AIHA or IMHA

Johnny -- my Billy had IMHA (auto-immune or immune-mediated -- depends on what your vet calls it).  He's a buffy cocker.  Coat color actually plays a big part in this -- let us know more about Tessy -- what meds she's on, how long she's had it, known trigger?, and anything else.  We all kinda try to watch each other's backs on here. 

and yep -- pictures are good!!! *smile*

Welcome to Johnny and Tessy from Lori and Willow

Tessy was diagnosed on February 14/09 with a PCV of 18.  After her PCV dropped to 10 (Feb 21) she was taken to a nearby animal hospital to have a transfusion.  She was started on Prednisone (50mg) at first and then 3 days later Azathioprine (25mg).  After approx. a month of good climbing her HCT leveled out in the high 20's.  It stayed this way till her relapse on April 1.  A week before this relapse she was started on 8mg of aspirin and 1g of sucralfate per day.  When she showed signs of a relapse I took her to a teaching veterinary hospital in case she needed a transfusion.  Her PCV dropped to 18+ -.  They changed her meds around a bit and added cyclosporine to her regiment.  After 4 days her PCV climbed to 25.  She takes 200mg of cyclosporine a day (100 in the morn and another 100 in the evening), 37mg of Azathioprine (up from 25), and 50mg of Prednisone.  They kept the 8mg of aspirin but dropped the sucralfate and switched to Omeprazole (10mg/day).  She also had her thyroid levels tested by hemopet and the results showed lower than normal numbers.  She was then started on thyroid meds.

Anyhow, they got her taking ...

8:00am - 100mg cyclosprorine & 200mcg eltroxin

5:00pm - 50mg pred, 37mg azath, 8mg aspirin, 10mg omeprazole

8:00pm - 100mg cyclosprorine & 200mcg eltroxin

I found it kinda odd they put all the meds together like this but all her doctors said this was OK.

Today she seems to be doing good.  Her numbers are leveling out again in the high 20's again (hct 27.7 on Thursday).  I'm afraid now that she will remain at hese numbers for some time.  We are going to reduce her azathioprine at the next visit if her numbers remain close to the same.

I'll keep you all posted on any results.

Thanks,

Johnny & Tessy

Johnny,

You really kept on top of things.  Your story reminds me of mine.. I found a teaching hospital because I was afraid I'd have to do a 3rd transfusion, it turned out I never had to, but so glad I found the teaching hospital.  Glad you found a teaching hospital. Keeping track of all those meds and keeping on schedule takes a little getting used to. You sound very organized and Tessy is very lucky to have such a good human in her life.

Now that I see you're in Canada I have doubts that we can get any cheaper Cyclo around here.  I am paying 275 for a total of 300mg per day. That should give you an idea of what it would be for 200mg per day.  I am guessing between 170-200 per month.   Of course if you're using Atopica then you're probably paying more.. but still am betting your generic drug prices would beat ours since I think my pharmacy gets their drugs from Canada!

I laughed when I saw the list of meds with what's given at what times.  I guess we all do that!

I am sorry another dog has to enter the group here.  But am happy she is doing well.

 You meds sound like mine--diabetes and thyroid half hour before breakfast, diabete with breakfast, diabetes 1/2 hour before supper, diabetes with supper, cholesterol and a rd type of diabetes before bed.  And then there is the vitamins I have to take and baby apsrin,  and Aleve for my arthritis  I have reached the point I can almost do it in my sleep.

Welcome Johnny! I'm sorry your dog has to deal with this too. :(

 Well, it's Thursday again which means Cooper goes in for his blood test today. I am REALLY hoping for a good number. This week has been awful with him peeing in the house. At first it wasn't so bad. He was just going in the house while everyone was at work. Now, he is going in the house in the morning, while we are at work, and even sometimes when everyone is home at night. It's hard to get angry because I know his meds are making him so hungry and thirsty but everyday cleaning it up is getting old fast!

Here's something crazy. So, two nights ago I was checking him out (as always) and I noticed a little bump on his ear. Cooper has the longest ears and it was near the bottom of her long ear. Of course I had to investigate. I saw that it was kind of black. I immediately thought it was a tick or something. Anyway, this is gross. I squeezed it and this yellow stuff came out. It was like a zit or something. I'm going to have the vet look at it. What do you guys think?

You're venturing into the "pred & steroids make the skin UCKY long term" territory.  for something so often prescribed FOR skin problems (as pred and cyclosporine/aka Atopica both are) after they've been on them a month or two they start making the skin really yuck.

It's literally toxins in the body looking for a way 'out' -- it likely will get worse and you'll see more of them.  Check back to just before you jumped in here to what gratefuldawg went thru -- Cloppy's back all broke out badly, he went to the vet and one vet exclaimed "THAT could be cancer" -- everyone got all wigged out, the did a punch biopsy and sent it off but he called the Oklahoma Vet school vet and she confirmed it just plain happens~~  Billy's skin was HORRIBLE the whole time he was on the steroids.

When Pirate was sick I put a rubber-backed shower mat on the place that he would use - I bought 2 at Ross or Wally-world or something so I could bleach one and have one out. You could try puppy pads, but they just freaked Pirate out.

YOU probably know but others who are lurking don't - make sure he has all to drink that he wants, even though it makes him have to go potty. It helps keep the kidneys flushed out, or something...

Tessy had what sounds like the same thing 2-3 weeks ago.  I cleaned it with mild anti-bacterial soap & water and then put a topical antibiotic cream (one without zink) over it.  Within a week or so it cleared up.  She has yet to get any more.  Her belly seems to be getting a little larger than normal so I guess that'll be my new worry.

Hope all of the furkids are doing good today.

Johnny & Tessy

We just got back from the vet. Cooper's PCV is at 26!!! Last Thursday it was at 21! We are so happy. I talked to the vet about the spot and we looked for it. We couldn't find it anymore. She isn't worried and said it can be common to have skin cysts or something. Anyway, my vet is calling the Arboretum vet and asking about possibly lowering his does of Pred. I called and left a message for him too just in case. My regular vet also wanted to ask him if we need to keep going everyweek for a PCV or everyother week.

So, another good day at the vet. Now hopefully I can relax on the couch with the beagles and veg out with some good tv. :) 

Right after I sent the post, my regular vet called. She just talked to the Arboretum Vet and he told her that he doesn't want to lower the dosage of the Pred until Cooper is in the normal range and then he wants to slowly go down by 5 mg each time. Cooper takes 20mg in the morning and 20mg at night so he would have me go to 20 in the morning and 15 at night. He would decrease the Pred over 8-10 months. He also said that Cooper doesn't need to go get his PCV checked every week and instead to go in 3 weeks and have a liver screen and a full CBC.

 Glad to hear Cooper's PCV is up; great news!!! Pred is tough on the liver, especially at the dose Coop's taking, so regular liver screenings are important. You're giving milk thistle, right?  I would give SamE too, if the vet said it is okay.

That's great news!!  I'm so happy for you and Coop.