AIHA Relapse

Started by Highbank, August 02, 2017, 05:37:47 PM

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Jo CIMDA

Hi David

This is brilliant news for Blossom. 

Thank you so much for this update.  It can give others hope.

All the best

Jo

Highbank

Hi again

Further news on Blossom, and not that good . We did stop the Azathioprine as PCV was over 40% for last few blood tests. We were only taking it  once every 3 days . Everything was looking good and had a blood test 4 weeks after stopping to confirm all still ok . The results for that were PCV down to 34% , then we did another one after a week and down to 29% . We then started preds back , 25mg twice a day and Azathioprine one a day . A blood test today 8 days after started the meds gave a result of  PCV 22% . Plan is another blood test this Friday . The vet has  prepared us for a possible transfusion. We have everything crossed that the meds start working there magic.

As you can imagine we are very worried . Will let you know how it goes.

Regards

David

Jo CIMDA

Hi David

I am so sorry Blossom has relapsed. Unfortunately it can happen.  Can you think of any potential trigger that she has encountered that might have caused the relapse?  If not then it is likely that she wasn't in full remission.

Putting her back on 25mg pred twice a day and the Aza once a day is the way to go. Check with your vet that she has non-regenerative AIHA.  This is most likely to be a primary AIHA in the bone marrow, whereas a regenerative AIHA is most likely to be secondary to something else going on.   

If it is non-regenerative then I can't see why the meds won't work - they did last time, so I really hope you will see an improvement in her PCV  on Friday.   Make sure she is on a gastroprotectant.

Unfortunately, it is starting all over again, but this is not uncommon and long term remission, without drugs, can be achieved.

Jo


Highbank

Hi all

Further update on Blossom,  another blood test today gave a PCV pf 22% so seemed to have stopped the downward spiral. We have another test Monday so hopefully stays the same or hopefully starts to rise again and we start the slow road back up again.

We have confirmed with the vet that is non-regenerative AIHA.

Regards

David

Jo CIMDA

Hi David

Ask your vet is there was any clumping in the blood sample because if there is then 22% is the lowest possible level and the true reading will be higher. Also ask if the reticulocyte (immature red blood cells) reading is high because it should be in order to correct the anaemia.  If it is high then this is also very good news.

Take her exercise very easy and try to keep her calm because if Blossom gets excited she might 'faint' because she may not have enough red blood cells to take adequate oxygen to the brain. If this happens just give her time to come around and she will be fine.

At least you are not looking for an unidentified cause for Blossom's non-regen anaemia and this can be easier to manage.  She responded last time so I am hopeful she will respond again.

Many thanks for the update
Jo