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Messages - trudiej

#1
Hi there

As of a blood test last week Fergus PCV was 42 so vets were very pleased. We have another blood test tomorrow and if results have remained stable then a blood smear will be done, and pending those results we may be able to reduce steroids.

I have spoken to specialist twice about the tummy protectant, she was of the view that there was no medical evidence to support giving this to Fergus, and as Fergus has a sensitive tummy and has been prone to bouts of colitis she was loathe to prescribe one. Should I raise this again?

Am noticing loss of weight, possibly muscle tone and fur, drinking is increased (though we were told increased thirst/hunger is a side effect of the steroids), is there anything else we can do to help support our boy?
#2
Hi there

Our beardie has been diagnosed with PIMHA and IMHA, he is on Prednicare, Atopica and Clopidogrel to prevent clotting.

We are trying to manage the costs as the Atopica and Clopidogrel is quite expensive through the vet. I can find Atopica easily online, but am having trouble finding the Clopidogrel. Has anyone out there purchased 18.75 mg tablets of Clopidogrel (Plavix) online, if you have, where did you get it from?

Thanks.

Regards.

Trudie
#3
Hi Catherine

Thanks for the reply; Fergus's PCV was 21, 19 and 22 - the 22 being the result of a test done on Wednesday 2 June.

Would you consider this low enough to warrant another blood test during this coming week (he's booked in at vets for next blood test on 15 June), and should we consider a biochemical test, as well as the PCV test, to check liver and kidney function?

I will speak to the vet regarding a tummy protectant - is there one you'd particulary recommend for Fergus's condition?

On reading the articles you linked to; should Fergus be on a broad spectrum anti-biotic? And should we consider a low fat food; he is currently on a grain free salmon, trout, asparagus and sweet potato kibble (it says the crude fat content is 11%).

Many thanks.

Trudie

#4
Hi there

I have an 8.5 year old male bearded collie who, just over a week ago became listless and lethargic. Prior to this, he had been having regular anal gland checks following recurring infections which took several courses of antibiotics to shake off (the checks had all been fine). He had also had what we thought was an allergy, with some sneezing and a runny nose, for which we were giving him Piriton - this hadn't totally cleared up, but had seemed to improve.

Following a check at our local vets his bloods showed he was very anaemic and an ultrasound showed a mass on his spleen, so we were referred to a specialist vet, who following a series of tests, have given the diagnosis and treatment plan below:

TESTS PERFORMED:

External blood smear examination: this showed evidence of very mild regeneration, but this was inadequate for the degree of anaemia. A type of red blood cell called spherocytes were observed, which are most commonly seen with IMHA.

Urinalysis: the urine was concentrated and did not contain excessive protein. Some crystals were observed, which occur with storage of urine. Bilirubin with bilirubin crystals were also present (likely secondary to IMHA).

Splenic nodule cytology: evidence of new red blood cell production, with some inflammation (common in conditions which cause systemic inflammation such as IMHA).

Splenic parenchyma cytology: evidence of new red blood cell production, with some inflammation (common in conditions which cause systemic inflammation such as IMHA).

Bone marrow cytology: there was evidence of an increase in the number of red blood cells within the bone marrow, which were then being consumed by white blood cells. This is consistent with precursor immune mediated anaemia.

Bone marrow histopathology: pending.


DIAGNOSIS

Precursor immune mediated haemolytic anaemia (PIMA) and immune mediated haemolytic anaemia (IMHA): these are conditions in which the body attacks its own red blood cells. In the precursor form, this occurs within the bone marrow. With IMHA, this occurs within the circulation.


TREATMENT

Prednisolone 20 mg twice daily

Ciclosporin 100 mg: give one capsule twice daily with a 50 mg capsule. This is an immunosuppressant. Side effects can include a reduction in appetite, vomiting and diarrhoea. We recommend freezing these tablets to reduce these side effects.

Unlicensed medication:
Clopidogrel 18.75 mg: give 2 tablets once daily. This helps prevent the risk of blood clots, which can be seen with Fergus' condition.


FOLLOW-UP

If Fergus remains clinically stable, repeat PCV is advised approximately every 2 weeks to assess for a regenerative response. Once PCV is within the normal range, we would advise sending a blood smear externally to assess for ongoing spherocytosis If resolved, then dose reductions of prednisolone can be commenced. Prednisolone should be reduced by 20-25% every 3-4 weeks, with repeat PCV performed prior to every dose reduction to ensure there is no relapse in anaemia.


QUESTIONS

This was a bit of a shock....., is there anything I should be doing to help Fergus?
Any questions I should be asking of the vet/specialist?
I notice on some posts, a tummy protectant is advised, I asked the specialist vet about this, and she didn't consider it was necessary?

Anything else you think I should be aware of?

Any/all help most gratefully received.

With thanks; Fergus' worried parents