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Old March 18th, 2015, 03:30 PM
prayforsassy prayforsassy is offline
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AIHA - so terrified for her.

Sassy is a 5-6 year old, spayed, rescued pit bull female..

Everything was so sudden. Last Wednesday, exactly a week ago, I noticed my baby was more tired than usual and didn't want to eat. I had just had to make a really tough decision in my life, and I thought maybe she was feeling my stress and sadness. The next day, things were the same. By Friday, I became really worried, and I took her temperature. I was shocked to see it read 104.9, and immediately went to the vet.

She did blood work and initially thought either a tick borne illness or an auto immune. Her red cells were low(not dangerous, yet), her platelets were low, and her white counts were high.

She was injected with Rimadyl at the vets and here are the pills I had to give her:
Doxycycline Hyclate
Prednisone
Famotidine

We went home. She wouldn't eat that night either. Saturday, I felt she was getting worse, and when she went to pee I saw her pee was the color of tea. It terrified me. We went to the emergency vet. He said then that her eyes might look slightly yellow, but it could of been the lighting... we re-ran her blood, the whites were up, the reds down..he told us to double the Prednisone until Monday.

By Monday, I felt Sassy leaving me. She would not move. She looked so bad, I was distraught, and we went to the vet the moment they opened that morning. They immediately saw she had jaundice, her entire skin is yellow, eyes, gums. Her gums were pale yellow. She had labored breathing. She was dying.... we did an x-ray, full chem test and blood work. The blood work came back and her RBC was now at 9%. She was on the verge of dying at any moment. We were told it was likely Autoimmune hemolytic anemia, and that she would need an immediate transfusion to survive. We were told her chances are guarded to poor. We were offered to euthanize her, and left alone to make our decision. I could not even consider it and we had her get the transfusion, it was whole fresh blood from the techs boxer.

They transfused her for about 4 hours along with tons of other IV meds and fluids, and we were able to pick her up that night - we opted to bring her home with us nights, because there is no 24/7 ER vet here. She would of just been alone, with no one to save her if something happened. That night was the hardest night of my life and I did not know what to do. I made a bed on the floor and I watched her all night, holding my breath every time I thought she stopped breathing. I have done this every night since Sunday. Back to the vets first thing in the morning for more IVs. At this point, her blood rose from 9% to 18%, and the dr was only hoping for 15% and even thought we'd need 2 transfusions to reach that. She looked pretty rough at home because of the massive amounts of steroids and I still felt she could leave me at any time. Her white counts were down 10,000 points to 50K (they were 60k+ at the time of transfusion.. they were 30k at the original vet visit...), her platelets I think are holding at around 140.

This morning. There was an incredible change with her, she slept okay through the night without the super labored breathing. When I took her outside, she was surprised to see my neighbor and tried to charge / bark at him. I took her back inside, then went out to get the car ready for her. On my way back in, I saw her sitting at the door watching me. On the way out on the leash, she pulled me to the car. She sat up for the ride and was alert. At the vets, she wanted to see all animals in the waiting room and once in the room with the drs that have been treating her I saw the baby I know for the first time in a week - she rolled over on her back and started pushing on people with her paws. I always call her a cat because of this, it's her way of affection and I haven't seen it for a week when it was an every-day occurrence.

The dr said based on the physical exam, she was comfortable waiting until Friday to do the blood work because we were doing full blood work Friday and my bills have already went to about 1,200 in a week. However, I opted to have the simple test done that only test the red blood cell levels - they were down to 15%, from 18%. The dr was not surprised or alarmed... but I am. She said the boxer blood was running out of her now and there was still time for her body to start producing her own....

but should that have happened by now? After her behavior today I was so happy, crying of happiness, only to hear terrifying news.

Today instead of IVs we just went to test and are now on a massive amount of oral meds (6 bottles), she took them at the vets and within an hour she was back to the tired, sad looked baby that is breaking my heart. The meds are making her feel awful. I know they are needed. I am praying for a miracle and that she holds at 15% and starts regenerating... is it too soon to expect regeneration on her own? Or should she have held and gone up from 18%?

Please pray for my baby. She is my soul. I have been crying so much, I can't eat, I can't sleep. Only a week ago she was bouncing off the walls. I miss her so much, my heart is just breaking into pieces...
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  #2  
Old March 18th, 2015, 06:35 PM
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So sorry for what you're going through, Sweetie. I have no experience with AIHA, but will keep you both in my thoughts and prayers.

that she starts producing RBC on her own now!
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Old March 19th, 2015, 07:28 AM
Longblades Longblades is offline
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I'm sorry, I don't know anything about this. I just want to wish you good thoughts she does start to produce her own good blood.
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Old March 19th, 2015, 08:16 AM
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I'm sorry sorry your having to go through this with your pup. I don't have a lot of knowledge but we did have amember here a number of years ago with a pitty that had been diagnosed AIHA but it took a very long time to come to that diagnosis. I will copy the link to the thread but it is very lengthy, take your time reading it and perhaps you will find some info that could be of help you you. Quite a few members here followed the story of "Sway" and will remember her. The one thing that I do remember 100% was that there is a special doctor that is incredibly knowledgeable about this. her name is Doctor Jean Dodds. If you google her you will find a lot of info.

Please don't get discouraged by this thread I am posting as I am hopefuly it will give you some guidance/help only as every dog is different. Please keep us updated on your case?

Good Luck
Cindy

http://www.pets.ca/forum/showthread....ighlight=sways
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Old March 19th, 2015, 02:46 PM
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Winston, I remember Sway! Great memory you have.

No experience either with this, but you are both in my thoughts and prayers. We all know how hard it is to have a terribly sick pet. Many people don't understand why we get so emotional about them, but everyone here gets it.
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Old March 20th, 2015, 12:54 AM
MaxaLisa MaxaLisa is offline
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I will add to your reading list:
http://www.pets.ca/forum/showthread.php?t=73066


Unfortunately, in suspected tick disease, many vets to a fatal combination, 1) under treat with doxycyline (aggressive dose is 10 mg/kg, which is approximately 5 mg/lb) which only at higher doses kills organisms, and 2) they add pred too soon, which interferes with the action of the doxy. Pred should only be added when the RBCs or platelets are dangerously low, not just low. Once though you get to that transfusion state, you do need the pred, or sometimes a different immune suppressant. Dodds has an AIHA protocol which may help.

Testing for tick disease would be important to do.
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Old March 23rd, 2015, 02:35 PM
prayforsassy prayforsassy is offline
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I have an update. Lots of things happened since my post, and incase anyone comes across it in search of hope or information like I have been doing for the past few weeks I wanted it out there. I'm going to post what I've posted to my friends/family, and this information starts from the day I made my first post here.

-----

By Wednesday, she was getting perky again, eating drinking and pulling me around. We went in for a check-up and her blood count had went from 18% to 15%, the dr wasn't surprised or alarmed saying it was normal as the transfusion wore off but if she fell to 12% we would have to consider another if she was acting depressed again. The normal lifespan of a transfusion is about 3 days, and as that blood starts to leave, the levels drop. It's up to the bone marrow to play catch up and start making their own, and Sassy hadn't started doing this yet.

Thursday- she wouldn't eat and wouldn't move. She had stopped drinking as well, when before she had stayed drinking this whole time. We took her back to the vet. Her count had dropped to 10%. She was very sick again... but her other numbers were improving still. Whites coming down. Jaundice was a little better. So we decided, it's too soon to give up, and gave her another transfusion. She had half that night because it was so late, and we went back first thing Friday to finish.

Thursday night I decided to overnight a product to me I researched .. It's called BioPreperation F3, and it is a holistic super food packed with live algae that have the ability to penetrate the blood brain barrier and "awaken" glands in the brain(claims). There are so many stories of it saving their dog from this disease, but I was highly skeptical that they were fake... still, we decided to get it here as soon as we could and try it for her out of desperation. It got here Sat. I did ask my vet before this and she said she can't advise it because it's not a drug that they use however she felt that it would not harm her if I wanted to try it.

Saturday, she wasn't eating again and was back to laying around. Also, her pee went from dark yellow the day before to turning orange again, and I think she was crashing again, I really do. The BioPrep I over nighted arrived and I gave her 1/2 a capsule. 2 hours later I gave her another 1/2. We had to mix it in chicken broth and shoot it in her mouth. Just a few hours later she started eating again. She started walking around, following us to the kitchen, outside, wanting in the couch. She did a BIG stretch in her sleep. Just a few hours after I was sure she was crashing. I gave her another 1/2 capsule that night.

Sunday, she was doing even better, eating everything in sight and her pee was looking better again. She had more energy than she had in a long time. We did another 1/2 capsule each dosage, 3 hours apart, a total of 4 times yesterday of the BioPrep again. Her gums were so red, she was showing nothing but improvement. I've been sleeping in the living room with her at night, and last night she came and demanded to be let on the couch next to me.

So today, we went in for the big test. Sassy was dragging us inside and the drs/assistants were already shocked by how pink her gums were, how less yellow she was, and how much energy she had. Results came back and she is at 22% red blood, 37,000 white cells, and the substance (bilirubin) creating her jaundice is almost gone (she was at 6.5%, then 4.5%, now 1%, normal is 0.5%). Shes alert and looks so good today.

I took her outside today...and she dragged me to the sun, plopped down and bathed in it. Not only that, she started rolling around on her back, huffing and just rolling. Incredible to see when she was so, so so sick just a few days ago.




Honestly, I feel that the biopreperation I ordered saved her life. I don't know what else to think of the drastic improvement starting only a few hours after taking it. Everyone at the vets office was amazed at her change. We are not out of the woods yet and have a long way to go, but today was a good day. The dr feels that 22% is her, and not the transfused blood and that is amazing and happy and such good news.

I've never even heard of autoimmune hemolytic anemia. This is a devastating illness that has a very high mortality rate. If you have dogs... please check their gums daily! Just pull the lip up in the morning and check their color. They should be a nice dark pink. It's one of the first things you'll notice with this illness, I think, besides tiredness. If you ever see them paling...get in for a checkup..have the blood levels checked.

As far as her treatment/drugs,
Day one she was given a Rimadyl shot for her fever and she was put on 3 tabs of Doxycycline twice a day, 1 tab of Prednisone twice a day, 1 tab of Famotidine twice a day.

The next day after rushing to a different emergency vet, he advised upping her Pred to 1.5 tabs twice a day, along with the other meds.

With her first hospitalization and treatment there, she was given (i think via IV):
b12
dexamethasone sp
baytril
k9 whole boxer blood
azathioprine (by mouth)
^ She had these for two days.

Coming home, she was on:
1.5 prednisone twice a day
3 doxy twice a day
1 baytril twice a day (enrofloxacin)
2 cerenia tab once a day (only two days)
1 famotidine twice a day
1.5 azathioprine once a day

During her second transfusion, she had the same treatment as above, also adding diphenhydramine injection.

By Saturday afternoon, I had the Biopreperation f3. I did 1.5 capsules the first day, and am now doing 2. 1/2 powder emptied into chicken broth every 2 hours if she isn't hungry, or if she is scarfing down food I sprinkle it over the food (I make sure shes very hungry so it doesn't get wasted) It seems like she perks up after every one of these.

She hasn't really touched her dogfood at all since this started. After the first transfusion she did scarf down two cans of hills AD prescription food but after that she actually wants to run from that food. She doesnt like any wet food I tried to buy her. We've been feeding her extra lean hamburger (squeezed as much grease as possible out), boiled chicken breast + broth and peas an carrots, a little bit of chicken liver. I did get her to eat a small handful of her regular dry last night.

I don't entirely know how important this is...but here is the progression of her urine.





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Old March 23rd, 2015, 06:39 PM
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That's such a great update, prayforsassy! Keeping her in my thoughts and prayers that the improvement continues!

She's a doll, by the way! Looks so happy in those pics!
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Old March 23rd, 2015, 06:52 PM
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That's good news thx for the update!
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Old March 23rd, 2015, 09:39 PM
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What a great update! You go Sassy! I hope she continues to improve, you did good. Sometimes the things we find ourselves, or discover on boards like this, work miracles that a regular vet cannot. My last girl Halo did much better with my own treatments than what the vet was giving her. So, sometimes when you have nothing to lose, trying something new is a good plan. So happy for you both. Keep us updated please. Now we're all in love you know.
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Old March 25th, 2015, 01:10 AM
MaxaLisa MaxaLisa is offline
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Glad she is better!

Just a mention, pitbulls are thought to be susceptible to Babesia, which is not often tested for, and I'm not sure how reliable the testing is. It's a common coinfection with tick disease, but can also occur on its own.
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  #12  
Old March 25th, 2015, 01:46 PM
prayforsassy prayforsassy is offline
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Quote:
Originally Posted by MaxaLisa View Post
Glad she is better!

Just a mention, pitbulls are thought to be susceptible to Babesia, which is not often tested for, and I'm not sure how reliable the testing is. It's a common coinfection with tick disease, but can also occur on its own.
The first few days she was sick I actually did mention babesia to the emergency vet on the phone when he called me the next day to see how she was. He'd taken her blood the night before. I mentioned babesia to him after reading a lot and thought she had all the symptoms of it(but she also had all the systems of AIHA). He said he didn't think so simply because it is so rare here he's never saw a case in his career - but he messaged me a little while later and said he looked at her blood under slides and saw no indication of babesia. Also, she seems to be improving on her current treatment plan and I think babesia is not treated this way at all - theres only 2 drugs possibly used?

Thank you for the well-wishes, everyone. We have an apt. tomorrow morning to see where her count is. Her gums are getting pinker by the day. She is still really tired, but it's not a... "I'm dead tired". Shes alert and watches us. Re-positions herself.

I am however getting concerned. I think it's the steroids but I don't know; I'm asking tomorrow but has anyone with a dog on heavy steroid treatment found that their abdomen becomes really hard? When she is standing up, it looks slightly distended and when she is laying on her side it's very obviously enlarged. I've saw "swollen" belly as a side effect of steroids; does that also mean a really hard belly? It is not painful to her. I can rub, push, etc and she doesn't react. I first noticed this about a week ago, and it seems to be getting slightly worse - but back then I had the vet look at it too and she wasn't concerned. She felt her belly for a long while, pushing in and stuff and it was all fine and sassy didn't mind.

Does anyone think it's simply because of how much she is eating right now? The steroids are making her so hungry, and after the initial 4 days of not eating I've started to try and limit her food. Still, sometimes I have to give her a little because she is just so starving. She is eating more than she was before getting sick, more frequently.
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Old March 26th, 2015, 12:00 AM
MaxaLisa MaxaLisa is offline
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I ALWAYS get nervous about the steroids in these situations, for a variety of reasons. Unfortunately, something like hemangiosarcoma also needs to be ruled out, and that's usually done with an ultrasound

As for the babesia, I do not believe that you can always see it. I would call this lab and ask, which is the one we use on the tick list, as they specialize in this stuff: http://www.protatek.com/reflab.html

When did your dog last have a vaccination? Or any new meds before this all happened?
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Old March 26th, 2015, 04:10 PM
prayforsassy prayforsassy is offline
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Originally Posted by MaxaLisa View Post
I ALWAYS get nervous about the steroids in these situations, for a variety of reasons. Unfortunately, something like hemangiosarcoma also needs to be ruled out, and that's usually done with an ultrasound

As for the babesia, I do not believe that you can always see it. I would call this lab and ask, which is the one we use on the tick list, as they specialize in this stuff: http://www.protatek.com/reflab.html

When did your dog last have a vaccination? Or any new meds before this all happened?
Sassy hasn't had a vaccine since the start of last summer and her last heartworm was about 3 months ago, flea meds even longer. I have tried to think back, and I really don't know what triggered this. She was literally fine, hyper and crazy, the next day, nearly dead. No meds at all in recent time. Shes never been on any meds actually except for 3-4 years ago when she was spayed. She is a very indoor dog, and has no contact with other dogs (I'm out in the county, not the city)

Went to the vet again this morning. Her red cells are at 27% now, her platelets are excellent (drs words, i don't have the paper in front of me to see exactly). Her white cells are still 33,000 down from 37,000 monday but they seem to be the slowest thing returning to normal. Everything else besides reds pretty much has. The dr is very pleased with her.

I mentioned her belly again and she pushed, pulled, massaged, sassy didn't care one bit and she feels it is just water retention from the steroids and the increased appetite. She said the spleen and everything felt fine, and we just had an x-ray a week ago and everything was normal, as well as the full chem test showing all organ functions being normal. I still hate seeing it like that and am concerned, but it seems to be something I will just have to keep an eye on.

She whined today when she saw the vet. This is something she always did in the past when she saw someone she really liked. Then she tried to shake her hand. I hadn't her her whiny butt for 2 weeks. Later, after we got home, she was kicking in her sleep and making whines/barks in her dreams - also something she always did before getting sick. It makes me very sad that these little things are making me so happy. We came so close to losing her.
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Old March 26th, 2015, 05:19 PM
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The news just gets better and better! Very happy to hear this!
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Old March 29th, 2015, 02:51 PM
MaxaLisa MaxaLisa is offline
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Definitely keep an eye on those WBCs. Some of the drugs, transfusions, etc. may be helping with the production of rbc's and platelet count and inflammation, but you want to keep an eye out for underlying infection. It's great that she is responding.
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Old March 30th, 2015, 04:57 PM
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I'm so sorry you had such a scare with your Sassy.

This makes me go back to our dog Timber and her experience with tick disease. Just curious to know if they tested Sassy for this? Our dog was misdiagnosed as having a platelet disorder and the high dose steroids caused her to become anemic so this takes me back to that time. It is very difficult to see them so ill but glad Sassy is feeling better.
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Old April 2nd, 2015, 02:44 PM
prayforsassy prayforsassy is offline
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They did the quick in office test and she was negative for ticks, although a test wasn't sent off to a lab where they can test for all tick illness, it was only the most common ones. She was already anemic when we went in the first day with the fever, and she dropped several % each day until we transfused and doubled the steroids/added azathioprine. However, it doesn't seem like she was truly stable until I added the bioprep - her other numbers were normalizing but her blood count was in freefall.
Would it still be a good idea to insist for a blood test being sent off site? is that too late?

Sassy is doing well, I guess as well as she can on high steroids. In that I mean she is alive, her gums are super pink, and she is eating/drinking/alert/happy to see everyone. But the steroids are starting to effect her and i'm feeling so awful. I'm starting to see the muscle wasting in her face and back legs, her life revolves are food she is so hungry, she has been lethargic and not her normal self at all. I cant get her to even glance at a toy. A 5 minute walk tires her, I think because of the muscle loss.

I am sure all of this is the prednisone, she was on 3 pills a day, we just yesterday dropped down to 2 pills a day. Her next appt. is the 11th, to check her levels before we drop it again. We are starting to come down now, however I am wondering if I need to get a second opinion - it doesnt sound like my vet is even thinking she will ever be able to come off pred/azathioprine, it's been discussed the goal is to have her on both for the rest of her life in a small dose that is every other day for each pill, alternating. I know lots of dogs with AIHA can come off the meds completely? Will small doses of pred still be effecting her like it is now? Right now I just want her off it. She is not the dog I knew. But I don't want her to relapse.
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Old April 2nd, 2015, 07:30 PM
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Yeah, high doses of pred are really hard on a body. As the dose decreases, though, the side effects should abate and at a very small dose every other day she may be almost totally side-effect free. I don't know anything about the azathioprine, but I suspect it's about the same as the dose comes down.

I think I would still have them send out blood for a tick panel. It's not too late--if she has something, it's treatable.

It never hurts to get a second opinion, of course, but if you get one, I'd go with a specialist.

Still praying for your Sassy!
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Old April 5th, 2015, 07:06 AM
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Just wanted go say I have been following Sassy's story. I hope she continues to improve. Good luck to you both.
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Old April 5th, 2015, 07:39 PM
MaxaLisa MaxaLisa is offline
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I too would want a tick panel run.
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