AIHA or IMHA

So I will start even though I asked the question  

For those currently battling IMHA:
         a.  How old is your dog Calypso is now 10 months old
         b.  How long has it been since since IMHA was diagnosed? June 2009
         c.  What meds are you on with most recent HCT:  Most recent HCT 26 for past 4 weeks
                   1.  Cyclosporin
                   2.  Prednisone
                   3.  Pepcid
                   4.  Aspirin
                   5.  Looking at adding liver protectant, but waiting for the specialist to approve
          d.  Any major complications? No complications so far.

I wondered if anyone is using a cooling bed in the summer to help with the heat, panting, etc. Any advice is appreciated.

 I have never used one of the cooling beds, but I am not sure that there is much you can do about the panting since it is a side effect of the Prednisone.

Keeping the house cooler made me think that it helped decrease my Great Dane's and cat's panting when they were on Prednisone, but did not "get rid of it". Panting is just one of the unfortunate adverse effects, as is increased thirst and appetite, and restlessness. 

I limit the amount of time outdoors that Calypso has when it is hot and make sure she drinks enough when it is hot.

Oh and one more thing.....is the dog comfortable or having trouble breathing?  If his/her breathing is "labored" than that would be a different situation and I would talk to your vet immediately.

Thanks for the reply! No, she's not having breathing difficulty, just the "usual" prednisone panting (and summer time panting which is very normal for her). She spends very little time outside during the daytime hours. She prefers very early morning and late afternoon (before the mosquitoes arrive). She's good at finding the coolest spaces in the house (no AC but fans and cool rooms). I had read about the cooling beds and wondered if anyone had tried one.

cerberusdog

5.  Looking at adding liver protectant, but waiting for the specialist to approve

I'm going to hasten to say -- some vets, despite the fact that even the AKC is now studying and recommending "silymarin" (the latin name for Milk Thistle) are just stellarly **terrified** of anything herbal or anything at all "natural". 

But I have learned **THE HARD WAY** that vets are not proactive.  They treat what comes in in front of them.  They treat what is WRONG on that day.  They don't look forward.  If an animal is in pain they'll give rimadyl or Deramaxx not really concerned about possible liver side effects UNTIL that comes up.

This isn't a slap against vets -- it's simply how they are trained to respond and do things.  But as time passes the drugs they use are stronger and stronger and have more potential to damage with their side effects. 

So very often they are **NOT** at all worried or concerned about protecting an order or protecting against side effects.  The problem is simple -- the liver DOES regenerate to a degree.  **the kidneys DO NOT**  But taking steps to protect those organs before that can help YOUR dog.

I'm not yelling at you -- please understand that.  But The vets are truly going to be completely focused on only one thing right now -- immediate treatment.  But they throw SO much damaging stuff at them, frankly, it is incumbent on the owner/guardian to take those steps to prevent disaster because the vet won't even *think* of adding something like that until **problem** raises its head and by then damage is DONE and it can be too late.

If you read back thru the 60-odd-long pages of this you'll see that the dogs who did NOT make it are often dogs who just quit eating ***SOMETIMES*** because diabetes or liver *failure* had crept up fast and hard.  It happens.  Your dog is a pup -- she's not even fully developed so the organs are more fragile and in some ways less resistant.

Frankly, I wouldn't wait for a regular allopathic vet to *approve* of milk thistle.  It's widely recognized as helpful.  It won't inhibit the absorption of the cyclo nor prednisone.  (You can research until the next full moon -- there's no contraindication at all.) 

I don't mean to sound ratty or nasty -- but it is simply incumbent on the owner to protect their dog.  And in your particular case, it's even more critical because she's just a puppy.  She doesn't have full growth yet so damage done isn't just damage to 'put up with' for a few more years.  It's the entire life.  And even the further development.  She's very young to be dealing with IMHA.

I know some folks are far more inclined to be comfortable with herbals and such -- but even if you want to go the route of Marin/Denosyl, etc. ASK FOR IT.  The vet is *not* gonna offer.  But time after time we're seeing that an integrated approach works best.

I've only known of TWO buffy cockers other than Billy to SURVIVE IMHA.  One is Tessy, and the other is a buffy English Cocker in England.  The death rate for light colored dogs, and particularly cockers is terrifying.  (See Dr. Jean Dodds' notes on http://www.hemopet.com about coat color and auto-immune) But what makes Billy so different from the majority of other dogs who don't respond?  -- Remember it took SIX WEEKS for his body to build the amount of cyclosporine necessary to suppress the immune system?????

***Intergrated Medicine***  The TCVM Billy got up to Gainesville and here at home (he got acupuncture while he was in ICU up at U of FL at Gainesville) and the milk thistle  -- and the use of milk thistle as protectant -- I've been told by both regular vets and holistic vets that THIS was what made the huge difference in not only his survival but the mitigation of the damage the drugs can do so fast and hard in the body.

Sorry -- off my soapbox now, but sometimes I feel like I have to push people hard for this -- because it's hard hard hard to see how FAST they can fail and die with this disease.  How fast kidney damage can actually happen and then it's like everything you've spent and done can be gone. I realize I come off like a majorly pushy broad but honestly, I have seen this happen now for three years -- and I've seen the dogs that make it and the ones who don't.  So I've learned to be vocal.  Majorly so. 

FrisbyPI

I wondered if anyone is using a cooling bed in the summer to help with the heat, panting, etc. Any advice is appreciated.

I'll second what Cerberus said -- partly the panting is pred related -- but PUSH WATER.  And Billy even **craved** cool watery fruits like watermelon, cantalope -- I would even crush ice and offer it.

They get SO many blood draws -- and I would take treats of all kinds and varieties just to make it easier for the techs and vets to do all they have to do.    He got to the point where he thot AWESOME!!! Vets = TREATS!!! and would get all excited over going to get his blood drawn!!

One of my fondest memories was when he was at his SICKEST.  It was hot and July in Florida.  I stopped at the grocery store before I got home to pick him up and got a small chilled dish of cut up watermelon.  When we got to the vet she needled him (acupuncture) AND did a blood draw and cathetered him for a sterile urine draw (gee fun huh???).  THEN dog and vet laid on the floor and she gave him the whole dish of watermelon.  HE LOVED IT.  ***SHE*** LOVED IT.  She got to give him a delicious treat (and even as a holistic vet she'd never given a dog watermelon before) but they both enjoyed themselves TOTALLY.

But do all you can to get your dog to drink.  Add water to his food, take meat juice from your steak, add water and freeze - don't try to play fair-- just get him to drink and it will help.

Most of my dogs are arthritic so I don't use cooling beds so I'm no help on that score.

calliecritturs

but it is simply incumbent on the owner to protect their dog. 

I went thru the same thing with Willow.  I had learned about milk thistle from Callie and I started using it.  Then after I had already started it I got curious to see what her vet would say so I asked her if it would be OK to give Willow milk thistle.  And, she said, "you could."  Sort of like with the tone of it won't hurt but why??  I did and then wouldn't you know once her blood work was up she gave me a milk thistle/sam E combo???  I wonder why she didn't offer me the Marin when I asked about the milk thistle.  But, it's like Callie said, they will wait for something to happen not try to prevent.  At least it's what I've seen. 

 All I can say is wow Callie. You do not know me or my vet. My personal vet saved my rottie mix from parvo using a homeopathic treatment, so maybe you need to find a better vet if you do not trust yours. Believe it or not I emailed the internal specialist this morning at 11am and by 2pm had a return email stating that they both approved of use of multiple liver protectant and even gave me the name of a store about 30 minutes from my house that they would recommend using if we decided to go with natural herbs vs what they sell at the office.

Callie I am very annoyed at the reference that I do not do all I can to protect my pets just because I am waiting to get approval from the specialist who I paid thousands of dollars to and who saved Calypso's life! I appreciate all the information I get on here but it is still just recommendations until I have done the research and asked the questions. Just like you mentioned giving Calypso's pills with liverwurst.....why would I chose to give a high fat and salt product to a dog that has the potential for kidney problems...salt intake needs to be monitored very closely. But do I bash you, no I respect your opinion and then form my own.

I have dealt with more diseases and injuries that any one pet owner should ever have to in their life time, but I know St Francis does not give me any more than I can handle so we just keep doing what we can for them.

I have written this response 4 different times today as I have calmed down. Maybe this is not the best place for me to find support. 

I think Callie was just trying to encourage you to be proactive in case your vet wasn't.  So, many of them aren't.  But, it sounds like you've got a very good vet! 

Please continue to post.  We all should be checking with our vet on things and even though we can share stories and compare what's right for one may not be right for another.  I was grateful for the advice I received here.  But, sometimes I put it on the back burner.  And, went with what I felt was right for me and my dog. 

Hope you stick around!  I know Callie didn't mean it the way it might of sounded.  She's a very good intended person. 

Lori

cerberusdog

So I will start even though I asked the question  

For those currently battling IMHA:
         a.  How old is your dog Calypso is now 10 months old
         b.  How long has it been since since IMHA was diagnosed? June 2009
         c.  What meds are you on with most recent HCT:  Most recent HCT 26 for past 4 weeks
                   1.  Cyclosporin
                   2.  Prednisone
                   3.  Pepcid
                   4.  Aspirin
                   5.  Looking at adding liver protectant, but waiting for the specialist to approve
          d.  Any major complications? No complications so far.

Willow has IMT---immune mediated thrombocytopenia.  It's a similar disease to IMHA and is treated exactly the same way. And, it can turn into IMHA or they can get it in additon to.  If anyone is interested in Willow's illness I just recently posted and it's on page 54 of this thread.  This week I will be finding out if she's still in remission.  Here blood test last week was concerning.  So, she's getting re tested this week and we go from there.

So, let me answer the questions:

Willow is between 8-11 years old.  We aren't exactly sure of her age.  We got her 6 years ago and the vet that spayed her told me then between 2 and 5.  If I had to guess I'd say around the lower end of that range.  She can still run, hear, see well, etc.  She's only slightly graying but it's hard to tell with her coloring which is blue. 

She was diagnosed in July 2008. 

She took Prednisone for five months and Pepsid daily during that time. She also took milk thistle and then then later Denosyl and Marin.  With her problem, they start with Prednisone and if that doesn't work they add from there.  We were very lucky in that she responded quickly to Prednisone by itself.  And, I think that's about it for medications. 

The only complications she's had are that she lost almost all her fur on the sides and legs during Prednisone.  Can you picture this?  She's a chow!!  It's all back now though but her coat has changed.  And, she's kept weight on.  She's not able to be as  active as she once was.  When she was first diagnosed she and I hiked almost daily.  Now, we do slow 20-30 minute walks.  It's all minor though compared to what could of been. 

Thanks for reading about Willow!!

Let's keep the title with IMHA and/or AIHA in it ok??  Just to make it easier for the folks looking for those words.

Lori makes a SUPERB point here -- one of the big huge mega deals is that any immune-mediate or "auto-immune" disease can morph into another one at any time.  AND they are all really similar in many ways.  AT least in the treatment.

Anything with 'cytopenia' in the title has to do with platelets.  What Pirate had (Slr2Meg) was "pancytopenia" and that was actually triggered by the phenobarbitol they had Pirate on for seizures.  When IMHA becomes thrombocytopenia or they are 'together' it's called Evan's Syndrome (which is what Outdoorschik's dog had *sigh*), but any time an auto-immune disease morphs into something else it becomes FAR more dangerous and far more difficult to treat and "stop".

That's one of the reasons you will hear all of us yelling "DON'T WAIT -- go to the vet!" and don't let them put you off.  If there's a symptom like the dog not eating, or the dog suddenly just not looking good or acting "off" the only thing you CAN do is make a huge deal out of it.

So you go have the tests done and you worry all over again and if it's all "ok" then FINE, but ignoring it is just too dangerous to think about.

cerberusdog

I am using Atopica Cyclosporin. Calypso takes 75 mg twice a day which costs $200 for a 30 day supply. So I think that is the correct form from what I read and is it a good price Mike?

Cyclops is also at 75mg 2x/day.  We are paying 150.00 for a 30 day supply.  But we're using a generic.  I think that 200 is a GREAT price for Atopica.  If you feel like switching I can give you the info.  Some dogs do not tolerate the human generic, my vet at OSU said 90% of her cases do just fine on it.  Cyclops and Val's Cooper are on it with no problems.  But I think you're getting a great deal on Atopica.  When I first started out at 150mg 2x/day the best price I could get was 800.00 a month for Atopica.

 I love the name Frisby, my other Border Collie, Domingo LOVES to play frisbee.

Its been a while since I mentioned Outdoorschik's dog Snickers.  I thought I'd put a link to the thread here because reading that thread is what made me want to keep a log of Cyclops here on this thread.  Anyone who is new to IMHA should read it to get an idea of what you could be in for.  It got me prepared for what was to come, both in terms of financial and emotional cost.

http://forum.dog.com/forums/t/74101.aspx?PageIndex=1