CIMDA

Hi, my dog has had a splenectomy too and is now doing very well.  We were told that a dog with IMHA shouldn't be fed a raw diet?  We have been feeding Royal Canin Sensitivity control and she is doing extremely well now.

Thanks Jo.  Having chatted over this, my husband is definitely of the opinion that it should be at the very least, reported to the head of the practice.  The crux of this matter is vaccinating a sick dog.... I'd be very interested in your opinion - would you be willing to look over the vet notes which I have a copy of? 

As Catherine also said, it seemed to be ingrained in vets that they must vaccinate at all costs but I think unless we start to challenge this and ask questions nothing will change.

Michelle

Thanks for your reply Catherine.  This is in the UK.  And to make matters worse, I worked there for 4 months last year!!  Unfortunately she became sick 2 months after I left.  I could go to another vet although they are further away and of course they would want to know why I have left... I am in contact with a few people who still work there.  I really don't want to make trouble as it's awkward, it's a small community.... At the same time, I think questions should be asked and perhaps this might make them review their procedures.  They don't have much competition in the area and a lot of people moan about them.  My husband feels we have every right to complain/ask questions as we have spent nearly £20,000 since October (mostly with the referral vets and lots of complications!! but they have also received about £5000 from this illness...).  My husband is after some compensation from them but I'm not sure we'll ever get any answers and they will become defensive.  One minute I agree with you, just leave it, and move on.  Other times, I think this must be a clear breach of vaccine procedure?  will other dogs be made sick because they are lax about their procedures?  I do feel strongly that this is bad practice... I think we most likely will end up having a conversation with them and as you say, keep it light and amicable but at the very least, it might make them tighten up a bit. The same vet also treated my cat,,, said absolutely nothing wrong with him (= over anxious pet owner...) and then he keeled over dead a few months later at the age of 5!!!  so we won't be seeing that particular vet any more!!!  I guess I am just keen to know how bad is it that she went ahead and vaccinated a dog with suspected IMHA....  Vaccine labels clearly state only for healthy dogs and that's the bit I feel very strongly about.  Luckily Milly is now doing very well, but it has taken a huge amount of work/money/stress to get her back. x

We've started doing this, and I think the vets even use the same company but charge double the amount!!  It's a shame it's not more widely known about.  spread the word!

Why don't they use Cyclosporine as well as Mycophenolate?  We used both these drugs as ours couldn't tolerate pred at all.  We are now at the fortunate stage of weaning off and our specialist said there is no known withdrawal protocol  for mycophenolate but we are erring on the side of caution (as she has been a particularly difficult case) and weaning off over 9 months. good luck x

I am just looking for answers as I feel very disappointed with our vets but am not sure if we are being a bit harsh.  Briefly:
May 2016 - brought Milly in as noticed she was eating "dirt".  Immediately vet did blood test and results were alarming - PCV 15% and they couldn't understand how she seemed so "well".  another test done, sent to lab - this happened a few times as the results differed widely. Sometimes the results would be 23%, sometimes 305, sometimes 15% etc.   I now understand from my own research (although no vet has told me this!) that chronic IMHA readings can fluctuate in the early stages.  How come my vets don't know this??  Milly seemed quite well so no medication was given.  We were just about to go to referral hospital when they did find hookworm and this was treated, and her PCV rose to 33%.  IMHA was then discounted....  However by October she started eating dirt again and I took her as she was due her booster.  I mentioned straight away that she was eating dirt and wanted wormer.  Vet took bloods as obviously realised something was amiss.  However, she still vaccinated her.....  This is the point of my post - 4 days later she crashed very badly and was given blood transfusion etc.  Is this a coincidence?  or did the booster push her from chronic to acute IMHA?  Now I understand that all vaccines have a label warning - "Only vaccinate healthy dogs".  Should I do something about this vet?  We were not told about any potential side effects etc. and it seems very wrong to me, in hindsight, that Milly was vaccinated when it was very clear there was an issue.  Should we discuss this with the seniors at the practice?  I don't want to cause bad feeling but in my view, this was bad practice.  Anyone have any views on this?  thank you!!

Sorry, I meant to say I believe it was regenerative.  Initially the notes said non-regenerative.

xx

Thanks Jo, she is a fighter that is for sure!!  xx

Hi all, just wanted to update you after we had a splenectomy performed on our 11 year old beardie.  She had IMHA and then IMT and didn't respond to IVIG etc.  However, the splenectomy has worked very well so if you have a "refractory" case, from our experience, I can say it has worked very well - platelets above normal and now able to reduce meds.  There is not much data available on splenectomy for dogs, but I was assured that anecdotal reports are favourable and we can now happily agree!!

Good luck to all of you fighting this horrible diseases xx

hi Jo, yes, I agree about the pred.  The other drugs are obviously not controlling the IMT and I've read Pred is the drug of choice.  He did say they may give her a low dose.  She has already had IVIG, 4 weeks ago, and her platelets went from 7 to over 450!  but it's transient and of course they are now back down again.  I asked about a 2nd transfusion.  It is possible but he said there is a risk of a reaction and this risk increases each time.  I mention Vinchristine, and he said yes they will keep that option "up their sleeve", don't want to do it now because she has had pancreatitis, and vinchristine can cause pancreatitis.  I agree about waiting for the leflunomide to work, I was wondering about this last night.  She is in ICU and I can't see how they are going to be able to tell much by this morning..  at such low platelets she is at risk of spontaneous bleeding and my thoughts re: the pred are exactly the same as yours and as you know so much, I feel we are correct!    I will ask this morning.  thank you so much for reading my post, and your advice.  I will read the links now.

Just off the phone, they are keeping her in ICU over night as her platelets are at 7 so at risk of spontaneous bleeding.  They think they will put her on Leflunomide and a small dose of pred.  They worry about pred because of her GI bleeding, and if she bleeds now they think that would be disastrous.  I asked about vincristine, and they may get to that point, but will keep that option open till they see how she responds to the leflunomide.  She has a little petechiae but considering how low her platelets are, they think she is coping very well so far.  so worrying.

Thanks so much Jo.  We'll find out more this evening but I understand they are indeed now resorting to pred again, and will give her antepsin and continue with Omeprazole.  Initially she was not on gastric protection (there was a good reason for this apparently, I can't remember what though!), and got the ulcer - they did also find heliobacter (spelling) which surprised them as there was a lot of it which can also cause ulcers but usually not found in dogs in such quantity.  She doesn't appear to have internal bleeding as her PCV is good, and seems clinically well.  She is at Dick Vet school in Edinburgh and they are very good indeed. They were wondering about a trigger, and have done all sorts of blood tests but we will never vaccinate again, nor use pesticides on our dogs (and I believe it was a flea/tick treatment that triggered her initial IMHA).  She has been on 250mg Mycophenalate twice a day, and 100mg Atopica once a day, plus 20mg Omeprazole once a day.  We are picking her up this evening and will see what the new treatment consists of.  Thanks for your advice, much appreciated.

Hi, my bearded collie is 11.  Diagnosed with IMHA last November although had signs since the previous May.  Incorrect diagnosis of hookworm.  However, she was at PCV low 20s for months, and seemed well.  She now has IMT also.  Had IVIG transfusion 3 weeks ago, platelets went to high normal.  Had call from vet this morning regarding yesterday's blood tests - PCV is 49% but platelets are low.  Waiting to see if the lab results confirm this.  I don't know what next steps are if the platelets counts are low again.  She is back on Mycophenalate 250mg twice daily, and Atopica 100mg once daily as well as 20mg Omeprazole.  She had a bleeding ulcer from Pred in December so was weaned off quickly, hence not on that for IMT.  If her platelets are low, is there anymore we can do for her?  The local vets are ok but we have been referred to Dick Vets in Edinburgh and they have been fantastic but your advice would be much appreciated.  thank you.