Auto Immune Diseases

[Guest onlymrsp]

Chance, was returned to us. He is currently in a foster home. I do not have all of the background issues with why he was returned, but he does have some major medical issues.

 

(One complaint to why he was returned was that he was'afraid' of the toddler in the house because he would hide in the back of his crate all day). While at the kennel for a week, Chance was agitated and vocal, obviously stressed about the situation. Right after he was moved, he became quiet, stoic, and would keep to himself, all through Friday through the beginning of last week. By Tuesday night, he had been refusing to eat much of anything for about a day, and taking in very little water. He was too quiet, not moving except to get up to go potty outside, and not showing much life. Wednesday morning, he had to be actually lift him up to get him to stand. He was told to take him immediately to the vet. The vet ran every blood test, body function test, urine test, including ehrlichiosis, needed and found out that he was severely anemic. His HCT was below 20, and HGB was around 11 (HCT is red blood cell count, and HGB is hemoglobin count--how much oxygen is being carried by the cells--greys are usually 60 and 18). All other body functions OK, urine was dark. So symptoms of lethargy, no appetite, low thirst, dark urine, no other organ output issues, fever, and anemia points to an auto-immune disease called "auto immune hemolytic anemia".

 

The vet started him on very high dose of corticosteroids and deoxycycline antibiotic. He went home that night and by next morning, was starting to respond. Eating a little, drinking, taking treats and wagging his tail. When the foster mom was called on Sunday to check up on him, he was getting better each day, coming up for love and being more alert. His follow up was to be on Thursday.

 

However, today his foster mom just called today at noon and said that this morning, he was very lethargic again and off all food again,she rushed him in to the vet. His HGB count went from 10.6 (last week) to 6.8 today. Basically, he's not responding to the corticosteroid. The vet is conferring with the immunologist at a local animal Hospital as this progresses. The next option is to put him on an anti-cancer drug to really suppress the immune system, and she wants to do an ultrasound since he is displaying abdominal pain today. There is a call in to her to speak directly to get a better understanding of what our options are. What we need is for him to respond to the new drug, then we can get him back onto the steroid. An ultrasound will rule out an internal issue with him , such as a tumor in the spleen. It is understood that is our next option, since we don't know why this disease shows up for sure, whether it's genetic or induce by something else (even from something as simple as a certain drug can trigger it).

 

So right now, he is to start on the other immune suppressor drug, and we'll talk to the vet about the ultrasound procedure. This poor boy was with his original family for over 3 years, and now this. Has ANYBODY ever had experience with this type of an issue? If so, can you please shed some light on it for us? Would any of the natural herbs help his system? Thank you for your help, may it be in the form of additional medical advice, personal experience, etc. I do not know his age, but can guess that he is around 6. At the present time, we do not have any prior medical information, and hope to contact the previous owners to get his vet records.

 

Thank you for reading this....

 

Jennie P.

[ahicks51]

Stab in the dark- make sure nobody's feeding him onions. Although the mechanism is very different, they too can cause hemolytic anemia.

[Guest Energy11]

No, I haven't been through this. I am sorry he is going through all of this, too!

 

Maybe a consult from OSU and Dr. Couto would be in order?

 

Also, Personally, I'd have a total tick panel done on him for ALL the Tickborne Diseases. Babesia is rarely included in the "standard" vet tick-testing. The vet can draw blood, spin it, and it can be sent to Protatek Reference Labs in Arizona. They are usually pretty fast. Couldn't hurt.

 

Info on TBDs: http://www.greyhoundrescueaustin.com/protatek.php

 

Info on Protatek:

Protatek Reference Laboratory

 

574 E Alamo Dr

Chandler, AZ 85225

480-545-8499

 

[sweetdogs]

 

Maybe a consult from OSU and Dr. Couto would be in order?

 

Absolutely - contact them ASAP. Here is the info: OSU Gather all his records - they'll review them & advise what to do.

 

Very best wishes for Chance.

[turbotaina]

Jennie, have they run a tick panel? My first guess would be babesia - it won't respond to doxy. I'd send a panel to NCSU.

[Guest Energy11]

Jennie, have they run a tick panel? My first guess would be babesia - it won't respond to doxy. I'd send a panel to NCSU.

 

 

DITTO on the Babesia! We used Protatek Reference Labs for all of our Babesia Titers, but if NCSU does them, it might be faster.

 

Yes, Babesia is not treated with Doxy. It is treated with: Imidocarb Dipropionate.

This is another good website, talking about the disease. Yes, it could be the cause of ALL these symptoms! Good Luck! http://www.marvistavet.com/html/body_babesia_infection_in_dogs.html

[Batmom]

Tick panel to NCSU, have them follow with a PCR if it's positive.

 

Sending prayers.

[Guest KennelMom]

This is originally what they thought our Harmony might have had, though it turned out it wasn't. The NCSU panel takes several days to get back (minimum)...days dogs often don't have and you have to decide how aggressively you want to prophylacticly treat a potential TBD w/o a confirmed diagnosis. Most vets will give doxy no problem, but Imidocarb can have some nasty side effects and we definitely didn't decide to give that to Harmony lightly.

 

Definitely consult w/OSU ASAP.

 

I hope and pray you will find a quick diagnosis quickly that reponds to treatment. You can read through our experience with Harmony: http://forum.greytalk.com/index.php?showtopic=220961 Everything is pretty much summarized in the first post, starting at the bottom.

[Guest Energy11]

This is originally what they thought our Harmony might have had, though it turned out it wasn't. The NCSU panel takes several days to get back (minimum)...days dogs often don't have and you have to decide how aggressively you want to prophylacticly treat a potential TBD w/o a confirmed diagnosis. Most vets will give doxy no problem, but Imidocarb can have some nasty side effects and we definitely didn't decide to give that to Harmony lightly.

 

Definitely consult w/OSU ASAP.

 

I hope and pray you will find a quick diagnosis quickly that reponds to treatment. You can read through our experience with Harmony: http://forum.greytal...howtopic=220961 Everything is pretty much summarized in the first post, starting at the bottom.

 

Protatek is FAST with it's results, but, yes, DEFINITELY contact OSU asap!

[Batmom]

I think NCSU can do a stat panel but it'll cost you. Idexx and Antech also have fast PCRs that shouldn't take more than 2-3 days turnaround. If pup has babesia, the doxy should at least knock it back a bit tho it won't cure it.

[Guest westexhound]

Yes, we went through this with one of our non-grey dogs this past summer. She suddenly stopped eating and became less & less active. We just thought she had a "bug". To keep a long story short,after several trips to the vet - blood work was done on 2nd visit and was "ok". The next day she couldn't walk but a few steps and fall down, gums as white as her teeth. Blood work that morning: everything crashed. Can't remember all the numbers but do remember hematocrit #'s and hers was at 10!! (norm is @ 40).They had to immediately do a blood transfusion and begin a frantic search for what was going on. They began her on the doxycycline, prednisone, sent tests off for tick panel, coombs/ana. They also kept questioning us if there was any possibility of her getting into poison. As all the tests came back negative it pretty much ruled out everything but what they were thinking all along: auto immune blood disorder, hemolytic anemia. Oh, and she didn't eat for many days and would try to bite the staff at the animal hospital,so we would go 3-4x/day to get her out and shove pills down her throat.

My understanding of autoimmune disease is that the body suddenly starts marking the red blood cells as bad and destroys them. After the blood transfusion we were on pins and needles to see if that would continue. We were very fortunate, she maintained her rbc and then began producing them on her own again. Prednisone was the treatment. We have not been able to take her off it because her blood count numbers start to decrease again.

I do remember one of the vets talked about using an anti-cancer drug also but for some reason they never did.

She displayed all the symptoms that your dog has shown. When we asked what causes this, our vet said it is often a result of a major stressor. We could not think of any that applied in our situation, but it sounds like your foster's sudden change in its home situation -- well, very stressful.

We'll be sending many positive thoughts!

[ahicks51]

She displayed all the symptoms that your dog has shown. When we asked what causes this, our vet said it is often a result of a major stressor. We could not think of any that applied in our situation, but it sounds like your foster's sudden change in its home situation -- well, very stressful.

 

At least some autoimmune diseases seem to be caused by "molecular mimicry." For example, rheumatic heart disease- caused by rheumatic fever- results from the body confusing proteins from group A streptococcus. Once the body is sensitized to the bacterium, it may begin autoimmune assault on the body. Another example is Reiter's syndrome (reactive arthritis), resulting in autoimmune attack of the eyes, urethra, and large joints (presenting with the lovely triad "can't see, can't pee, can't bend the knee"). This comes from confusing a number of bacterial proteins with human collagens. The third example is bacterial proteins from Klebsiella pneumoniae mimicing certain types of collagen causing ankylosing spondylitis. Similarly, Chlamydia pneumoniae (related to the chlamydia that's an STD, but NOT the same organism) may cause multiple sclerosis in a similar fashion.

 

For "true" autoimmune hemolytic anemia (versus that caused by TBDs), a latent infection or commensual organism could cause sensitization during periods of stress when the organism undergoes a growth spurt for whatever reason. Some protein cranked out by some bacterium or virus- maybe even a fungus- might resemble some protein on, say, the outer part of red blood cells. If that becomes an epitope- whammo, the body starts attacking its own red blood cells. Bad juju.

[Guest Cris_M]

Yes, I have been there -- sort of. My first grey, Gabriel, was thought to have AIHA. Turned out to be something worse (leukemia, lymphoma, pancytopenia).

 

Like others have said, get Chance tested for tic borne diseases and contact Cuoto. I would suggest starting Chance on doxy (for possible TBD), Prednisone (since he will be on that if it is AIHA), and something to protect his gut from the Pred. We put Gabriel on Bottswellin -- a herb we were told would help cleanse the liver. We also let Gabriel have chicken liver every day. Liver is packed with iron and each red blood cell has four molecules of iron.

 

Can daily PCVs (packed cell volumes) be done? That is a super quick test that uses almost no blood. It will let you know when/if it is time for a blood transfusion. Go ahead and ask the vet now if he has a donor dog available. If he doesn't, contact your adoption group or another greyhound owner. Someone will probably volunteer their dog for you. Be aware that the first blood transfusion is no problem. If Chance needs a second, his blood and the donor's must match.

 

Since Chance is already stressed, is the vet letting you keep him in a home environment? Greys often don't do well in the loud atmosphere of a vet kennel.

 

If Chance does have AIHA, it can often be managed. Pred is the drug of choice which is good because it is cheap. When symptoms start disappearing, the dose of Pred is dropped. If symptoms reappear, a Pred regimen is reinstated. Some dogs live well enough with AIHA that they die of other causes.

 

Getting past the initial bout of AIHA seems to be the worst part. My thoughts are with you during this anxious time.

[Guest lovemyhounds2]

Hi all,

 

I am following up with more info from user "onlymrsp", since we are from the same group. I'll try to cover all the comments that were brought up. 1) Onions--that I will look in to, I know it can cause the same symptoms as AIHA. 2) All 3 tick tests were done and all were negative, which was my first question to the vet. 3)both CBC and body panel were done, with all body functions within normal ranges (this week after the 2nd crash, the BIL was elevated but not too high). 4) urine infection ruled out too. 5) after adjusting the values read off the chart from the owner, the HCT (red blood cell count) is falling between 20-15 the first time, and after 7 days on steroid, they were around 31. So it would appear it was helping (he's at least regenerating cells), but something made it drop again. Everything I've read so far is right on with what everyone is saying, and I am in the process of asking the foster's vet if she would consult with Ohio State as soon as possible. After the first night on the heavy immune suppressor (azathioprine--which has it's own side effects, most of what it is used to treat can be a side effect, so it seems like a toss up right now!), he ate like a champ and kept it down. I understand why to use the suppressor, we have to get him stable and regenerating before we can switch him over to steroids fully. His mucous membranes are white to pink, not yellow, so he's not having issues with increased BIL in the bloodstream (at least for now). I'm curious if anyone else has had their hounds on this azathioprine in the past. Most AIHA is idiopathic, so I am hoping it's not a tumor somewhere. If he crashes again, it's transfusion time and ultrasound. Thanks everyone for throwing out their thoughts on this, I appreciate it!!

 

oh I forgot! Foster mom has been taking him home between vet visits so he doesn't have to stay over. He's with 2 other dogs to keep him company, and the house is low maintenance, so that should work in his favor!

[Guest EmilyandSioux]

Also make sure he is not getting white potatos, grapes or raisins and has not a sago palm. These will cause strange values on bloodwork and cause the fur kid to act strange and disoriented. Also marajuanna will cause these guys to act like they are seeing things and have appetite. You can look undder a vet school and usually geta list of poisonious plants or try poisin control Our prayers are with you

[Guest EmilyandSioux]

Also make sure he is not getting white potatos, grapes or raisins and has not a sago palm. These will cause strange values on bloodwork and cause the fur kid to act strange and disoriented. Also marajuanna will cause these guys to act like they are seeing things and have appetite. You can look undder a vet school and usually geta list of poisonious plants or try poisin control Our prayers are with you

[Guest Tes623]

Most of the symptoms sounds like what William went through about 8 years ago. He was hospitalized twice and it was classified as an "auto-immune disease" He's been on Prednisone since it happened and started out at an very high dose and now he is down to 5mg every other day. He's going to be 13 in a few months and is doing great. Hope you can find out what's going on with Chance--we never were able to figure out what caused it.

[Guest Cris_M]

There are a couple of shots that will increase the number of RBCs being created in bone marrow.

 

Sorry I don't remember what the drugs were, but that might be an extra help. I don't remember what they cost.

[Ullaluv]

I think you're talking about hematopoetin. It's used in humans undergoing chemotherapy to stimulate the production of red blood cells. Very expensive, and can only be used in dogs for a certain length of time. I think the dog develops antibodies to it, since it's a human protein rather than canine. I know they were working on a canine version, but don't know if it's out yet.

[Guest lovemyhounds2]

Update time!! Champ's foster mom called me tonight, and it's great news! His follow up CBC shows that his red blood cells and hemoglobin have both increased! His appetite is through the roof and he's on all 3 drugs. His yellow tinge is going away and going back to pink. He's happy, wanting attention, and being more active. It is such greyt news to my ears!!!!! His next follow up is on Thursday, so I'll be keeping my fingers crossed. Thanks to all for their input and wishes :)