CIMDA

Sorry for my delay in replying.  I have had computer problems. Congratulations on baby number 3.  No wonder you are very busy!

I am so sorry Ezzy has relapsed.  Unfortunately with AI disease there is always a chance of a relapse because of the genetic predisposition, and yes, fleas could have been the trigger, but not necessarily.  If the things that you have already tried are not working, then there is a natural product you can buy on the Internet called Billy No Mates. Some people say Diatomaceous earth is very good for controlling fleas, but I suggest that you do your research on both of these products.

If you can't control the fleas by natural methods, then I would suggest that you use Frontline Spray and just spray the coat in an open space so Ezzy can run and the coat will dry.  If a flea jumps onto the coat it will die. 

Also, as Catherine posted, doing the house is very important too, but spray it when you are about to go out for a while so it can do the job, but you or your family and Ezzy aren't subjected to those freshly sprayed chemicals.  Unfortunately, sometimes conventional methods have to be used.

Good luck and I hope Ezzy is getting over the relapse.

Jo

I did a quick search on the main CIMDAsupport page and have copied a previous post from Jo in reply to a person with a dog with SLE:

>>>>    I would make up a spray of natural essential oils such as lavender, eucalyptus and teatree oil (total oil: 15 drops 500ml water - Pet lovers Guide to Natural Healing for Cats and Dogs by Barbara Fougere).  You can put a splash of hair conditioner and use it as a grooming spray.  It is only a repellent so if you have a real flea problem, to avoid using chemicals on your dog, you may have to think about intensive vacuuming and then using a house spray in the cracks and corners like Indorex, but I would choose to use it when you were going out for a few hours to give it time for any left over smell to dissipate. There are ready made natural flea repellents on the market too.<<<<<             

Are there any areas other than indoors that they could be picking up fleas from? For instance behind sheds or in the garden where wildlife might be. They could be hedgehog fleas for instance.

Hi guys- back here again! Ezzy is 10 now- almost 11 but has just relapsed again. We think due to fleas. We treat our other animals and that usually keeps them at bay- had baby number 3 last year and haven't been as on it this year apparently.
Have searched the old posts and found one from Jo but the link didn't work anymore.
What can we use naturally to help? Have been combing with shampoo and lots of baths- hoovering and washing bedding lots too. Just don't seem to be winning. PCV was 23 last week so hopefully we've caught it early enough to help her 😭

Thank you so very much - yes it does help!

Unfortunately one of my dogs has secondary IMPA due to ehrlichioses, therefore I wanted to seek further advice based on your extensive knowledge also.

We will continue to monitor the ehrlichia and hope his bloods improve.

Thank you again - if we find out more I might come back to you if an immune mediated condition is suspected.

Kind regards
Kylee

Jo's computer is not working properly, but I have talked to her about your post. Here is her reply:

Given that this dog has tested positive for Ehlrichia, and is showing many of the typical clinical signs,  and also is being treated appropriately, I doubt, at this stage,  that there is secondary immune mediated complications.

Fortunately, in the UK ehrlichiosis is rare, so I don't have enough experience to give any advice, but I would ask for a further test for ehrlichia to see if there is any difference in the IgG levels which will hopefully indicate that the medication that he is having is bringing this under control.

Sorry to be so vague.  Please get back to us if there is an immune mediated cause.

This is an informative website:

https://vcahospitals.com/know-your-pet/ehrlichiosis-in-dogs


It is difficult to advise without seeing the dog, or knowing the full details, but I hope some of it helps.

Hi Catherine

Thank you for your guidance - he's been on 16mg on and off as they wanted to taper down and then put him back on again, so it's been really frustrating, but clearly he needs to be on a higher dose.

I'd really like to understand also what the vet needs to look at/ investigate to be able to determine for sure whether he has an autoimmune disorder or not - they have been really reluctant to do additional testing although I have asked for it numerous times. They even say a urinalysis and blood smear are not needed although I think it's imperative to get an overall picture of his condition.

We just want this lovely boy to get better and know how to proceed...

Again thanks for your input !

Regards
Kylee

Thank you. Has he been having 16mg of Prednol the whole time or just recently? If it is now autoimmune then for a labrador, (weight about 36kg), he should be having 36mg of Prednisolone every 12 hours, plus a gastroprotectant for his tummy.

I have notified Jo Tucker, so hopefully, she can advise you a bit more.

https://live.staticflickr.com/65535/54527593930_640a56abd5_n.jpg

Hi Catherine,

Thank you so much for responding - I tried to upload with FLickr with the link above but not sure it has worked - so I have also pasted them below...



Value   Normal Range           20/04   28/04   05/05   10/05   15/05
RBC   5.65 - 8.87 M/uL   3.58   4.56   3.69   4.45   5.05
HCT   37.0 - 61           27.1   34.5   25.7   30   33.2
HGB   13.1 - 20.5 g/dL   8.7   11.1   9   10.5   11.9
MCV   61.6 - 73.5 fL           75.7   75.7   69.7   67.4   65.7
MCH   21.2 - 25.9 pg           24.3   24.3   24.3   23.5   23.6
MCHC   30.0 - 38.0 g/dL   322   321   348   34.9   35.9
RDW   13.6 - 21.7%           14.2   14   12.6   14.1   13.5
%RETIC   %                         0.4   1.3   
RETIC   10 - 110 K/uL                 16.1   58.6                  
WBC (Leukocytes)6.0 - 17  K/uL   4.63   5.67   5.19   7.7   6.08
NEU   3.6 - 12.3           3.12   2.82   2.96   5.51   3.91
%NEU   52-81                   67.4   49.8   57   71.6   64.3
MONO   0.1 - 2.0           0.61   1.06   0.82   0.8   0.52
%MONO   2.0 - 13           13.1   18.7   15.9   10.4   8.5
EOS   0.0 - 1.6           0.12   0.17   0.15   0.09   0.17
%EOS   0.1 - 10           2.6   3   2.9   1.2   2.8
LYM   0.8 - 4.9 K/uL           0.78   1.62   1.25   1.29   1.48
%LYM   12.0 - 33.0           16.9   28.5   24.2   16.7   24.4
PLT   148 - 484 K/uL           54   50   114   94   88
MPV   8.7 - 13.2 fL           15.4   12.1   15   15.3   11.3
PDW   9.1 - 19.4 fL           15.6   15.7   13.7   14.7   14.8
PCT   0.9 - 5.8           0.83   0.61   0.17   0.14   0.99
CREA   .5 - 1.8 mg/dL           0.67            
BUN   7 - 27 mg/dL           12.2            
BUN/CREA 4.0 - 27           18.2            
TP   5.0 - 7.2 g/dL           10.2            9.1
ALB   2.6 - 4 g/dL           2.5            3.1
GLOB   2.5 - 4.5 g/dL           7.7            6
ALB/GLOB 0.8 - 2.0           0.3            0.5
ALT   10 - 125 U/L           46            
ALKP   13 - 83                   48            
GGT   5.0 - 14           10            
TBIL   0 - 0.9 mg/dL                       0.4

Do you have the normal range values please?

If he has low haematocrit and platelets together then that can be Evans Syndrome. See here:https://cimda.co.uk/smf/index.php/topic,13.0.html Also he would need to be started on a higher dose of Prednisolone. See here:

Immunosuppressive Protocols for Oral Prednisolone in the Dog.
Ref: Clinical Immunology of the Dog & Cat by Michael J Day  – Professor of Veterinary Pathology, University of Bristol, UK and WSAVA - Chairman of Scientific Advisory Committee.

This example is base on a dog receiving an induction dose of 1.0mg/kg/q12hrs

Dose                Duration (based on clinical effect)

1.0mg/kg/q12h             10-28 days
0.75mg/kg/q12h            10-28 days
0.5mg/kg/q12h             10-28 days
0.25mg/kg/q12h          10-28 days
0.25mg/kg/q24h          10-28 days
0.25-0.5mg/kg/ Every other day      at least 21 days
0.25-0.5 mg/kg/ Every third day       at least 21 days

Azathioprine (a cytotoxic drug) can be used in combination with prednisolone at 2mg/kg/24 or 48 hrs and dose gradually reduced, when remission is achieved, over a period of months.
Clinical response to Azathioprine may take up to 6 weeks. (Plumb's Veterinary Drug Handbook)

Don't forget the gastroprotectant!

Hello team,

I hope you can help! We are trying to help a rescue dog who is currently in Turkey. Unfortunately, he has been seen by different vets and none of them concur about his condition. One moment they say he could possibly have an immune mediated condition (IMPT or IMHA), the next they don't.

He has anemia and a low platelet count and an enlarged spleen. He also showed a positive IgG for Ehlrichia (IgM negative). He has been on prednol and doxycycline on and off now for 4 weeks because the vets just cant agree on his condition. One vet just wants to perform a splenectomy and says the ehlrichia is no longer active (as all he did was a PCR). The other vet says he's too ill for an operation but also doesn't quite know what to do next. I have attached his bloodwork from the past 4 weeks in one overview.

He is not showing any signs of being poorly - however we need guidance on the best course of action for him. He is a 4 year old, non-castrated labrador. He has not had any vaccinations yet. He's currently on 16mg Prednol and 4x doxycycline per day.

Thank you for any advice you can give as we are truly at a loss 

I can't upload a document, so here some details of his blood results over a 5 week period:

Platelets: 54   50   114   94   88
RBC: 3.58   4.56   3.69   4.45   5.05
HCT: 27.1   34.5   25.7   30   33.2
HGB: 8.7   11.1   9   10.5   11.9

WBC: 4.63   5.67   5.19   7.7   6.08
PCT: 0.83   0.61   0.17   0.14   0.99
TP: 10.2            9.1
GLOB: 7.7            6