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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24454
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My miniature schnauzer is sick with IMHA-- she was doing

Customer Question

My miniature schnauzer is sick with IMHA-- she was doing very good with prednisone 20mg daily until last week-- her red blood count started to drop-- as of Sat she was still in the low normal range however she seems very depressed this morning and I can't get in to see the vet until tomorrow-- is there anything I can do? The Vet here wanted to put her on cyclosporine-- she seemed to not respond to that is a good way-- her bowels have slowed down -- she is still eating and drinking-- I boil Chicken breast and plain rice, the vet gave me some canine probiotics to use also, which I have been mixing in with her food.. Suggestions???
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry to hear of this with Mindi. You're limited at home to doubling her prednisone dose until she can see her vet tomorrow. Please also administer an over the counter antacid such as famotidine (Pepcid) at a dose of 0.25 mg/lb twice daily as a stomach protectant. There are other immunosuppressant medications to consider - azathioprine, mycophenolate, or leflunomide - and thromboprophylaxis (prevention of blood clots) should be considered in such a patient. For example, heparin has been associated with significantly greater survival in IMHA dogs and clopidogrel (antiplatelet therapy) should be considered as well.

This is what you need to know:

Mortality of dogs with IMHA has been estimated at 20-60%. 90% of dogs surviving the initial 2 weeks of management have good long-term survival.

Indicators that may predict negative outcome include severe icterus (jaundice), severe anemia, severe thrombocytopenia (low blood platelets). severe leukocytosis (low white blood cells), or massive thromboembolism.

Thromboembolism is a major complication of IMHA and most dogs have evidence of thromboses in necropsies. Hence, my recommendation for thromboprophylaxis above.

Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
What are Necropsies? and what Thromboprophylaxis are you referring to?
Expert:  Dr. Michael Salkin replied 1 year ago.

Necropsy is performed on animals. Autopsy is performed on people. They refer to the same procedure.

Perhaps my message didn't post correctly. It should say above that thromboprophylaxis (prevention of blood clots) with heparin and clopidogrel should be considered for Mindi because such therapy is associated with significantly greater survival in IMHA dogs.

Please continue our conversation if you wish.

Expert:  Dr. Michael Salkin replied 1 year ago.
Hi,
I'm just following up on our conversation about Mindi. How is everything going?
Dr. Michael Salkin