Hello,
I have a 6 pound Chihuahua named Baby. He is 7 years old. Around Memorial Day weekend, Baby became very lethargic and wasn't eating. His stool was black. I brought him to my family vet and they advised me to wait a bit and to try chicken and rice and that he was probably fine. I brought him back again as I knew something was wrong. They gave him a blood test and saw his PCV was very low (10) but did not know why. They sent me to an emergency vet hospital on 09/10/18 and he was given an emergency blood transfusion and put on 20mg of doxycycline twice a day and 5 mg of prednisone once a day. He continued to decline so I brought him back to the hospital on 09/21/18 and his PCV was back down to 10. It was that date they realized he had IMHA. They did another blood transfusion on that date and sent him home that night with 20 PCV and added 10mg of cyclosporine to his daily meds and kept the pred and doxy the same. He had been doing well for a few days but I took him back in this past Monday, 10/01/18 for a recheck and he was back down to 8 PCV. He had his third transfusion on 10/01/18. He was discharged yesterday again at 20 PCV. My vet and the internal medicine specialist advised me to continue the meds as prescribed. I did not like that response because clearly that treatment plan is not working and they were not open to anything else. I brought him to another animal hospital and another vet and they advised the same. They advised that he has a very poor prognosis and that he is likely not going to survive and I should be thinking of end of life. I went back to my initial vet and asked that she please prescribe me something else to help him and a stomach protectant. She was reluctant because she said the meds are not as effective with a stomach protectant. She advised me I could go get Pepcid over the counter for him and give him that twice a day with his meds. I insisted again that we needed another treatment plan. Can we increase meds or add another med I asked. She advised me that would make him worse off and that more meds or increasing could cause a whole bunch of other issues but at this point what do we have to lose? She agreed and prescribed him 30mls of Azathioprine alongside the 5mg of prednisone, and the doxycycline and the cyclosporine. The Azathioprine needs to be compounded and they cannot get it for 3-5 days. I am currently awaiting response from another vet to see if they can get the Azarhioprine sooner. Baby is eating and drinking as normal but he is just very weak and lethargic. He is losing blood so quickly and they do not know the cause of this and whether it is primary or secondary. They did an x-ray Monday and everything looked fine. They said his liver was a little inflamed but that was most likely from the steroid. We are from a state that has a lot of ticks and I had found one on him last year and it did have to be pulled off so they thought it may be something to do with that but they advised the doxycycline would've taken care of it already if it was tick borne. I am at a loss. I am in the IMHA support group on facebook and they directed me to this site. A lot of the members advised Baby was not on a high enough dose of meds but my vet is adamant he is at the most he can safely take. Any direction from here would be wonderful. I am just so lost and so devastated. Please help us. Thank you.