Immune Mediated Hemolytic Anemia (IMHA) Survivor: Pete's Story

by Jenny MacKay

It was the evening of Monday, October 24 2011, when my husband, Mike, and I first heard the term IMHA

We searched the internet for everything we could find and what we learned filled our hearts with fear... but we hoped for the best.

This is the story of Pete's illness and recovery


Mike and I adopted Pete, a Basenji Corgi mix, from the BC SPCA Sechelt branch in April 2010. Pete was 10 years old, had serious allergies and eczema caused from the stress of being in a shelter environment; he had such a sweet temperament and obviously needed a loving home - it only took 5 minutes for Pete to steal our hearts.

Over the next year and a half Pete became, and still is, an integral part of our lives. He spends his weekdays in the office with Mike and the rest of the time snuggled next to us on the sofa, going for walks on the beach, or hogging as much of the bed as he can while we sleep.

Forward to Sunday, October 23, 2011, we left Pete at home happily snuggled in his bed, then returned 2 hours later to find a very different dog. 

He stood in the corner, his head lowered; we called his name several times and, when he finally turned toward us, he had trouble walking. His back legs buckled under him.

Something was dramatically wrong. 

We stayed up all night and watched Pete closely. In the morning we took him to the Urban Animal Hospital, they examined him, took a blood test, and advised that given the symptoms it might be something called IMHA but results of the blood test would confirm.

They sent us home and advised us to call if anything changed. 

We diligently monitored his behaviour and for a while he seemed to stabilize. However, within hours everything changed - Pete once again lost mobility and in the space of an hour he could no longer walk. We rushed him to the Vancouver Animal Emergency Clinic.

Following another blood test they diagnosed with IMHA - Immune Mediated Hemolytic Anemia

Pete was immediately admitted and put on several IV drips; the vet provided an overview of immediate treatment- the various costs and options (we are so thankful we had pet insurance with Trupanion). Then came the worst news, the vet explained in depth what IMHA is and cautioned us that even with early detection and appropriate treatment 80% of dogs diagnosed with IMHA do not survive beyond hospitalization. If they do fight the good fight and are able to go home the survival rate beyond 6 months is only 20%.

Pete stayed in the Animal Emergency Hospital and we walked back to the car with an IMHA pamphlet in one hand and Pete's leash in the other, not knowing if he would get the chance to wear it again.

IMHA is a life threatening hematologic disease. It is a disease in which the body's immune system attacks and kills its own red blood cells; without an adequate number of red blood cells the body becomes starved of oxygen and cannot survive.

The causes of IMHA remain largely unknown, with 75% having no found causation at all. 

While some cases may be triggered by an event such as cancer, vaccination, or infection, these do not explain why or how the immune system misdirects and harms the body it is meant to protect.

IMHA occurs more often in middle aged dogs 3 - 8 years old, and in females rather than males. It is a rapidly life threatening disease that even with appropriate treatment is often fatal.

Because IMHA is not well understood there are no known cures or preventive measures.


IMHA comes without any early warning signs. Once the typical symptoms present themselves your animal is already very ill and must get medical attention immediately.

Typical symptoms of IMHA include:
  • Pale or yellow tinged gums
  • Yellowed eyes
  • Dark or pinkish/red urine
  • Tiring easily or weakness
  • Lack of appetite, lethargy, or rapid breathing

**NOTE: IMHA is a very aggressive disease. It is possible for your pet to show no signs, then for the disease to take full hold within as little as 4 hours!

IMHA Resources: University of Prince Edward Island and Pet Place Canada

Following a very long night at the Animal Emergency Hospital we arrived home mentally and physically exhausted, went to bed but couldn't sleep. 

Early the next morning, groggy and tired, we readied ourselves to make the trip back to the hospital for an update on Pete's condition.

When we arrived the vet warned us that Pete had become very ill during the night and we should prepare for the worst. The vet took us to the back room where Pete was. Walking past all the other hospitalized animals, we readied ourselves.

Pete had an IV in each leg and the symptoms we read about had revealed themselves in Pete. 

His skin and eyes were bright yellow with jaundice; he didn't even have enough energy to raise his head.

When he saw us, he could only move just the very end of his tail... all his efforts to wag his tail were barely perceptible.

I have never before felt so helpless and hopeless in all my life.

Pete's case was very serious; they performed a full blood panel testing and his red blood cell count (RBC) was 12, a normal range is between 40-55. The vet recommended immediate blood transfusion, and reminded us that the procedure was not guaranteed to save his life, that he may require multiple transfusions, and that it would be very expensive. Even without knowing what his response would be or the survival rate, so long as it wouldn't cause Pete any additional pain, we would do anything and everything we could to save his life.

We visited Pete in the Animal Emergency Hospital 3 times a day for the next 7 days. Mike visited in the morning, I visited at lunchtime, and we both went together in the evening after work - staying as long as we could, begging for just a few more minutes after visiting hours closed.

Over the course of those 7 days Pete's condition fluctuated - improving, worsening, stabilizing, and around and around. 

The whole time he kept getting yellower and yellower - the jaundice was getting worse as his RBC was improving at glacial speed. He received all his nutrients, food, and medicine from an IV.

Each time we visited we tried to persuade him to eat; we took purred salmon, white rice, eggs, chicken stock, liver... all his favourites, but to no avail. Pete was just too sick to eat. He was losing weight rapidly. If he couldn't eat then we would do everything else we could think of to make him comfortable. We took his blanket, toys, even our own sweaters - in the hopes that he would recognize our smell and make his feel a little less lonely in the times when we couldn't be there with him.

One evening, when we were visiting the vet told us that she'd never seen it before but was convinced that each time we left Pete cried himself to sleep. It broke my heart. To be honest, it still does...


Mike and I grieved and hoped, hoped and grieved - with the exception of visiting hours when we saw Pete there was no joy in the world and time seemed to stand still.

Following the blood transfusions Pete showed very slow signs of recovery until finally he was stable enough to come home. 

He'd lost 30% of his body weight and much of his muscle mass, he couldn't walk for more than a few minutes at a time. It was still another week before he would eat on his own, and until he could we fed him from a syringe, ounces at a time, every hour. Pete's appetite slowly came back and within 3 weeks his appetite had returned.

Pete's release included a heavy regime of medications required every 4 hours; the vet warned us that because the medication was so strong and hard on the system that the medication might be as dangerous to Pete as the IMHA.

We kept him with us at all times so we could monitor his health. IMHA is a very tricky disease that has no cure, and only sometimes can it be managed. Relapses are always possible, and quite common, and happen without warning.

For the next 4 months Pete received weekly blood tests to monitor his RBC. 

The first few weeks nothing changed much, then slowly the RBC crept up. He was, and continues, to be on a daily regime of medications. Some suppress his immune system, while others promote the healthy growth of new red blood cells.

For the first two months the medications are not effective as they need to build up in the system before they can affect any change.

Yet, while they are ineffective in fighting the disease, they bring powerful and scary side effects. 

Pete suffered severe thirst. He couldn't drink enough water, always panting, and with that came round the clock visits to the little doggie room for bathroom breaks. Pete developed ulcers on his tongue and had multiple stomach troubles.

One of the medications suppressed Pete's immune system, as this was the crux of the disease, and as a result he was very prone to illness and infection from any cuts or sores. Each blood test the vet needed to work around the previous injection as each took weeks to heal.

More troubling, given his lack of immunity, he developed a serious skin infection and lost most of his fur. 

Given it was winter and he was still underweight, poor Pete was always trembling from cold. Pete accumulated quite the collection of sweaters, booties, and blankets.

While we waited for the medications to take effect, we tried everything we could to speed up and assist his recovery. 

We took him for holistic therapy, gave him vitamins and supplements, herbs, changed his diets, and many other things.

We lived our lives in weekly installments, always holding our breath for the results of the next weekly blood test. 

Slowly, Pete's personality came back. On Christmas day Pete was inundated with gifts from friends and neighbours, and for the first time since October he played (if only very timidly) with his toys.


During the first few months of recovery Mike had to carry Pete to the office, a walk he would normally look forward to twice a day every day. Pete spent his days relaxing under Mike's chair and receiving visits and best wishes from everyone in the office. It took 2.5 months before Pete could walk the whole 30 minutes to the office. 

In late February 2012 the vet gave Pete a 4 month clean bill of health. 

His RBC had gone up to 50. It would not be for another 3 months that Pete would have to endure another blood test. Even though the vet reminded us that the possibility of relapse was always there, and that Pete would be on medication for the rest of his life, we all slept soundly for the first time in 4 months. Mike and I were forced to the far edges of the bed while Pete slept in the middle; that night I even appreciated his snoring. 

On October 24 2012 it was a year since Pete's struggle with IMHA. 

He beat the odds, and is a healthy, energetic and happy dog.

In February 2013 Pete returned to daycare 1 day a week. He was so happy to see all his dog and human friends at Sit Doggie Daycare!

Pete survived the most dangerous first year with IMHA - I strongly believe his will to survive was no match for the disease.

IMHA cost 7 days in the Animal Emergency Hospital, 2 blood transfusions from a Boxer named Beau, 7 days of non-stop IV's, and 4 months physical rehabilitation. It still carries daily medications - this will never go away. And despite all this, it wasn't enough to dampen his spirits.

When we tell this story to others we often hear that they wouldn't spend such a large amount of money or expel that amount of emotional upheaval to control an incurable disease, or they wouldn't be able to watch their pet so ill. Yes, emotionally and financially it was very difficult.

We owe our ability to give Pete all the medical attention he needed to our Insurance provider, Trupanion.

They reimbursed us quickly so we could fund the next course of treatment.

As for the emotional side, it still makes me sad to think of it and even writing this story is hard, reliving those worst moments, but it's an important one to share so others who might be fighting this disease can take a little comfort from this happy ending. And for those who have not heard of it, maybe reading this story will help them recognize the warning signs in their pet.

Most importantly I tell everyone that when we adopted Pete from the BC SPCA, we made a commitment to him - to look out for him, protect him, and love him like a member of the family. It just so happens Pete is the only family member with fur. 

I would like to thank all the staff at the Urban Animal Hospital and the Animal Emergency Hospital - both located in Vancouver, Canada, and the blood donor dog Beau - without which Pete would not be with us. I would also like to thank all our friends for their support and kindness.

I don't know what the future holds for Pete but I do know that every day with him is something to be thankful for!

**This article has been written from my own experience and research. I am not a vet; please consult your vet as soon as possible if you believe your pet is ill. 
Jenny Mackay – - Owner, House of Pete www.house-of-pete.com

***

Related articles:
Immune Mediated Hemolytic Anemia (IMHA): Reader Stories (Part I) 
IMHA Is Not To Be Taken Lightly: Know The Symptoms
Dr. Jekyll And Mr. Hyde: Razzle's Immune Mediated Hemolytic Anemia (IMHA)
Battling IMHA With Integrative Veterinary Medicine (part 1)
Battling IMHA With Integrative Veterinary Medicine (part 2)
I Am An IMHA Survivor! Dylan's Story
Liver Tumor? IMHA? Daphne's Story (Part I)
IMHA Complications: Daphne Didn't Make It 
Immune Mediated Hemolytic Anemia (IMHA): Reader Stories (Part I) 
Immune Mediated Hemolytic Anemia (IMHA): Reader Stories (Part II) 

Comments

  1. I going thru this right now with Belle. Her appetite is still good and she is drinking and staying hydrated. She still gets up and walks to the food and water and anywhere the children are. We found out she had this when she was having a bad bout with diarrhea. The first cbc her RBC was 12. She was placed on a regimen of 40 mg of cortisteroids and an antibiotic. Her rbc went up to 16 in a week but two week later it started going down again to 15. The cbc also showed that her marrow was making red cells but were being overwhelmed with the increase of white cells so he changed her antibiotic to slightly higher level and we are now in a wait and see mode. He was surprised that it wasn't higher as he found her to be more alert and her coat looked shiny. And her gums are still pink. She doesn't pant as much as she was and being stubborn tries to go for walks on the leash which is pretty much once or twice across the front yard. I have to cut it short cause she will keep going and exhaust herself. This has my husband and I and the grandchildren very upset. She has always been a momma dog to them. We are hoping she starts to perk up. I have hope considering what you went through. She turned 12 this past April, that being the top of the bell curb for labs and they start to decline. This seemed rather sudden. She is a magnificent specimen of the breed.

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    1. So sorry that you're going through this with Belle. Best wishes for good recovery.

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    2. So sorry. I and my beautiful girl, Juno are going through this also. It was sudden. She was always a perky, excited about life kinda of girl and then....she wasn't. We've been battling this for 3 weeks now. I thought she was going to die last night. She has lost her spirit and my heart is shattered. She's tired, but she can't seem to rest. I don't know how old she is; I adopted her 3 yrs ago. The vet thinks "older" than our guessed age of 11. We have a vet appt. today....I believe we'll be saying our goodbyes. #thissux

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    3. So sorry about Juno. This is a terrible disease, hard to battle.

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  2. Thank you for sharing your wonderful story. Today we left our baby boy Rico to stay overnight for low blood count as well. We are worried SICK about him. I don't even think I can sleep..... Keep us in prayer...!

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    1. So sorry about Rico. Wishing him successful recovery.

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  3. We are going through the same with our Sammie, he is only 5.5 years old. 6 days in hospital, 1 blood transfusion so far. Lots of medications that worry us he may be worst just because them. He started to eat when bringing him home, he never had a day without us, we think he was suffering more being alone than the illness itself. He wants to eat all the time, drink a lot, pee a lot, it's a change in our lifestyle. He is our son, since we don't have kids. It's just been 13 days and feels like weeks. Sad to read that it can happen again, that it's not over, that he will have to be on medications for rest of his life, or he may not make it after so many...it's even hard to try to make him take them. Only time will tell. And yes, it's a very expensive illness, we don't know how far we will be able to afford for it...

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    1. So sorry about your baby. Such things are always heartbreaking. Once he's over the initial crisis, try consulting an integrative or a holistic vet.

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  4. Does anyone know the status of Pete today?

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    1. I really don't know, their website is no longer live.

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  5. 4 days of it. Vets were ...I don't even know the word... not really positive, didn't give enough information and really gave him no chance from the beginning. $5000 later...My beautiful, extraordinary baby boy... Jax died at 8 years old on 6/20/16. He couldn't breathe-basically he drown in his own blood and to say I am devastated is the most ridiculous understatement ever. My heart is gone

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    1. So sorry about that. Not all dogs, unfortunately make it. And sometimes transfer to another hospital might be too much for them to make it too. So sorry for your loss.

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  6. I feel guilty for not waiting for a turn around... I don't know if it was right thing to do or not...

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    1. I doesn't always turn around ... sometimes relieving the suffering is the best thing you can do.

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  7. We lost our lovely male cocker Sunny to this disease in just 3 days last June 2016. His CBc was 8. Came on very suddenly. 3 days hospitalized 1 transfusion drugs no promise of success he suffered terribly. In our 80s we could not keep fighting it as it took its toll on us. He was 10. A foundling he had tested positive for ehrlichia but it was in remission all 9 years we had him. a tick born illness we think it may have activated causing the MIHA that took him from us. Last week we scattered his ashes in the sea where he so joyfully lived to swim. We loved and miss him terribly. Our sympathies to all whose fur babies are going through this.

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    1. So sorry about Sunny. It is a terrible disease. The tick-borne infection being present could have been behind it, though there are many different things that can trigger it. Letting a dog who is suffering go is the kind thing to do. So sorry for your loss.

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  8. Our Roxy came down with this disease April 2016. After days at vet specialist trips to our vet she is doing much better. She is a 7 year old Sheppard husky mix. It was about 3 days after getting her vaccinations when she became ill. So some have said put her down spending 6 grand on a dog your crazy. Not for us. I would sell a kidney for her. My reply if your child is ill what's your expense limit? She is doing better now. I pray everyday for her.

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    1. So sorry Roxy and yourself had to go through this. I'm glad she's improving <3

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  9. We just lost our beloved Mocha to this disease 2 wks ago and I'm devastated. It was so sudden. She woke up ate breakfast then two hrs later I went to give her a bone which she has never turned away and I instantly knew something was wrong. I looked at her gums and they were pale white. Rushed her to vet they took blood tests and rushed her to animal hospital where she was put on iv's and had two blood transfusions and didn't even last a day and a half. She was always healthy even at 11 yrs old with no underlying conditions so they said this was considered a primary condition. My sweet Mocha, I love and miss you and her passing pains me so much $6,500.00 later and it didn't work at all. She went so fast. I will see you on the other side my baby girl. God please take care of my Mocha.

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    1. So sorry to hear about Mocha. This disease can move really fast and can be devastating. I'm so sorry your baby didn't make it <3

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  10. My Beautiful Rough Collie ECHO was 6 years old,, running around playing and swimming and the next day I looked at her and her gums were yellow and she was wobbly on her feet, I rushed her to the vets and they thought kidney , liver , etc after ALOT of mismanagement she was sent to a specialist vet who took one look at her and said IMHA ,, 3 blood transfusions 5 days in intensive care, round the clock monitoring and $8500 later she passed away,, This is the cruelest and nastiest disease , a perfectly healthy , shiny coated , in the prime of her life , and then yellow and critical and in a life threatening situation the next,,
    She was the most amazing Collie ever and her best friend is still at the window waiting for her to come home,, She passed away on good Friday and there was nothing good about it,,,if I seem bitter and devastated I AM :(

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    1. I am so sorry about the passing of your baby. IMHA is a nasty disease. So sorry, jay.

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  11. I lost my 11 year old mini schnauzer, Stitchie, to this disease. It took her in 5 days. The vet said treatment would cost a minimum of 5-8K, if money was no object, but we didn't hat it or the pet insurance to us fund th treatment. We tried prednisone and doxycycline but her body did not respond. She had two hydrotherapies and was eating and drinking, but there was no guarantee she would survive even with the blood transfusions. My heart is beyond broken. I miss my Stitchie more than words can express. She was the best dog and was and will always be part of my heart. I can never get another dog for fear of this horrific hitting us again.

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    1. Julie, so so sorry about Stitchie. IMHA is a nasty disease and can take lives quite quickly, with or without aggressive treatment. Some dogs have the good fortune to make it, some do not.

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  12. My cat Luna is currently going through a transfusion she was diagnosed with IMHA and within hours was also Diaognosed with ITP. She was perfectly fine yesterday. She needed the transfusion within hours of the IMHA diagnosis. My stomach is turning reading some of these comments and waiting to hear from the vet.

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    1. So sorry about Luna. This stuff hits hard and hits fast. Best wishes for Luna's recovery.

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  13. My 5-year-old dog Leia was diagnosed with IMHA today. This morning, she was very lethargic and she didn't want to eat or drink anything, so we took her to the vet. He told us that since we caught it early, it's very treatable. She has to stay at the vet for 48 hours (at least).

    They called a few hours ago and told us that her RBC production is very good, and her x-rays are normal. However, after reading other people's stories about their dogs' struggles with this disease and about the possibility of thrombosis, I'm really scared.

    I wish everyone who is currently going through this and everyone who has already been through this all the best. This is a truly horrible thing for dogs and their humans to go through.

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    1. It is a very scary disease. Catching it early really helps. Many dogs do make it, hopefully Leia will join the IMHA survivors ranks. <3

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  14. This is a terrible disease. I just wanted to share that my little Raider, a five pound mixed breed had this seven years ago. The vet gave him a blood transfusion and he spent five days in the hospital, but he is doing well now! They gave him just a very small chance of survival, but we love him so much, we took it. Do not give up on your loved one, he/she can survive this terrible disease.

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    1. I'm so glad Raider made it. There is certainly always hope, however slim. <3

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  15. my dog issuffering from anemie hes in hospital since last tuesday night...we go everyday to visit....hes a fighter but everyday is another battle because still waithing doe the blood results....they are too slow....and hes life in danger hes at 16 % and hes A 10 years old bullterrier....i give him yesterday cooked liver but at the hospital they said he trew up....its really exausting for everybody but all my wish is to see him home ....we are trying to be strong and i hope some mirracle happen and he will come home

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    1. It is hard on everybody. How do you mean waiting for blood work? The place doesn't have the ability to check the blood in-house?

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  16. my 10 years old bullterrier his in hospital since last tuesday....we are fighting everyday to stay alive....hoping that some miracle happen and he comes home....i feel like things not going enough fast ....my gogs life is in danger...its a really scarry disease....we are visiting everyday...i try to bring him cooked meals...yesterday i bring some cooked liver with sweet potatoes but this morning he trew up....dont know what to give him dont know how to help him couse i try everything....i really want a miracle to happen and he comes home...couse i miss him i want to wake up i feel like is a nightmare...

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  17. My two year old feisty, fun, spirited, energetic, wheels-off dachshund/rat terrier mix went in for her shots at 2 years old. She started acting funny by that evening. By the next day, I took her to the vet. The vet noticed her gums were white, so gave me some medication and we she brought her home. The next morning, the dog and I were waiting in the vet's parking lot before anyone even got there. As soon as they opened, I rushed the dog in, and said, this girl is seriously ill!!! She was practically not moving by that time. Her gums and tongue were totally white. I had no idea what was wrong, because this dog was a completely healthy 2 year old! Long story short, she was accurately diagnosed, we were told the truth of the matter and the risks, she had an immediate blood transfusion, a strong steroid shot, and more meds. We chose to bring her home that nite to care for her. If she was gonna pass, we wanted it to happen at home, and we also wanted to monitor her 24/7. My daughter was at the Vet Emergency Clinic in the middle of the night. Another blood transfusion, then another. After that, miraculously, she seemed to stabilize a little bit. Any normal dog has a red blood cell count of 50-60. Our dog was at a 6, she almost died. Her blood count would go up with the transfusions, and then it would go down again. She had no energy, she couldn't hold her legs up under her. It was terrifying. But the vet started her on very high doses of steroids, and then on Atopica, which is basically a medicine that a human would take if they had an organ transplant, so that their immune system wouldn't reject it. The medicine dials the immune response way back, and the steroids do too. I was reading everything I could find on the internet about this disease. I found this site at the time. I am on here today to tell you that our dog lived, and that it's also been two years since IMHA happened to us. She can never have vaccines of any type again. But her vet took excellent care of her, she was in every week for a medication adjustment, she was tested, monitored, babied, looked after, in every way. Her treatment lasted close to a year, and totaled in at about $10,000. I definitely wanted her to live, and I did everything in my power and knowledge for that to happen, in addition to telling God that she just HAD to live. One night, and she had started recently eating somewhat well again, I was cooking some filet mignon steaks, rare. I was thinking while cooking about how I had always been a bit sickly before I started eating beef, which had gone away. I thought of the blood product in the rare beef, and my poor little doggie, who was fighting everyday for her blood to stabilize. I put a good chunk of my steak (cooked with NOTHING on it) in her bowl, she gobbled it up. I will never know exactly what made her well, but my vet said I took excellent care of her at home, and putting filet mignon on top of her kibble certainly may have helped her!!!!! I started doing it every day, through the worst part. She continued to strengthen after that, and today she is, and has been for about a year, the very same dog as before. It was an extremely stressful, long, expensive process, but I am here to tell you that SOME OF THESE IMHA DOGS WIN!!!!!!!! So don't give up!!

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    1. Thank you so much for sharing the story. I'm so glad your baby made it. <3

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  18. My 3yr old Shih-Tzu Oscar was diagnosed with IMHA this week. He spent 2 days in the hospital and received a blood transfusion. He has been home for three days now and his red blood cell count is holding stable at 28 ( it was as low as 12 when he first got to the ER ). It seems like he is recovering but VERY slowly. He is still weak and listless but not nearly as bad as before. He has also started eating again. He is on Prednisone, Cyclosporine, Clopidogrel and Cerenia. He goes back for more bloodwork next week. We live in Los Angeles and VCA Animal Specialty & Emergency Center has taken great care of our little guy. We love him very much and are hoping for the best.

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    1. I'm glad your baby is receiving great care and is recovering.
      many dogs do indeed recover.
      best of luck. <3

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