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Imha - Possibly Kicked Off By Babesia


Guest Mygreytgirls
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Guest Mygreytgirls

I posted on this board about a month or so under the subject "Babesia Treatment". My girl has since had a PCR test that was negative. This was after treatment for the Babesia. She's still battling IMHA, possibly as a result. I guess we'll never know if she truly had babesia since her original titer was 'marginally positive'. Coombs test was negative, but that's not uncommon. Flow cytometry was negative for leukemia.

 

We're probably looking at our third blood transfusion today. Her PCV has been up and down. The highest has been around 24 just a week and a half ago. She's on a TON of medication as we've had 2 months to try and tweak things. Currently, she's on the following:

 

Doxycycline - 300mg 2x/day

Prilosec - 1/day

Carafate - 3x/day

Dexamethasone - 2mg 2x/day (yes, I know this is a large dose. Already been down the prednisone path too)

Cyclosporine - 2x/day

Cyclophosphamate - 4 days on, 3 days off

 

She just doesn't seem to be responding and holding her PCV yet. I know it can take some time and it's a matter of finding the right medicine combo to stop the RBC destruction. Can anyone offer some advice on positive outcomes? How long did it take? I know about the Meisha's Hope web site....

 

I've read on this board of other people having to deal with IMHA, but I couldn't find any info further down the line from dianosis.

 

Ellen

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Have you contacted Dr. Couto & his team at Ohio State? I would do so asap.

 

Also, in the back of my mind, I think someone consulted with Jean Dodds regarding IMHA. I'll email the person I am thinking of and let you know. In the meantime, call Ohio State or email the consult line.

 

Consult: greyosu@osu.edu

 

Last Name First Name Title Department Work Phone eMail Address

 

Couto Guillermo Professor Veterinary Clinical Sciences (614) 292-3551 couto.1@osu.edu

 

Diane & The Senior Gang

Burpdog Biscuits

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Guest Mygreytgirls

Meant to add that I have been in contact with Dr. Couto's office for weeks now. They actually recommended the PCR and the flow cytometry. They're very happy with what our vet is trying and can offer no other help short of me driving out to Ohio State. They have been helpful, but it sounds like my vet is on the ball. My vet mentioned last week he still has a few things up his sleeve. It's just hard watching and being on this roller coaster ride.

 

Ellen

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Can't help but you are in my thoughts and prayers. I lost my first grey to IMHA, but she crashed so bad and so fast there was really nothing we could do other than doxy, vitamin K and one transfusion. Her Coobs was postitive --it came back shortly after she died. The vet was just trying everything he could until it came back.

 

:grouphug to you and your girlie. It sounds like she is holding her own and that you have an excellent vet.

 

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Guest Mygreytgirls

If someone can provide the contact info for Jean Dodds, I'd appreciate it. I'll try to search on-line. I know Colorado State University is doing some studies, but it's more of a way to extend the time of life so traditional treatments have a chance to work. I take it most that lose their battle die from a clot. She did fall ill suddenly, but we've been blessed with having her for 2 months since then. I keep telling myself that's a good sign.

 

Vitamin K? What did that do?

 

I'm on the very eastern side of PA, so the drive would be long. Plus, all the additional cost.... I'm already way past the financial comfort point. My e-vet here has been at least great with costs (after that first few weeks that is). I think he doesn't want to give up for any reason. Good person to have on my side right now. Originally, I was VERY skeptical. Unless OSU had an experimental treatment, I don't think it would be worth going there. I know my vet has talked with them too.

 

Ellen

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Guest Mygreytgirls

Nope, didn't know that acupuncture might help. I'll look into that as well. Just sent an e-mail off to Dr. Jean Dodds. I happend to have a record in spreadsheet format of all the medicines she's been on. Helps me remember what she gets when. I think it's come in handy when we've asked for help from other vets! Certainly don't want to reinvent the wheel!

 

Ellen

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Guest Mygreytgirls

Okay, I have some feelers out for local people for acupuncture. I'll ask the vet too as I'm taking her right now. If there's any links to on-line articles about acupuncture and IMHA, would love to read up on it!!!

 

Ellen

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Guest Mygreytgirls

Already found 2 places and one is right near our house! I'm in (610) area code.

No transfusion today, but we're down to a PCV of 20. The vet is calling tonight to give us directions on a new med - Cellcept.

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Did you talk with Colorado State? Was it a Dr. Dow(?) I believe this is the name of the drug:

 

liposomal clodronate

 

Looks like Cellcept is used in transplant patients and processed by the liver. Talk to your vet about using Milk Thistle.

 

Sending lots of prayers!

 

 

This one is from the CHI Institute (you may already have):

 

Patricia Blakeslee, VMD, CVA

OXFORD, PA 19363, USA

Tele: (610)932-6800

 

Whoever you call ask if they will come to the house.

Edited by Burpdog

Diane & The Senior Gang

Burpdog Biscuits

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Guest Mygreytgirls

Dr. Dodds called me from her trip in Italy. Had a very enlightening conversation with her and she sent me some information. Apparently, with her lymphocytes so high, she's not going to respond. I happened to be researching the Cellcept and it turns out it targets the lymphocytes. So, maybe we're moving in the right direction. I faxed off all the great info she provided to my e-vet. I'll speak with him tonight.

 

I think that is the Dr. at Colorodo state and yes, that's the drug. From what I'm reading, that will help with the clots that end up killing IMHA dogs as they are waiting to recover. Looking at the Vitamin K, that does the same thing.

 

Here's what Dr. Dodd's e-mailed me:

Wow ! This has got to be a case now of "polypharmacy syndrome" now. She shouldn't need more packed red blood cells until hematocrit get down below 15%.

My suggestion is to stay on cyclosporine at 4-5 mg per kg divided BID [i.e. 2-2.5 mg twice daily] , prednisone at 0.2 mg per kg twice daily or less for maintenance and azathioprine at standard dosing. To this I'd add thyroxine [ 0.1 mg per 20 lbs of optimum weight twice daily] to stimulate the marrow's hematopoietic stem vcells and a hematinic containing iron, vitamin B12 and folic acid [important for RBC maturation]. I'd stop the cyclphosphamide, especially in a greyhound for risk of hemorrhagic cystitis.

The other gastroprotectants etc. are fine.

The next important point is to keep the absolute lymphocyte count below 1,000/ uL so that the targeted T-lymphocytes destroying her RBCs will also be suppressed in #s -- making it easier for her to rally and fight off the process.

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I've been following this thread and only understanding .1% of it. It looks like Madame Burpdog has got the right resources, again! :yay

 

Good luck working to help your baby girl.

Colleen with Covey (Admirals Cove) and Rally (greyhound puppy)
Missing my beloved boy INU (CJ Whistlindixie) my sweetest princess SALEM (CJ Little Dixie) and my baby girl ZOE (LR's Tara)

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Guest Mygreytgirls

I know I've become FSGR's in-house expert on Tick diseases and other issues with the immune system. There's one other person in our adoption group that has at least been through the IMHA portion. It's helps to have the support through this as it's a rough ride. It can be reversed, but it takes so long. It's hard when you see one step forward, two steps back on occasion. She's been roaching, which she typically doesn't do. I swear she's saying "mommy, look how cute I am. Don't give up on me"....

 

Thank you to the people who have given me such great leads!!

 

My vet called me last night and he's taking some of Dr. Dodd's suggestions, but not all. I'm going to have to trust as there seem to be different approaches even when you talk to the experts. I know my e-vet is willing to try things, but since everything takes time to start working, we can be chaning constantly. Maybe in 2 weeks, we'll change more. I'll keep updating!

 

Ellen

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Guest Mygreytgirls

Friday Update -

Just got back from her CBC. Her WBC is going down and her PCV is up to 23! It was at 20 on Wednesday. The vet was so happy! He think maybe she's turned a corner. I'm not going to believe it until next Wednesday when she gets her next round of tests. Although, she's never had a big jump like that without a transfusion... So, maybe the Cellcept did wonders. It targets the lymphocytes, which is exactly what Dr. Dodds said we had to go after to get the hematocrit up!

 

I asked about her 'heavy' breathing and snorting. We're hoping it's allergies, not clots starting to form. We've come to far in the past 2 months...

I have the Pet Tinnic on order.

 

Ellen

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Guest Mygreytgirls

Well, we had a fun weekend. Turns out she's allergic to the Cellcept. Started with a swollen front paw on Friday. That night, her snout swelled up. Thank goodness for Benydryl. She was vomiting too over the weekend after isolating to see which drug it was. Figures, it's the one that started to help her. She's still recovering her appetite, which hasn't been great to begin with. I have the vitamins now with the B12, folic acid and iron. The vet is hoping just this addition will help. I started calling around about the acupuncture too.

 

Ellen

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  • 2 weeks later...
Guest Mygreytgirls

Update - On Tuesday, her nose swelled up again. The good news - she's not allergic to the Cellcept. Bad news, now we don't know what was causing it! She's been back on the Cellcept and had a 3rd blood transfusion last Wednesday. I noticed today that along with one paw being swollen (been that way for about a week and a half), she now has a 'lump' on her elbow on the opposite leg. The whole leg looks puffy. I'm really hoping this isn't clotting. She goes for her weekly check tomorrow. I'm thinking the worst as her gums are pale again. We need her to hold on. We have an appointment at the holistic vet on the 5th. Apparently, this vet has successfully treated IMHA dogs in my e-vets office. WHY this wasn't mentioned to me previously ..... Still hanging in there, but having more doubtful days than I have over the past 2 1/2 months.

 

Ellen

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I have no advice to offer, only good thoughts. You both are such fighters - I hope her check-up goes well. :bighug:goodluck

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Deirdre with Conor (Daring Pocobueno), Keeva (Kiowa Mimi Mona), & kittehs Gemma & robthomas.

Our beloved angels Faolin & Liath, & kittehs Mona & Caesar. Remembering Bobby, Doc McCoy, & Chip McGrath.

"He feeds you, pets you, adores you, collects your poop in a bag. There's only one explanation: you are a hairy little god." Nick Galifinakis

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