Starkehre Posted November 20, 2009 Share Posted November 20, 2009 Hope tomorrow brings some good news for Jordy Bokezu. Try and get some sleep if you can. Link to comment Share on other sites More sharing options...
Danois Posted November 20, 2009 Share Posted November 20, 2009 We used a combination of pred and imuran aka Azathioprine too. With a 75kg dog I certainly got value for my money with his insurance. There is a Yahoo Group called CIMDA which can be useful. Link to comment Share on other sites More sharing options...
Starkehre Posted November 20, 2009 Share Posted November 20, 2009 Thanks Danois, yep Azathioprine (is the other name for Imuran and is the one you can't touch). I have just dragged out our old bag of left overs. Dyzney was also on Misoprostol and Cyclosporin. The Cyclosporin is the quite expensive one. We also ended up giving Ondancitron a go just before the 5 weeks point to try to settle her ulcerated tummy so she would eat, but unfortunately one of the side affects of it was more nausea, so we stopped that within 24 hrs. Am hoping for good news with Jordy this morning. Hope you got some sleep Bokezu. Link to comment Share on other sites More sharing options...
Danois Posted November 21, 2009 Share Posted November 21, 2009 I never worried about gloves with Imuran! We were considering Cyclosporin etc but we were beaten by time. I was iffy about using it because of risk of exposure for me and the cat too. Link to comment Share on other sites More sharing options...
Starkehre Posted November 21, 2009 Share Posted November 21, 2009 (edited) I wasn't brave enough to risk it with the imuran. I am sorry you ran out of time Danois, and I understand about the risk. I am thinking that maybe the other drug Bokezu mentioned they gave Jordy last night to help him get started was the Cyclosporin, as that is the one that does just that. I don't mean to seem like a nosey parker, but I am really worried about Jordy. I hate it that I have such an invested interest in this disease, but that is what happens when you have had it before. I really hope Bokezu is busy giving Jordy kisses and hugs because he is feeling so much brighter. Naturally I do not expect her to be rushing back here to inform us of how he is going. She will let us know when she can and wants to. Edited November 21, 2009 by dyzney Link to comment Share on other sites More sharing options...
Bokezu Posted November 21, 2009 Author Share Posted November 21, 2009 I've just got home from seeing him, he is very weak and looks pretty awful, but ate 1/2 a bbq chook for me, he won't eat for them. I still haven't been able to speak with the vet , they are having a really busy day apparently, my hubby went in to see him just after 9 am and they could not let him visit as they were too busy. Anyway two assistants have told me his pvc levels are up .........I don't know what that means? platelets or red blood cells?/ no matter up is good The vet is ringing me later to bring me up to date so I will pass on what she tells me. Hoping this is the start of good things. Poor little boy, we had lots of kisses and cuddles but after 10 mins he had to lay down, and he new he wasn't coming home, he just couldn't get up when I went towards the door, doesn't it just break your heart :p Link to comment Share on other sites More sharing options...
Starkehre Posted November 21, 2009 Share Posted November 21, 2009 Thanks for the PM Bokezu, I have replied. Get well soon Jordy. Link to comment Share on other sites More sharing options...
Rappie Posted November 21, 2009 Share Posted November 21, 2009 Anyway two assistants have told me his pvc levels are up .........I don't know what that means? platelets or red blood cells? I expect this was the PCV or packed cell volume - this is the % of the blood that is red blood cells. It should increase with a whole blood transfusion. Accurate platelet counts generally require a blood smear being sent to a pathology lab, but I will often have a look under the microscope myself (to quantify whether there are "enough", "some" or "none"). However, in a dog with ITP and anaemia there is a balance between limiting the number of time that venepuncture is performed in a day, and getting enough information. If you have any questions, don't hesitate to PM me. I can't give specific advice about management but I'm more than happy to explain things if you have queries. Link to comment Share on other sites More sharing options...
Bokezu Posted November 21, 2009 Author Share Posted November 21, 2009 Anyway two assistants have told me his pvc levels are up .........I don't know what that means? platelets or red blood cells? I expect this was the PCV or packed cell volume - this is the % of the blood that is red blood cells. It should increase with a whole blood transfusion. Accurate platelet counts generally require a blood smear being sent to a pathology lab, but I will often have a look under the microscope myself (to quantify whether there are "enough", "some" or "none"). However, in a dog with ITP and anaemia there is a balance between limiting the number of time that venepuncture is performed in a day, and getting enough information. If you have any questions, don't hesitate to PM me. I can't give specific advice about management but I'm more than happy to explain things if you have queries. thanks Rappie made need to one day the vet rang me tonight quite late. She said his red count has gone from 18 to 25..... nothing to make me excited. She can't see any platelets looking herself. He is on cortisone and Imuran, he is on a drip again to have an iv open, and he is stable......sort of in limbo....waiting for these drugs to take effect. Hoping he starts to turn the corner soon...... Link to comment Share on other sites More sharing options...
berty Posted November 21, 2009 Share Posted November 21, 2009 hi bokezu, im dyzneys friend that lost my lovely rotti bitch this year to primary imha , iv read this thread with interest as its not an easy disease to treat , ours was primary as there was no underlying condition after extensive testing ! my only advise to you is to ask your vet lots of questions and get them to reapeat answers if you dont understand anything . they always pick up after blood transfusions but dont forget they can start to drop (pcv levels) if the cells are still attacking , ask for frequent pcv tests and dont be kept in the dark , my vet did not have enough experience in the disease so i moved her to some one that did , we went to the animal emercency centre in hallam (vic) under the watch full eye of the renown dr merrin hicks ( she was the best in this disease that i could find) so please ask your vet as much as you can so you understand fully what is to come , in saying this i understand your disease may not be a primary imha so your odds and treatments will vary , atleast your on the right track with all the above mentioned drugs, even thou i lost my bitches battle after 3 weeks from diagnosis my friend dyzney however survived and that gives me hope for the future and proves that it can be beaten , it will be a roller coaster and an expensive one at that so i wish you lost of hope and pray that you beat this disease so stay strong for your boy , you can read more about our journey in rainbow bridge under honeys thread its on about page 6 i think , good luck and i will keep reading in here to see how your going .. Link to comment Share on other sites More sharing options...
Starkehre Posted November 21, 2009 Share Posted November 21, 2009 (edited) Morning bokezu. Howz Jordy this morning? It is so frustrating waiting for the drugs to start taking affect, I know. I really feel for you and what you are going through. took 5 and a half days for Dyzney's drugs to kick in and she was on all that Jordy is on plus the Cyclosporin. Same as Berty's Honey, Dyzney's IMT was primary. But it can take a while to learn whether Jordy's is primary or secondary, as I understand keeping him alive at the moment is the main priority. The specialists were convinced Dyzney's was secondary as she took so long to respond and had so many set backs for weeks, but we tested, tested and re tested for every possible underlying disease that they could think of, and still nothing came up. And as we still have her now and she is a picture of health and no other nasties popped up, we definitely know it was primary. Hope Jordy had a good night. Praying for some good new soon. Edited November 21, 2009 by dyzney Link to comment Share on other sites More sharing options...
fiery_di Posted November 22, 2009 Share Posted November 22, 2009 (edited) Hoping Jordy has picked up from the transfusion!! Ruby's also was primary.. Lots of testing concluded this. I think at one stage we were considering a bone marrow transplant. To be honest, I cant remember exactly why, but I will see if I can find the paperwork from the vet to exactly explain why this was, and what the procedure was. I just wanted to add (just thought of it too) that Ruby first came up with the disease not long after having her first ProHeart SR12 Heartworm injection. The following year she got the injection again, and funnily enough her platelets dropped drastically again (she was on something like half a pred at this stage and quite manageable, but had to increase the dosage back to 1 full pred for quite some weeks). I didnt realise the connection until I read back on my DOL threads and noticed the timeline. 2-3 weeks each time after her injection did we notice her illness. I still to this day feel that the SR12 was either the cause OR a contributing factor. My vet refuted it, and most vets will saying that the research is inconclusive. I know in my heart that this was the cause of her disease. I never heartwormed Ruby again after that. All heartworm treatments contain Ivermectin. This is what I believe is the chemical that caused the ITP. Ruby lived another 3yrs without ever being heartwormed and never had an issue with it, or contracting heartworm, so I felt it was safer for her not to do so. I am based West of Sydney, so not a hugely predominate area for heartworm, but still a higher risk than colder climate areas. Edited November 22, 2009 by fiery_di Link to comment Share on other sites More sharing options...
fiery_di Posted November 22, 2009 Share Posted November 22, 2009 Oh, I thought I better add too. My vet never allowed Ruby to be vaccinated again either, as he felt the risk was too great & felt it would extremely aggravate the disease. Might be an idea to talk to your vet about this too. Really quite important. Link to comment Share on other sites More sharing options...
Starkehre Posted November 22, 2009 Share Posted November 22, 2009 FD, I am totally in agreement with you about your suspicions of Ruby's ITP being caused by the Ivermectin. As it has been explained to me, because the diesease is idiopathic, (although we as owners can pretty much work out what has caused the onset), it is never documented because it is not proven. So, this is why there is no documentation of actual case studies with attached causes. There are lists of probably linked drugs etc to these immune mediated diseases, and it is interesting to see these, but most vets are either in denial, don't know or don't want you to know, I have found. Both the drugs that I believed caused IMT in both my girls are on this list.... I now know. 2 vets tried to tell me that it could not possibly have been the Rimadyl.... then I saw Rimadyl on this list. Of course this is not to say it is not safe for the majority of dogs to take these drugs the majority of the time. Thousands of dogs do safely have these drugs without any side affects every day. It is believed by most vets (from what I have learned) that the dog must already have a predisposition to actually contracting the disease, and then if it comes into contact with, is medicate with, ingests something that can cause the immune system to go haywire, then that is when it happens. But it also may never occur to that dog with the predisposition. Most of the specialists I speak to believe there is definitely a genetic component. But once again this is not a proven fact. You did the right thing by avoiding further heartworm and vaccination medications with Ruby FD.. Regarding the bone marrow transplant, I know it is difficult to remember stuff from way back then, I have difficulty also, but perhaps was this suggested as a possible treatment when they may first have thought that Ruby's ITP was secondary (as in they may have suspected bone marrow cancer).... and when they tested for white blood cells and found her bone marrow was fine, that was when they said they didn't need to?? Just a thought, as that is how conversations went with Dyzney also. Link to comment Share on other sites More sharing options...
Bokezu Posted November 22, 2009 Author Share Posted November 22, 2009 I had to work today, so I haven't been able to visit, they close at 1pm. Vet will ring me later today/tonight....hoping like crazy things have started to pick up. No heartworm meds here, we don't need it here. No vaccs since 16 week vac over 12 months ago, no medications at all. The blood tests that were sent away came back saying primary. Hi berty, so sorry to hear you lost your bitch, so, so sad for everyone involved I will read your thread later tonight My vets are pretty switched on, they have told me lots, including just how difficult a disease it can be to treat. They are watching him very carefully. The vet I spoke to last night said she could see new red blood cells so he is making some after the transfusion. All we need to see now are some platelets, hope that is the news I receive later and I will be very very happy. A question I have for you guys is.......... when Jordy comes home, does he have to be kept quiet, restricted excercise, can he run outside with the other dogs...there are 5 but they all sleep inside, will it be all too much for him the argy bargy of 5 other dogs? do you think he will need to be kept away from them. He obviously won't have much energy or enthusiasm, will he need to sleep a lot? Will I be able to go to work and leave him? I know a lot will depend on how quickly he starts and maintains recovery, so silly questions really, but I don't know what to expect. Will come back after the vet rings me, hope its not as late as it was last night Link to comment Share on other sites More sharing options...
Bokezu Posted November 22, 2009 Author Share Posted November 22, 2009 ok vet just rang........ his red cell count has gone down again to 18 but she can see mega platelets...little immature juvenile platelets that his body has produced, so that is a good sign his chest is clear still, abdomen still good shape she will not transfuse at this stage....she said it can go down to 10 or 12 all I have to do is pray all night it doesn't drop any lower, but at least he is making some so we are still in limbo waiting for the drugs to kick in Link to comment Share on other sites More sharing options...
fiery_di Posted November 22, 2009 Share Posted November 22, 2009 I would definitely seclude him and restrict his activities for the next few days. Let himself pick up again. You will notice in a few weeks that he will be fine to participate in normal activities. Link to comment Share on other sites More sharing options...
Starkehre Posted November 22, 2009 Share Posted November 22, 2009 (edited) That is great news Bokezu. Platelets are a good sign. Production is wonderful, as long as his immune system is starting to be supressed so it does not kill them again. I am very glad for you that it appears his IMT is primary. Have you come up with any possible ideas yet as to what you think might have caused it, so you can avoid it in the future? Having Jordy home will be pretty full on, but it will depend a lot on exactly what his condition is like. If he appears well in himself he will require definitely being segregated from the other dogs at all costs (risk of knocking and bleeding internally and severe bruising). also it is super important that nobody visits your house unless they are disinfected at the front door and keep unnecessary visitors away from him. Family members that must come and go also need to be hypervigilent of what they come into contact with outside of the home and wash/disinfect before coming in or going near Jordy. I strongly suggest Jordy does not leave your property at all, and even when he gets back into the car again to visit the vet don't allow him sniff outside your property. We went into complete lock down, no one in no one out, but I understand this is pretty drastic and not everyone is able to do this. You will need to remember that by the time he comes home he will have little or no immune system so will be very susceptible to picking up anything and he won't be able to fight it nor will he be able to be put on anti-biotics without risk of firing up his immune system again. No rough patting, no running and playing. All as low key as possible. Also keeping in mind if he has had any muscle atrophy there may risk bone breakages and falls. If Jordy comes home feeling very sick in himself but showing signs of recovery, then you may need to take time off work or get some assistance from family and friends to have someone with him. As I mentioned earlier if he is crook, maybe vomitting and not eating, then he will need round the clock care and supervision. Hopefully it will not come to this. The other issue with home care is the drinking. Jordy will always be thirsty. You always have to monitor his drinking. He cannot be allowed free access to water whilst he is still on reasonably high levels of cortisone as he will drink so much that it will make him sick, I can almost guarantee this and he will not learn by it, he will keep doing it. He needs to drink the excess water that he will crave or his kidneys will shut down, but he has to get it gradually. As we keep saying all cases are different and much will depend on just how sick or well he is. As each day passes you will know more of his actual condition. But definite risks are bleeding, infection, thirst and gorging water, vomitting and also if he is feeling unwell he may not eat. Then round the clock tiny portions of something really exciting may be called for just to keep up his energy. He will need to be kept in an almost sterile environment with no perfumes or sprays being sprayed into the air, no chemical cleaning products to risk alerting his immune system again. Currently his immune system is on high alert, and could possible try to fight off his platelets again if it feels called upon. Jordy's immune system believes his platelets are foreign and that's why it wants to destroy them, it is working over time, and that's why the vets are doing everything they can to suppress it. Length of time he will need to remain quiet etc will depend on how long it takes for his bloods to return to normal, and then how long it takes for him to be weaned off the drugs or onto such low levels that his body can cope with knocks etc. Even if all goes the very best that can be expected he still needs to be very quiet for a few weeks at least. Aside from all the drugs his body has taken a severe battering and will need to recover. he has youth and a loving family on his side. Bokezu, once again I have written something and feel like I sound like a really negative person and like I am over dramatising it. Believe me, if it was anything else I would be saying something like... "no big deal, just keep a bit of an eye on him", as in typically I am not a hypervigilent type when it comes to my dogs or illnesses. and I wish with all my heart that everything goes extremely well with Jordy, all fingers crossed...... but I just feel with my experiences with IMT that I at least owe it to you and anyone else that might want to know to be honest and tell you exactly what happens and what can happen. I am not adding any frills for affect or embellishing, I am not like that. I think FD's Ruby was one of the very lucky ones and I hope Jordy is too. From what I have heard it is often less severe is smaller dogs.... and that is not to take away any of the importance or recognition of Ruby's ordeal FD. I know it was hard for you also FD. Any illness in our dogs is dreadful. It is wonderful that your vets are being so great. They are giving you a lot of information and it sounds as though they know what they are doing. I am really glad about that. Hope Jordy has a restful and good night. Edited November 22, 2009 by dyzney Link to comment Share on other sites More sharing options...
fiery_di Posted November 22, 2009 Share Posted November 22, 2009 I can fully appreciate what you are saying Dyzney. Ruby, being a smaller breed did fare quite ok. I do think IMHA is alot harder to deal with than the standard ITP. The fluctuations in red blood cell count seems more drastic & far more life threatening. I will not refute that. You have offered some great advice. What a great community we have in DOL!! Link to comment Share on other sites More sharing options...
Starkehre Posted November 22, 2009 Share Posted November 22, 2009 Thanks for being so understanding FD. I had hoped you took what I said in the genuine vein intended. Your advice has been great for Bok also. I am sure she has preferred reading yours to mine, , and I feel bad about that, but like I said, better to be forewarned. Yes, DOL community is quite amazing isn't it?! Link to comment Share on other sites More sharing options...
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