Immune Mediated Hemolytic Anemia: Not my dog’s best friend

So–there’s no Monday post up as there usually is on MidLifeBloggers. Well, there’s this, but it’s definitely a ByJane, so it doesn’t count (yeah, there is a method to my madness–you haven’t discovered it yet???).

My beloved Molly is VERY VERY VERY SICK. Right now, she’s getting a blood transfusion. The vet hopes that will buy enough time for the meds to start working. She has something called Immune Mediated Hemolytic Anemia (IMHA). Sounds grotesque, and it sort of is. It’s an autoimmune disease in which the body stops recognizing the red blood cells as good and attacks them. And destroys them. And without red blood cells, you die–end of story. It came on suddenly (as IMHA does) and without warning on Saturday. When I took her to the vet on Sunday, her red blood cell count was 17%. Normal is 37-55. This morning, it was 11, and thus the reason for last ditch transfusion.

IMHA is not that uncommon. Sometimes it’s caused by an underlying disease (which Molly doesn’t seem to have). Most of the time, it’s just spontaneous. Statistically, it happens more often to females in the 6-7 years of age range. That’s Molly. It also happens more to poodles. That’s half of Molly.

The symptoms are not particularly cleancut. Molly was kinda funny-ish on Saturday morning, but was fine after a bit. She ate, walked, played, etc etc etc. We went to friends for dinner, and maybe she was a bit more subdued, but nothing that alarmed me. When we got home about 7:30, she was tenuous jumping out of the car, but again nothing that alarmed me. Normally, when she jumps out of the car, she runs right over to the grass to pee. She didn’t this time. Instead she just flopped down on her side, like she was taking in the sun. But it was night. And cold. And that did alarm me.

I carried her into the house and she spent the rest of the evening on the sofa with me. Normal. But she refused her beloved Greenie. Not normal. I examined her all over and couldn’t find anything untoward. So I left her on the sofa when I went to bed. About twenty minutes later, she came in and jumped up on the bed. Normal. Then promptly fell backwards on to the floor. Not normal. I cuddled her for a while, brought her back onto the bed and fell asleep. Sometime in the middle of the night, she got off the bed and in the morning when I got up, she was just lying kinda calmly on the floor. I tried to take her out, but she wouldn’t get up. I’m fairly good about human diseases and what’s serious and what’s not. I’m a dunce when it comes to dogs. Maybe she had doggie flu. Maybe she just needed a day or two to get over it.

This was Easter Sunday and her usual vet is closed on Sunday. Their weekend emergencies are handled by a clinic in Sacramento, miles away. Was this serious enough to traipse all the way into the city? I didn’t know. Some friends said yes. And then I remembered driving by a local vet’s that I thought maybe had 24/7 emergency services. I looked them up–Bradshaw Veterinary Clinic–and they gave me an immediately appointment. Before I took her over there, I put her down on the grass to pee. She promptly fell over again.

I want to blow Bradshaw’s horn a bit because if Molly lives, it will be thanks to them There are TWENTYONE vets on staff there and probably an equal number of licensed vet techs. And no, it’s no more expensive than where she’s gone in the past. Fortunately, Molly has pet insurance (yeah, yeah, I know–but I’ve been down this road before with my Yorkie, so I got it for Molly the day I brought her home).

If you’re the praying sort, or the meditating sort, or just the sort who will think good thoughts for a little dog who means the world to me–please do.

Updated 4/9/10:

Molly came home last night with a bagful of pills.  Her red blood cell count yesterday was 19.  Not great, but stable and will, we hope, improve.  She was in the hospital four nights total.  They did all sorts of tests and xrays and ultra sound to see if there was a disease that was causing the IMHA.  The good news is: nope, it’s just a fluke.  However, considering that exactly four years ago (April of ’06) she ended up in the hospital with what is essentially the opposite of IMHA–her platelets were being destroyed then, not her RBCs–I’m wondering if anyone is doing research on these autoimmune diseases.  It just seems too much of a coincidence.

Thanks for all your thoughts and prayers and concern.  It really meant a lot to me–and, since she’s on the mend–to Molly as well.

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  • Cbailey5150

    My baby girl Simba is having a transfusion right now. I just got word that it is IMHA. She is about 10 years old and is a yellow lab mix. She started out having seizures, which she is prone to when she gets sick as she is also epileptic. These were not the normal Grand Mal seizures. They seemed alot less severe, but almost continual. The Vet did blood work and said everything looked good except an elevated white blood cell count. They put her back on phenabarbital for seizures and gave a broad spectum antibiotic shot. She seemed to be doing better for a while when I had returned home with her. She seemed to get disoriented every time she sat up so she would almost immediatly lay back down. My biggest problem with all of this was getting her to the car to get her to the Vet. When a 103 lb dog doesn’t want to budge it’s all about bribery with treats and so forth. All prayers for my sweet baby are appreciated. I wish you all the best of luck.
    Carol

    • Jane

      Hope Simba is doing better. Isn’t this doggie blood transfusion an amazing thing. They actually have doggie donors willing to give.

      • Cbailey5150

        Yes It is absolutely amazing. She is still in the hospital 6 days now and still not sure if she will make it. My Vet has been doing lots of tests and a specialist in Dallas has now found out Why the IMHA is happening. They said as some time in her life she was exposed to Rocky Mountain Spotted Fever from a tick. What is strange to me and I told the Vet as well, that I don.t remember ever having seen a tick on her. Always have had to fight fleas’s but not ticks. Vet said she probably found it and got rid of it herself. Vet said this has been dormant for a long time and is probably the reason that in 2004 or 2005 she was diagnosed with epilepsy and have been treating her for seizures. I dont understand alot about IMHA but it appears there is an underlying reason that it happens and when they find that the real treatment can begin.
        Thank you Jane for the well wishes, all I can do is pray she can beat this terrible thing.

      • Cbailey5150

        Yes It is absolutely amazing. She is still in the hospital 6 days now and still not sure if she will make it. My Vet has been doing lots of tests and a specialist in Dallas has now found out Why the IMHA is happening. They said as some time in her life she was exposed to Rocky Mountain Spotted Fever from a tick. What is strange to me and I told the Vet as well, that I don.t remember ever having seen a tick on her. Always have had to fight fleas’s but not ticks. Vet said she probably found it and got rid of it herself. Vet said this has been dormant for a long time and is probably the reason that in 2004 or 2005 she was diagnosed with epilepsy and have been treating her for seizures. I dont understand alot about IMHA but it appears there is an underlying reason that it happens and when they find that the real treatment can begin.
        Thank you Jane for the well wishes, all I can do is pray she can beat this terrible thing.

        • Jane

          That’s fascinating about the tick bite because I clearly remember getting one off Molly a year or so before. I’ll tell my vet. Maybe this will be a breakthrough that will help others…

          These weird fevers and viruses that attack the immune system are scary. A friend of mine has spent half of the past month in the hospital with low white count and fevers and they still aren’t sure what he has.

          Keep in touch about Simba. I know it’s not funny at the time, but I always smile when I read about your efforts to get your 100+ dog into a car. Molly is very transportable at 16 pounds!

  • Mary Jo

    Our dog Meeka, an Miniature American Eskimo, age 6 years, 11 months old. She started with real bad breath, which improved with teeth cleaning and then returning about 4 months later. One day she was fine. Next morning she was fine and played outside. Didn’t eat much. Around 4PM she was restless and went to the basement and into her pen. Didn’t want to be bothered. Next morning we noticed her eye was bloodshot. Then a couple of hours later, both eyes were bloodshot. We made an appointment with the Vet. He thought at first it was from rat poison. Further test showed it was IMHA. Gave her a shot of vitamin K and sent us home with Amoxitabs and Prednisone. She had no fever but there was signs of blood in and around her teeth and gums. She went thru the night and once asked to go outside. She just layed on the cool ground. The next day she was worse. She vomited up dried blood twice and was real restless. She went into a coma and died in our arms 2 hours later. We had never heard of IMHA before and wonder if anyone else had a dog that had the same progression. Yes, we used prayer but she went from being fine to death in 53 hours.

    • Jane

      Several years ago, Molly went through a similar bout with that version of IMHA–bleeding at all orifices, etc. There’s an excellent VCA urgent care specialty hospital in Sacramento and she ended up there for a week. This latest bout of IMHA, that you read about in my post, was the opposite. I think the fact that she had a transfusion is probably why she made it through. Veterinary medicine has caught up to human medicine, but it is expensive.

      My thoughts are with you, Mary Jo
      Jane

  • Bellamarcus

    Is Molly still doing well? My 13-14ish rescue terrier mix just got out of the hospital Sunday with the same diagnosis.

  • Luckyme99

    I hope that your Molly is all better now. . . over a year from your last post. . . I was doing a GOOGLE search for IMHA and your blog showed up. The onset of the illness was rather slow with my shih tzu, compared to Molly’s, about 3 weeks ago it started, and still, no FIRM diagnosis, just an assumption on the part of the vet. VERY stressful. Tashi is about to go on a course of prednisone to stop the destruction of the red blood cells. . . hopefully it will work!

  • http://www.facebook.com/profile.php?id=100000733074071 Nicole Petersen

    I hope that your dog got better, but this article certainly helped me. My Lily died quite suddenly last Wednesday. She was only 7, like the article stated. She had been fine the previous day, playing and running around, but the only difference was that she didn’t eat as much. I woke up to my dad calling me to check up on her. I eventually found her out in our caged area in the shade. She was lethargic and couldn’t walk very well. When my dad and brother got home from the vet they thought she might have either Anemia or Leukemia. The vet also said that her blood count was nearly non-existant. The events that followed were quite bad. She couldn’t breathe well (lack of red blood cells-oxygen) and it was very stressful for her :’( In the early evening, when my entire family was finally in one room together with her, her little ticker just gave out. It was very traumatic and I was hoping that it was something that we couldn’t have known about. Seeing as that IMHA is a sudden-onset type of thing it makes me feel a little bit better, not much, but a little. I hope more people know about IMHA so that they can prevent it and treat their dogs before it gets as bad as your dog and mine.

    • Anonymous

      Nicole,
      I’m so sorry to hear about your Lily. For those of us who are lucky enough to have pets, losing them is indescribable. The loss is the loss of a loved one, no matter the species.

      I’m glad my post made you feel a little better, at least about what you could have done. IMHA is usually a fluke (although certain breeds are predisposed); there is some connection, however, with vaccinations.

      I loved the description of all of you being with Lily when she died. She went feeling very loved.

      Jane

      • Nancy

        I lost my 5 yr. old Boxer Millie to IMHA Dec. 25 2011, the vet seems to think a new pain pill she just started taking Tramadol for her Hip Dysplasia triggered it. I feel this was my fault for putting her on this medication, not sure if this would happened later down the road or if it was the meds. Nancy

        • Jane

          @Nancy,
          I’m so sorry to hear about Millie. I never heard of a pain med being responsible for it. Molly had had heartworm meds right before she got sick, but my vet didn’t think that was related. What a horrible Christmas for you! I hope 2012 will look up.

  • Brenda

    I know how tough it is when your best friend gets sick and you feel so helpless. Good luck with Molly and thank goodness you had pet insurance. Which is a good reminder to me since I adopted a new dog recently to keep my old dog company (who has cancer and on medications to prolong his life). My best friend, Meesha, was diagnosed with prostrate cancer over about 16 months ago (and we don’t know how long he had it before). Luckily I have an holistic vet and we started him on herbs and western meds which has given him more energy, has helped his arthritis and he seems to not be in pain. I am grateful for every I continue to have him in my life because he has been a gift from the Universe and helped me get through some really tough times in my life. He is now 15 years old and has perked up a lot since I have brought home a rescue dog (that I was fostering). It is so hard to let go and I pray that he doesn’t suffer….this little creatures are truly gifts from the Gods and deserve all the love, nurturing and care we can give them.

    Best of luck,

    Brenda

    • http://midlifebloggers.com byjane

      @Brenda,

      Before Molly, there was Pupi, a Yorkshire Terrier, who died when she was 19. That’s a ripe old age for a dog, but she was really sick at the end and I think we put her through some misery just so we could be with her. My experience with Pupi taught me that hanging on is sometimes not the loving thing to do. When Molly got sick this time, I kept that in mind and knew that I would take the hard road for me if I had to for her. I feel for you and Meesha…

      Jane

  • lauren Jarvis

    Be well Molly~

  • http://www.duchessomnium.com Duchess

    So glad to hear that Molly is on the mend. I hope she keeps on getting better.

  • http://www.duchessomnium.com Duchess

    I checked in to see how Molly is doing. We will all be glad for an update whenever you feel ready.

    • http://midlifebloggers.com byjane

      @Duchess,
      thanks for giving me a poke. I’ve been updating on Facebook–and now on the post itself.

  • http://www.BabyBoomerTalkOnline.com Boomer54 Mark

    We have 2 Boxer Dogs and they are like our kids! We will keep you and your precious Molly in our prayers.

  • http://ladyfi.wordpress.com Lady Fi

    I’m thinking of you and Molly and sending you healing thoughts.

  • http://www.duchessomnium.com Duchess

    Oh, I hope Molly will be well again! I know how loved a little dog can be, especially when you live alone. And Molly should be with you for another 6 or 7 years or more.

  • http://midlifebloggers.com byjane

    Thank you for all the kind thoughts. She was better last night after the transfusion, but she’s still not out of the woods.

  • http://www.sammystory.net sammy bourke

    Molly and Jane:

    We are rooting for Molly.
    And thinking of you both.

    Love from Sammy,

    And his Best Friend & Kind Friend.

  • Dorothy

    Sending good thoughts and prayers for sweet Molly…

  • http://anntracy.blogspot.com/ ann tracy

    Sending good healing energy to Molly….

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