AIHA or IMHA

 JackieG

I will do that.  I sound like callie now I know.  But I mention you and all the people who keep checking back on Cyclops.  I keep telling her how many people are talking about her and thinking about her.  Oh and her belly is so funny right now because they shaved all the fur off to do ultrasounds so its like a very soft skin.

 Nikko

thanks.  and yes  i know looking forward it will be like what willowchow said.. just a lot of worry about relapse.  hoping there are still some good days and good times left.  i am guessing that there are because I don't see any regret in willow or callie for the steps they have taken.  but at the same time the are honest about the never ending rollercoaster.  

IMHA takes some dogs so fast and no amount of money would make the difference.  the twist on this is when you know that dumping large amounts of money will extend life (to an undetermined extent).  that choice is very hard.  the dog is not in pain.  in the past you could always say you were doing the right thing by ending pain and suffering by a terminal illness.  but with imha euthenasia takes a really dark turn.  makes you think about all these cases with human lives too and what insurance companies will and won't do.  

 Callie.. I called the TCVM Vet.  The only one in the area.  The number rang through straight to him on his cell phone.  You'll never guess where he is at?  Florida.. doing some advance training.  He is suppose to call me back tonight since he was in class when I called.  That is kind of working out good since I told myself I wouldn't add anything to the treatment until after we get Cyclops' CBC/Chem on Monday at my regular vet.

 Cyclops is doing really well so far.  Only been on the generic since Monday so I know its too early to tell.  But energy levels have not fallen, color looks good, appetite is unreal she wants to eat everything.  Just hoping that Monday the reticulites and pcv will show good things.  

THIS SOUNDS GOOD.  THE LEAST LITTLE IMPROVEM,E NT IS GOOD. MY HUNTERS HEMOCRIT NEVE EVEN REACHED 20 EVEN WITH 3 TRANSFUSIONS OF 2 UNITS BOTH TIMES.   AND IT WOULD DROP WITHIN HOURS OF THE TRANSFUSION.    THE CYCLOSPORINE MADE HIM VERY SICK.  HOPEFULLY THINGS ARE LOOKING UP FOR YOUR BEAUTIFUL LITTLE GIRL.  OH, I SENT YOU A PM ABOUT THE MILK THISTLE.

Thank you for your thoughts!  I really believe that you may have a good chance at success here.  I read an article when Shanny was sick that most that pass do it in the first 10 days.  Keep fighting and stay on it, I know it's work and draining, but at least you get more time.  Remeber this disease is not painfull,  you are doing all the right things.  You should be proud of yourself, it makes you stronger as a person! 

 Freaking Out:

 Its 3:25 am local time.  I woke up about an hour ago and had the urge to check Cyclops' color.  It seems very pale.  I called the vet at OSU and started getting ready to head back.  But she isn't any more lethargic than she was yesterday - and her appetite is still good.  I have a feeling that the generic cyclosporine is not working.  She has been off the azathiaprine for a week now.  It took her 2 weeks to get her stable on the azathiaprine.  If this is really the case and its just not me freaking out then I should have been more firm and insisted she stay on the azathiaprine.  We could have lowered her prednesone a little and done more liver therapy.  

I talked to the vet at OSU on the phone. I decided to wait and get a CBC at my local vet and if it shows a lower PCV (which is what my gut is saying) then I will get a refill of azathiaprine and up her prednesone right now.  Depending on the PCV I will either leave right away for OSU and a blood transfusion or wait a day or two.  If I can't comfortably make it until Monday then I will definately leave today to avoid emergency/after hours fees.  

I figure 3 things will happen.  Either #1 - The CBC shows everything is stable and I was mistaken about the color and freaked out for no reason.  I really hope that is the case.  #2 - The cyclosporine is not being absorbed but the PCV isn't low enough to warrent a transfusion.  I will switch drugs and keep her at home and get another blood test on Sunday.  #3 the same as #2 but she needs a transfusion right away.

Now I just have to wait a few hours for the vet to open.  Cyclops is looking at me like "everything is fine".  Yesterday we went for a ride and she was sitting up and looking around.  

Am I crazy for just letting COLOR do this to me?  Maybe I am looking at it in the wrong kind of light or too bright of a light?  I don't think so but when you're alone you doubt yourself.  It was much more comfortable having her at the hospital.  But I think that I can take better care of her liver here.  

Nothing I can do until I get the results of the CBC.  Will post back later.

 Been on the internet - searching.  Another thought crossed my mind.  Maybe it isn't the cyclosporine - maybe we are reducing the pred way too fast?  Most things I am reading show a reduction of pred very slowly and over the course of months if not years.  Yet my instructions are to have her off pred altogether by next week. 

I am thinking of upping her pred back to where it was - possibly giving time for the cyclosporine to kick in.  she's only been on the cyclosporine for a week - not long enough to tell if its working or not.  i have no idea.  i'm going to leave in an hour for the vet and run the idea of increasing the pred and/or switching back to azathiaprine past him if the CBC shows decreased PVC.  Will consult with the hospital too.  I know that the liver is in trouble but I think that the pred is working and we're lowering too fast.  i'm no vet but as Callie has said.. listen to your gut.  My gut is telling me these things.  

I'm not sure if you can switch her that fast back to azathiaprine ... seriously?  I'd get the TCVM vet involved because it could also be that the transfused cells are dying without her making blood fast enough yet.

Also -- check her color again after she's been 'up' a while -- I've seen Billy lay his head on his paws and kind of shut off the circulation to his mouth -- once he's been up a while the color restores. 

And yeah, you're perfectly NORMAL for freaking out!!

Mike, I hope she's doing OK this morning. 

I agree with Callie, the gum color can vary a little especially after they've been sleeping or laying down, I've noticed that too.  Also, Willow's gums were much lighter than normal when the meds were at their highest.  She had a lot of inflammation naturally and once on the meds they got much lighter. 

I also wanted to mention that I do agree with you I think they took the Prednisone down way too fast.  I mentioned that when you first posted that on page 6, I think.  There are plenty of ways to support the liver thru this and liver issues with these drugs are to be expected.  So, not sure why they are freaking out so much over it.  Willow was on antibiotics she had so much liver inflammation and also Denosyl and Marin and milk thistle.  But, once the Prednisone was stopped, the values returned to normal and rather quickly. 

Anyway, it's an ordeal, isn't it?  I've spent many early mornings worrying myself so I know what you were going thru. 

Hope she's OK. 

Lori

Hey Gratefuldawg - lookee what *I* found!! (jumping up and down and waving)

http://arkansasholisticvet.com -- that's Dr. Baker - the TCVM vet near you?  It also looks like he's in a bigger practice as well -- he's not on his own.  "Weddington" or something like that.  I just thot it was kewel he had his own website!!  He looks darned good (at least he says all the right stuff.)

 Any update on Cyclops; how's her PCV?

Okay, I'm new here - I've been searching the internet and found your site.  My boy Andy has IMHA - and was pretty bad about 3 weeks ago.  On Dec 18th he was lethargic, and then threw up some bile.  He had pancreatitis in May and I'm paranoid about it now - so I called my vet, who came in on his day off to check Andy.  Next day he called me in the a.m. to say that he was concerned about some blood counts, and that he had made an appointment with an internist at the Emerg. Clinic downtown.  He said it is on par with the University of guelph (I live in Toronto - and Guelph is the premiere vet program in the province)  So I took Andy to the clinic, very afraid of what the problem was.  The vet there told me he suspected Andy had IMHA, and after more blood work it turned out his PVC was 15.  Long story short, next day he needed a transfusion, and apparently he wasn't producing any new red cells so a bone marrow biopsy was done.  Next morning the vet called to say that Andy had rejected the tranfusion, something he had not seen in a long time.  I will now just forward to today, because I want to let GratefulDawg know that we had many, many setbacks, another transfusion, and 3 weeks later, Andy's PVC is 28 and holding, which is soooo much better than it was just a few days ago.  Tomorrow we start to lower the pred and Imuran (azathiaprine) dosages, and we are hoping that there is no relapse, but understand that there may be.  Andy was on 15 mg's of pred for 2 weeks, and now we are lowering to 7.5 mg's.  I have also read alot about slowly reducing the drugs, and thought that maybe that was too fast, and of course we will have to see, but I believe the vet knows what he is doing.  My regular vet told me that this particular specialist got a couple of his other patients with IMHA through, with very good results, So, even though I don't know what the future holds, having Andy back with us, and having him happy (and hungry, thanks to the prednisone) is a blessing.  So, please, don't give up, I read somewhere on the internet the other day, that once a dog has passed the 1 week mark, something like 93% have at least a six month survival rate, and often much more. 

I have been thinking about Cyclops all day, and hope that some good news comes your way. 

I am not sure how I should have entered this, it is the first time I have joined a group, and hope I haven't broken any rules - if I have I apologise...

Andy'sMom

I am not sure how I should have entered this, it is the first time I have joined a group, and hope I haven't broken any rules - if I have I apologise...

  Welcome to the forum; Your post is perfect and I'm sure you didn't break any rules. I'm sorry your dog has such a serious disease but am glad he's stable now; sending healing vibes your way.

calliecritturs

Hey Gratefuldawg - lookee what *I* found!! (jumping up and down and waving)

http://arkansasholisticvet.com -- that's Dr. Baker - the TCVM vet near you?  It also looks like he's in a bigger practice as well -- he's not on his own.  "Weddington" or something like that.  I just thot it was kewel he had his own website!!  He looks darned good (at least he says all the right stuff.)

 You know what is funny?  Weddington Animal Hospital is my regular vet.  I knew the 2 vets (both OSU grads) who founded the place before it became Weddington Animal Hospital.  Since 1996.  What I didn't know is that Dr. Baker was working out of there.  So ya.  I was just there today.  Dr. Herring and Dr. Wright are the 2 doctors that normally see Cyclops - would be cool if she were to receive TCM because the communication would be pretty good considering they are in the same building.