Immune Mediated Hemolytic Anemia

[Finnsliz]

May 23 Update

It looks like Birdie is one of the lucky ones. Last week she started running and digging her holes. This week she is running full out and has started attacking the Fatahoula. This final milestone means she is totally back to her old self.

This has been a LONG haul and I literally thought the prednisone was going to kill her. It's amazing how differently my 2 greyhounds react to that drug. Nearly 14 year old Wink has been on 2 courses over the last 6 months without any sign of a reaction. Birdie was so down for the count... had every bad reaction in the book, but the worst was the muscle wasting.

She is starting to look like herself again. Her muscle is coming back more every day.

Again thanks for all the good thoughts.

Liz

 

Friday 4/26/13

Well Birdie has had it rough, but finally this past week has shown some encouraging signs of improvement. Small things like holding her head higher, wagging her tail again, loping out into the yard, joining the Catahoula in defending the property and barking!... never thought I would be happy about barking.

She looks like hell still. I don't dare bring her out in public for fear of animal control being called as she has suffered from Cushing's syndrome from the strong steroid doses. (excessive thirst, urination, muscle wasting)

Two more weeks of slowly decreasing steroids, doxy, and immune suppressants left for her, however we are hopeful now and feel she is definitely happier.

Birdie has always been in top form physically. I hate looking at her shrunken body. I hope her muscles can come back from this and she can once again be tearing up our yard.

This has been a long journey that hopefully has a happy ending.

Thanks again for all the healing wishes.

Liz

 

 

Monday 4/8/13

My mobile vet was in the area and just called to ask if she could swing by for a blood check on Birdie as she was close by. (have I mentioned how much I love my new vet? Dr Sarah Curry All Creatures Mobile Vet. servicing southeastern NH and ME.)

Anyways she just left....

Birdie's PCV count was 20 on Sat. It has come up to 28 today!!! She was thrilled that she has responded this well so far! I am feeling more hopeful that she will be one of the lucky ones that recover from this IMHA.

Thank you St Francis and Birdie's well wishers out there. Will keep you posted. Liz

 

 

My 9 year old Birdie has just been diagnosed with this.

She was totally fine Saturday.

She started with 3 pee accidents in the house Sun pm through Monday AM and we just thought UTI. She rapidly went downhill, not eating or drinking much, running a low grade fever and very lethargic. After 2 days of no improvement we had the vet over yesterday. She took blood and urine. This is the diagnosis that came back with the blood work today. It doesn't sound very hopeful. Billiruben (sp) is very high and lots of hemoglobin in her urine, so liver is affected.

We will do IV fluids, steroids and doxy once the specialist she is conferring with agrees. Abdoninal xray and ultrasound to follow.

She mentioned she has not seen a greyhound with this, but has seen it often with other breeds in her emergency experience.

 

Has anyone had any experience with this? It all sounds like a lymphoma diagnosis to me

Edited May 23, 2013 by Finnsliz

[MP_the4pack]

I have no experience, but it scares the bejesus out of me. I've seen it plenty here. I hope they chime in soon.

 

{{{{{{{{{{{hugs}}}}}}}}}}}}}

[MaryJane]

Maybe ask for an OSU consult ....

[KF_in_Georgia]

Unfortunately, these immune mediated diseases are not rare enough in greyhounds.

 

Two things: open a consultation with Ohio State:

 

Greyhound Health and Wellness Program
Ohio State University College of Veterinary Medicine
601 Vernon Tharp Street
Columbus, Ohio 43210
Phone: (614) 247-6757 or (614) 247-8490
Email: greyosu@osu.edu
Website: http://www.vet.ohio-state.edu/GHWP.htm (registration and fee now required to get full access to this site)

For a consultation, you must use the online consultation service found here. Do NOT contact Dr. Couto directly or you will not receive a timely response.

 

Also, consider a full tick panel sent to North Carolina State University. They currently have a discount on their panels, and these immune diseases may be triggered by tick-borne ailments.

 

Your vet probably will want to run an ultrasound to get a look at Birdie's spleen and other organs. That's sometimes the fastest way to determine whether it's cancer.

 

Also, see the long current thread from Nekos_Mommy. Your vet might want to talk to Neko's vet to compare notes. (Don't be confused: Neko's experts at "OSU" have been Oregon State, not Ohio State.)

 

Good luck to you and Birdie.

[Fiona3]

Liz, I am so sorry to see that Birdie has been given this diagnosis. We had a yellow lab, Molly, years ago who developed IMHA. She received blood transfusions and always seemed more comfortable after each one. Has your vet mentioned transfusions to you yet? Molly's symptoms sound very much like Birdie. There is a lot of good information about treatment that was not available to us back in 2001 when Molly had it.

 

All my thoughts and prayers are with you and your sweet girl.

[a_daerr]

Also, see the long current thread from Nekos_Mommy. Your vet might want to talk to Neko's vet to compare notes. (Don't be confused: Neko's experts at "OSU" have been Oregon State, not Ohio State.)

 

Very sorry you are going through this.

I'm agreeing with the above poster. It sounds very similar to what Neko is going through.

[Finnsliz]

Poor Neko.

It doesn't sound like what we are going through here. Birdie's white cell counts are high and red blood cells low so she is getting very little oxygen. With this condition the red blood cells actually start destroying each other was what I was told. No bleeding or bruising here. She is having a better day today. Actually ate some nice stinky mackeral and sat in the sun out in the yard for a couple of hours. We will have to wait and see what the xray's and ultra sound tell us.

Thanks for the replies.

[Hubcitypam]

They had to have run a Coombs test to diagnois IMHA. If the Coombs test was postive I'm not sure there is much arguing about what it is.

 

My very first greyhound died from IMHA at the age of 4. It is more common among cockers and poodles, but for some reason middle aged bitches of any breed seem to get hammered worst by it.

[Guest KennelMom]

No experience with it, but it was suspected when our Harmony got sick years ago. She ended up having a rare form of leukemia.

 

Anyway, I hope you have a good outcome A consult with OSU never hurts...our vet worked with them as a second opinion when Harmony was sick.

[JJNg]

This is the diagnosis that came back with the blood work today. It doesn't sound very hopeful. Billiruben (sp) is very high and lots of hemoglobin in her urine, so liver is affected.

 

Sorry to hear about Birdie's diagnosis. IMHA is very serious, but I just wanted to point out that the high bilirubin doesn't mean liver involvement. The elevated bilirubin level is from the breakdown of red blood cells.

 

We will do IV fluids, steroids and doxy once the specialist she is conferring with agrees. Abdoninal xray and ultrasound to follow.

 

Sounds like you have a good plan in place to start with. Depending on her clinical signs and response to treatment, you may need to consider blood transfusions as Fiona3 mentioned. And sometimes stronger immunosuppressive meds are needed in addition to the steroids. I would also strongly recommend a full tick-borne disease panel. NC State is currently offering a good discount on a very comprehensive panel. Here's a link to their website for details.

 

A Coombs test is helpful but not always a reliable indicator of whether or not a dog has IMHA. The diagnosis is often made based on the combination of clinical signs and test results. Unlike Neko's case, IMHA usually causes a regenerative anemia because the red blood cells are destroyed in circulation, and the bone marrow is not affected.

 

While there are similarities, and cancer can sometimes trigger secondary autoimmune diseases, primary immune-mediated diseases are very different from cancer. If her additional testing checks out, and you can get her through the initial illness and get the overactive immune response under control, she can make a full recovery. Some dogs do need to stay on long term medication and can be at risk for relapses.

[Finnsliz]

Saturday AM update on Birdie.

Our vet came out last night to do a quick blood count. Bad news -platelet count had dropped to 20. Good news -she started her medications got some sub q fluids and is eating a little. (Nana o's chicken parm last night and home made waffles this AM) She also has more energy which is weird considering her anemia, but we will take that.

Thanks for the good thoughts and advise. Fingers crossed she is one of the lucky ones.

Edited April 6, 2013 by Finnsliz

[Fiona3]

I'm so glad to see Birdie is feeling better and has both appetite and energy. That's a good sign. She is in good hands with your vet and I'll keep my fingers crossed and lots of good thoughts going for Birdie to indeed be one of the lucky ones.

[Charlies_Dad]

No advice, just good thoughts for Birdie.

[RhodyGreys]

Liz, tell my favorite little girl hound to get better riteawayquick so she can try to steal hot wings from me again (I remember this vividly from my last Dewey).

 

We lost our Heidi to this back in 1998. But I have heard some survival stories. My thoughts are with you!

[Finnsliz]

She has eaten 3 good meals today, only needed assistance for breakfast and has been more energetic. She even jumped off the couch when she heard the sounds of the chip bag being opened. . Mobile vet came today for xrays. She is sending them to pathologist for a double check, but saw nothing suspicious.

[Finnsliz]

Sunday update:

She is improving in energy and appetite, however her temp is now below normal at 98.9.

[Batmom]

Check your thermometer on one of the other dogs, too -- I've had them read low or high, and that can be way confounding when you have a sick dog.

 

Gentle scritchies and best thoughts for your girl.

[Finnsliz]

Check your thermometer on one of the other dogs, too -- I've had them read low or high, and that can be way confounding when you have a sick dog.

 

Gentle scritchies and best thoughts for your girl.

Thanks Jey, I heard from my vet who said to make sure the thermometer was against the large intestine wall and not stuck in poop.... She is encouraged by her progress .

[Hubcitypam]

We're rooting for you Birdie! Not an expert but seems like she is on an encouraging track.

[Fiona3]

That is a wonderful update on Birdie. She seems to be holding her own and doing very well. It is encouraging progress for her. Keep on feeling better, Birdie!

[Finnsliz]

bumbing for update

[carronstar]

Thank you for letting us know about this update. It sounds very good. Keep feeling better, Birdie.

[Finnsliz]

bumping for hopefully the final update.

[Batmom]

Thank goodness she is so much better.

[tbhounds]

Thank goodness she is so much better.

X's 2!