Quick Post

Aplastic Anemia

New Topic
Aplastic Anemia
  • Thank you Johnny and Annie for your response.  Annie, you are so right about being overwhelmed.  I am extremely overwhelmed and I don't know if Josey is on the right track with the vet.  We are doctoring at the University of Wisconsin Vet School and I have had some very positive experiences and some questionable experiences.  Reading your posts makes me question a lot of things. 

     Johnny, I have read all of your suggestions and will definitely bring them to the table.  I just read a study by Dr. Dodds in regards to the thyroid.  We have NOT done a full thyroid testing and we probably should.  Can you still do this once the medications have been started?  I do not have copies of all of her blood work.  Should I have?  And I should make sure we are checking the reticulocytes as well as PCV?  How often should we be doing this?  They are having me bring her back in two weeks which will be the 22nd.  I feel that is a long time to go.  Thoughts?

     Annie, did you utilize Chinese medicine at all?  Callie has highly recommended this and I have been trying to make an appointment with a chinese medicine vet to see her.  Has anyone ever mentioned both milk thistle and dandelion root?  Also, where do you find the Denamarin?  I am extremely worried about Josey's eating.  She is a very picky dog to begin with and never has been a dog that cared much about eating.  It's been a huge challenge and she has already vomitted from the meds.  Did you ever try probiotics?  This was also suggested to me.  Coconut oil was also recommed just for nutrition sake.

    What kinds of issues did you have with the immunosuppression?  Callie told me about all of the UTIs that Billy had.  What other things did you encounter?  Where can I find urine dipsticks and what would this tell me about her urine?  My other concern is that Josey likes to eat her poop.  Could this potentially be an issue with her immunosuppression as well?  What are your thoughts on tripe bones?  Josey really likes them and I took one and pulvarized it with my food processor and sprinkled it on her food.  It definitely sparked her curiosity and she did seem to eat a bit better.

    How often was Jasper transfused?  Josey was transfused on Saturday, February 5th.  Her last PCV was tested on the 8th and it was 24.  We are not scheduled to see the vet and recheck blood work until the 22nd.  Do you find that to be a long time?  I feel like I am obsessed with checking her gums.  She is not eating the best, she is still very active, and drinking, peeing, and pooping okay so far.  She has vomitted twice, once after starting the prednisone and cyclosporine.  She has definitely adapted to having a low PCV since it got down to 16 and she was still relatively active but definitely not herself.  The vet told me that they would not transfuse her until she dropped down to 10.  I honestly don't understand this since she did not feel good when it was 16.  It just seems so counterproductive.

     I was wondering if you could go through your schedule of medications with me.  I have been trying to figure out what is the best time to be giving everything and I am feeling EXTREMELY overwhelmed with this aspect of things.  While I understand this has a lot to do with her eating, just knowing how you went about administering the medications would be very very helpful. 

    Again, Annie and Johnny, thank you for your posts.  I think there are many things that I need to bring to the attention of my vet at UW Vet school.  I appreciate your posts so very much.

     

     

  • Johnny, where can I find the hematinic?  I was just reading some info on homeopathic remedies that said Vitamin b12 was great for bone marrow problems.  Also, what is the dose for pepcid?  I am currently using 10 mg tabs twice a day.  I am also trying the milk thistle powder but should probably switch to something stronger since she is already vomitting.  My sister is bringing me a sample of slippery elm, but I am not familiar with the cocktail.  What is the cocktail?

     Again, thank you so much for your post.

     

     

  • baiceyjo7
    I was just reading some info on homeopathic remedies that said Vitamin b12 was great for bone marrow problems. 

    Homeopathic or holistic?  I'm not aware of B12 in a homeopathic form -- but it might be.  Send me the article will you please??  (remember the honey = natural homeopathic I was talking about on the phone, with a homeopathic being a super diluted "thing" used medicinally?  if you've found someting on B12 homeopathic I'm SUPER interested.

    I've misplaced my Pill Book Guide and I can't give you the dose on Pepcid.  sowwy.

    baiceyjo7
    I am also trying the milk thistle powder but should probably switch to something stronger since she is already vomitting.

    Try the tincture and see if it works better.  If you can get her for a PCV somewhere tomorrow I'd do it -- I don't like the sound of this -- it sounds like either she's having a difficult time with the cyclo (which sometimes lessens as their body acclimates to it) but you want to make sure it's not from the PCV being too low

    baiceyjo7
      My sister is bringing me a sample of slippery elm, but I am not familiar with the cocktail.  What is the cocktail?

     

    Here's the reecipe for the "slippery elm cocktail" -- that's just Dr. D's affectionate name for it.  Whole Foods should have all that stuff.

     

    1 -- half a cup of boiling water.

    2 -- add 1 rounded tsp. of ground slippery elm

    3 -- let cool totally

    4 -- add 1/8 c. + 2 tablespoons of aloe juice

    5 -- add 10 drops of chlorophyll

    6 -- Add 2-3 capsules (open the caps) of acidolpholus

     

    Once you get it mixed up and whipped smooth, it keeps in the fridge for 3-4 days (after that the acidopholous dies). 

     

    Use a baby medicine syringe and load it FULL.  Give about half an hour before a meal.  Just put the tip of the syringe behind the canine tooth and hold the mouth loosely closed.  Squirt slowly so they can work their tongue to swallow.

     

     

  • baiceyjo7
    We are doctoring at the University of Wisconsin Vet School and I have had some very positive experiences and some questionable experiences.

    I've actually heard LOTS of positive feedback from this school...compared to other veterinary schools!  They're ahead of the game IMO in various fields!

    baiceyjo7
    We have NOT done a full thyroid testing and we probably should.  Can you still do this once the medications have been started?

    You can still do the tst but in most cases the T4 and T3 will be skewed some (lower than should be).  This is when I'd usually recommend sending a sample off to Hemopet and Dr. Dodds for analysis.  She does the breed/age/sex specific thyroid testing and it's by far the best most comprehensive canine thyroid testing on the planet!  In fact, for under $200 you can get this, a FULL CBC, a FULL chemistry including electrolytes, a morphology (which is sooo important to have) and her own personal analysis and recommendations!  Sending blood toher was one of the best things I've done while treating Tessy!!!

    baiceyjo7
    I do not have copies of all of her blood work.  Should I have?

    YES....get ALL copies from the past and ask for copies at each visit!  Keep a folder for reference or make a spreadsheet...that's what I did!  Makes it soo much better for researching and answering questions!  Plus you can watch for trends!

    baiceyjo7
    And I should make sure we are checking the reticulocytes as well as PCV?

    If you are only getting a PCV then it doesn't include a reticulocyte count.  You'd have to get a CBC in order to follow these.  I always tell people that if you can afford to do so ALWAYS get a CBC as opposed to a PCV.  That way you get a more full picture of what the blood is doing!  I NEVER get PCV's for Tessy....always CBC's!

    baiceyjo7
    They are having me bring her back in two weeks which will be the 22nd.  I feel that is a long time to go.

    That's up to you but for me it would be too long. 

    baiceyjo7
    I am extremely worried about Josey's eating.  She is a very picky dog to begin with and never has been a dog that cared much about eating.  It's been a huge challenge and she has already vomitted from the meds.

    The slippery elm cocktail that Callie posted would help here!  You could also try giving the pepcid an hour before giving hte meds.  You really wanna be carefull for ulcers!  If this all fails you could ask the vet about using an appetite stimulant.  Mirtazapine is a good choice.  It's a human antidepressant but workd good for this!  It's an RX drug.  Giving meds with food is also important.

    .

    baiceyjo7
    Did you ever try probiotics?  This was also suggested to me.
      Yes...anytime you are using an antibiotic then a good probiotic should also be used to balance out the good bacteria.  Just make sure it's given at least a couple hrs AFTER giving anm antibiotic so that the anti's don't kill them off!  I give them to Tessy every so often adn Forti Flora is one of the better ones you can get from a vet.

    Dandelion root and coconut oil.....I don't know anything about these so can't comment or recommend!  Maybe someone else here might know.

    baiceyjo7
    I was wondering if you could go through your schedule of medications with me.  I have been trying to figure out what is the best time to be giving everything and I am feeling EXTREMELY overwhelmed with this aspect of things.  While I understand this has a lot to do with her eating, just knowing how you went about administering the medications would be very very helpful.

    Feel free to post your schedule you use for meds and we'll look it over for you.  I always tried to separate all of Tessy's meds for optimal benefit.

     

     

  • baiceyjo7
    And I should make sure we are checking the reticulocytes as well as PCV?  How often should we be doing this?  They are having me bring her back in two weeks which will be the 22nd.  I feel that is a long time to go.  Thoughts?

    It's probably not a bad idea to do them pretty frequently early on--since the reticulocytes appear to be what her immune system is targeting, it can help you stay on top of the destruction, and if you catch the corrected reticulocyte count starting to drop, it gives you a little jump on helping her if she's heading for a crash. The RBC indices can also give you an idea of her regeneration--immature red blood cells are larger, so a high value for mean corpuscular volume (MCV) is a pretty good sign that she's making new cells--but the reticulocyte count is a lot more illustrative of what's being produced. Jasper took a while to start regenerating, so we held off until she started to stabilize; we did them weekly for a month or so, and only stopped after her PCV had been definitively rising for a couple weeks. We checked her PCV twice a week as well--sometimes three times a week if she seemed clinically off, and even waiting a day or two was nerve-wracking so two weeks would probably kill me! It's typically a really inexpensive tests, and takes about ten minutes to run, and can save some drama in the long run, so I would recommend doing them pretty frequently to start off.

    baiceyjo7
    What kinds of issues did you have with the immunosuppression?

    We got really lucky, and didn't have to deal with anything other than a nasty abscess on her elbow. Try to keep her skin as moisturized as possible (vitamin e oil is awesome), and if you see any skin that looks irritated, especially around her joints, it's probably going to crack and be open to infiltration--whenever Jasper had anything like that, I put triple antibiotic ointment on it to keep it moist, and then left it covered for a day or so--I have no idea if that's medically sound, but it seems to have worked pretty well haha. She also gets omega 3s and vitamin e capsules and that's kept her skin in pretty good shape as well. Be REALLY gentle when you brush her teeth, and try not to abrade her gums and leave them open to gross mouth bacteria. It's safest to turn her into a total recluse--no walks, no grooming, and if there have been any nasty cases at the vet when you take her, sweet-talk them into looking at her in the car : ) If you have people over, be totally neurotic about handwashing and taking shoes off. I'm sure Callie's given you a ton of info on supplements and stuff, but d-mannose was a miracle for her bladder, and I still can't believe she hasn't had an infection. The dipsticks we use test "Glucose, Bilirubin, Ketone, Specific Gravity, Blood, pH, Protein, Urobilinogen, Nitrite and Leukocytes," and you can buy them online and probably from your vet too. They definitely don't replace a legitimate UA, but can help catch problems early.

     

    baiceyjo7
    My other concern is that Josey likes to eat her poop. 
    ughh, Jasper eats out of the litter box, and it got so much worse once the pred-hunger kicked in. It never seemed to cause any issues, but it freaks me out to no end, and she's pretty persistent in terms of what she'll do to get to it. There's something called For-Bid--it's a powder that you sprinkle on her food for three or four days in a row, and it's supposed to make the stool really bitter and turn them off from eating it. I think it's pretty effective, but definitely check with someone who knows their stuff and make sure it's ok to use with IMHA.

    baiceyjo7
    How often was Jasper transfused?

    She had a whole blood transfusion the night she crashed, and then an additional plasma transfusion the next day because she had some bleeding around her liver (she has von Willebrand disease, so they were trying to pump up her clotting factors and help her reabsorb the fluids). She had her second whole blood transfusion a little over a month later, and her third was a week and a day after that. Her cutoff seemed to be 14--whenever she dipped below 14 it was pretty clinically obvious, so whenever she started inching to 16 or so we got ready to transfuse. A pretty common cutoff seems to be 12, and most importantly, you know Josey, so if she doesn't seem ok below 16 or so, don't feel weird about questioning why they'd let her get so low. Transfusions are pretty last resort, so the mindset of routine transfusions (just to help her along until she can start making blood herself) is sometimes kind of weird to consider. There are definitely legitimate reasons for being wary of multiple transfusions, but transfusing a dog who has been typed and cross-matched, who is in relatively stable condition otherwise, and is on a hefty dose of steroids (reducing the risk of an inflammatory, if not hemolytic, reaction) is a completely different situation from transfusing a critical dog that's been hit by a car, or a dog with hemangiosarcoma.

    baiceyjo7
    She is not eating the best, she is still very active, and drinking, peeing, and pooping okay so far.  She has vomitted twice, once after starting the prednisone and cyclosporine.

    That sounds really good! I don't know what to do in terms of enticing her to eat, but if she's vomiting, try offering her small meals throughout the day? The cyclosporine can definitely take getting used to, and even Jasper's typically iron stomach couldn't handle it initially, but she did adjust. If she seems to be getting dehydrated, unflavored pedia-lite works really well--just make sure it doesn't have any artificial sweeteners (I don't know why it would, but...). You can also mix it with wet food and warm it up a little bit to make it smellier and more appealing if she just doesn't seem hungry (if she's nauseous though, that's probably not a good idea).

    baiceyjo7
    I have been trying to figure out what is the best time to be giving everything and I am feeling EXTREMELY overwhelmed with this aspect of things.

    Definitely post it! Ours was so ridiculous, and we went through about 9 different schedules before things calmed down a little bit. It gets totally mindboggling,, and every drug seems to have its own specific requirements, but the most important thing is that she's getting them, so don't drive yourself crazy if it's impossible. 

    Finallyyyy, Denamarin is made by Nutramax, and if your vet doesn't sell it you can definitely get it online!

     

  • I am going to post my current schedule for medications and feedings.  Josey has had a better day today and I am trying to have faith that the people at UW know what they are doing and talking about.  I have been in touch with Dr. Dodds over the weekend and she has offered to consult with my vet.  Now I just have to get my vet on board.  Plus Dr. Dodds is leaving for Italy on Tuesday afternoon, so time is of the essence. 

    Here is my current schedule:  (Any additions, subtractions, changes are appreciated) 

    530 am:  Pepcid 10 mg, one capsule of milk thistle powder in teaspoon of plain yogurt and a little bit of water; I give with a syringe

    6:00 am:  Feed her what ever she will eat ( I had to force feed her today - is this common?); then I give her Prednisone 10 mg

    6:30 am:  I give her Cyclosporine 50 mg and another small feeding (Is it best to let some time pass between the prednisone and cyclosporine or just give them toegether?)

    Throughout the remainder of the day, I will offer her small feedings every couple of hours.  If she won't take any, I will force feed her a little bit just to keep something in her tummy. 

    I start the process all over again at 5:30 pm. 

    I am trying to find some pet tinic that you suggested Johnny.  Is that something I will have to get online?  Any suggestions of what the best place is to find it? 

    Where can I find calm stomach?

    Has anyone used colostrum or mother's milk?

    Do you give the D-Mannose every day and where do you find that?

    Do you just rub the Vitamin E oil on her coat or just in the specific spots that you notice are dry? 

    And all of these drugs are okay to administer in conjunction with the pred and cyclo?

    I have emailed my vet with a multitude of concerns, the biggest her contacting Dr. Dodds to optimize her treatment.  Did everyone here have their dog on the thryroid medication in addition to the immunosuppressants?  Sorry...sidebar.  I am also going to get her in sooner for a blood draw.  I much rather pay the money to have it checked then pay the consequences. 

    This forum is a god sent on my mental status.  I know you all know what I mean!

     

  • I forgot to ask about Aspirin for the slow moving blood issues.  When I asked my vet about this, I was told that this was not necessary.  However, in reading many posts, it sounds like others were recommended on its use.  I read a post about someone that diluted an 81 mg in 8.1 ml of water and then administered 0.8 ml to their 35 pound dog.  How can I find out how much to administer to Josey, a 22 pound dog?

  • baiceyjo7

    530 am:  Pepcid 10 mg, one capsule of milk thistle powder in teaspoon of plain yogurt and a little bit of water; I give with a syringe

    6:00 am:  Feed her what ever she will eat ( I had to force feed her today - is this common?); then I give her Prednisone 10 mg

    The dogs who are picky and who don't eat well are the dogs who have the greatest difficulty -- that's sad but true because in order to tolerate the drugs thay HAVE to eat and the more they DO eat the easier time of it they have.  You do have to force feed some dogs -- HOWEVER what you were giving her in the syringe I'd likely put in her food.  I usually didn't give milk thistle all by itself - I'd just add it to everything else. 

    I used Prilosec and I always gave it with food and the other drugs - I *know* they say to give cyclo on an empty stomach but I figured that because it kinda made even Billy look 'green' that I'd lose the war if I tried to give him cyclo on an empty stomach so I ALWAYS gave it with food.  Now I gave it before the meal but  WITH food.

    I always gave meds in a lob of soft slidey cheese (like ricotta) or with liverwurst.  Everyone got some (which helps in a multi-dog household because you get good old fashioned GREED working for you) so medicne times were seen as "YUM GOODIE" times.  I never hide it -- I tell them "this is your pill so DON'T CHEW - just swallow!" (I actually train for this -- "just swallow" means exactly that - it's bitter and yuck so let it slide down! -- but when something is yummy I teach "Chew GOOD" so it's like teaching a dog TO bark to teach them "NO barking" I teach them that when something is yuck I'll warn them so they don't taste the bad stuff but when something is GOOD I'll also let them know to chew it bunches.  

    baiceyjo7

    6:30 am:  I give her Cyclosporine 50 mg and another small feeding (Is it best to let some time pass between the prednisone and cyclosporine or just give them toegether?)

    Throughout the remainder of the day, I will offer her small feedings every couple of hours.  If she won't take any, I will force feed her a little bit just to keep something in her tummy. 

    Give the cylo and the pred together -- you just don't want her to bite the cyclo, nor do you want it to stick in the throat. 

    Be creative -- sometimes they want something hot versus cold or something NOT smelly vs. smelly or vice versa -- will she eat more if YOU are eating (i.e., sharing?)  Billy ate all sorts of stuff from watermelon on down.

    I don't get religious over "plain yogurt" -- one of Billy's favorite things on the planet is Stoneyfield "Rockin Raspberry" yogurt -- I don't give anything with nutrasweet in it at all but I DO give fruity yogurt.  If it makes him smack his lips he got it.

    Note on Probiotics -- she's not taking antibiotics NOW so I wouldn't major in probiotics.  Remember - probiotics ARE bacteria -- good bacteria, yes, but they ARE bacteria so don't overdo them.  Yogurt is a good probiotic for right now.

    baiceyjo7

    I am trying to find some pet tinic that you suggested Johnny.  Is that something I will have to get online?  Any suggestions of what the best place is to find it? 

    That's a Dr. Dodds recommendation -- vets usually carry it and I'd *think* UW would have it or know where to get it.  You CAN get it online -- in fact someone posted a few pages ago they got it, I *think* on E-bay.

    baiceyjo7

    Where can I find calm stomach?

    Has anyone used colostrum or mother's milk?

    Calm Stomach is TCVM -- http://www.morningstarhealth.com carries it, but talk to that TCVM vet you're talking to before you just launch into that -- but I would make it PLAIN that tummy problems are paramount here.

    Try the slippery elm cocktail FIRST.  There's nothing in that which will fight with the meds and that *does* have a probiotic in it and not an overly strong one.

    Colostrum?  Why that?  Colostrum boosts the immune system -- that's not something I'd use now.  You want to support the immune system but not push it *on* more.

    There's another thing out there you'll see some folks push called Bio Prep -- it's an algae - and it's nothing I like to see people fool with.  I think it's risky at best.

    baiceyjo7

    Do you give the D-Mannose every day and where do you find that?

    Do you just rub the Vitamin E oil on her coat or just in the specific spots that you notice are dry? 

    You don't need d-mannose unless she's having uti problems with the cyclo.  Anyplace that sells Now Foods brand is a good source for that, but you don't need that now.

    Vit E -- i'd just put that on dry spots -- again the dry skin was a specific side effect she had.  With Vit E there is a difference between Vit E for topical use and Vit E for oral use, but in a dog I'd use the oral one ALL the time because you don't want her licking the topical (it's toxic).

    baiceyjo7

    I have emailed my vet with a multitude of concerns, the biggest her contacting Dr. Dodds to optimize her treatment.  Did everyone here have their dog on the thryroid medication in addition to the immunosuppressants?  Sorry...sidebar.  I am also going to get her in sooner for a blood draw.  I much rather pay the money to have it checked then pay the consequences. 

    Yes, Billy took thyroid med the whole way thru.  He was low thyroid before but his supplementation went thru the roof while we were using the big drugs because they suppress the thyroid so much.  This is where Dr. Dodds is invaluable.

    baiceyjo7

    This forum is a god sent on my mental status.  I know you all know what I mean!

    That's what we're here for -- and don't hesitate to call me, ok??  I don't care how late it is CALL ME.  It's not worth YOU having to stress!! *hugs*

  • I've been thinking about everyone and sending lots of prayers.  

    Baiceyjo 7, For the liquid aspirin, I would just as the UW vet hospital for it. (That's where you're going, right? Or, did I get mixed up? If it's not, just ask your vet for it, and if he/she doesn't have it (mine didn't keep it in stock), ask them to call in an Rx at a vet that does. Frisby's emergency vet had it, so my reg. vet would just call in the Rx to them and I'd pick it up. You could also use a compounding pharmacy, if there's one near you.) I just used an oral syringe to get the exact dosage. If you (or anyone) need any oral syringes, I have tons in a couple different sizes (I ordered 100 of each...just in case I needed a lot :-)  Just let me know--I can pop some in the mail to you. I didn't have luck making my own liquid version, in part because I couldn't be sure the aspirin was fully disolved and evenly distributed in the liquid.

    For regular blood testing, I requested a full panel every time. It cost a bit more, but I felt it gave us the best picture we could get and helped me be less (or more) paranoid.

    For the Pet-Tinic, I ordered Frisby's from EntirelyPets.com, I think. It is a bit hard to find, but I did use it per Dr. Dodd's recommendation. Later, I switched to Pet-Tabs (chewables that have a bit less iron). You may find you only need to give the Pet-Tinic every other day.

    I don't know aplastic anemia in dogs--only in people, but it such a close cousin to IMHA a lot of the issues and treatments seem to be the same.

    Hugs and prayers for all.

  • Thank you FrisbyPI for the hugs, prayers, and information.  We will take all of the good, positive thoughts as possible.

     I am feeling a bit frustrated with the UW Vet school and the vet Josey is seeing.  I spoke with her about the conversations that I had with Dr. Dodds over the weekend and that Dr. Dodds was willing to consult with her over the phone.  I was told that Dr. Dodds is very unconventional and that the things that she suggested doing (ie: starting thyroxine) were not part of "their standard of care."  I can't imagine telling one of my patients that I wouldn't even entertain the idea of trying something new.  I finally convinced her that checking Josey's PCV at least weekly was what I WANTED to do.  So we checked in yesterday and will check it again on Thursday.  She was 20 on Monday and I am hoping she will just chill there rather than drop for now.  I at least felt like I accomplished one thing I wanted for her.  But I would really still like the thyroxine issue addressed.

    I want to make sure that I understand the whole aspirin issue as well.  I asked Josey's UW vet about this again as well.  She told me that since Josey has aplastic anemia and not the hemolytic anemia, she is not at risk for clotting.  Can anyone clarify this for me in terms of what you understand and what your vets have told you?  I have a fairly good understanding of prednisone and its nastiness.  If Josey is at the slightest risk for clots, then I want to make sure that we are doing something to prevent this.  Frustrating!!!

    So I decided to make a phone call to Josey's primary vet.  She had me send her the information that Dr. Dodd sent me and was going to do a bit of research and reading.  Now, that is what I need someone to do for us.  Her primary vet said that they could definitely treat Josey there and that if she needed to be transfused that she could be sent back over to UW.  I am seriously considering just going back to her normal vet where she feels most comfortable.  I am going to make one other phone call to another specialty vet service here in Madison and see if they have a lot of experience dealing with this disease and what kind of protocols they follow in treating it.

    On Monday, after Josey's exam, the UW vet had me stop her cyclosporine for now.  She was not eating and actually lost weight.  She does not have any weight to give and I know the seriousness of her not eating.  We are going to focus on the prednisone and probably start her cyclosporine back a bit slower later this week. She ate very well last night and today.  She actually is taking the food from me rather than me having to force it down her throat. 

    I continue to try to keep a positive attitude but I am leary of the UW vet and the care she is receiving right now.  If there are people out there that have greater knowledge on specific diseases, I don't understand why you wouldn't want to learn how to optimally treat it.  I am just trying to take it day by day for now.  We will see what Thursday brings. 

    Thank you for just listening....

  • baiceyjo7
    I was told that Dr. Dodds is very unconventional and that the things that she suggested doing (ie: starting thyroxine) were not part of "their standard of care." 

    LOL....I've heard this more than once!  Her thyroid testing and protocol have been controversial amongst vets for years but slowly and slowly more vets are clueing in!

    Did you at least have the thyroid checked or rechecked??  Do this with the regular vet to find out if the T4 or T2 is low.  If borderline then you could use this info as leverage to add thyroid supplements.

    baiceyjo7
    the whole aspirin issue

    If it were me I wouldn't be using aspirin either.  This is more for acute cases with lots of lysis and autoaggutinating!  They can usually tell just by the way the blood looks when they draw it from a vein!  ALSO...you gotta be carefull when adding this.  It might actually cause more problems than preventing them.  I agree with them that it isn't necesary!

    baiceyjo7
    I am seriously considering just going back to her normal vet where she feels most comfortable. 

    FOR SURE!!!!  I think it's soooo important to do whatever keeps the dog happier and less stressed.  Can you get full CBC's and chem panels with the regular vet?  If so then I'd be using them instead of the school!  Making Josey happy is a good thing!

    baiceyjo7
    On Monday, after Josey's exam, the UW vet had me stop her cyclosporine for now.  She was not eating and actually lost weight. 

    This would have me concerned!  Cyclo is THE BEST drug to use when treating these particular cases where the bone marrow is involved.  I recommended above to pulse dose so perhaps a couple days off won't hurt.  Start with a smaler dose and then work your way up to the original dosage.  Give AFTER at least a handfull of food to help.

    Good thoughts and healing vibes for Thursday!

  • Wheee -- we have a PICTURE of the girl!!!  What a cutie!!!

    baiceyjo7
    I was told that Dr. Dodds is very unconventional and that the things that she suggested doing (ie: starting thyroxine) were not part of "their standard of care."

    Given how closely she works with Dr. Schultz that's not very complimentary.  She's also the biggest expert on thyroid care in the entire US.  That's pretty well undisputed. 

    baiceyjo7
    I asked Josey's UW vet about this again as well.  She told me that since Josey has aplastic anemia and not the hemolytic anemia, she is not at risk for clotting.  Can anyone clarify this for me in terms of what you understand and what your vets have told you?  I have a fairly good understanding of prednisone and its nastiness.  If Josey is at the slightest risk for clots, then I want to make sure that we are doing something to prevent this.  Frustrating!!!

    I was told it was the drugs -- that particularly cyclo causes "disturbances" in the blood flow which enhance the risk of embolism.  And I was encouraged from the time Billy **started** on cyclo to keep him pretty darned sedentary.  no ball chasing, no running ... even when he FELT like it.

    baiceyjo7
    Her primary vet said that they could definitely treat Josey there and that if she needed to be transfused that she could be sent back over to UW.  I am seriously considering just going back to her normal vet where she feels most comfortable.  I am going to make one other phone call to another specialty vet service here in Madison and see if they have a lot of experience dealing with this disease and what kind of protocols they follow in treating it.

    I don't blame you for wanting to change -- and a regular vet who is willing to be open-minded is a GOOD thing.

    Be cautious of specialty vets -- they can have a HUGE competition with vet schools and I have often heard them say "OH yeah we treat a LOT of that" or "oh yes we have experience in that!" when they don't really -- but they want the business from the vet school (and I really hate it when "business" gets in the way of care!).

    In honesty, if you can find a TCVM vet -- they are really GOOD at helping the body make blood.  I was convinced then, and now, that it's one of the things that tipped the scales in Billy's favor.  And a TCVM vet is NOT going to ask you to take her off the other drugs. 

    I think you're right to be concerned.  I was going to call you tonight but your number has fallen off my "list" in my phone *sigh*.  But you ARE being thot of and lifted up!!  MANY times a day *hugs*

     

     

  • I am sorry to read about you little one.  iI can tell you this---the folks here probably know as much if not more, than most vets do about this kind of thing.

    when my golden retriever, Hunter, was diagnosed with AIHA just after his 4th birthday, I had never heard of it. .  At the time I had never used a computer and had to go to the library and have them show me how to use itso I could look this nasty, horrible disease up, read about treatment, etc.

    My Hunter never stood a chance.  We know his ws brought on by his ProHeart6 heartworm prevention injuection, but it also was killing his liver.  He was diagnosed on Oct. 9, 2003 and died, still in ICU on Oct. 15, 2003.  We had the necropsy done and results were of course the AIHA and also "drug induced necrosis of the liver."  I started hitting the comuter and started fiding all these stories of dogs who had died or almost died following their PH6 injection.  Some familieseven lost 2 dogs to it.  And this is how I found this forum all those years ago.

    As a warning I was telling Hunter's story (as were so many other telling of their dogs near death.death and it turns out very few people had actually heard of AIHa before their dog was diagnosed.  Also it turns out that liver damage and AIHa were two of the leading causes of deaths following PH6.  It was pulled from the market 10 months after Hunter's death because of the outrageous amount of reactions and deaths, but was "{reformulaed" and returned 4 years later.  However, people are jot using it like they did the first round.

    I visited my Hunter 3 times a day in ICU and talked a lot with my vet.  But I didn't havbe the hands on experiece so many here have.  Listen to them.  Only advice I have is never, ever givde another vax or non disease realted med if possible  wishing you lots of luck and a long life for you little one.

  • Josey was transfused again yesterday at UW.  Her PCV was 18 and she was symptomatic with heavy breathing and tachycardia.  I knew she was not feeling well since she had spent the last few nights under my bed....never a good sign in my opinion.  She came home much more chipper and hungry.  They also gave her an injection of Cerena for naseau and sent me home with four more doses for the next four days.  She was able to eat and we have restarted her Cyclosporine at half of the dose.  She took it both last night and this morning.  I am so hopeful for her and pray to god that we can keep the cyclo in her tummy and turn this darn disease around.  She saw the chinese medicine vet and will start Gui Pi Tang herbs tonight which are to help the blood, heart, and spleen.  I am also going to start cooking for her per the recommendaiton of the chinese med vet.  We will see what kind of food I can cook up this weekend.  I have all of the supplements she needs....just need the meat and veggies.

     We are still doctoring at UW Vet school but Josey's vet will be rotating services so we will have someone new.  I am going to take the weekend to really think about what is the best thing to do for her in terms of all of these vets that I have talked to.  Josey's primary vet and chinese med vet work together and I feel the most comfortable with them.  However, neither one of them have ever treated this disease process before.  Should I let that bother me?  I just worry about the vet school with everyone always rotating through...I understand it...it's a teaching hospital.  Nobody wants to entertain anything to do with Dr. Dodds.  So I am trying to turn that frustration into more positive energy and trust that everyone here is trying to do the best they can for my baby. 

      I am hoping for a quiet weekend with all three of my girls.  I have lots of cuddling, snuggling, and good eating planned.  We will see what happens!

  • Good to hear Josey is feeling better after the transfusion!  Any idea what the new PCV is? 

    I'm with you that the regular vet and the TCVM would be the best bet to use and then just use the university for emergency uses...if need be!

    Get after them to include Dr. Dodds and also a thyroid panel done!  Very important!

    Home cooking....yay!