AIHA or IMHA

Cyclosporine works weird - it isn't this "dose" -- it's how much of the drug is accumulated in the body.  "enough" works -- but it doesn't work until there is "enough". 

When we thought of switching Billy to azathiaprine (because the side effects of the cyclosporine were SO bad on him) they told me what they would need to do is add azathiaprine IN FULL MEASURE to the cyclosporine -- run both drugs full tilt for 3 weeks or a month and then wean off the cyclosporine while having the azathiaprine full blast. 

And Billy took cyclosporine with that full dose of prednisone too! 

By the time they were thinking of switching Billy we didn't dare add the extra side effects of the azathiaprine since we'd STILL have had to wean him off both.  That was honestly why I suggested he decide *now*. 

But I am sure they can't run cyclosporine at a lower dose -- it just doesn't work that way unfortunately.   Not to do immune suppression.

 Hi Everyone -

I talked to my wonderful medical student. I told her about my knee jerk reaction - saying yes to the Cyclosporine.  She was very understanding.  She really made me feel ok about the decision to switch back.  She said that the Cyclosporine is easier on the liver.  She said Cyclops liver is enlarged but not excessively so right now.  I told her about the Milk Thistle and she sounded very supportive about me using it.

She said that this morning they moved Cyclops from the ICU to the Ward.  She said that if the need would develop they'd transfer her back but right now she is stable.  Then she said that Cyclops has been spending most of her days in the Student Lounge!  She said that they all love Cyclops because she is so sweet and always wants to be petted.  Her normal behavior in a room full of people is to go around and get a pet from each person and sit with them a while then move on to someone else.  The medical student loves Cyclops.  I've always had people tell me I should have taken her around to hospitals - if I ever have a dog so mellow and sweet again I think I will not keep him/her all to myself.  Cyclops could have been doing a lot of good for people I think.  I just never realized how special she is. 

So the doctor called me back.  She said she also understood about the cost.  She said that since Cyclops is doing ok she is going to look into a generic form of Atopia.  She said the absorption is not as high as Atopia but maybe a lower dose of the cheaper drug might help.  She said that in any case she is going to do all she can to keep the price down.  She is going to consult with the top doctor there and see what they come up with.  She said she has been able to help other dogs when there are money issues and she would do everything she could to get her the best treatment at a lower price.  

What we haven't really talked about yet is how to get her bone marrow to start producing cells.  But I can start her on the Milk Thistle and then take her to the Chinese Vet that Callie helped me to find in my area.  Maybe there is something he can do to help her.

 I receieved in the mail a bottle of Bio Nutrition "Bio Preperation Micro Algae Dietary Supplement" - he included a lot of information where this has been used in people in Chernobyl to get their systems back in line after being exposed to radiation.  He also had some information from people who used it for IMHA in their dogs.  I wish some of those people would post here.  It would be 100.00 a month to give Cyclops 4 pills a day.  I think I may take the bottle to the Chineese Doctor and see if he has things that are similar or if he thinks its just a bunch of crap.  I mean 100.00 a month I could handle but I don't want to just be throwing it away on a placebo.. a placebo for me no less.. not the patient! 

Cyclops count was 22 today and her color was good.  She had diarrhea  for the first time though.  They thought maybe stress from the anesthesia and/or switching meds might have something to do with it.  Because of this they want to hold her a few more days just to make sure her stool returns to normal.    I am hoping to pick her up on Friday which would be 1 week since I dropped her off.  We'll see what happens with the diahreah in the next day or so.

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its funny how life is mirroring what we are discussing here with the cyclosporine and the doseages etc.  I will keep you all updated.

yay... go cyclops! jiayou, as we say over here. i am happy to hear encouraging news about her. how is lilly doing in the mean time? how are her counts? please, we would really love to hear updates about her as well!!!

GratefulDawg

She said that since Cyclops is doing ok she is going to look into a generic form of Atopia.  She said the absorption is not as high as Atopia but maybe a lower dose of the cheaper drug might help.  She said that in any case she is going to do all she can to keep the price down. 

DON'T let them use a people drug.  I've been cautioned against that time and time again -- there's something about it that just doesn't absorb as well into the body or something and I've honestly heard nightmare stories from both vets and owners about it.

GratefulDawg

What we haven't really talked about yet is how to get her bone marrow to start producing cells.  But I can start her on the Milk Thistle and then take her to the Chinese Vet that Callie helped me to find in my area.  Maybe there is something he can do to help her.

This is where my experience will help you -- the TCVM will help with the blood and the milk thistle will mitigate the damage the azathiaprine causes.  Remember?  I told you that if *I* had it to do ALL over again, I would NOT use cyclosporine.  That's part of what we need to talk about on the phone -- but cyclosporine is HORRIBLE on the kidneys.  The liver **will** regenerate, the kidneys will NOT. 

Vets notoriously aren't proactive -- I'm not dissing them here -- they're looking at **right now** trying to get her body to stop ... but they're also looking at liver values and dreading potential damage iwth azathiaprine.  But even the AKC is having a study done NOW on silymarin (a/k/a milk thistle) and how advantageous it can be to mitigate damage done to the liver.

This WILL be the answer because the TCVM vet ***can*** help get the blood built up.  If you can get the milk thistle to them NOW (frankly it would be worth overnighting it to them) -- or even ask them to give her Marin *this week* and you'll switch to milk thistle when you get her back.  That will protect the liver and help bring the liver values down.

The Chinese herbals help the MOST.  There were two Billy was on -- Dang Quai and Gui Pi -- Gui Pi is the one I still have and can send you a whole bottle of it I think.  I sent the last of my Dang Quai (and I'm spelling that wrong I think) to Outdoorschik for Snickers earlier this year.

I honestly can PROMISE you that if you float her in milk thistle (use both the powder and the tincture -- or whatever the heck works) you will find it WILL bring down those liver values.  AND it will protect the kidneys too.

GratefulDawg

"Bio Preperation Micro Algae Dietary Supplement" - he included a lot of information where this has been used in people in Chernobyl to get their systems back in line after being exposed to radiation.  He also had some information from people who used it for IMHA in their dogs. 

My instant guess is this may help later ... but getting the body to regenerate is going to take a serious blood tonic and blood mover and I *think* your money will best be spent on the TCVM right now.  I have a feeling I know which way that's going but I'll check it out later. 

 There are phases to this -- right now you're in the "get the body to LAY OFFFFFFF!!!!" phase ... next you're in the "I gotta keep my dog able to tolerate the medicines and protect from long term damage until we re-train the immune system" phase -- Lori and I have talked by the hour about Willow and Billy on that one. 

Eventually tho -- when you get the dog weaned off, then you enter another phase of raising the dog back to real health -- and such things as that supplement *then* may be a real help.  Radiation is not ulike the cancer drugs (and they use radiation IN cancer, remember?) -- and teaching the immune system to turn on and off again -- without getting stuck in that "on" position is a big huge mega deal.  I just think that one is premature probably.

GratefulDawg

Then she said that Cyclops has been spending most of her days in the Student Lounge! 

I'm glad to hear that Cyclops is stable. Thanks for putting her pictures up. I never would have pegged her to be a "Cyclops" with out knowing the story behind her name. She looks very sweet.

Still saying prayers for your girl.  She is an adorable, beautiful girl.  hoepfully they can hit on an affordable drug that will do the trick.

 The Teaching hospital called this morning.  Cyclops is having problems.  Her Liver Enzymes are very high and she is developing a yellow color to her blood.  Hey appetite is gone for the first time since she's been there.  They moved her to the ICU.  She is already off the azathiaprine.  They lowered her Preds.  She is still on the first box of Cyclosporine which I had already paid for. Her PCV is 25 which is actually her highest reading. 

 My plan right now is to leave early in the morning Jan 2nd.  The doctors will all be there.  I want to see Cyclops and bring Domingo to visit her too.  I want to bring the Milk Thistle and have them feed it to Cyclops with her food.  I am going to call Callie right now and ask about dosage.  While I'm there I will discuss with them about the generic Cyclosporine.  But if I can't afford the brand name and her liver can't take the azathiaprine then I'm not sure what other choice I have right now.

The medical student sounded hopeful.  She said so far the yellow isn't noticable in her eyes or gums so that means they caught it earlier than I would have had she been at home.  I want off the rollercoaster - this disease sucks. 

GratefulDawg

I want off the rollercoaster - this disease sucks.

Just can't imagine how tough this is for you all.  It's good the med student sounded hopeful, I'm going to be hopeful too.  Have a good trip tomorrow and healing thoughts being sent to Cyclops.

Mike if you are still reading have them give her some Denosyl and Marin today.  And, I'm betting all the milk thistle she can tolerate will be best for her.  Willow could only tolerate about double the human dose before she started getting nausea and other GI symptoms.  But, as much as she can take right now. 

Also, why did they lower her Prednisone???  I've read often that they can use a combination of these drugs not just one or the other.

And, when Willow had really high liver enzymes they also started her on an antibiotic for the inflammation. 

Good luck and we are really praying for Cyclops with all we have here!

I know the rollercoaster you speak of.  I was on it for five months!!

Lori

We did talk on the phone this morning/noon and maybe I can explain a few of the "in betweens".

They lowered the pred because it's THE most likely one to be causing the liver distress.  It's the hardest for the body to tolerate. 

Honestly -- my encouragement was for him to ring the TCVM vet before he gets to U of OK.  The Chinese herbs **will** truly make such a difference in getting the liver values down *and* helping the body manufacture blood.  The fact that her pcv is *up* indicates that the body IS manufacturing some blood - that's awesome.

The University did the common sense thing in switching over to the cyclosporine simply because the liver values went high.  Cyclosporine is typically less hard on the liver than azathiaprine.  Not by much. 

 I told him to ask them to put her on Marin if they hadn't already (Denosyl isn't so much a liver protector as it is a liver support -- it's another pharmaceutical but not a bad one.  Marin is a pharmaceutical version of milk thistle.)  But Lori, I *did* tell him to call them and ask for her to be put on that if they aren't already giving it.

The fact that she went off her food was the big huge deal because you can't give them the big meds if they can't keep anything in their tummies.

It's a hard call to make, but the university isn't thinking about how much the Chinese medicine can help take the load off the liver -- it's just nothing they have experience with.  But the TCVM vet should and hopefully he can help with this. 

The fact that the pcv is up to 25 is awesome. 

We are thinking about her all the time. 

Lori

calliecritturs

(Denosyl isn't so much a liver protector as it is a liver support -- it's another pharmaceutical but not a bad one.  Marin is a pharmaceutical version of milk thistle.) 

FWIW, Willow's vet feels they work best together.

 I'm so sorry she's having liver problems; I'll keep praying for her.

Using Denosyl and Marin together?  It may be, Lori - I just don't have experience with Denosyl but I can believe that they work well together (because Marin IS so processed that I can believe using them in concert may be the way to go and get the best results).

Just FYI(for anyone)--they are taken as different times of the day too.  The Denosyl, which is a fairly large pill has to be given after a fast of at least 4 hours--Willow fasted six.   And, then they have to wait one hour before eating. 

The Marin is a chewable taken with food.