AIHA or IMHA

 Thanks for posting the picture of Hunter.  We know now the PH6 is a killer.  I am now questioning everything.  Including Interceptor and Front Line Plus.  and of course the yearly vaccinations. 

I think we need to create an IMHA/AIHA database.  

I'd have in it -

Dog's breed (if any), Dog's Gender, Dog's Age at diagnosis. 
What brand of Dog Food
What vitamins/suppliments
What dog treats
What flea/tick preventative
What heartworm preventative
What brand of Shampoo
Tick Collar
What vaccination schedule.

Maybe we could find some comminality.  We need some sort of database entry fields where this could be entered quickly.  

GratefulDawg

The doctor on the phone said it may be IMHA/AIHA or (as she worded it) "this may not be a true IMHA".  I asked her what that meant and she said that the anemia might be caused by something like a  cancer or something else in the bone marrow that stopping it from creating baby red cells.  What I didn't think to ask at the time was if not auto immune then what is destroing all the red cells? Unless  its a combo of cancer and auto immune.  

Mike, my understanding was that they rule out other things that could be causing the red blood cell destruction first.  If everything else is negative then they consider it an auto immune disease.  Willow had all the tests with the exception of the bone marrow because I declined it because everything else was negative and she was responding well to the Prednisone. 

There was a drug called Vincristine that they had in mind to try if the Prednisone didn't work.  It's a chemo type drug. 

I also sent you a PM.

Lori

i just read this. i'm sorry, i have no info! just wanted to say, i cannot imagine what you are going through! i cried several times reading through this whole thread. i really hope your baby makes it! i will keep her in my thoughts!!

Mike, Thanks for the update on Cyclops. It's amazing how quickly you have to educate yourself when something like this strikes.  No matter what happens you have helped others be aware of the symptoms.  There are always lurkers who may never post but may see something that could mean the difference for their dog.  Database idea is great.  I had a Lab who had Chagas disease which caused the cardiomyopathy that killed her.  Never heard of it till we were searching for why a young, healthy dog would collapse for no reason.  Hang in there.

GratefulDawg

they are going to put Cyclops under anethisia and take a sample of bone marrow.

GratefulDawg

if you have any info about the bone marrow draw

Pirate had a bone marrow aspirate when they were trying to diagnose him. What he had (Immune-Mediated Pancytopenia) basically MEANS he wasn't producing RBC/WBC/platelets, and the ones he had left were being attacked. He was a little sore (OK, I lied - a LOT sore!) for a few days afterwards but he recovered just fine. Just wait until you see the cool hair-do Cyclops will have when you get her back. Between the spots on both front legs for IV cathaders, his belly (from the ultrasound) and the spot on his shoulder where they did the draw poor Pirate looked like someone was chasing him with clippers and just took off whatever fur they could. But (and he will tell you this!) baldy spots are the best places for kisses.

It sounds like Cyclops enjoyed her road trip and some fast food...and 22!! What a PVC! :) I will keep Cyclops in my thoughts today and I hope they can get a clear diagnosis soon.

Hi -- I'm SO glad you got to the vet school and they treated you well.  And boy -- what you said about the difference in vets, vet schools, e-vets -- none of them are always good or bad, but it makes SO much difference when they are  **GOOD**.

If the reticulocytes (baby red blood cells) are being killed IN THE BONE MARROW by the IMHA, then it will look like she's not regenerating.  She likely IS, but it's just that the body is killing them before they appear IN the blood.

That's what was going on with Billy and why it was so hard to get it under control. 

 Here's where my next suggestion comes in -- the thing that was done for Billy that was DIFFERENT was his treatment.  Now my vet school didn't follow Dr. Dodd's protocols - they didn't exist then.  BUT my vet school (University of Florida at Gainesville) -- they do some pretty cutting edge stuff there and they actually teach Acupuncture and Chinese herbals.

They have Dr. Xie on staff there and he's the founder of the Chi Institute (http://www.tcvm.com ) -- if you go there and use the locator on the left, I bet you find someone either near the University or near your home. 

THIS likely was what saved Billy's life -- and I'm not downplaying the incredibly excellent care he got at UF.  But he **also** got acupuncture and Chinese herbs to tonify his blood and help make his body "make blood" faster.  Make it faster, and help support the blood and the heart.

Any time the 'crit goes way low you're gonna hear a murmur -- and it can *stay* or it can appear ex nihilo (out of nothing/nowhere) any time after.  Billy developed a freaking grade FOUR murmur last year out of the blue.  With acupuncture we've gotten it down to a grade 2 (scarey enough but he IS nine and his body has been thru a war and a half in the past 2 1/2 years)

I did this before -- but I'm gonna do it again so you have it.  A little vocabulary lesson for you and anyone who wants to read it.  Words you hear ALL the time in dealing with IMHA (I'm not treating Mike stupid folks -- he's a smart guy but he, like me, seems to be REAL interested in preserving this information for others)

1.  IMHA is "Immune-mediated hemolytic anemia" -- where the immune system causes, i.e., kills, the red blood cells because the immune system perceives them as "invaders" or bad guys.

2.  AIHA = IMHA -- different name "auto-immune hemolytic anemia" -- generally not used much in the US ... somehow it's considered more 'correct'.

3.  hematacrit -- it's the amount of red blood cells in a blood sample - a 'normal' hematacrit or "crit" for a dog is between 35 - 48 depending on breed & individual - Billy's normal seems about 42-43

4.  pack cell volume -a/k/a PCV or pack cell -- frankly it's the SAME THING as a 'crit -- it's just that a pack cell is a human-measured value (they spin the blood and lay the vial next to a chart to 'read' it) -- the crit and pcv will vary just a bit so DO NOT be scared (and ohhhhh it's SO hard not to be) if you had a crit pulled 3 days ago and todays pcv says 1 point below or above (and you were hoping for higher).

**I'll say here** machinery DOES vary from place to place so plan on results being a bit more of a general idea than you really *want* to  -0-- Folks, it's tough to make the un-initated understand how incredibly IMPORTANT these numbers become to you and how you literally HANG on something being a point higher or lower than it was previously -- it's scarey scarey stuff!!!

5.  Reticulocytes - baby red blood cells.  They are actually formed IN the bone marrow and then make their way from there to the blood vessels.  In IMHA *very often* the immune-system will go deep and literally wage war on the reticulocytes in the bone marrow before they even get TO the blood.  This is why Cyclops has to have a bone marrow draw.

6.  Bone marrow draw -- they literally drill a tiny hole in a bone near the hip -- then they withdraw a bit of bone marrow. 

• It's a difficult test -- they have to sedate the dog - because they actually have to drill into the bone.  It's not horrible after -- it leaves a very tiny tiny wound and it seemed not to bother Billy at all. 
• It's a bit expensive so it's not a test done casually but only after they determine after a couple of regular blood draws that there is no evidence of reticulocyte destruction.
• If they don't see 'waste' from reticulocytes in the bloodstream, it looks like the body isn't making ANY blood.
• If they go deeper into the bone marrow for a sample
• They look at that sample for several things -- to see if they see ANY reticulocytes of any 'age' *and* to see if they see the waste that results when the immune system kills them.  If they see those then they know baby red blood cells ARE being produced but that the immune system has simply gone VERY deep to "get to the source" of what it considers 'invaders'.

7.  Heart Murmur -- it's sort of a flutter in the valves of the heart as the blood whooshes thru from one chamber to another -- in the case of IMHA it's often caused by the fact that the blood is so THIN that it moves too fast

There are a lot of heart problems that can happen from IMHA because of the thin-ness of the blood, or any abnormality in how the blood pumps

8.  Acites -- the blood can get SO thin in the very low registers (particularly below a pcv of like 10 or so) that the blood vessels can't "contain" the blood and the plasma leaks out into the body cavity -- that can cause systemic infection and kill. 

9.  Milk thistle or silymarin -- an herb.  It "protects" the liver and helps detox it a bit.  ALL these steroids and steroid-like drugs -- are incredibly hard on the liver.  This can also be one of the reasons dogs don't survive.  By the time you get the meds high enough to make the immune-system lay off and cry 'uncle' the body can't tolerate the meds.

"marin" is a pharmaceutical produced milk thistle.  It's made by the same company who makes Adequan.  Good product - very pricey.  But Mike -- PLEASE get milk thistle while you are home -- call me or email me and I can tell you where to get it cheap and how much I used.  This COULD likely be the thing to long term save Cyclops life -- because you have GOT to protect the liver.  If the liver values are already elevated you have to help her body.  marin is good but it's very expensive, but you also may not be able to give the high quantities needed to adquately protect the liver and kidneys.  I gave milk thistle with the blessing of ALL the vets -- holistic, regular and vet school. 

Right now the AKC is conducting tests ON milk thistle/silymarin (silymarin is just the latin name for it.

10.  Idiopathic -- "no known cause" -- meaning they don't know what caused the IMHA (or any disease - that's a generic medical term).  VERY frustrating for the owner because you can't figure out where this came from.

=====ALSO==== you figure out quickly that if there is a *cause* then the chances are that once the body gets back on track that the IMHA may not recur as easily. 

Back to theory:

This is why they always interview you to find out if the dog has received antibiotics, vaccines, or any sort of chemical recently.  In Billy's case, his was *likely* (we'll never know) triggered by a bite from a sick tick.  HIs body DID form antibodies (we got a very very faint tick positive test) but his body also then likely just generalized and said "hmmmm, THESE were invaders but these things (antibodies) look a lot like them so we don't like those either" ... and then from there the body generalized to ALL red blood cells and then all BABY red blood cells.

The other thing we did wrong with Billy was once we got that faint tick test we were SO thrilled to think it was Erlichea instead of IMHA that the vet started doxycycline.  The antibiotic threw the immune system into panic-overdrive and his pcv zoomed from 29 (on its way back up from 20) to under 10 almost overnight.

It's one of the reasons I encouraged Mike to zoom to OK State -- simply so they could track it and BE there if the immune system went deep and started killing reticulocytes in the marrow.  Right now Cyclops is holding on transfused blood -- but those WILL die eventually and her body has to leave the baby red blood cells alone in order to recover.

Hope this helps -- Mike I'm so thrilled she's got a good shot now. 

(and p.s. -- apparently Dr. Dodds is Jewish -- she was celebrating Chanukkah whilst emailing *smile*)

Here's mine but likely won't help -

Dog's breed (if any), Dog's Gender, Dog's Age at diagnosis. 

English cocker spaniel - male -- 6 1/2 (close guess)

What brand of Dog Food

I home cook & did all the while he's been with us (4 yr)

What vitamins/suppliments - Vit A & D & E (not dog - human grade).  Various Chinese herbals (his skin was horrible when we got him -- MEGA allergies)

What dog treats

Home-made -- he's allergic to wheat

What flea/tick preventative

Frontline -- given once every 3 months and less in low flea season but I'm in Florida so they are around ALL the time -- ticks less seen

What heartworm preventative - Interceptor (milbemycin) - since he's been with us (again-- Florida -- MEGA heartworm state)

What brand of Shampoo - Dr. Bronners (mild human soap) or maybe Selsun Blue if he's really yeasty.

Tick Collar - never use

What vaccination schedule. - Billy was likely over vax'd before I got him but NOT since.  I've always pulled titers and his rabies shot was just prior to my adoption of him.  But no other shots b/c we titer.

***MY additions***

You'll need to add antibiotics, medicines, allergy shots - virtually anything like that.  Antiibotics are known IMHA triggers, and everything else that touches the immune system.

General health history is probably super germaine -- Billy IS/was a mega allergy dog.  I never in all my years (even years of *dealing* with allergy dogs) had a dog with SUCH severe allergies -- which essentially means his immune-system was crap anyway.

You gotta consider tick stuff here -- and it's one of those "you can't win" things.  I'm in one of those states where you just can NOT avoid all flea/tick/heartworm stuff.

HOWEVER -- there's a huge huge difference between stuff that is systemic like Revolution, Promeris, BioSpot (stays in the dog's body for months and months) and the stuff like Advantage and Frontline that virtually don't go into the system at all. 

ANY chemical can be a trigger -- but then so can the ticks be a trigger for IMHA.

I know Billy had ONE tick that attached about 6 weeks prior to the onset of the anemia.  I found it (it had attached but not long and wasn't enlarged -- but when the tick 'attaches' is when it feeds and *that* is when tick disease is spread -- during feeding.)  So I was watching FOR tick disease. 

GratefulDawg

I am wondering what they quoted you to give her 1 transfusion and start her on meds?  It would be helpful to know because I have just been learning about the huge differences in costs between one vet and another.

 I really hope Cyclops gets through this; many prayers and hugs.

 Holly; I'm so glad that Lily's doing better. Please keep us updated.

There are quite a few people on other boards and even at the vets that I've talked to that prefer to give Interceptor every 45 days instead of monthly for dogs with these problems.  I've been giving it to Willow monthly still.  But, this month I'm waiting, I'm afraid of causing a drop in her platelets.

Mike, how is the baby doing??

Nikko Bo

For those of you with dogs that have been treated for IMHA and made it I am curious to know how long has it been since diagnosis, what was the red blood cell count at the time of diagnosis and how much has the treatment cost totaled so far? How many have dogs that have relapsed?

Billy was first diagnosed in June, 2006.  At first they did prednisone.  His timetable was a bit unusual:

1.  mid-June -- he seemed "just didn't feel well" and I took him to the vet for bloodwork (had been a while and needed to do senior bloodwork ANYWAY).  Saw just a tiny evidence of nausea (didn't want to jump on the waterbed, etc ... nothing major but not "typical";). 

Bloodwork came back with a hematacrit of 20.  WHOA!!  The vet immediately put him on a big dose of pred JUST IN CASE. 

We did a tick test immediately BECAUSE I knew he'd been bitten about 6 weeks prior.  Got a very FAINT positive.

While waiting for the tick test to come back, I had his blood checked (just a 'pack cell' not a whole blood panel) and it had climbed to 29 !!! RAH!!!

That was about two weeks after that first 'crit of 20 by the time all these tests were done and came back.  Vet called me with the "faint positive" results on the test, so he recommended adding doxycycline.  So his pcv was 29 and it was Wednesday and we added the doxycycline in the evening of that day.

By Friday (not quite 48 hours later) when my husband walked in that evening, Billy got up to go 'greet' him and STAGGERED.  We literally grabbed keys and my purse and his leash and walked out the door to the e-vet.  In just that 48 hours since the pcv was seen at 29, it had plummeted to TEN !!!!!!  A drop of 19 points in less than 48 hours.

Because my vet had already diagnosed IMHA potentially triggered or exacerbated by tick disease AND Billy was already on prednisone (big dose), the emergency vet simply transfused him because it was so low.  That was like 11:00 p.m. (the night he staggered when David came home) and we picked him up about 5:30 a.m.and went sailing up to the vet at 7:30 a.m.

After he got the blood his PCV was back up to about 24.  That was Saturday morning.

By Monday it was back down to 12 by 8:00 a.m. and my vet sent me straight to Gainesville (University of Florida).

 That was the "beginning" of Billy's onset and treatment.  Billy had a total of SIX transfusions over the next month. 

Like Cyclops they did a bone marrow draw and in Billy's case his body was killing the baby red blood cells in the bone marrow.  That's why it took so long to respond.

NOTE:

1.  The faint positive tick test was sort of a red herring.  It was NOT accurate.  It wasn't a positive at all but rather the test read **antibodies** that had been formed as that mild positive. 

2.  That means that the doxycycline that we gave him HURT - it didn't help.  The antibiotic actually TRIGGERED the IMHA to go into overdrive.

 THIS IS ***NOT*** typical.  this IS what happened to my dog tho -- and honestly it wasn't until a month later when we got the findings back on a huge tick PANEL that they did (that darned thing was over $1000 itself) that we were able to completely rule OUT tick disease and take him off the doxycycline. 

In short, Billy began to respond AFTER we took him off the doxycycline.  Now -- we'll never know.  Did his body finally just get saturated *enough* with cyclosporine (Atopica is the dog brand) to finally completely suppress the immune system, OR was the doxycycline just exacerbating the whole thing and triggering the immune system to just keep on beating up the blood???

All I know is once we took him OFF the doxycycline he began to turn around. 

COST???

Frankly, it's almost impossible to calculate.  For several reasons:

1.  His wasn't typical because of the whole tick disease/doxycycline thing -- that may have actually exacerbated this enormously -- we'll never know.

2.  While he was up at UF Gainesville -- he was In/Out of ICU for the better part of 3 weeks out of 4.  (up for 5 days home for 2, up for 4 days home for 2, etc.)  THAT was pricey -- ICU is pricey period. 

3.  Gainesville is 3-4 hours away from where we live so do I factor in how much it cost me in gas and motels?  and being gone from work??

4.  We also opted to have him treated with acupuncture and Chinese herbals (right AT the University of Florida -- they teach acupuncture and Chinese herbals *there*).  So that was extra expense but it also likely helped his body respond and regenerate blood *enough* to keep him alive.

5.  Billy is a buffy coated English cocker.  English cockers are HARD-WIRED ***NOT*** to respond well to treatment for IMHA.  There are some breeds that are notorious for NOT responding and English cockers specifically are a breed with a huge mortality rate for IMHA. 

Further -- there is somethig genetically related about the buffy coat -- I was told again and again TO EXPECT fatality because buffy coats just did *not* respond well and usually died. 

to this day, in all the internet trolling I've done, I know of only one other buffy coat English cocker to have survived IMHA. 

6.  We opted to have them use Atopica (the dog formulated version of cyclosporine - you can NOT use human cyclosporine on a dog). 

 Atopica is fiercely expensive.  But it tends to have a higher response rate than azathiaprine or some of the other used.  For example -- a month's worth of azathiaprine for Billy would have been about $25.00.  A month's worth of Atopica?? Was about $800

Yeah --a house payment!  Then the dose was reduced eventually but he stayed on the high dose of cyclosporine for 7 months ($5,600 just for Atopica).  That would have compared to $150 for azathiaprine.

I didn't pay quite that because my vet ordered the Atopica for us at his cost. 

6.  Because Billy had some mega side effects (major huge urinary tract infections and stomach ulcers) I wound up having to use other meds and supplements that were incredibly pricey to deal with the side effects.

HOW did we afford it?

A.  Billy is a therapy dog -- I couldn't face telling the parent of a child helped by Billy that I didn't want to afford his treatment. SOOOOOOOOOOOOOOOO

B.  We had gotten a settlement that was significant AND I had not touched my Christmas bonus for the past several years.  We aren't independantly wealthy -- but for THIS illness we were willing to spend the money.  I still have the same ratty drapes up that were in this house when I moved in 23 years ago. 

SO my point is??  We were willing to cut corners in other areas in order to do this for Billy.  We have no children -- and we were both willing to drive older cars and "make do".

 BUT PLEASE REMEMBER:

It's not just A + B = C. 

Billy's case was complicated by other things.  I don't know of ANY case yet where anyone knew UP FRONT what the ultimate cost would be.  It's a matter of making the best guess you can, and then how willing you are to sacrifice or borrow or whatever to take the next step.

Some folks can NOT do that.  That doesn't mean they are bad -- it's just their situation. 

I wish I had kids.  I've never been ABLE to have them.  These dogs ARE my "kids". Each one of them give's back in huge measure because they are all therapy dogs (or in training to be). 

But what it cost for MY dog isn't at all what it might have cost for YOUR dog.  PLEASE understand that. Because of his breed, because of the distance, because of the false tick diagnosis -- those things made Billy different.

then in addition, we were also willing to spend the extra money to protect his body (with the tons of milk thistle) and the Chinese medicine to help minimize the damage. 

Because of his breed it took us EIGHTEEN MONTHS to wean him off all the drugs.  That's not typical.  Again.

so ... this is why I never break out the cost of what Billy's cost.  It's not fair -- it mis-represents to other people what their dog might incur.

Billy has never actually relapsed but he has had a few 'scares'.

YOu won't know how many relapsed -- because most of the time when a dog relapses it dies and frankly, people in that situation often just don't hang around here.

The charges for the 23rd were over $400.00. As far as I know that was for her blood work, catheter, IV, meds and ultimately euthinization. I called the hospital in Tacoma and spoke with the Doctor there. He said that I would be looking at $1500 if this were a best case scenario. Unfortunately, it wasn't. He said that with Nikko being in the condition she was in she would need more than 1 transfusion and the more realistic estimate would be around $3500 for her first week of car

-------------------

You live in an area of the country where the cost of everything is very expensive.  I used to live in California and Alaska for a couple years each so I understand.  I've been in NW Arkansas for the last 15 years and the cost of living here is cheap compared to the rest of the country.  For example my totall charges for Cyclops at my regular vet was 600.00 this covered 5 visits, blood work, x rays, cbcs and 1 transfusion.  I spent more than that for 6 hours at the e-vet.  

I came very close to euthanizing Cyclops at the e-vet because of the way they were so certain she was just going to die anyway.  I think if I were hit with a 3500.00 estimate right off the bat before doing anything and doing any research on IMHA I would have done what you did.  I just got very luck how things unfolded and that I happened to run across all the great people here and had TIME to study and make decisions and find the teaching hospital which has reasonable prices.  

------------------

Quick update for Sunday:

Cyclops had a count of 21 today.  Relieved that it is not falling right now.  Friday she was 22, Saturday 20 and today (Sunday) 21.  The doctor told me that she is so glad I brought Cyclops's toy giraffe.  She goes and puts it between her paws and lays her head on it everytime they take her back to the kennel from going for a walk.  They are walking her every 2 hours because of the huge amounts of water she is drinking.  Her appetite is still good.  So now there is nothing to do but wait until they take the bone marrow sample tomorrow.  

They have been great.  They are really teaching the future DVM's how to treat people and its so appreciated.  The phone call updates mean a lot and how they are feeding her Chicken and not neglecting her.  I'm really very happy she is there.  

 I'm getting some pics ready to post.  She won't really look much like a "Cyclops" to you.  When she was a puppy she had a perfectly round white spot on the top of her head and she was a little monster of a puppy.  It was one of those things where she was doing something or another and I said "You're a little monster" and then I looked at her and said "You're a Cyclops" and thats how she got her name.  By the time she was a year old her white spot was more like a white line and her personality is so mellow and sweet and loving that the name makes absolutely no sense.  All the doctors have really liked the name though.

This is awesome.  Now I can tell you a few more of the silly things I did for Billy that really helped. 

when you get a willing bunch of folks who are EXCITED about your dog getting better it makes SUCH an ***ENORMOUS*** difference, doesn't it??

While Billy was up at UF in the ICU like Cyclops, I cut and pasted ALL his posts into a fax every day.  I'll start it off for Cyclops if you care to do this -- people are VERY cooperative about that on here.

Then his student (who literally STILL keeps track of Billy 2 years later!) named Eric, would go get "Billy's fax" and he would sit down next to Billy's crate and READ IT to him every day. 

 See, I'm online all the time and I TELL the dogs about this stuff.  In fact, I just read BILLY about Cyclops "P C VEEEEE is 21!!!" and trust me -- Billy remembers "PCV" and he STILL goes all a wag when he hears it's a "good one" in my voice. 

But Eric would read Billy his "fax" every day and apparently it became quite the "honored" thing to do among students.  "Can *I* read Billy his fax today??" (it cracked me up -- kinda like Tom Sawyer whitewashing the fence??? once they saw Billy liked it and Eric DID it, it became the "thing" to do!!).

Because David and I talk about these names at home -- Billy KNEW the names.  He knew "Willow" and "Jessies_mom" and so many, many more.  He LOVED the attention.

Now some folks are shaking their heads saying "Why would you spoil a dog like that?"

BECAUSE HE IS SICK!!  Because we needed him to ****WANT**** to live.  Because we needed him to be excited about eating and drinking and pooping and yeah -- even getting his PCVEEEEEEEEEEEEEe taken!! (my dog got STUCK literally thousands of times in the period of a year and a half!!)

The other thing I did was take him "treats" -- silly stuff like a cereal he likes, and for a LONG while I took him yogurt because he was on the doxycycline antibiotic (and I figured all they really needed was diarreha??).  But once again, they discovered (*as I told them*) that he'd greedily take his meds via yogurt or baby food or liverwurst.  He would sit up and be excited about them (medicines are a fact of life in a home where we rescue "sick dogs";). 

Again -- this got to be one of those silly things that excited ALL the students.  toys?  YOU BET. 

True story -- I'm not a sports nut and neither is my husband. Our dogs are truly never exposed to "game day" or anything else sports oriented families DO. 

Well, remember please that the University of Florida is home to the "Gators" (someone out there is screaming "GO GATORS" as they read this??).  Well that means everyone at the Small Animal Hospital at UF ... well either they have Gator socks on or a Gator on their T-shirt or Gator this or that or other thing.  Everybuddy's gotta
"GATOR" on somehow. 

Believe this or not -- Billy began to RECOGNIZE that emblem.  It sure as heck wasn't from MY house!! 

At one point I kept my bosses dog for a weekend.  Now my boss is an attorney and a MAJOR Gator.  So .... it was no surprise when Laddie came that he had a big ole GATOR BED!!!  (Blue/orange with a Gator logo in the corner -- *rolling eyes* YEP!)

So, when I put the bed in his Crate, I looked at Laddie - with Billy standing there and I WONDERED why Billy was all excited over Laddie's bed -- he was jumping and hopping all around.  They *knew* each other but weren't mega buds -- and neither are puppies.

But when I put Laddie's bed in his crate, I pointed to the logo and said casually (cos I knew my boss would) "Go Gators!"

BILLY WENT NUTS!!!!!

Oh yes he did too recognize it -- and as far as HE was concerned "GO GATORS" was THE awesomest thing ever and it was a GREAT HUGE WONDERFUL TERRIFIC THING!!!

Then I remembered -- he'd spent countless hours up there where everyone would say to each other in the halls (particularly near a game) "GO GATORS" or point to a new shirt "GATOR". 

See silly stuff like this truly helped MY DOG get better.  It gave him a better attitude.  It helped him want to live.  It made him POPULAR and so he was exceptionally well treated by staff.

this DID, I feel soooo strongly -- this HELPED him get better.  And the staff were completely realistic about it -- they ADMITTED this -- that he was fun to care for and these silly little things like toys, faxes, etc -- it made them more excited about him and that excitement was contagious.

So often the dogs who don't make it are the ones who won't eat.  The ones who give up and don't have the will to GET better.  Anything you can do towards that end is a good thing for Cyclops..

Whatever U of OK has for it's mascot -- get Cyclops one -- or print something out for his crate up there.  Gimmick?  Sure -- but why not?

Now, one time when I went up there (after he'd been at this for a while and was ready to come home, hopefully for the last time) -- I stopped at Panera Bread (it's just a chain coffee shop).  I got a gift card and handed it to Billy's vet so they could bring in bagels or something just to thank everyone.  Cookies or fudge would have done the same thing. 

But as Gratefuldawg has mentioned -- these folks are training FUTURE vets.  And showing a future vet how beneficial the EMOTIONAL side of healing is?? That's incredible.  that will make them better at dealing with the owners/guardians.  that will make them better at dealing with the animals.

Some vets only get excited over an "interesting case".  They may be technically good but ... in my mind they lack soul somehow. 

But even 6 months and a year later (I took him back for two check ups) people would see him in the HALL and say "IS THAT BILLY??????? WOW -- what's his PCVEEEEEE???"

It made it all that much more worth it that we tightened ourselves down the way we did to DO what we did.