AIHA or IMHA

Coopers PCV was 21 yesterday. That is up from 14.9 on Monday. He has been on the Azathiprine for a week 10 days today. He has only been on the Cyclosporine since Tuesday. I am going to get him an appointment to see if they can diagnose him and get his meds all straightened out. I am curious to see what they are going to do to diagnose him since my vets haven't done that for 3 years! I know Cooper isn't out of the woods or anything but he is much more stable and feeling better. He's barking and howling outside and when I come home. He's been eating like crazy. I'm still hoping for his numbers to go up.

I'll keep everyone posted. Thanks again for praying for Cooper. He appreciates it too. :)

I feel like I would be wrong if I didn't publicly state my opposition to going to this clinic in Chicago.  I think that Cooper's mom should hear all opinions. 

The University at Madison has gotten grants from the Morris Foundation.  Probably one of the first sites on the net that people get info from when their dog is diagnosed.   The University is also involved in vaccination studies and they know the dangers of over vaccinations.  Universites are places where ground breaking treatments are discovered.  If the clininc in Chicago had a drug no one else did or a treatment no one else did I would say fine.. but why pay 2500 for a bone marrow test that cost under 200 at the University?  All the basic tests need to be done and the University is completely capable of doing these proceedures and they also are capable of getting Cooper's meds on the right track. 

You can take a trip in a Chevy or a Cadillac and arrive at your destination alive and healthy.  Sure the Cadillac has heated seats and premium stereo system but did you need that to get where you are going?  Oprah is rich and she can do what she wants.. Val has a husband who is going to freak out on her if she comes home with a 2500 bill.  Thats for one test.  The final bill could be 8000.

Why not get everything done that would have to be done at either place at the cheapest place?  Then if they can't seem to diagnose what is going on then you go to the more expensive place?  You can always take records from Madison to the Oprah place and then they can go from there.  

There is nothing negative or wrong with the clinic in Chicago but there is also nothing wrong with a teaching hospital.  I could have listened to Dr. Dodds and taken my dog to Los Angeles but my dog turned out just fine at the Oklahoma State.  Even if Cyclops dropped dead tomorrow I'd have no regrets about what I did.  I've spent 5000.00 since December 12 on this disease.  You can't tell me that my bill wouldn't have been double or triple that at this clinic in Chicago.  

I've said my peace and thats all I can do. 

Cooper is a strong dog to have survived years worth of this problem.. I think any competent doctor could make sure Cooper would pull through.

I am so sorry to hear of another dog with this horrible disease.  When my 4 year old golden retriever was diagnosed with it Oct. 9, 2003, I had never heard of it.  At that time I had also never used a computer, did not know such things as dog forums existed.  I had to go it alone til he died 8 days later. BUT, AND THIS IS IMPORTANT, HE ALSO HAD LIVER DAMAGE.  Both the liver damage and the AIHA were brought on by that 6 month injectable heartworm preventative, ProHeart6.  His histopath report came back "drug induced necrosis of the liver".  and  as I learned to use the computer and found dog forums (this was the first) I found story after story of dogs having severe reactions, many dying following PH6.  And I also leanred that AIHA and liver damage were 2 of the leading death causing reactions.

The FDA had them pull it 10 months after Hunter's death and it was only returned (reformulated) last summer after a 4 year absence and with a TON of warnings on the lable.    I wish I had had something like this thread for those 8 days Hunter was in ICU with all thoswe dsrugs, 2 transfusions, etc.     We totally understand just what you are going thru.  Prayers for your beautiful beagle boy.

 Hunter would be so proud that his mom Sandra continues to sound the alarm about PH6.  You have no idea how close I came about 6 years ago to switching to that.. but then my vet said "ya its only 6 months but it doesn't have all the other benefits of Interceptor".   I'm so glad that Interceptor and PH6 were not the same thing or I may have switched.. well that and I didn't want to have to come visit the vet every 6 months.. it was bad enough to go once a year.  I sure have made up for it now though.

Hope all the dogs and their parents dealing with this illness got to enjoy the Easter/Passover holiday.  

Yesterday I took Cooper to meet with an internal medicine vet. He wants to do an ultrasound of his abdomen, chest xrays, and a tick panel. I think there is some confusion with his meds so I am waiting for a call back to clarify and to find out how his blood test went.

The new vet called me back. I think we have the meds straightened out.
Doxcycline- 100mg a day
Pred- 20mg twice a day (up from 25mg once a day)
Azathinaprine- 25mg every other day (down from 50mg once a day)
Cyclosporne- 100mg a day (either Atopica or Nyoral)
 
He wasn't comfortable having Cooper on the Az. because its been 2 weeks on the higher dose. He called in a prescription for the right Cyclosporine since he's been on the wrong one for a week now.  
He said he also wants Cooper to start taking a 5mg a day of compunded asprin. He said that with the Az and Pred combination he has read that because both those drugs can cause high incidents in blood clots, a low dose of asprin is beneficial. He said to keep a close eye on his stool because of ulcers that could develop. 

Cooper's PCV went down to 16. :(  I was really sad and started to cry when he told me. I guess I was hoping they had either stayed the same or went up since he has been acting so great.
 
As for other info from the blood test...
White Blood Cell count- 8,300 (normal range)
His liver values are fine. One is a little higher but the vet said it is because of the steroids.
 
Not sure exactly what these mean... MCV 80 (high)  and MCHC 31 (low)
He said both of these are good. He was looking at these levels yesterday from his CVC a week ago. 
I think the MCV showed big immature cells and the MCHC showed the hymogloban content of the red blood cells
 
He said the Riticular cells were elevated moderately- 150,000. So he is regenerative and has regenerative anemia.

Cooper is still active and not acting like he's at 16. I'm keeping a close watch on him and praying still. Continue to keep Cooper in your thoughts and prayers. :)

Hey are you doing milk thistle? You NEED to be for the liver, that or the prescribed pharmaceutical (more expensive) brand Denosyl ... it will help save the liver from all of these drugs.

 Karen

 Cooper's Mom.. outdoorschik (Karen) has been through it all and she knows a lot.  The Milk Thistle is very important, just as important as the Pepcid AC.  Hopefully you can get some in bulk powder form, as that is more economical.  I give 1 packed teaspoon in the morning and 1 in the evening which is something like 20 capsules a day (or more who knows?). 

Hey everyone.. Cyclops is going in today for CBC and Serum Iron check.  If everything works out we will reduce her Cyclosporine from 150mg 2x/day to 125mg 2x/day.  If the iron is high enough we'll also discontinue the iron pills.  So wish us luck!

I will be crossing my fingers for Cyclops! Hopefully, you will get great news. :)  Cooper has been taking Milk Thistle. Callie sent us some of the good stuff in bulk. We are keeping up with the powder form each day! Thanks for looking out for us!

Go Cyclops-Sweetie -- you rock Girl!!  Aunt Callie is SOOOOO PROUD OF YOU!!! You've done so good!!!  I'm sure the iron is probably high enough.  Billy's was bottomed out and he only had to take it a couple of weeks.

Coopbay

5mg a day of compunded asprin

FOLKS LURKING DON'T MIS-READ THAT~~

This vet is not telling her to give him just any low-dose aspirin NOOOOOOOOO.  this is a specially compounded dose (5 mg is TINY compared to anything else) specifically to help keep blood clots from forming. 

When a dog or human is on major steroids you can't give NSAIDS like aspirin, Rimadyl, or anything else.  I just wanted to make sure that point was crystal clear.  I don't want anyone mis-reading that.  5 mg is like 1/40th (that's a ONE over a FORTY) of a regular aspirin ... and this is specially compounded probably with other materials. 

If you look back to the early pages of this gigundo thread, you'll read where gratefuldawg and others discussed the huge risk cyclosporine and other other "super-steroids" are in causing stroke and embolism.  This is pretty cool that they've found something like this that can help -- pricey tho, I'm sure.

Cyclops, you just keep it up, girl!!

As always prayers and healing vibes to all the dogs and the people who love them.

 I'm so glad I found this forum!  I was researching demodex and came across Callie's info and one thing led to another and now I'm so excited to see some non-veterinarians who are taking matters into their own hands and researching treatments and options for IMHA.  Hopefully someone can help us out now.
My labradoodle, Bucky, was diagnosed with IMHA about nine months ago.  He was 18 months old (just turned into the perfect dog, too) and one day we found him lethargic and rushed him to the pet ER.  After two days and thousands of dollars, we brought him home against their orders with a diagnosis of IMHA.  I didn't elect to have additional tests (x-rays, ultrasounds) to determine if it was secondary to cancer or some other problem since his prognosis was so poor.  He had also tested positive for erlychiosis (sp?), a tick-born infection, but many dogs test positive for that with no symptoms.  They put him  on Pred and Doxycycline.  I brought him home with PCVs of 17 (I didn't do a transfusion due to pragmatism and costs).  I nursed him round the clock and brought him back to life.  Along the way I discovered a raw food diet, plus started adding kelp and fish oil to his diet.
He miraculously recovered and I tapered him off Pred (too quickly, in hindsight).  He started digging in the trash and eating stuff (from pica, a symptom of anemia) but I thought he was just regressing to puppy behavior.  Fortunately, while at the vet for his rabies booster, they caught a spot on him gums (petechiae) and we ran a blood test to find that he had relapsed, even though he didn't yet show it outwardly.  We amped up the Pred again and after a few weeks I congratulated myself for catching it in time.
Then in November he developed a swollen elbow that the vet diagnosed as a bursa, but the next day his whole arm swelled up into his chest.  It was the weekend and I got the vet to give me antibiotics.   A few days later the abscess drained (icky) and he was left with torn skin from his elbow to armpit, plus nasty holes where the infection drained out.  I managed to nurse him back to life as we tried to heal the wound from the inside out.  After six weeks, he had surgery to repair the arm but since his skin is so fragile from all the pred, healing has been torture.  Now, four months later, I'm still trying to close up one last hole, now the size of a pencil eraser.  However, the wound keeps getting resistant to antibiotics.  The last time we cultured it and it was resistant to everything in round one, so they tested 12 more and he was resistant to all but one.  So now he's on a sulfa-based antibiotic (I read from Callie that it's not good for an IMHA dog, but that's all we're left with after Doxy, Cipro, and Amoxicillin use). 
 Fortunately his IMHA is under control (last PCV was in the 40s, a few weeks ago, and he's even more frisky now) and he's on a minimal dose of pred (10 mg every other day).  Nevertheless, he shows signs of Cushing's Syndrome that I hope will abate soon (pot belly, thin skin, hair loss).  Plus I think he has demodex -- which is how I found this forum in the first place.  Fortunately, I don't think the skin issues are bothering him; no itching, just some patches of hair loss and some dark spots above one eye, and some more spots at various patches of hair loss.
Also, he has a fungus infection on his tongue.  We tried to put him on Ketaconazole but he couldn't take it -- explosive diarrhea, eeew.  But it seems to be getting better on its own as his immunity builds back up.  Poor thing's had every beneficial bug killed out of his body from all the antibiotics so I give him probiotics, too, and I hope they are helping with the fungus.
So, any suggestions on what to do with his arm, the demodex, and the fungus?  He's immuno-surpressed for the IMHA (but coming off the meds). I currently have him on raw food, fish oil, kelp, priobiotics, DMG, pred, famatodine, grapefruit seed extract, and the antibiotic.  After reading this forum, I'm going to add milk thistle, too.

Wow -- I'm at work, and this is going to take a while, so I'll give you just a couple of thots now, but we probably should talk. 

labrickner

Nevertheless, he shows signs of Cushing's Syndrome that I hope will abate soon (pot belly, thin skin, hair loss).  Plus I think he has demodex -- which is how I found this forum in the first place.  Fortunately, I don't think the skin issues are bothering him; no itching, just some patches of hair loss and some dark spots above one eye, and some more spots at various patches of hair loss.

He's been on pred now HOW long??  Cushing's would certainly be possible.

I'll be honest -- as immune-suppressed as this dog is because of all of the steroids, I wouldn't dare do a raw diet.  I'm not anti-raw, not at all, but not with an immune-compromised dog.  You may be lucky that your meat source is a good one, but it's a bit like Russian roulette simply because this isn't like allergies or something where you are trying to get the immune system TO respond and 'be all it can be' with the raw diet.  In this case, quite honestly, you want the immune system to just chill out and relax right now.  You truly don't WANT to boost it, nor do you want it responding to various things willy nilly (which is what a raw diet is supposed to do -- it's supposed to MAKE the immune system work, and in this case you want it *not* to work.)

If you'll email me I'll send you my demodex article - you can do a whole lot topically with bathing, etc. to help keep the mites under control. 

Milk thistle at the very least -- and honestly I would be telling you to do a blood panel every couple of months just to check the liver/kidneys (because all of this can SO easily morph into diabetes, etc -- particularly where there has been such huge steroid use for a long time).

Honestly, the skin thing sounds chonically auto-immune to me as well

"(pot belly, thin skin, hair loss).  " -- yes, those can be signs of Cushings.  They can ALSO just plain be side effects of prednisone.  They will get a pot belly from the months of pred use, and steroids generally CAUSE thin skin (even topicals do that).  Hair loss -- generally all these drugs are heck on the skin (the body actually tries to expell some of it) but they are ALSO extremely hard on the thyroid. 

Here's where I'm going to tell you something different.  The only reason Billy is in "one piece" literally and figuratively is because I used alternative medicine on him -- he was treated with TCVM (traditional Chinese veterinary medicine) with acupuncture and Chinese herbals all the while he was in IMHA treatment and still is.  Once I got him off all the steroids he was, flatly, STILL a mess -- his skin was a mess, he went from one chronic inflammation to another boom booom boooooooooooom!!  At one time he had both pancreatitis and hepatitis at the *same* time.

So from there I *also* have used homopathy extensively on him.  We go to Dr. Joe Demers who does the "autosanguis" treatments on him (it's sort of a cutting-edge homeopathic treatment where they make a serum from his blood added to homeopathic remedies so that the genetic mapping in the blood literally becomes a 'remedy' to tell his body exactly what needs to be done.

The results have been unbelievably good.  He is HEALTHY.  Frankly, healthier than he ever was **before** IMHA.  Homeopathy can really work incredibly well with auto-immune stuff because it is, at it's roots, a body balance problem.

The other reason for a broad spectrum blood panel is to see what the liver is doing -- if the liver is "not happy" then frankly the skin isn't going to be good.  You can do all the "right" things and fail because the liver is so completely intertwined iwth the skin

Also some good thyroid testing -- and for that I'd go to Dr. Jean Dodds (http://www.hemopet.com) -- not just the traditional veterinary approach -- her approach screens not only in a breed-specific manner, but she's also developed new auto-immune checks (there's a lot about auto-immune stuff and hemolytic anemia generally on her website). 

Sorry, that's all I can do for now.  I'm available by email to help you more.