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View Full Version : Flynn - bad news IMHA and possibly polyarthritis along with meningitis



Sabre's Mum
01-04-2010, 05:31 PM
Hi everyone

We have had a very eventful christmas - new year. Flynn (now 6 months old) refused his food on 28th December. We were staying at my parents for Christmas and Mum had told me that he had eaten three bowls of cat food the day before. So, I initially thought he is just full. A couple of hours later he started shivering ... I went over and checked him out and he was HOT!!! So off to the vet on a Stat Holiday!!! He had a temp of 40.5 degrees Celsius (104.9 F). So he gave us some antibiotics with instructions to ring our vet in 48 hours if his temperature had not gone down.

We went off to our vet the next day and he did an x ray to check for obstructions as his temperature still wasn’t going down - none. That night he would not put his head down to eat or drink I had to lift up his bowl and he started to have a stiff gait – his rear legs were very stiff. That night he yelped at me when I tried to pick him up.

The following day the vet discussed that we could possibly change the antibiotic or go to the third step which was to presume that it was an auto immune response and possibly meningitis and hit it with steroids as his temperature was still above 40. You can imagine my initial reaction … STERIODS!!!! My husband and I did agree that he really did need to get better so the vet gave a shot of dexamethazone. That night he improved and the next day his temperature was back to normal. He was bouncing around again … we had our boundle of joy back again. He was really on death’s door.

The only way to actually confirm meningitis is with a cerebal spinal fluid (CSF) tap which we were told that only specialists would do nowadays and would cost $1000 and upwards. The results are somewhat masked once steroids are given and there was no surgeon available to do the tap – holidays! SO … we treated on symptoms. After a phone consult with a specialist he concurred that it was most likely meningitis.

So our handsome 6 month old is going to be on prednisone for at least 6 months – starting at VERY high levels – currently 3.4mg/kg and will reduce. They also want to add in azapiothrine but I really need to find out all the costs as I picked up 8 tablets and they cost $67.50 and require monitoring of the bloods as it can have an effect the bone marrow!

So I have been pouring over the internet researching the added illness in our family! Unfortunately there is not as much information as cushings and I am battling to fully understand the illness, prognosis and treatment BUT I will get there.

On a happier note … Sabre is doing well at the moment so let’s try and keep it that way.

Angela, Sabre and Flynn

Casey's Mom
01-04-2010, 09:33 PM
Angela that is a very scary story - thank goodness you got him to the vet right away and that you were able to find one on a holiday! I hope he is okay, and glad to hear that Sabre is doing well.

Someday I would love to go to New Zealand. Sorry Aussie friends but New Zealand does hold a special fascination for me. One day . . . .

Love and hugs,

MiniSchnauzerMom
01-04-2010, 11:24 PM
Angela,

What a scare!! I'm glad that Flynn is better. Just in case you haven't already found this reading material, I've included a couple of links for you about meningitis.

https://app.vetconnect.com/5min/data/08180819.htm
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/101600.htm

Hope Flynn does well on his therapy....and glad Sabre is giving you a break. :D

Louise

AlisonandMia
01-04-2010, 11:57 PM
Oh what a shock! Not what you expect to have happen with a young one - serious illness I mean. It looks like this particular disease is a young dog's disease, though. Kudos to your vet for picking it so quickly!

Here's an encouraging case history: http://www.itsaspringthing.co.uk/case%20notes.htm

A family friend has recently been diagnosed with autoimmune hepatitis and the medication regime for that is pretty much the same. High dose steroids in a human are not a pretty thing but fortunately they have been able to halve the dose after the first month and she's doing well now and the side effects aren't so bad. I don't know if she's started on the Imuran (azapiothrine) yet or if she is even going to need it after all.

Have you contacted the breeder to let them know?

Alison

Franklin'sMum
01-05-2010, 12:12 AM
Angela,
How scary for you all. I'm so glad you were able to find a vet who was open on that day. Is the $67 drug you mentioned an anti-biotic?

The most likely problem with the symptoms that you describe is steroid responsive meningitis. Puppies with steroid responsive meningitis usually have a fever, they have a stiff or uncoordinated gait, they often resist having their head and neck touched or manipulated and may show signs of severe pain. Paralysis, severe weakness or seizures may also occur. Unfortunately, these are also the signs of most other forms of meningitis, so bacterial meningitis, distemper induced meningitis, vasculitis and fungal infections can cause similar signs.

Examination of a cerebrospinal fluid (CSF) sample is helpful in confirming that this condition is probably the cause of the symptoms seen. The number and type of cells seen in the sample and the composition of the fluid varies from one disorder to the next. It may not be possible to absolutely confirm the presence of steroid responsive meningitis from the CSF sample but it can be helpful in guiding how long to use corticosteroids and whether other therapy, such as antibiotics, is necessary.

That quote is from www.vetinfo.com/dmeningitis.html and had a couple of people ask questions and the answers are from Drs.

Glad that Sabre is doing well, and hoping Flynn gets better really soon,

Jane, Franklin, and Bailey xxx
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Sabre's Mum
01-05-2010, 01:25 AM
Thanks to all above for their replies. Thanks for the links - I will check them later.

Jane - the drug I was referring to is a cytotoxic drug which has to be handled in a similar manner to Lysodren. It has some bad side effects one of which is on the bone marrow but it tries to counter the evils of prednisone.

Alison - absolutely a shock and to think that we didn't take out pet insurance because with Sabre's diagnosis we mentioned that it was a shame we didn't have insurance but the vet said she no longer recommended pet insurance due to the ongoing exclusions. I have kept the breeder up to date but have been told that it is not hereditary - although there appears to be a hereditary link in bernese mountain dogs with aseptic meningitis and also possibly meningitis polyarthritis syndrome in Weimaraners. Do you have any information to counter this?

Louise - we too hope that Flynn does well on therapy. The vet we saw said it had an 80% response although what I have been reading has been more like 50% without relapse so we take each day by day and love him even more. He has become closer to us - we broke one of our rules to allow him on our bed whilst we sleep at night. Vizslas LOVE being on beds and particularly under covers and this was one of our steadfast rules with this pup ... duly broken. We have reverted back to the rules.

Casey's Mom - thanks ... yes NZ is beautiful .. although I am really partial to those Australian beaches and the occasional shopping!

Thanks everyone for your kind words.

Angela, Sabre and Flynn

Harley PoMMom
01-05-2010, 02:01 AM
Hi Angela,

Here are a few more links:

http://www.animalhospitals-usa.com/dogs/dog-health/dog-meningitis.html

http://www.upei.ca/cidd/Diseases/nervous%20system%20disorders/meningitis.htm


Breeding advice

Affected animals should not be used for breeding. Although little is known about the inheritance of these conditions, it is best to also avoid breeding parents or siblings of affected pups.


http://www.petplace.com/article-printer-friendly.aspx?id=2903

Sending positive and healing thoughts and prayers your way.

Love and hugs,
Lori

SasAndYunah
01-05-2010, 02:59 AM
Hi Angela,

what a shock to receive such a diagnosis in your pup!

To the best of my knowledge it's advised that whenever a pup is diagnosed with aseptic meningitis, that the parents and siblings of that pup (and of course the pup itself) should not be bred anymore. There is strong evidence that it is indeed hereditary (affected dogs are usually close related) not just in the Bernese Mountain Dogs but several other breeds as well. Since the exact cause is not known yet but the evidence is strongly pointing towards hereditary involvement, a reputable breeder would keep to these guidelines to avoid the risk of breeding even more pups with the possibility of developing aseptic meningitis.

About the Azathioprine, it's not a cytotoxic but an imunesupressant, like Prednisone but even stronger. It's often used to prevent rejection after an organtransplant for example or severe cases of Crohn's disease.
Again, to the best of my knowledge, it's used if Prednisone alone is not working well enough. It's not to counteract the side effects of Prednisone, it does exactly the same as Prednisone...it's only more potent.

Personally, I would ask your vet if he has a specific reason to prescribe the Azathioprine in this stage. Normally they would start with the prednisone regime and if the dog relapses when the Prednisone dose is lowered or when the Prednisone is discontinued after several months, they will add the Azathioprine. So you could ask why he wants to start right away and if it is an option to start with the Prednisone only...and see what happens down the line. It's always possible to add the Azathioprine down the road if neccesary. Especially since Flynn seems to respond very well to his Prednisone at this time.

In most cases, the dog will fully recover but unfortunately about 10% of all affected dogs will need lifelong treatment. A friend of mine with 2 German Shorthaired dogs, battled Aseptic meningitis in both dogs and both recovered fully...

Hope any of this helped to make a few things more clear. All our best to you and Flynn,

Saskia and Yunah.

littleone1
01-05-2010, 07:01 AM
Hi Angela,

I'm sending positive positive thoughts and prayers to you and Flynn. I hope Flynn's treatment will be very successful.

AlisonandMia
01-05-2010, 07:17 AM
I've found a reference to where Vizsla's are listed as being prone to this disease:

http://www.hungarianvizslaclub.org.uk/health.html

One of the links on that page takes you here: http://www.vizslahealth.net/illnesses.htm

and here:

and from there you can find this link: http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2008&PID=23996&O=Generic

So it looks like in the UK (bloodlines?) at least Vizslas are regarded as being a "SRMA breed".

Somewhere in there it mentions that it is thought to have a big hereditary component. Certainly in humans autoimmune diseases seem to cluster in some family, often with different members having different diseases and some unfortunate individuals having more than one.

My understanding of Azathioprine is that it is an immune suppressant that is used either because steroids alone aren't controlling the condition or to make it possible to use a lower dose of steroids - something that is very desirable in humans particularly because of the really nasty side effects that humans suffer on high-dose steroids. So Azathioprine can be used to "reduce steroid side effects", but not because it has any effect on those side effects in and of itself but because its use can allow a lower dose of steroid to be used.

I'm with Saskia - I would think you'd start with the steroids and then see if the Azathioprine was really going to be necessary. That is is what I believe the girl I mentioned earlier has had happen - so far she hasn't needed the Azathioprine and so hasn't started on it although I guess they may eventually use it keep the long-term steroid dose as low as possible.

Alison

Sabre's Mum
01-05-2010, 04:54 PM
Thanks for all the links - much appreciated.

I agree with both of you - Alison and Saskia with regards to using azathioprine. I have joined a yahoo group (not as active as this group) but the one reply I have back is that prednisone is reponsive in 80% of cases. If it the prednisone is not working or there is a relapse then azathioprine can be used.

Thanks for the info on the combination effect ... I did understand this (as Alison described it) but did not explain this in my post ... trying to be brief and simplistic doesn't always work.

I am seeing the vet tomorrow so will be firing lots of questions at her!

Once again thank you for all your links, thoughts and replies.

Angela, Flynn and Sabre

gpgscott
01-05-2010, 06:29 PM
Angela,

I can't help a bit from personal experience with this issue, and you have very good advice from other members.

I know how hard it is to have a young one with issues and am praying for you all.

Sorry to be late to respond, please let us know how Flynn is getting on.

Scott

MiniSchnauzerMom
01-15-2010, 04:09 PM
Angela,

Was thinking about you. Wondering how Flynn is doing and how the vet visit went on the 6th???

Louise

Sabre's Mum
01-15-2010, 06:44 PM
Thanks Louise for thinking about us.

Flynn has reduced his dose from 60mg to 50mg per day. He is doing well ... I just can't handle the hunger that is in the little boy! We have gone from the gentle taker of treats to snapping your fingers! I have given up giving his pred laced cheese to him and just toss it into his food bowl after he eats! He was oh so gentle before!

Our vet visits are weekly ... which I hope to discuss with our regular vet in a couple of weeks (we are off to see the original vet who diagnosed him next week as our regular vet). Visits consist of weigh in, gum check, temperature taken, do you think he is ok at the dose of pred ... then see ya next week. $$$ Maybe she will be ok if we weigh weekly and just visit when dose changes are needed.

Forgot to say that we decided not to use azathiprine as well and just to stick with the pred at this stage.

Thanks for asking
Angela, Flynn and Sabre

Sabre's Mum
02-02-2010, 11:18 PM
Through my tears I will try to type this ... so I won't make it long! Flynn started limping last night so I took him off to the vet today. I mentioned that his gums were pale and she checked ... urgent bloods. He is now also diagnosed with IMHA and also possibly polyarthritis along with his meningitis. The prognosis is not good ... He is currently on 40mg of pred a day split into two doses ... and weighs 18.9kg. At this dose it is not keeping the IMHA at bay. His PCV is 15 ... normal range (37-50) ... vet said 10 is when they really start to go down hill. Platelets are 3+. This is all I got over the phone.

We now have a really tough decision to make ... and it is the hardest thing I have ever have to do. We could add azathioprine but will take at least two weeks to kick in, his pred dose will have to go up in the interim. The vet believes that it is likely to be lifelong and I am not sure that I really want him to have to go through this treatment forever. He is a changed little boy at the moment ... the old Flynn is no where to be seen.

Does anyone have experience with IMHA?

Wow, I actually made it to the end through the tears. Excuse any typos.

Angela, Sabre and Flynn

AlisonandMia
02-02-2010, 11:47 PM
Really, really clutching at straws here but there isn't any way Flynn could have gotten hold of anything with onion in it? I know the pred has made him very hungry so he must be in food-seeking mode just about constantly.

Onion can cause a type of hemolytic anemia that can initially be mistaken for IMHA. There are ways of differentiating, through further testing.

Alison

MiniSchnauzerMom
02-02-2010, 11:55 PM
Angela,

I'm so sorry about Flynn. I have no experience re IMHA. All I have to offer is a link with some info and my support.

http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=569903&sk=&date=&pageID=2

Keeping you, Flynn and Sabre in my prayers.

Louise

Sabre's Mum
02-03-2010, 01:03 AM
Alison

I was going to say no BUT ..... on Saturday night he did grab a little of my daughters spag bol which had a small amount of red onion in it. My husband and I have had a brief discussion about him .... hard when I got the news when I was cooking dinner and sorting out the girls. BUT could this miniscle amount cause anemia???

He has finally eaten some dinner ... he didn't want breakfast this morning.

Angela, Flynn and Sabre

Sabre's Mum
02-03-2010, 01:06 AM
Louise

Thanks for your support. I will check the link later ... after I get the kids off to bed - which might be a while ... only second day back to school but they can't quite get back into the routine after the summer holidays.

We are thinking of treating with azathioprine to see if we do get a response but really need to work out just what sort of a life he is going to live ... possibly on pred and azathrioprine for life!

Angela, Flynn and Sabre

AlisonandMia
02-03-2010, 01:34 AM
Alison

I was going to say no BUT ..... on Saturday night he did grab a little of my daughters spag bol which had a small amount of red onion in it. My husband and I have had a brief discussion about him .... hard when I got the news when I was cooking dinner and sorting out the girls. BUT could this miniscle amount cause anemia???

He has finally eaten some dinner ... he didn't want breakfast this morning.

Angela, Flynn and Sabre

Sounds like a question for the vet. Does seem to be a tiny amount though. The timing, however, (around 48 hours after ingestion) would be about right.

What testing has been done? I think the specific tests that can give an idea as to the cause of the anemia may be lab tests - not ones a vet would normally be able to do in house - but I'm not sure.

Could the spag bol have had any other source of onion other than the red onion? Sometimes some of the tomato mixes/purees can have onion added sometimes in the form of onion juice or powder.

Alison

Sabre's Mum
02-03-2010, 01:08 PM
Alison

Later last night I remembered that i had texted my husband to say that Flynn's gums were pale and .... that was on Friday ... I now recall that the spag bol was on Sunday (after this). In hindsight I believe that it actually started just under two weeks ago ... on the Saturday we were very concerned with his lethargy ... rang the vet (our vet was off but the other one on duty was the vet who actually diagnosed Flynn with meningitis) and he said that it was most likely one of two things. 1. It was just the high dose of pred or 2. he wasn't responding to pred. He said not to come in monitor him and ring our vet when his next reduction was.

I have not been checking his gums ... didn't think it was an issue ... now checking them regularly!

The test we did were a lab test - we are lucky and get ours the same day. The bill says haematology. PCV is the main indicator on the test - Packed Cell Volume - vet said it was the percentage of red blood cells and as indicated earlier this is 15% and it should be between 37 and 50%. There is a test that can be done to confirm IMHA (which can result in false negatives if I recall right) but because Flynn has been on pred this test is pretty much useless. It is the Coombs test.

Off to the vet today to pick up the results and the durgs.

Thanks for being here
Angela, Flynn and Sabre

gpgscott
02-03-2010, 03:14 PM
And I can't offer a bit of advice, but am still here waiting to hear and hoping to help.

Scott

StarDeb55
02-03-2010, 04:38 PM
Angela, I'm not sure why a vet would think a Coomb's test is useless in the presence of pred. What a Coomb's test checks for is the whether or not the red blood cells are coated with antibody. The presence of the antibody leads both the spleen & liver to destroy/hemolyse the RBC's which lead to the anemia. I suppose the pred might interfere with the antibody attachment to the RBC, thus causing a false negative results. You might ask about this. The other test that really needs to be done which will help to determine if the pred is working is reticulocyte count. This can be done on the same blood sample that is drawn for a CBC. I doubt if it can be done in-office, though, probably has to go to a vet lab. A reticulocyte is a "baby RBC", recently released from the bone marrow. In situations like this, you want to see an elevated retic count which will demonstrate that the bone marrow is responding, & working "overtime" to try to compensate for the anemia. If I were in your shoes, & had to make certain decisions, I would want this test done to see if my pup was responding to therapy before I made any decision, one way or the other.

Hope this helps.

Debbie

Sabre's Mum
02-03-2010, 05:11 PM
Thanks Debbie

I wasn't the vet that told me about Coombs it was what I read online and what I recall it has the problem of false negatives if the dog is already on pred.

I now have all the tests ... sorry I have been on another forum posting and reading lots of things!!!! He has had reticulocyte count done. High/low results are:

HCT 0.15 L/L L (0.37-.55) ..... PCV
HB 45 g/l L (120-180)
RBC 2.59 x 10^12/l L (5.5-8.5)
MCH 17 pg L (20-25)
MCHC 300g/l L (320-360)
RETIC 130 x 10^9/l H (0-80)

Test Comments
Red cells show: Anisocytosis 2+ Spherocytes 2+ Hypochromasia 3+ Polychromasia 1+ Howell Jolly bodies occ.
Platelets clumped. Platelet numbers appear increased 3+. A smear estimate is 1900-2500x10^9L. There appear to be increased numbers of both large and giant platelets.

Organism Comment and Sensitivity
81000
10000
8000
1000

Report comments
now a severe anemia with mild regeneration and spherocytes suggests IMHA? Anaemia may have been more severe if not on current steroids?? Platelets are likely a marrow repsonse in these cases.

On the plus ... the pred had been keeping his meningitis under wraps ... WBC came down from 23.6 x 10^9/l to 12.3 x 10^9/l (6-17).

Our vet does no tests in-office all tests are sent to the laboratory which is 1 1/2 hours away.

Any comments Debbie?

Thanks
Angela, Flynn and Sabre

Franklin'sMum
02-03-2010, 07:08 PM
Angela,

I'm so sorry to read about Flynn's IMHA. I found this bit about treatment in "Hound Health Handbook" Betsy Brevitz, DVM, pg 344-


For at least the first few days, the dog is hospitalized on IV fluids and her PCV checked 2-3 times a day to make sure she is responding to treatment. Blood transfusions are often given if the dog's PCV drops into the teens. Even though the transfused red blood cells are likely to be attacked by anti-bodies as well, they will provide extra oxygen-carrying capacity for at least a couple of days.
The PCV should level off and begin to rise within a few days of the dog's starting steroids, and she can go home once her PCV is on a strong upward trend.

It goes on to say that steroids are continued at a lower dose until the PCV level rises to at least 35%, which can take many weeks. If the steroids don't halt a plummeting PCV then stronger immune suppressing drugs like azathioprone, cyclophosphamide, or cyclosporin. In the book it says that the most definitive test for IMHA is an antiglobulin (Coombes') test.

Alison's thought of onion ingestion is the top of a list that can cause anemia, other things are pennies, nappy/diaper rash ointment or Tylenol. Also lead (from fishing weights, foil collar from wine bottles, old linoleum floors, caulk or paint.)

Huge hugs,

Jane and Franklin xx
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StarDeb55
02-03-2010, 07:31 PM
Angela, absolutely everything you have posted is on target for some type of hemolytic anemia. The presence of spherocytes on a blood smear is one of the dead giveaways. Normal RBC are basically discoid in shape. When antibody is coating an RBC & it passes through the spleen, the spleen detects the antibody coated cell, "nips" off the section of the cell membrane that is coated with antibody to try to preserve the RBC. In response to the missing chunk of membrane, the RBC will roll up & form a sphere to try to preserve itself. Spherocytes are severely abnormal & will, also, eventually be removed. Flynn's retic count is approx. 60% above normal, so that tells me that his bone marrow is indeed responding to the prednisone. The elevated platelet count is also an indication of a hyper bone marrow response. Clumped platelets simply mean that it was a less than ideal blood draw, in this case, the tube was probably not mixed enough to prevent platelets from clumping. I have not read all of Flynn's thread yet, so I don't have any idea how severe the other medical issues are, but simply looking at the hemolytic anemia, I would give him a chance as it really looks like he is going to bounce back from this. Karen's little poodle, Jed, had a bad round of hemolytic anemia about Christmas time that may have been onion induced. All indications from Karen, now, say that Jed has pretty much fully recovered from the anemia, & he was only treated with pred, but he did, if I remember, have IV fluid support, as needed.

Hope this helps. Ask away, if you need something else clarified.

Debbie

Sabre's Mum
02-03-2010, 07:58 PM
Debbie you are a Godsend to have here!

Thank you so much for explaining everything. The vet has only really explained the PCV (HCT) and sometimes I read things at the bottom of the report with some hesitation ... particulary when I had them for Sabre as they list nearly every possible issue that may cause certain elevations!

We have decided to give it a go in treating him with azathioprine along with the pred he is currently on. His dose tonight is slightly reduced ... I presume the vet was just wanting to HIT him with an extremely high dose last night and this morning ... so we are back to the initial hose dose of 60mg per day split into two doses. He had his first 1/2 tab of azathioprine this morning as well and we are rechecking bloods again tomorrow.

Once again thank you so much.

Angela, Flynn and Sabre

gpgscott
02-03-2010, 08:09 PM
Thanks very much Debbie for the analysis.

My best wishes for you and all of yours, Angela.

Scott

StarDeb55
02-03-2010, 08:11 PM
You are very welcome! I will keep my fingers crossed for your little one & will be looking forward to your updates.

Debbie

Forgot, there is one other test that may be useful & that's an LDH, (lactate deyhydrogenase), which is an enzyme. It is definitely useful in diagnosing hemolytic anemia as RBC are full of LDH, when they are destroyed, LDH is released into the bloodstream which will show up as an elevated result. At this point, I'm not sure it's totally necessary, but it might be worthwhile asking the vet. I guess you could say an elevated LDH would be the final piece of evidence that you are dealing with hemolytic anemia.

Squirt's Mom
02-04-2010, 11:24 AM
Hi Angela,

I have been reading along but don't have anything to offer except my support, prayers, hopes, and healing thoughts. I do know that Flynn couldn't be in better hands than yours.

Hugs,
Leslie

Sabre's Mum
02-04-2010, 04:18 PM
Flynn's PCV value has gone up to 18! So we are happy for now. Much to my pleasure they do this test at the vets so we just had to wait 5 mins after a draw! I have joined another group for immune mediated issues and have made contact with a vizsla breeder in the UK who has been absolutely wonderful so we I feel I am making headway ... she has given me contacts of a specialist in the US ... who is a bit like Jack Oliver to the atypical cushings folks! Also another contact of a lady who had a vizsla with IMHA in Australia.

Thanks for everything. I will keep you updated along the way.

Angela, Flynn and Sabre

gpgscott
02-04-2010, 04:20 PM
I am very glad to hear that you are making progress Angela.

Continued prayers and well wishes for you all.

Scott

Franklin'sMum
02-04-2010, 08:17 PM
Hi Angela,

Woo Hoo!! Great news on the PCV values rising :D:D:D Continued hopes for a full recovery,

Jane and Franklin xx
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Sabre's Mum
02-19-2010, 06:59 PM
Things have gone for the worse for our little Flynn ... his PCV has dropped after a number of increases and he now has an iron deficiency. He has a gastric upset and had a small frank blood movement this morning. He is now on Stomorgyl for 6 days. we have increased his azathioprine to 37.5mg per day.

His results from yesterday are:

PCV 0.19 L (0.37-0.55)
HB 54 L (120-180)
RBC 3.72 L (5.5-8.5)
MCV 56 L (62-74)
MCH 15 L (20-25)
MCHC 284 L (320-360)
RETIC 99 H (0-80)

His PCV has gone from 15 to 18 to 19 to 22 and now 19.

From 2 Feb
PCV, MCV, MCH, MCHC and RETIC has gone down
HB and RBC have gone up.

Once again the vet is suggesting euthanizing him ... and getting me to feed a "high" quality dog food like Hills Science Diet or Eukanuba ... pfffff .... My thoughts exactly (NO WAY). I have considered Orijen a few weeks ago but was actually put off by the supplier who said that although it was 6 star on the dog analysis site ... raw was best.

So we are NOT euthanizing and we are monitoring him. PCV will be checked next week. I have contacted Jean Dodds - Hemopet for input and we are seriously considering completely changing vets (complication here as I am happy with Sabre's treatment) or having a consult with a specialist.

We just want him to pull through so much.

Angela, Flynn and Sabre

AlisonandMia
02-19-2010, 07:49 PM
I'm sorry to hear that all is not going well with poor little Flynn.:(:(:(

With the diet - I feed raw food too and believe that generally it is best BUT I do worry (theoretically anyway) about a raw diet with an immune suppressed dog. Having said that I did feed Mia raw when she was actively Cushingoid (didn't realize a the time) with no ill effects and goodness knows what else she got into too (:eek:) - she was nothing but a life support system for an appetite at that point! I believe she was blessed with a naturally pretty resilient, non-nonsense gut which no doubt helped - Zac seems to be a little more delicate in comparison.

I just wonder if Flynn isn't actually even more immune suppressed than a Cushing's dog (and he's young too). His ability to cope with bugs may not be much better now than a human's. If I was in your position I think I'd consider cooking the raw commercial food for Flynn just to get rid of any bugs (apparently normally harmless to a healthy dog). Things like fresh bones are probably less of a problem. Its that finely minced up meat in the presence of raw vegetables that worries me as far as bugs go.

On the odd occasion I did cook the raw diet (to tempt a picky appetite in hot weather) I dry fried it on baking paper in the fry pan. Mia absolutely loved it, BTW. (Had to label it carefully if I put one in the fridge as it looked just like a hamburger patty.:eek::D)

I realize that cooking it probably does destroy some nutrients but I doubt its a big issue. Plenty of dogs do fine on a good home cooked diet - and so do we!

I think a consult with a specialist great idea. Probably better than changing vets.

Alison

StarDeb55
02-19-2010, 07:51 PM
Angela, with the blood in the stool, it goes without saying that Flynn has some type of major GI upset. I just hope it's not an outright GI bleed because of everything he's dealing with. The one thing I can think of is some of his medication wreaking havoc on his GI tract to the point he is developing something like ulcerative colitis? I would think the high dose steroids would help with this problem, but I honestly don't know.

Debbie

BestBuddy
02-19-2010, 07:56 PM
Hi Angela,

So sorry to head that Flynn is not doing so well. I am always on the lookout for good quality foods here and I wanted to try Origen but found out that it is no longer available here in Australia because we irradiate it when it comes into the country and many cats (maybe dogs too?) got ill and the makers stopped export to us completely. Can you get it in NZ. The other food that has always interested me is Artemis. I did buy a small bag when Luke and Joey arrived but Luke has skin issues and I started using a special food and haven't thought to try again, maybe I will now.

Jenny

MiniSchnauzerMom
02-19-2010, 08:37 PM
Angela,

I'm so sorry to read that Flynn is not doing well. I think having a consult with a specialist is an excellent idea and I wholeheartedly recommend it.

Praying and hoping right along with you that your little guy will pull through and be ok.

Louise

frijole
02-19-2010, 08:40 PM
Angela, Add me to the list sending prayers and warm thoughts for our Flynn. Kim

Sabre's Mum
03-23-2010, 07:22 PM
I thought I would add an update on Flynn whilst I was here.

His PCV has risen slowly but surely and he tested at 30 today so we are nearly at normal ... on 7 more to go!!! He is experiencing side effects from the high dose pred ... with his front feet becoming splayed and more recently his pasterns are now weakened. I really hope that this will reverse when we get to lower doses ... he is currently on 40mg pred per day and 37.5mg azathioprine per day.

On a really bright note .... Flynn's grand father just won Best In Show at Crufts - Hungargunn Bear it in Mind ..... obviously the "good genes" that Flynn has inherited ... not the immune issues!

Angela and Flynn

frijole
03-23-2010, 08:15 PM
Great news! Lord knows you deserve it. Hugs, Kim

gpgscott
03-23-2010, 08:16 PM
All I can wish and pray for you and Flynn,

Scott

MiniSchnauzerMom
03-23-2010, 09:53 PM
Angela,

Thank you for your update on Flynn. Appreciate it. I was wondering how he was doing. So glad Flynn is making progress and I'll be thinking positive thoughts for continued improvement.

Good luck with your new job. Night shift....arrghhhhhhhh! :eek:

Louise

StarDeb55
03-24-2010, 05:51 PM
Angela, I am so very happy to hear that Flynn continues to improve. Hears hoping that you can start weaning him off the steroids ASAP.

Debbie