IMHA

[Penny]

I know this isn't a new topic but I can't sort out how to post something within an existing topic.  My 5 year old Australian Kelpie (Alice)  was recently diagnosed with IMHA.  Luckily, my vet was on the ball and caught it right away, based on a CBC, so she was put on appropriate meds quickly even before her positive Coombs test results came in she was started on steroids.  She  got sick 5 days ago, was on steroids for two days and then an immune suppressant and ultra low aspiring were added on day 3 along with omiprazole (sp?) to protect her stomach.   She is still very lethargic but her PCV is holding at between 25% and 29% so I'm hoping she will be in the lucky 50% who make it.   I'm taking her to my vet every other day or every third day to check her PCV.    Does anyone have any suggestions for me in terms of her immediate care?   I am a little freaked out and want to do the very best that I can for Alice.

THANKS,   Penny

[shawkyelisabeth]

Hi penny, i am  sorry for your fur baby to have been diagnosed with imha and hope he will recover. He will with the correct treatment. Pls read the files and check the michael j day protocol and get it to your vet, it is a reliable treatment course. I am sure jo and pennel will read your post and suggest the same. Get him on the right dose of prednisolone as quickly as possible! You will see an immediate improvement in his condition but the treatment takes a long time, several months due to his clinical signs and blood picture with very slow tapering..thumbs crossed for you and your baby...elisabeth

[Penel CIMDA moderator]

hi Penny,
it's good that you've started a new topic for Alice with IMHA - it makes it easier for everyone to follow her case.
Can you tell us how much Alice weighs - I'm guessing about 18 - 20 kgs?  and also how much prednisolone she's on, in mgs - is it split into two doses?  do you know which immune suppressant she's on.
Omeprazole is a great gastroprotectant but must be given 2 hours before any other medication as it can stop absorption of the drugs.
It sounds like your vets have a good handle on the situation so far.  Anything we can do to help just ask please.

Here's some more info just in case you haven't already seen this.
http://cimda.co.uk/smf/index.php/topic,11.0.html

this is our preferred drug protocol.

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)

[Jo CIMDA]

Hi Penny

I hope Alice is improving.  Does your vet know if she has an underlying condition that is causing the anaemia? I ask this because she has a positive Coombs test. If an underlying condition is identified this has to be treated as well as the AIHA.

Jo