Question Details
Immune Mediated Hemolytic Anemia In A Dog
by
LJH
-
September 5, 2018 View Case Report
Replies
by
LJH
September 7, 2018
Hi again. Bloodwork today RBC and HCT same Ret 1.5% but WBC up to 34. His appetite is a bit more picky. Stool normal. MM very pale. Temp 38.4 Panting HR 84 Tongue very pale pink, flabby, a bit less moist. Pulse weak, a bit less slippery and less superficial, more moderate depth. Not fluctuating back and forth to wiry. He is needing a bit of help to get up but is still better energy wise than on our initial appointment. Thanks, Llewanda
by
naturevet
September 12, 2018
Hi Llewanda,
It sounds like you've made an excellent start. See if his pulse becomes more moderate with tonification of GB points like BL 19, GB 25 or GB 34. If so, then you have confirmation to continue with the Shao Yang approach.
If those points don't help, then try draining or sedating Spleen points like BL 20, LV 13, and SP 9. If the pulse improves, then a Damp Heat approach is called for. I'd consider Si Miao San, 100g, with about 20g of Dang Gui added. It might also help reduce the toxicity of the pred.
If they are thinking about putting him down anyway, they should at least reduce the pred dose. With the other drugs and your bone marrow stimulating herbs on board, there's no particular reason to keep it so high. You'd have added confidence to recommend that if RBCs move up over 30.
Hopefully they will give you the same time allowance as they gave the conventional practitioners to produce results, as once you find an effective approach, it will probably work to rapidly treat or eliminate any future episodes.
Naturally any and all future vaccines should be avoided unless the dog is vulnerable due to high risk of exposure with the pathogen being more deadly than IMHA; or lack of a protective titer if already vaccinated. Any distemper or parvo titer at all in an adult dog is considered protective. Rabies titers are often protective for five to seven years
Steve
It sounds like you've made an excellent start. See if his pulse becomes more moderate with tonification of GB points like BL 19, GB 25 or GB 34. If so, then you have confirmation to continue with the Shao Yang approach.
If those points don't help, then try draining or sedating Spleen points like BL 20, LV 13, and SP 9. If the pulse improves, then a Damp Heat approach is called for. I'd consider Si Miao San, 100g, with about 20g of Dang Gui added. It might also help reduce the toxicity of the pred.
If they are thinking about putting him down anyway, they should at least reduce the pred dose. With the other drugs and your bone marrow stimulating herbs on board, there's no particular reason to keep it so high. You'd have added confidence to recommend that if RBCs move up over 30.
Hopefully they will give you the same time allowance as they gave the conventional practitioners to produce results, as once you find an effective approach, it will probably work to rapidly treat or eliminate any future episodes.
Naturally any and all future vaccines should be avoided unless the dog is vulnerable due to high risk of exposure with the pathogen being more deadly than IMHA; or lack of a protective titer if already vaccinated. Any distemper or parvo titer at all in an adult dog is considered protective. Rabies titers are often protective for five to seven years
Steve
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