Charlie has IMHA.

[Hua]

My Charlie has Immune Mediated Hemolytic Anemia.  We are waiting for 2 more tests to come back in a few days, but the vet is about 90% sure it's IMHA.

I first posted about Charlie not eating here: http://www.doodlekisses.com/group/healthandmedicalissues/forum/topi...

After antibiotics and a bland diet, his diarrhea were getting better, but he was still not eating and I had to basically force feed him for a week and half.  Then on Sunday, I noticed his energy was way down and his gum was a very pale pink.  So this afternoon, I took him to a different vet (one of the largest 24 hour pet hospital in the city) that allows walk in.  I went in thinking that I'll ask them to do some blood test or whatnot, and after the tests they will tell me I'm overreacting/paranoid and Charlie is fine.  But no, that was not the case. 

We spent 5 hours at the hospital, and 4 tests turned into 14 tests.  The initial blood test came back with low HCT, HGB, MCHC and RBC (everything else were within normal range).  The vet raised the possibility of IMHA and I just freaked (I read about IMHA quite a few times on this site.) and long story short, we ended up doing a whole bunch of other tests to be sure (with 2 to be send offsite for result, including the Coomb's test), and I spent the afternoon crying (and they had to get me a separate room because everyone in the waiting room were all very concerned.) 

Vet said it's a good thing we caught it early because Charlie's HCT was 22% (she said 12% is when he'll need a blood transfusion, range is 37-61%), and Charlie is young (barely 4 years old) and relatively healthy, so we are going to start with an aggressive treatment plan to hopefully get this under control.  Charlie ended up getting an IV/fluid, 3 shots (steroid, cerenia, and some kind of stomach protectant) at the hospital.  He also got prescribed Prednisone and Sulcrate for 7 days.  We have a follow up visit at tomorrow afternoon for PCV and platelet count, a specialist appointment this Thursday, and another yet-to-be-scheduled visit at the end of the week once those 2 tests results are back. 

After we went home, I got about half cup of baby rice cereal into him, and he ate (by himself!!!) about two table spoon of boiled grounded turkey (plus the half cup of water/broth the turkey was cooked in.)  We cuddled for an hour and he went off to bed.  I've also finally managed to calm down a bit and decide to post this.  The vet and nurses at the hospital were all being very positive and gentle towards me (probably due to my non-stop crying), and seems to think that Charlie has a good chance and not in any immediate danger of dying.  But all the doodle parents out there who has similar experience, what are Charlie's chances?  Are there anything else I should be doing or be aware of?  Thanks for all your helps.

[Bonnie and Kona]

I'm so sorry Hus. Hoping and praying Charlie will pull through this just fine. I have no experience. Hugs.

[Hua]

Thanks.  He seemed to perk up a bit this morning and even ate half cup of rice and ground turkey all by himself, so I felt a bit more hopeful.  I've started to keep a detail diary of everything he does (food, med, potty, etc), and I'm going to take daily picture of his gum/tongue for color comparison.  We are going to take it one day at a time.   

[Bonnie and Kona]

That sounds like a very good plan.

[Karen, Jasper and Jackdoodle]

I'm sorry, Hua. 

The survival rate for dogs with IMHA is pretty good, 50-75%, and catching it early (as you did) seems to help a lot. I hope that the vets will be able to get Charlie into remission quickly and keep him there a good long time. 

You will also want to notify your breeder, as this is genetic, running in Poodle lines. Dogs with IMHA in their familial lines should not be bred. 

Some info: http://discoveryspace.upei.ca/cidd/disorder/immune-mediated-hemolyt...

[Hua]

Thanks Karen!  Those are encouraging stats.  I will also contact my breeder right the way.

[Staci & Simon]

Gosh, I am so very sorry for all that you're going through. If it is IMHA, it's definitely a hard pill for both of you to swallow. Here's our experience with IMHA.
We have our Labradoodle, Simon, and we also have a terrier mix rescue, Mona. Mona is now 6 years old & she was diagnosed with IMHA in Sept of 2015 at the young age of 4. I will first tell you that Mona is doing pretty well now. The road has been very long though.
We are fortunate to have some amazing vet care here in the SF Bay Area (UC Davis) & I'm certain that without them, this journey would have gone very differently. Confidence in your vet is key with IMHA since time is of the essence. Mona's PCV was 17 when we caught it. She did not have to undergo transfusions, thank goodness. However, she did have a feeding tube for several weeks that I had to feed her through. The amount of tests & hospitalizations was never-ending for approximately 5 months or so. Constant charting of medications, because there were many. As many as 10/day initially. We had to suppress her immune system so Mona was put on Cyclosporine initially with prednisone. That combination did not work for her. Her bloodwoork & her gastro issues reflected that. She eventually was put on Mycophenolate that came from a compounding pharmacy. Trying to find a food she could tolerate was a huge obstacle. Most of the time it was the awful canned stuff that they sell at the vet. I would cringe feeding it to Mona when she finally came around to eating but at the same time, you're just so relieved that they're eating.
After over a year on the Mycophenolate & stable bloodwork, Mona was taken off the Mycophenolate. Another big test to see if her immune system would revert back to its old ways & begin attacking her red blood cells again. It did not!!!
Our biggest challenge these days continues to be food. I home cook for Mona. Boiled ground pork & boiled yams are the only food that she's been able to tolerate consistently. Mona was always bulletproof! Could eat anything! Now, her stomach is a mess from any little thing she may snatch up on our walks.
I do want to tell you that our vet was confident from the diagnosis that we could beat IMHA. They had experience with it. Other options weren't suggested to us & we wouldn't have listened even if they were. But, many, many days along this journey my husband & I wondered if we'd made a selfish decision fighting this fight.
It's a life-changing diagnosis. Financially. I'm embarrassed to openly admit the amount but it is thousands upon thousands. And I can't tell you the amount of work that I've missed.
You'll also never be able to vaccinate again. Which for us in California means no boarding or grooming. Or dog parks.
And the heartbreak. It is heartbreak like I've never known before. I'm sorry.
I sure with this wasn't happening to you both and if I can help in any way, please let me know.
Please keep us posted.
Staci

[Hua]

Thanks Staci for sharing. Your post gave me so much hope.  I stayed awake all night last night just watching him sleep because I was afraid he would stop breathing in the middle of the night.  Good news is the shots Charlie had yesterday had some immediate affect (of course we won't know for sure until the PVC this afternoon), but Charlie's appetite has returned a little bit last night and this morning which just made me so happy!  I feel a bit more confident now that as long as he continues to eat, he'll get the nutrition and energy to beat this! 

I'm blessed with good family support, and wonderful bosses (who told me to just bring Charlie to work if needed).  I was also very impressed by the hospital we went to yesterday.  It's one of the best one in the city with 5 star reviews on google (over 100 reviews), and they open 24 hours and is only 15 minutes from my house.  Financially, due to my constant worrying and paranoia, I have separate saving set aside for Charlie related expense on top of insurance with very generous coverage.  I already got a taste of how expensive this will be.  The hospital visit yesterday set us back for over a thousand dollars.  But I figure I'm as prepared for the long haul as I can be.  I haven't really given much thought to the other things you mentioned like vaccination, grooming, dog park (which Charlie loves), but I guess I'll have to cross that bridge when I came to it. 

You're right about the heartbreak.  I felt like I have never been so sad/scared in my life.  I'm not ashamed to admit that whatever life I have outside of work revolves around him.  To me, Charlie is everything that is good and pure in this world, and the  thought of him suffering or dying just make me physically ill.  It's also put things into perspective for me.  Objectively I understand that a dog only lives 10-15 years and will die eventually, but it's like one of those things that I don't think will ever actually happen, and with Charlie being so young, I always thought oh we have at least another 10 years at least.  Now I'm facing with the real possibility of him dying.  This has taught me to treasure every single moments we have together. 

[Karen, Jasper and Jackdoodle]

Hua, this post brought tears to my eyes. I feel certain that your love for Charlie is going to help him beat this. 

[Staci & Simon]

Hua, you've brought me to tears!  What a beautiful post:)  Let me say that Charlie is so very blessed to have you as his mom!  People keep saying that about my husband & me regarding Mona and all that we've been through... and I know they're right but I refuse to take more credit than I'm due.  Mona is the one that continues to reassure us that she's a survivor.  I tried very hard to read her throughout all of her challenges.  To listen to her.  I felt certain that she would let me know if it became too much for her.  At times it felt like it was too much for me, but she kept me going.  They will let us know.  Whether it's just a couple small bites of food or a bark through the window at a crazy squirrel, the signs will be there!  

I, like you, dedicated my life to my two fur babies the moment that I met them!  It was automatic!  That's what they deserve!  So, Hua, just try to stay strong for Charlie!  Sounds like you're all in good hands and you're more prepared than most so you're already ahead of this IMHA!  And you're right to not think too far ahead.  You've already chosen to fight this and do all that you can for Charlie, so don't worry about those other things that I brought up.  Charlie's path will certainly be different from my Mona's and I still have much hope that we'll be back to the dog park soon!  Until then we have plenty of open spaces (even vacant parking lots work!!) for Mona to go run and enjoy life!  She also plays with our neighbor dogs since we know that they're as healthy as can be!  And her brother when he feels like it!  He's the real boss of this house:)

So, hang in there Hua!  Please keep me posted and let me know if you need anything!

Staci

[Nancy, Ned, Clancy, and Charlie]

I'm so sorry for this diagnosis.  I am so glad that there are others here that can share knowledge and experiences.  I hope Charlie responds to treatment quickly and you both have many years to share your love.

[Debbie and Toby]

I am so sorry to hear this. Will say a prayer for you and Charlie and hoping he feels better soon. So happy you caught this early and were able to get the diagnosis and start treatment.