AIHA or IMHA

Tessy doesn't puke that often at all.  We were out and got home right at med time.  I usually try to keep her calm 20 minutes before she takes her meds and then an hour after.  I find when she gets overly excited, like when we come home, she tends to be more likely to puke.  It's been so long since she's puked I don't really remember the last time.

Speaking of the cost of this disease....up here in Canada the human form cyclosporine is only approx. $20 cheaper than the Atopica.  With the Atopica alone I am spending almost $500/month.  That's freakin insane eh.  I've looked into buying elsewhere but by the time I go through the hasle/time/shipping/taxes/etc.....It almost works out to the same....I think I'm in a no win situation with regards to the cost of this drug.  I made all her doctors aware of this so that when they feel it's time they'll start to reduce.  I'm not going to rush it if it's working though.

Tessy got treated today....I bought bones for them!  Talk about luvin it!  I took some pics of her eating it....will post later.

Hope everyone is doing great this weekend.  Give hugs to the furkids from Tessy & I.

 

Johnny & Tessy

Here the cost of human cyclo can vary widely -- If you can get the script into places like Wal-Mart or the discount clubs (Sams Club, Costco -- I'm not sure if you have an equivalent up there) where you buy large amounts of stuff cheaper, but I know people get quite creative about WHERE they get them. 

When Billy had it, the human equivalent wasn't an option (because they didn't have it 'modified' then available that way) so I used Atopica and it was more than my house payment a month.  So trust me -- I understand completely. 

Just wanted to let everybody know that Tessy got her test results back from Hemopet tonight.  One thing has me concerned though....her BUN/Creatinine Ratio is high.  Tessy's ratio was 130 (reference range of 4-27).  Her Creatinine was low at 0.2 (reference range of 0.5-1.6).  Her BUN was high at 26 (reference range of 6-25).

Amazingly enough all her other Chem numbers were all in normal ranges!!!!  YAY

She had a RBC morphology done and showed
Anisocytosis +2 and Hypochromasia +1
...didn't state anything about spherocytes etc...not sure why
There were also not retic numbers found...also don't know why.

She was showing elevated neutrophils at 11704  77 (2060-10600)...infection maybe?

Here's where it kinda gets confusing....concerning her red blood numbers....I'll compare her results from here at her regular doctors office to that of Hemopets.  What do you think...

Regular Vet / Hemopet (from the same blood draw!)
RBC  3.88 (5.5-8.5) / 4.9 (4.8-9.3) !?!?
HGB  10.1 (12-18) / 12.2 (12.1-20.3) !?!?
HCT  29.1 (37-55) / 37 (36-60)  !?!?!?!?!?!?!?
WBC  16.9 (6-17) / 15.2 (4-15.5)
PLT  486 (200-500) / 509 (170-400)

This seems a little odd to me.  There's quite a difference in range here don't you think? 

Johnny & Tessy

 

SOOO....another thing yet about puking.  She did it again tonight almost to the minute.  She took it thismorning alright without puking.  Can't help but wonder now what the problem is.

 

Johnny & Tessy

I would be giving it to her with food.  I would be on the phone to the vet or be emailing the vet if that's possible.  You may be seeing some ulcer starting ... she's taking a TON of very very strong medicine and you may be seeing stomach damage.  Email me if you want the recipe for the slippery elm cocktail -- truly it HELPS a ton (it actually helps the gut heal without adversely affecting the meds). 

I would be very very concerned -- simply because this is a side effect that can signal the dog not tolerating the meds well and SO FAST it can head downhill.  Absolutely be on the phone to the vet first thing Monday morning. 

 With regard to the Cyclo - my vet school has a special deal with a pharmacy and I've checked Walgreens and Walmart, no one comes close to the price.  Now, I'm not sure what the law is about shipping drugs to Canada.  The Pharmacy I am speaking of mails me the Cyclo once a month and also does it for Val (Cooper's Mom) too. 

 I just don't know what the law is and also how much it costs to mail something to Canada.   I'll be ordering on Monday and this will be the first time I'll be ordering 100mg x2 (60 pills total).  I'll let you know what the cost is, I am thinkng that it will be about 100.00 USD. 

 What is ironic is that whenever Americans want cheap drugs they go across the border to get it from Canada.  So I'm wondering if it would be worth your time to call some places in a major city like Toronto or something and ask some pharmacies there or maybe call some vet schools?  

Would be willing to help in any way I can.

I'm sorry to hear about Tessy puking again.  I know what its like to have yet another worry.  It may be nothing.  But I would really try giving it with food.  Like you said, at a time when she is least excited.

I'm here checking every day on you guys so please let me know if you find out anything about her puking.

 

This is from the Atopica product label:

"The most frequently observed undesirable effects include gastrointestinal disturbances such as vomiting, mucoid or soft stool and diarrhea. They are mild and transient and generally do not require the cessation of the treatment. "

The way I am reading that is that the vomiting could come and go or may never happen again.

I still wonder if the dose you are giving it too high for her little body.  If she starts having skin lesions then you'll know for sure your dose is too high.

I totally agree with Callie that you can't be sure what it is so you might want to get her into the vet and see what they think about the vomiting, or at the very least call the vet and see if he/she thinks its something you need to bring Tessy in for.

In a way I'm hoping it is the Cyclo.  

HOLY CRAP Johnny.. I just reread your post about the HCT being 37!! Thats in the low end of normal range!

W O W !!!

I mean if that is the case then maybe the Cyclo has worked and you can lower the dose of some of the drugs some?  

I know different labs vary but that is ridiculous as far as how much the two blood draws are off.  Maybe you can take another draw and get it sent to a lab somewhere?  My vet, his equipment is never calibrated so I've given up and have all my labs sent to Antech.

I'm choosing to believe that the 37 is accurate.  How can she be on that many drugs and NOT have an increased HCT?

Wow that is great news man.  

I mean.. I know you still have to be cautious but if you can get a 3rd party verification and it turns out its in the 30's then that is really a cause to celebrate!

 

Congratulations Johnny on Tessy's great 37!! I'm sorry I had disappeared for a little bit. I was really sick and just now have started to feel like myself. School is out for the summer and I am ready to enjoy the summer with the beagles. Here is what is going on with Cooper. We went to our regular vet this week and two weeks ago for a PCV. He has remained at 35. We have lowered the Pred twice now since the specialist vet said every two weeks to lower. Next week if he is still at 35 or higher, we can lower the Pred again. Currently he is taking 15mg in the morning and 10mg in the evening. Next week he will be at 10mg and 10mg! I am extremely happy. Cooper is doing much better with the accidents in the house and the amount he has to go outside. He still has accidents when we are gone for several hours but they are not even close to what it was. Thankfully, he has not had ANY other issues. My regular vet wants to to a CBC and a tox. screen next week and it will be sent to a lab. She will call the specialist at Arboretum View and see what he thinks about starting to lower the Az. or if we just continue to lower the Pred and once he is off that, begin to lower something else. I am really happy with the 35 but I wonder why he isn't going any higher.

Thanks everybody....37 is a great number!  I'm trying not to get overly happy with it just in case there was something on her end.  I've been going back over all Tessy's records and compared results from her regular vet and the teaching hospital up here.  Although it wasn't the same blood draw, both blood samples were taken within a few minutes of each other (March 17)....here are the results:

Regular vet / University (recieved March 18)

RBC 3.54  /  3.65

HGB 9.6  /  96

HCT 28.3  /  30.8

WBC 40.9  /  40.4

PLT 708  /  706

The only thing I can think it might be is the time frame between when the blood was taken and when it was analyzed.  The blood analyzed at hemopet sat for a couple days (shipped on June 2 & recieved on June 4...then reported on june 5).  I might e-mail them back to see if they still have her blood and if they do I'll get them to do a spun PCV.

NOW....since these two HCT's are so close and done on different machines it is making me lean more towards the hemopet analyzer/sample having a problem.  ?!?!?!?

Anyhow, it's good to hear Cooper is reducing meds.  Keep us posted on any news.

Callie....I'ld love to get the slippery elm recipe from you.

 Gratefulldawg...I might go ahead and check out some other cities for prices on the cyclosporine.  I'll let you know what I find out.

Johnny & Tessy

 

 

 

 Hey Val

35 is really good but I know what you mean about wanting to keep seeing it go up.  Its hard to be patient.

I think I may have the first symptoms of depressed immune system with Clops.. so far avoided infections but I got a lot of crud come out of her ears when I took a swab to it.  

I have a ton of experience with ear infections from my last dog who had a chronic problem that took over a year to resolve. In that case there was a definate odor to the black tar like wax coming from the ear.  Also there was a lot of pain and sensitivity in the ear.  With Clop right now it doesn't have a smell and there doesn't seem to be any pain.  I think I will try to flush it out with some ear medication and keep an eye on it and then maybe have the vet run his scope in there and take a look when I get the next blood draw.

Hopefully its nothing.  I'll be interested in hearing from the vet at OSU if we are going to go any lower on the Cyclo or what next month.  How low can we go is what I'd like to know.  She told me last winter she thought Clops would be on the Cyclo for the rest of her life but I'm wondering if it could ever go as low as say 25mg 2x/day.  I'd love to get it low enough to where her immune system worked a little bit.

Slippery Elm Cocktail:

Combine and store in airtight container in the fridge.  Get a couple of those baby medicine syringes and give a full one twice a day about 1/2 hr (if possible) before eating.  Just put the tip of the syringe behind the canine tooth and squirt gently so they can swallow.   

1 -- half a cup of boiling water.

2 -- add 1 rounded tsp. of ground slippery elm

3 -- let cool totally

4 -- add 1/8 c. + 2 tablespoons of aloe juice

5 -- add 10 drops of liquid chlorophyll

6 -- Add 2-3 capsules (open the caps) of acidolpholus

 

GratefulDawg:  here's my Blue Power Ear solution recipe -- it works awesome on yeast in particular (in case there are lurkers this contains more than "just" the recipe -- you know what I mean by yeast vs. bacteria but not all people will):

Try the Blue Power Ear Solution for two weeks and if that doesn't totally elminate the problem then get the culture and sensitivity test done ASAP and REQUEST it.  A bacterial infection can be tough to 'find' and it can be covered up by a yeast infection (and Clop will be more prone to a bacterial infection than normal). 

 Ear infections come in two types.  The typical "yeast" ear infection is from moisture in the ears and it particularly troubles flop-eared dogs (cockers to beagles and beyond).  BUT I stress here, if you follow these instructions CAREFULLY and thoroughly - doing it every day as directed and giving it the "massage time" it requires, you can kill many ear infections.  BUT if the two weeks doesn't totally 'cure' this or if even after a week you see no real improvement GO TO THE VET.   IF the Blue Power Ear Stuff doesn't totally get rid of this, then you'll have to go to the next level and have the vet do a  "culture and sensitivity" test on those ears.  Because if there is a bacterial infection deep within, you won't get the ears to heal otherwise. 

The Blue Power Ear Solution was first circulated on the AOL Cocker Spaniel Board.   This is a home-made recipe and if all you are dealing with is yeast ear infections it will really help them.  

 DOWNSIDE - this stuff stains.  You ***Must*** put it in their ears outside so they can shake and not stain everything because gentian violet is just like ink!!! 16 oz. bottle isoprophyl alcohol (just a cheap $.69 bottle)4 tablespoons boric acid (use human boric acid -- it's about $2.50 at a pharmacy or grocery store)17 drops gentian violet (1 or 2% , but the 1% is MUCH cheaper and is fine but you'll have to get it at a pharmacy)medicine dropper to use to measure the gentian violet Add the boric acid and gentian violet to the alcohol (Yep, it will all fit in that brand new bottle of alcohol -- surprising but true).  Shake well.   Transfer some into a squirt bottle (an old shampoo bottle or a hair dye bottle -- anything with a squirt top on it).  The boric acid never dissolves til it hits the skin so you have to shake constantly.  The boric acid soothes.  The gentian violet deals with the yeast.  It STAINS.  So do it outside, not in your kitchen!  Even 17 drops of this in a whole bottle of alcohol *does* stain.  But it sure works. Gentian violet is the stuff that they give human babies with "thrush" (oral yeast infection).   If the ear is inflamed use this twice a day for 2 weeks -- just squirt in and massage behind the ear.  The first day don't worry about massaging, but thereafter massage for a minute EACH EAR.  Yes, I'm serious -- COUNT.  They'll discover this does NOT hurt, but rather it soothes, and after you are done massaging, they will shake their head violently and all sorts of yuck and junk will fling out.  THAT IS GOOD.  After 2 weeks of twice a day, then do a week at least of once a day, then just put it on maintenance once a week. Once you make up the blue power stuff once -- that small bottle of boric acid will make several whole batches of this stuff.  It's way cheaper than chlorhexaderm and it's less likely to cause problems.  Al you have to buy is that cheap bottle of alcohol (and DO use cheap alcohol -- it actually works better than the expensive stuff!). When the dog shakes their head that purple stuff will sling everywhere -- so do it OUTside or you'll be wanting to kill me!!!

 

Hi all...I just got another of Tessy's tests back on her blood iron levels.  Her iron levels were "high" at 281 (65-125).  Has anybody ever had this problem?  Should I be worried or is a high amount alright while she is anemic?

 See I don't understand that.  If 65 was normal then Clop would always have been in the normal range.  But according to Antech, normal does not start until 98.  And the high range is 220.  Is your unit of measuring Serum Iron listed as ug/dL ? 

Are you supplimenting her with Iron Pills?  That would be the only thing I'd change is just stop giving her the Iron pills.  Don't know what else you can really do.  My vet thinks I'm being obsessive about the Serum Iron Levels.  He said that she is producing so man RBC so fast and her HCT has climbed so fast that is why Clops Serum Iron is low and that once things stabalize her Serum Iron will too.  But in the meantime I'm supplimenting anyway.  

How are things going with Tessy regarding the vomiting?  Has it stopped and if so have you acomplished that by giving the pills with food?

Hi Michael...how's Clops doing today?  Tessy's serum iron IS tested in ug/dl.  Although I sent the blood to Dr. Dodds for testing the top of the test paper says...and I quote..."Antech Diagnostics 17672-A Cowan Avenue Irvine CA 92614 Phone: 800-745-4725"

I wonder if that means it should be the same testing as what Clops gets?  I'ld assume that Dr. Dodds must have her own reference ranges she uses on a case to case basis.  Have you ever talked to her about this?  Another thing....I was always under the impression that if the MCHC was in normal range then the iron levels are alright within the body.  I have yet to verify this with any doctors so I might be wrong here.

Tessy gets multivitamins with Iron in them....I'm waiting to hear back from her doctor (she doesn't know much about high iron levels...she's going to research some) to see what to do about it.  I'm probably going to switch to a more specific B vitamin with folic acid or somehting of the sort.  The vitamins she takes now has 9.5mg of supplemental iron in each pill and Tessy gets 2/day. 

To be honest I really don't know what to think anymore....just seems like once you get comfortable with one problem another one comes to take it's place. 

The good news is that she had 3 cyclo pills so far since her last puke without puking! Yayyyy

Her doctor was talking about wanting to take her off of the 8mg of aspirin/day as well as the 10mg Omeprazole/day since we will be weaning her meds soon.  Wouldn't it be a good idea to keep her on each until her doses get much lower?  Any thoughts on this anyone?

Anyhow, I've got to run around and get some more meds for her today.

I'll keep you all posted on any news that comes.

Give hugs to all the furkids from Tessy and I.  Prayers to all.

Johnny & Tessy