IMHA and Diabetes

Welcome -- we have a gi-normous thread (I think it's up to 93 pages) that will be full of information **and support** for you.

In honesty, MANY folks have found that there quickly may come a point where you have to seek additional help -- either your state's best vet school (or one in a neighboring state) OR a specialty clinic (be VERY picky -- some of them don't have a ton of IMHA/auto-immune/immune-mediated expertise).  Often, a vet school can be a stellar choice simply because they can be more reasonable as well as being more 'up' on the newest nuances of the disease.

I'm not saying anything bad about your vet -- it's simply that this disease can be SO tricky and it can turn on a dime.  It is not uncommon to see diabetes linked to IMHA.  Once the body chooses an immune-mediated reaction, it is awfully easy for the body to do other immune-mediated things at the same time. 

TRULY this takes an expert.  I'm not advocating leaving your vet -- merely by getting extra input.  Most vet schools are awesome about working **with** the home vet, and often pass off the treatment as soon as possible.

 I realize that huge thread is difficult to plow thru and I've spent significant time trying to help index it to make it a bit more user friendly.

I know earlier on in the thread we did have one member whose dog developed diabetes but unfortunately their vet wasn't quick enough to catch it in time to be treated.  All the various drugs used to treat this (and cyclosporine IS the benchmark drug right now to treat IMHA) have some serious side effects and learning to cope with all this is no small task. 

One of the instant problems with cyclosporine is that it takes a while to kick in (so does azathiaprene).  How long depends on the dog and the individual case.  There IS a generic cyclosporine now that they are using successfully on dogs (for a long long time the generic wasn't dog-friendly but at this point they have formulated a "modified" version of it that is successful).  It can be helpful to use because it's a liquid -- which can make dosing easier.

cyclosporine has to reach a "level" in the blood to be effective ... how high that level has to be can depend on the individual case and how much immune suppressor is needed to get the immune system to lay off and stop killing the blood.

This is honestly where you need to go to the next level and seek extra help.  Simply because determining where the blood is being attacked (in the bloodstream?  only adult red blood cells?  only reticulocytes or 'baby red blood cells'?? or in the bone marrow before it gets To the bloodstream).  Determining that and determining how insulin responsive the diabetes is truly is one of those things that depends on good diagnostics.  Your vet likely can use some help with that.

There is a lot of discussion on that long thread as to the different vet schools, what's good, what's helpful, how to make the decision.  Also putting a plan in motion to begin to protect the body (because cyclosporine also has some serious side effects and chances are the dog may be on these drugs for a long, long time).  There is much discussion on that as well -- and discussion on which things vets may prefer to work with (milk thistle, or the pharmaceuticals marin/denosyl/denamarin, etc.)  -- it can be surprising where vets may stand on this.

My Billy is an IMHA survivor -- He began in late spring 2006 with the disease, and has been completely off immune-suppressors for about 22 months now.   I'm no vet -- simply "been there done that" and I've been fortunate to have gained some really good knowedge and contacts along the way.

This link will take you to today's "last page" of the IMHA AIHA thread.

Good luck -- feel free to holler if I can help in ANY way.