and she sees me put them in her food so she knows they are there.  I always hope that when she feels sick she doesn't think I'm poisoning her food.  She still seems to love me though so I guess she doesn't think I'm trying to kill her.  =)

 I love hearing stories about Pirate.  

 Oh ya.. doxy is another med that does not mix with dairy. For some reason dairy products reduce its effectiveness.  People who take doxy also have to be careful not to have dairy at the same time they take the pills.  I think the recommendation is 1 hour before or 2 hours after dairy.

GratefulDawg

 I love hearing stories about Pirate.

Oh believe you me...Pirate has stories. For a lovely example, the first day we adopted him he was covered in fleas and just kinda smelled like the dog pound, so I bathed him in the bathroom off of the garage. I put a collar and leash back on him when we were done and opened the door to the bathroom. Well, the garage door was open and Pi must have spotted his chance at freedom, he wriggled out of his collar and made a run for it. Now, I had literally adopted him an HOUR earlier. He was a stray with no name, still, so I chased him down the street shouting, 'DOG!! DOOOG!' Once I caught up with him I went to Wally world and bought a harness. LOL.

He was sick in August of 2007. He was on the meds until about December and was back to 'normal' by last spring. Our new house (we've moved since the collar-slipping incident) backs up to woods and is up a little sidewalk from the parking lot. Pirate likes to chase lizards up the sidewalk when we get home from our walk, so I used to let him drag his leash and he'd run to the front door. Weeeeeell, one day last spring there was a CAT at the edge of the woods and Pirate BOLTED. He treed this cat, but instead of waiting at the bottom of the tree he climbed three or so feet into it. Once he figured out he didn't know how to climb down he just kinda looked back at me like, 'a little help, ma?' I scooped him up and thanked my lucky stars that he was feeling good enough to BE that naughty. Clops will get there, soon. I know it.

GratefulDawg

Knox Nutrajoint has a lot of Calcium in it, she is getting a scoop per day which is something like 400mg.  Don't know if thats remotely possible but these things go through your mind..

Half a scoop a day should be ample -- even *I* only take a scoop a day of it.  Calcium isn't just calcium -- it's in a proportion with phosphorous too -- so since you are supplementing her diet the extra calcium really shouldn't be a problem, and I would think that it would have shown up on some of the bloodwork you've run - it IS one of the things usually checked.

+++++++++++++++++

Poppalicious

Since we are seeing encouraging results on the meds (established that both predisone and doxycline were prescribed as a safeguard from the first visit - so it seems they were also considering IMHA at the time), the vet wants to continue on them but gave us more (!) meds for her vomiting, prescribed a low protein diet made up of regular small meals and told us to give her water via a syringe after each pill (still to be wrapped in something) to ensure they are 'washed down' and not stuck in the throat as they dissolve. 

Of the 3 meals she has had since, Poppy has held down 1.  She's been eating small amounts of low protein treats and peanut butter between meals which have thankfully stayed down and drinking sugared water (I have been checking her gums obsessively!) 

The poor thing is now cautious of any food and has become rather picky about what she eats (especially if it is something she has had before and thrown up - she has even gone off cheese and ham!) but we can tell she is still interested in food which is a good sign.  So far what has worked best is inserting one half of a pill in a corn kennel and smothering the opening with peanut butter, and/or crushing the pills in some mashed banana but we’re thinking it’ll only be a matter of time before she goes off these foods...

Poppalicious -- I"m going to tell you to be incredibly careful.  You said something that REALLY scared me

Poppalicious

The poor thing is now cautious of any food and has become rather picky about what she eats (especially if it is something she has had before and thrown up - she has even gone off cheese and ham!) 

 -- it would be in your best interests to have your vets draw more blood and check for RENAL problems.  That's a classic sign of renal problems -- avoiding a food that has made them sick previously.  I've seen it happen -- and ALL these drugs (particularly pred) are very very hard on the kidneys and this can sneak up on you from behind -- the dog gets nauseus and the vets think it's just the drugs causing the nausea, but if she's thinking it was the last thing she ate, that can actually signal something else.

Once of the ladies who posted above (Jennifer back on about page 20 - 22) -- her dog was vomiting and the vets were assuming it was just the drugs -- NOPE the dog had diabetes and was in renal failure. 

what can happen is you take an animal that maybe is "iffy" -- and no one knows there is a problem UNTIL they start on these big drugs and they crash SO fast (because maybe the kidneys weren't superb to start with).

You might want to try meat baby food (or ANY baby food) -- generally they are pretty tasty and they are *slippery* so the meds slide down easier.

Liverwurst -- it's like liver pate -- you should be able to get some form of liver ground into a paste there.

Peanut butter is sticky -- I tend to avoid sticky things. 

I would also make SURE the vets know your dog had a ProHeart 6 shot -- in honesty, it is probably NOT tick disease.  Not with ProHeart 6 in there -- and the problem is that ProHeart was also VERY hard on the kidneys and liver. 

sl2crmeg

I put a collar and leash back on him when we were done and opened the door to the bathroom. Well, the garage door was open and Pi must have spotted his chance at freedom, he wriggled out of his collar and made a run for it. Now, I had literally adopted him an HOUR earlier. He was a stray with no name, still, so I chased him down the street shouting, 'DOG!! DOOOG!' Once I caught up with him I went to Wally world and bought a harness. LOL.

 Oh this really brings back memories for me.  My first dog as an adult was an older dog I rescued from a shelter.  I think she was a lab mixed with maybe some irish setter but not really sure.. for some reasons all my dogs end up being black and white. 

Well I had just got her home and we went for a walk.  I was about a mile away from the house and stopped to talk to someone and let go of the leash.  I looked around and no dog.  This was literally the same day I brought her home.  So I'm looking all over and finally I gave up and went back to the house to get the car.  She was sitting at the front door waiting for me.  This dog picked me out when I was at the shelter, she hugged her body up against the fence of the kennel and just begged to be adopted.  I guess she just wanted to make sure I wasn't going to leave her some place.  The people who owned her before left her chained to a tree outside and in thunderstorms.  She was deathly afraid of thunderstorms and I'd have to put her in a room with fans running when a storm was comming because she'd shake in fear.  Another fear she had when I first got her was feet.  She had been kicked and she would shy away from feet.  If I was sitting on a chair and tried to rub her with my foot she'd get so scared.  It took about a year before she lost that fear.  I felt so good the day I realized that she no longer thought I might kick her.

I got her at 8 years old and I had her 6 years.  I knew when I got her I'd only have a short time but I still feel very good about the choice I made with getting her.  Its like.. she knew she was close to being euthanized and she knew she had a second chance and she was appreciative.  Not that my dogs that I have now are not.. but I've had them both since they were 8 weeks old and they've known nothing but the good life.  It was just like this rescue dog was thankful.. 

Didn't mean to go into all that.. but your story about losing the dog the first day reminded me of that.  I also had not picked out a name yet but I'm not sure if I was yelling "DOG!" or not.  =)

calliecritturs

Half a scoop a day should be ample -- even *I* only take a scoop a day of it.  Calcium isn't just calcium -- it's in a proportion with phosphorous too -- so since you are supplementing her diet the extra calcium really shouldn't be a problem, and I would think that it would have shown up on some of the bloodwork you've run - it IS one of the things usually checked.

 So you think 1/2 scoop would be enough to still work on a 65 pound dog?  I guess you're right the instructions don't say take more if you're big.   I guess I can cut it in half.  I mean it would save some money that stuff is pretty expensive.  People swear by it though.  

I thought I'd have the results of the Cushing's test but I didn't know they had to send that off to the same lab as the CBC.  So I should know tomorrow (Saturday).  The doctor said that she sure doesn't look like a Cushings dog to him but that he understood why OSU wanted to run the test.  

Here is something.. for the first time since Clops got sick, she jumped.  Before she got sick, I'd open the car door and she'd jump right in.  She'd jump up on the bed or whatever.  After she got sick no more jumping.  I'd open the car door and she'd put her front paws up and then wait for me to lift her rear end up and she'd walk in that way.  Today I opened the car door and was getting ready to help her in and she just jumped right on in.  I mean I am not encouraging her to do this again.. I want her to take it easy but it was really a good sign.. good to see her a little closer to her old self.  Thats why I never thought it was arthritis that time when she couldn't move.  She had never shown signs of arthritis before let alone something that severe.  But I figure the Nutrajoint and the G/C pills can't hurt and at her age it is just something good to have her on and keep her from feeling bad from arthristis.  

It simply takes months for the Knox to kick in -- but it's a permanent change not a temporary one b/c it helps the body actually REBUILD cartilage.

Human body mass is considerably bigger usually and I've always decreased the dose accordingly.  Usually a 20 pound dog or under I give 1/3 of a scoop and my 30 pound dogs I give about 1/3 scoop (or a short half in other words).  Seems to work for folks.  Now me?  I take the whole scoop in my coffee (yeah the last mouthful is a bit gritty but you don't even taste it and I take mine black!!)

It's actually ME who has started the whole thing on here -- about 10 years ago when David and I were early married I had gotten to the point where I had to walk with TWO canes and just trying to get IN to work was a major chore.  But I couldn't even get to my own bathroom without canes in the house.  My boss at the time suggested I try the Knox, that a friend of hers had found a lot of relief.  $8 every two weeks we could handle (but man, we were POOR then and I couldn't afford g/c). 

She told me I'd have to take it about 3 months to 'see' the change so just "do it and don't bother worrying about whether or not it will work ... you'll just know one day".  She was right -- It was about 2 1/2 months later -- one day I was in the living room and just got up and went to the bathroom.. Once in there I thot "dang, I forgot my cane... EITHER of them" and I realized I didn't NEED them to get there.  I was so happy I literally stood there and blubbered like a baby I was so thankful. 

Periodically I go back on it, but I've seen no need to use it ALL the time.  I've taken glucosamine/chondroitin and honestly it's never done that much for ME.  I just use the Knox in the little orange/white cannister -- I don't buy the expensive one with the other stuff in it.

POPPY, I HOPE YOU SEE THIS.   I DO HAVE A VISION PROBLEM AND NO WAY CANI GO BACK AND READ EVERY POST, SO I MAY HAVE MISSED THIS.

 1. DID YOUR DOG GET PROHEART6 INJECTION AND ANY OTHER VAX AT THE SAME TIME OR WITHIN A MONTH OF EACH OTHER?  ACORDING TO THE NEW WARNING LABEL THAT CAME OUT WITH PROHEART6 WHEN IT WAS ALLOWED  BACK ONTO THE MARKET LAST YEAR, IT IS NOT TO BE GIVEN WITHIN A MONTH OF ANY VAX.

2. HOW LONG AFTER THE PROHEART6 INJEC TION DID YOU YOUR DOG GET SICK. IT IS PROVEN THAT THE ONSET CAN BE FROM DAYS TO SEVERAL WEEKS LATER,.  aLSO, ONCE IT SETS IN, IT CAN ADVAMNCE LIKE A RUNAWAY TRAIN OR MORE SLOWLY.  iN HINDSIGHT, WE REALIZED hUNTER HAD BEEN NOT QUITERIGHT FOR ABOUT 2 WEEKS BEFORE HIS DIAGNOSIS, BUT WAS SUCH LITTLE THINGS THAT NONE ALONE MEANT ANYTHING.  bUT PUT TOGEHTER, THEY MADE THE PICTURE.

3.  IF YOU DOG WAS DIAGNOSED WITHIN SAY 6 WEEKS OF GETTING THE PROHEART6 INJECTION, YOU NEED TO FILE A REPORT WITH THE FDA.  ONE OF THE REQUIREMENTS OF IT'S RETURN WAS THAT VETS  FILE REPORTS ON ANY SUSPECTED REACTIONS.  hOWEVER, MANY OF US BELIEVE A LOT OF VETS WILL NOT DO THIS UNLESS THEY ARE 100% SURE IT WAS A REACTION TO ph6--LIKE THE DOG GOES INTO SEIZURE ABOUT THE TIME THE NEEDLE IS REMOVED... iT INVOVES THE DOG C OMING IN TWICE A YEAR--WHERE POSSIBLY SHAMPOO, EAR CLEANING, ETC, ETC WILL BE PURCHASED AS WELL AS THE INJECTION.  aND SOME CHARGE OFFIE CALLS.  tHEY DO NOT WANT IT REMOVED.  BUT THE FDA WANTS REPORTS SO THEY CAN GET THE PICTURE OF WHAT IS GOING ON. gET ENOUGH REPORTS OF THIS THAT OR THE OTHER HAPPENING WITHIN CERTAIN LENGHT OF TIME FOLLOWING THE INJECTION AND IT MAKES A PRETTY CLEAR PICTURE THAT IT IS CAUSING THESE REACTIONS.  I DO NOT WANT TO HAVE ALL TH DEATHS AGAIN THAT HAPPENED LAST TIME.

4. yOU CAN GO TO www.thepetguardian.com  or www.dogsadversereactions.com  AND FIND OUT HOW TO REPORT TO THE FDA.  THE FIRST SITE WAS STARTD BY jEAN WHO LOST 2 OF HER 3 DOGS WITHIN, A COUPLE OF MONTHS OF GETTING PROHEARTR6, NIKI TO LIVER, tASHA TO AIHA.  HER 3RD DOG IS STILL ON MEDS OVER 6 YEARS LATER. ALL 3 OT PH6 THE SAME DAY.  THE OTHER SITE WAS STARTED BY LAURRYN AFTER ALMOST LOSING HER PUG, VELVET TO IT.

 This is what Poppy said

"I suspect Poppy's profile may fit with IMHA also as per the above symptoms + age/gender + had Heartguard shot within past 4 months + had annual vaccinations a week before developing the above symptoms [they don't do titters here] + 'over vaccinated' (when she arrived they gave her a 3 year rabies shot anyway despite having already had one in the States 6 months prior - part of HK’s quarantine policy.)  "

From reading that it would seem that she had the PH6 4 months ago and then a week before Poppy got sick she had annual vax.  Not to mention 2 Rabies Boosters in 6 months.  

I think all vets should just refuse to use PH6 and they should also go to Dr Dodds Vaccination Protocol.  My state just adopted a 3 year Rabies Law - which is a step in the right direction.

Cyclops 3/16/2009 - IMHA Since December 12, 2008.

PCV 39.1%

Cyclops!  You are looking beautiful, girl!  39, woo hoo!!!!!!!!  Fingers and toes all crossed for her continued improvement.