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Elaine, this is long but I am hoping you find somewhere to post on your site. I do believe this read will be beneficial for those just starting to deal with IMHA, as this is from my experience with my dog Lucia over the last 60 days. ------------------------------------------------ As we have all experienced, IMHA appears suddenly. Your dog is running, eating and doing the normal daily routine.and a couple days later you find yourself at the vet hospital or office with a life threatening disease on your hands. Unfortunately, many loved dogs have succumbed to this disease within only hours or days of being diagnosed. My 10+ year old dog, Lucia, was diagnosed on December 22, 2008. Her pcv was not as low as some of your pets, but at a pcv of 20 she had a blood transfusion. We were lucky to live in Minneapolis near the U of M veterinary hospital. It's like the Mayo clinic for pets. She has been up and down for 2 months on various medications, but she IS on her way to recovery! Don’t lose hope! I'll share my "check list" with the hope that it will benefit others. 1. Get your pet to a veterinary hospital if at all possible or at least someplace that can run xrays, ultrasounds, blood transfusions, immediate CBC blood panels, etc. Unfortunately many vet offices do not have the equipment for full testing. I took my dog to an emergency vet, then 2 days later to my regular vet, and then finally 4 days later (on my own) I took her to the U of M emergency were she was diagnosed and treated. 2. Research the disease on your own and ask every question you can. Get familiar with the different types of meds that can be used for treatment (Prednisone, Azathioprine, Cyclosporine, Sucralfate for stomach ulcers, Famotidine/pepcid AC for stomach acid, etc.). Ask about aspirin to prevent clotting, especially if your dog has agglutination where the blood cells are sticking together. 3. Once your pet comes home, monitor him/her all the time. You must know the basics on how to take their pulse, breathing rate and temperature and know what is normal range for your dog. Keep checking the gums and other membranes for color. Call emergency rooms and talk to vet techs to describe symptoms before racing into emergency. The call is free and may put your mind (and pocket book) at ease. 4. DIET: very important. You may only be able to feed your pet boiled chicken breasts for some time (2 weeks or more). Once you start introducing kibble, make sure it is high in protein and low in fillers. Meat should be the top 2 ingredients. I go grain free now, with EVO pet food (the red meat formula at 42% protein). 5. Don’t be afraid to seek treatment elsewhere for second opinions if you feel the need. I acted quickly to take my dog to the U of M vet hospital when a diagnosis was not achieved elsewhere. Once diagnosed at the U of M, I took my dog to my regular vet and a new holistic vet for a check-up. First, my regular vet has seen my dog for 10+ years so he knows what is normal for her and second, the holistic vet introduced me to some herbs and vitamins that were complimentary to the meds my dog was prescribed (obviously, share with all vets what you are giving your pet for meds, supplements…even food and treats). Through all of this, the U of M has been the primary vet care, and I have followed their medication plan, followed-up blood testing there, etc. 6. Blood tests: make sure you keep up with regular blood testing. Plan to do this weekly, if not more often. Don’t get discouraged if the pcv is fluctuating. If it is, ask about adding or replacing meds. 7. Medication side effects: Prednisone is a wonderful drug for so many diseases…but it has many side effects. Ask about these and research them. Too many times I found myself back in the emergency vet room for a $150 visit because Lucia had a potbelly stomach, or was panting excessively or was falling down due to weak leg muscles…all side effects of prednisone. 8. Expense: yes, this is a very expensive disease with blood transfusions, regular blood testing and medications. If you have not found the cause of the IMHA, expect lots of testing. 9. The cause? The disease can be PRIMARY (suspected that vaccinations, bee stings or reactions to some medications can bring on IMHA) or SECONDARY (as a symptom resulting from cancer or some other disease). And…you may never know what caused this to happen to your pet. The disease will be easier to treat if you know the cause. We have not yet found the cause for Lucia’s IMHA, so we’ve spent a lot of money and time testing for cancer, tick disease, etc. 10. As you take care of your dog, TAKE CARE OF YOURSELF. Try to keep your routines as normal as possible, it WILL help your pet. NOW, after 2 months of yo-yoing with her pcv, meds, and symptoms caused by the meds…Lucia has finally reached a normal pcv level of 43! Medication Summary: We tried to introduce Azathioprine along with Prednisone during weeks 2-3 of her disease, but her liver enzymes were too high on this drug. However, her pcv was not climbing or remaining stable on Prednisone alone. Finally (about 45 days into the treatment), we introduced the miracle drug: Cyclosporine. Get ready…it’s $6 per pill, so at two pills a day you are hoping that it kicks in quickly…and that’s exactly what it did! After taking 200mg of Cyclosporine + 25mg of Prednisone a day for 10 days, her pcv crept up to 39 (normal range of pcv is 38-60 for a dog). Her meds were then reduced to 100mg Cyclosporine and 20mg of Prednisone and 5 days later her pcv had risen to 43. WELL within the normal range. Lucia’s blood is now free of spherocytes (attacked blood cells) and agglutination, so we discontinued the aspirin. That made a huge difference to how she was feeling, as aspirin can be tough on their stomach. We then discontinued the sucralfate and that has cleared- up the remaining upset digestive tract issues. Reducing the Prednisone has greatly improved her muscle coordination, because high doses of long term Prednisone causes muscle weakness. Here are some other things I practiced, that I DO believe made an impact on her recovery: • First 25 days, I fed her boiled chicken breasts and ground beef. That’s it. Bland diet. Not even rice. I gave her vitamin supplements w/antioxidants + herbs as prescribed by my holistic vet. Also gave her a couple tablespoons of yogurt a day. Treats: pieces of 100% all beef hotdogs. • Days 25-35, I introduced EVO dog food, mixing it with the chicken/ground beef and yogurt. Plus vitamin supplements w/antioxidants + herbs as prescribed by my holistic vet. Treats: Bil•Jac liver treats. • Days 35-45: EVO dog food. (42% protein, no grains) + 2 tablespoons yogurt + 2 teaspoons pure pumpkin (no spices) + 1 teaspoon chopped carrot + vitamin supplements w/antioxidants. Treats: Bil•Jac liver treats. (note: pumpkin is a good source of fiber to keep the digestive system flowing. A little bit of pumpkin can ease constipation, double the dose and you can ease diarrhea) • Days 45+: EVO dog food + 3 tablespoons EVO canned food (give with pills) + 2 tablespoons yogurt + vitamin supplements w/antioxidants. Treats: Bil•Jac liver treats + Authority heart and immune treats. I also give her real baked bones with bone marrow still in them. One a week, and let her chew on it each night. Must monitor dog when they have the bone. (make sure it’s a USA product!). This is great for removing the tarter on her teeth and helps get rid of bacteria in the mouth. Remember, on the immune suppressive drugs your dog is very susceptible to infections, etc. At day 40, I also began EFT with Lucia. (tapping on meridian points, to reconnect the body’s energy flow. To learn more about this see emofree.com). I do believe this had an impact on her, as her pcv started rising once I introduced the EFT practice. I’ve taken classes on EFT, so make sure you read things thoroughly before trying this. We aren’t over this yet, but it is completely remarkable where she is 60 days after her diagnosis/blood transfusion. She can now go for short walks, chase after her ball without falling down and wags her tail all the time. Next week, we go in for another blood test. We’re hoping that her pcv has continued to climb or at least remain stable. If so, I would think that the medications can be reduced even further. Many dogs are on meds for an average of 4 months and some continue on very minimal doses for the rest of their lives to keep them in remission. Keep the faith, love and positive attitude with your dog during this time. This disease has opened my mind to the power of healing in any and every way. And, it’s made me take notice and action on my own health issues. Lucia and I are planning to have a lot more time together. ~Laurie

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