AIHA or IMHA

GratefulDawg

Well said Val.  But what do you do when one doctor says lower it fast and another says lower it slow?  Thats the thing with IMHA there seems to be varying opinions on just about everything. 

Sorry even tho I elaborated I want to say something about that one sentence.

I think you have to view *all* of this thru your own common sense.  Yeah, the vets are educated, and I'm not disagreeing with any of these protocols.

I think that all has to be filtered thru YOUR observation of YOUR dog.

If Cooper's vets feel they have the luxury (and yeah, sometimes with this disease time IS a luxury if the dog isn't reacting badly or is doing well with no bad sideeffects) to reduce it the **safe** way (remember Coop's got a different type of IMHA than Cloppie had because the reticulocytes were disappearing in a different place and Cooper responded in a different time frame from Billy) level then fine.

With Billy -- his kidneys were taking SUCH a beating with the uti's and other symptoms (shown by the blood work too) that the vets relaly felt the pressure to reduce the load on the kidneys FAST (and I'm remembering how LONG he'd been on pred too).

In many ways the way the vets took Billy off was very responsive to how *I* told them he was doing.  For a BIG example when we reduced the cyclo from 110 to 100 and he 'bobbled' and I was worried they put it up ... not just ONE notch up but TWO.

It's like I said above -- there is not ONE tried and true "way to do this".  It all has to be so very very individually calculated to fit in with what stage this animal is in this disease, and how well the animal is tolerating ALL the meds and what external factors there might be.

I think you also have to temper this TO A HUGE DEGREE with how much confidence you have in *your* vet.

Frankly, if that confidence level is shakey then you keep a closer eye on the dog and maybe you question a little more, or gripe a little more and CONSULT SOMEONE ELSE.

I try never to be shy about asking "Can you explain to me why you did this THIS way?"

or

"She's still really suffering with ____________ ... can we change that to ___________?"

I don't think that's out of line -- and I don't think that's questioning their professional status ... I think that's just good dog-parenting and letting your vet know what's going on with THIS dog -- cos they won't know unless you tell them!

Does that make sense?

calliecritturs

I try never to be shy about asking "Can you explain to me why you did this THIS way?"?"

or

"She's still really suffering with ____________ ... can we change that to ___________?"

I don't think that's out of line -- and I don't think that's questioning their professional status ... I think that's just good dog-parenting and letting your vet know what's going on with THIS dog -- cos they won't know unless you tell them!

Does that make sense?

  That's true for any condition that your vet is treating. Great post Callie.

calliecritturs

Does that make sense?

Yep it makes sense.  When I was in the hospital a nurse told me that I have to be my own advocate.  That doctors are not gods and they are busy and tired.  I respect vets and doctors but if I had a kid I'd be doing the same thing I am with my dog.  I would be questioning and getting second opinions from other doctors.

I understand where Val is coming from.  If something happens to Coop then she can say to herself that she did what the experts told her to do.    The up side is that she doesn't have any of the blame.  Had I been like Val and listened to my doctors Clops would be dead right now.  I was just looking back today at some of the first emails I sent to you Callie and it sent shivers down my spine because I was so close to listening to these idiots.  Had I not stood my ground they would have euthanized Clops on Christmas Eve.  I went in there and took charge and saved my dogs life.  So ya.. I know when I break the rules and ignore my vets or find another vet that shares my concerns that I might not be making friends and I know that if I make a mistake then I might feel some guilt.  But I'm ok with that.  

Just thinking about it makes me angry really. I think that most people do listen to their doctors like they are a god.  Then when they screw up they sue the doctor for malpractice.  Anyway I am the same with my doctor as I am with my vet.  I question him about prescriptions and research things myself and ask questions.  They may not mean to kill you but if you're not alert you can end up dead in a hospital really quick.

And Callie caught my misstatement in my previous post.  You CAN screw your dog up by not getting it off the Pred fast enough.  Like Callie said it depends on the dog.  The longer on the Pred the more of a chance of Cushings type syndromes.  Some dogs may have the luxury of time to get off the Pred some may not. 

 Wonderful; way to go Coop!!!

 39, that is great, Coop's Hematocrit is in the normal range now!  Its really nice to hear good news like that.

Grrrrrrreat work Cooper!  39 is a solid number!  I'ld be super happy also.

All the best to you and Cooper.....have a great weekend.

Johnny & Tessy

Yeah for Coop!!

Totally agree with Callie's earlier post concerning questioning Vets on their thinking and reasons.  A good Vet will welcome the interest, same for human doc's.  It's not about anyone's ego and if a doctor takes offense, time for a new one.

Woohoo for Coop! I just skimmed the last page or so, so I don't know all the ins and outs of this situation, but Callie's right about being an advocate for your dog. The vets (usually) know much, much more than we do about animal medicine, but they don't know our own dogs like we do (just as human doctors don't know us; I had a horrible reaction to an antibiotic--Levaquin--in February and the ear-nose-throat doc tried to brush it off, saying that he's used that same med for five years and no-one has ever had an adverse reaction. Found out the FDA has a black box warning out on it and that it has caused deaths!). Praying for Coop.

Ems will be a two-year survivor of IMHA at the beginning of next month. She looks incredible and is energetic and happy...but I still keep an eye on those toes, gums, and poops! I hope Coop can recover as well as she has (with the help of great vets and great members on these boards).

<3 Wendy and Emma

GraniasBard

I had a horrible reaction to an antibiotic--Levaquin--in February and the ear-nose-throat doc tried to brush it off, saying that he's used that same med for five years and no-one has ever had an adverse reaction.

Wow, when they prescribed Levaquin to my husband they were very upfront that it was a very powerful drug and could have side effects.  He had a very serious infection at the time.  And, it was one of the big guns they brought out for him to try. 

YAY to COOP!!!  So, happy for you!!

GraniasBard

Ems will be a two-year survivor of IMHA at the beginning of next month. She looks incredible and is energetic and happy...but I still keep an eye on those toes, gums, and poops! I hope Coop can recover as well as she has (with the help of great vets and great members on these boards).

<3 Wendy and Emma

Hi Wendy and Emma! I'm glad she's doing well!!

*waving hi to Emma and her Mom* -- SO glad to see you around!!  Emma is such a pretty girl.  It's awesome to hear from you!!!!

 Nice to hear from a 2 year survivor.  Tomorrow will be 6 months for me and Clops since diagnosis. 

Hi everyone.  Hope the furkids are doing good today.

I just have a couple of concerns, or things I don't really know much about.  Maybe someone can fill me in on what this all means and what I should do or if I should be worried.

Like I was saying in a previous post, Tessy's iron levels are high at 281ug/dl (65-125).  Her folate levels (from same blood draw) also arrived and was high at 24 ng/ml (6.5-11.5).  Cobalamin levels remained in the normal range at 334 pg/ml (249-733).

Given these results I'm just looking for some opinions on what I should do.  I really have no idea what these all mean and if I should be concerned or worried.  Should I avoid certain foods like spinach or liver?  Is 281 high but not high enough to cause problems?  I've read that too much iron is bad so now I'm just overly worried.  I'm finding it difficult to find any literature with regards to these ranges.  Since her cabalamin is in the normal range is there still a need to supplement the B vitamins?

Just so many questions with no answers.  I feel so confused at times.

Sorry for the rambling.  Just wondering if anyone can educate me a bit on these questions.  It would be greatly appreciated.

Thanks,

Johnny & Tessy