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Jeff Has Immune Mediated Hemolytic Anemia (Imha)


Rickiesmom
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After a great deal of time and blood work in the last days, negative ultrasound and chest rads followed by a repeat of the ultrasound to be really sure no cancer was visible, Jeff has been diagnosed with IMHA.

 

He's in a specialty hospital and the Internal med vet has him on Pred, Imuran and a low dose of aspirin to offset the risk of clots due to the Pred and Imuran.

 

He's also on doxy and they are waiting for a tick panel to come back (I asked them to ensure Babesia was included and they added something else on which I can't recall).

 

Internal med vet is greyhound knowledgeable and recognized right away that the "normal" RBC was low for a greyhound.

 

His marrow is regenerating at 4% vs, normal 1%, trying to keep up with the red blood cell destruction.

 

At this point the prognosis is 50/50, mainly due to the risk of clotting.

 

If they can get this under control, then he will come home on those drugs, and will be monitored and gradually tapered down over 9 months. If all goes well he may then be fine, or he may relapse.

 

At this point I just want him to get through the week.

 

I asked about cause, and as I understand it, while they understand the process of what is happening, it is almost impossible to identify the trigger.

Edited by Rickiesmom
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I'm so sorry. Very glad you at least know what's going on and are getting treatment. Lots and lost of good thoughts that he pulls through and is home with you soon :hope

 

I had no idea what this was btw so had to look it up. I'm sure you're already doing a ton of research but I came across this detailed article so figured I might as well post the link in case you haven't yet seen it. http://www.veterinarypartner.com/Content.plx?A=1390

gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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You're right - I am reading up on it, and I will read the article you found tomorrow morning when my mind is less like mush.

 

One thing I learned through this - if Bilirubin is high but liver enzymes are normal, look elsewhere for the problem, it isn't the liver. A factoid to store away in case ever needed.

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So was his skin actually discolored like you thought? Makes sense if anemia is the problem that it would have been. (Also to be filed away)

gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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Yes. As recently as yesterday morning it was still light and the vet didn't think there was an issue - he thought because Jeff's skin (like all greyhounds) is so thin, that he was just seeing the musculature. But today it was much bluer, and there was no question something was going on.

 

His RBC is within the lab normal ranges, but low for a greyhound (I have to request the labs, I haven't seen the values). His clotting factors are still OK, though I get the sense that is something they will be monitoring.

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:( Sending best thoughts for your boy.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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Good thoughts for your boy.

Kyle with Stewie ('Super C Ledoux, Super C Sampson x Sing It Blondie) and forever missing my three angels, Jack ('Roy Jack', Greys Flambeau x Miss Cobblepot) and Charlie ('CTR Midas Touch', Leo's Midas x Hallo Argentina) and Shelby ('Shari's Hooty', Flying Viper x Shari Carusi) running free across the bridge.

Gus an coinnich sinn a'rithist my boys and little girl.

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Mary, I'm so sorry Jeff got this dx. I was really hoping nothing serious was wrong with him. Sending lots of white light and hope that this is treatable. :grouphug

Jan with precious pups Emmy (Stormin J Flag) and Simon (Nitro Si). Missing my angels: Bailey Buffetbobleclair 11/11/98-17/12/09; Ben Task Rapid Wave 5/5/02-2/11/15; Brooke Glo's Destroyer 7/09/06-21/06/16 and Katie Crazykatiebug 12/11/06 -21/08/21. My blog about grief The reality is that you will grieve forever. You will not get over the loss of a loved one; you will learn to live with it. You will rebuild yourself around the loss you have suffered. You will be whole again but you will never be the same. Nor should you be the same, nor would you want to. Elisabeth Kübler-Ross

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Sending healing thoughts and :grouphug for you.

Cynthia, & Cristiano, galgo
Always in my heart: Frostman
Newdawn Frost, Keno Jet Action & Chloe (NGA racing name unknown), Irys (galgo), Hannah (weim), Cruz (galgo), & Carly CW Your Charming

Princess http://www.greyhound-data.com/d?i=1018857

"It came to me that every time I lose a dog they take a piece of my heart with them. And every new dog who comes into my life, gifts me with a piece of their heart. If I live long enough, all the components of my heart will be dog, and I will become as generous and loving as they are." -- Unknown

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I am familiar with this road you are on. :grouphug:grouphug for you and Jeff.

Old Dogs are the Best Dogs. :heartThank you, campers. Current enrollees:  Punkin. Annie Oooh M. 

Angels: Pal :heart. Segugio. Sorella (TPGIT). LadyBug. Zeke-aroni. MiMi Sizzle Pants. Gracie. Seamie :heart:brokenheart. (Foster)Sweet. Andy. PaddyALVIN!Mayhem. Bosco. Bruno. Dottie B. Trevor Double-Heart. Bea. Cletus, KLTO. Aiden.

:paw Upon reflection, our lives are often referenced in parts defined by the all-too-short lives of our dogs.

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How is Jeff today? Any updates from the vet?

gallery_12662_3351_862.jpg

Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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I just got back from the hospital. His red blood cell count is down 7% which the internal med vet said was to be expected until they have the disease under control. The TBD results that are back so far are all negative. They said he had a good night.

 

We went for a walk and he peed an ocean - he's on fluids - had mushy dark orange poop, but no blood or mucus chunks, so that's good (he didn't before either - this was something they asked about when I got back).

 

I brought some of his own food and some treats. Happy to eat treats, ate some food with a few crushed cheese bunnies mixed in. I left everything there plus a can of green tripe. Will probably go back this evening and will bring other temptations along - and I'll keep changing them to maintain interest.

 

He slept a lot of the time I was there. I just petted him, massaged very, very lightly, and rubbed his tummy. The treatment area is busy during the day and it sounded like they are doing renovations upstairs, which added to the noise. They have a few low-walled 3-sided enclosures for larger dogs and he's in one of those, so he has lots of space, and they piled up a bunch of those white fleecy pads so he has some warmth and also cushioning. He is being well monitored and looked after.

 

They will call around dinner time tonight with an update, so I will wait for that and then decide what to do. Thank you for the good thoughts, we are far from being out of the woods.

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Vet just called - Jeff's PCV/Hematocrit dropped to 27% today :( Greyhound normal is 55 - 65.

 

Heart rate and respiration still alright, they are monitoring those closely.

 

He said this is not unusual, that it typically takes 3 - 4 days for the drugs to start having an effect, sometimes longer (we are on day 2). He also said if it continues to drop they may need to give him a transfusion during the night. They'll call if that happens, but I told him to note on the chart that they should always assume the answer is Yes.

 

If you have healing energy to send his way, he could certainly use it, and I would be so very grateful.

Edited by Rickiesmom
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