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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24408
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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I just brought my dog home from a 3 night stay at the

Customer Question

I just brought my dog home from a 3 night stay at the hospital. The vet couldn't figure out why my dog fell so suddenly ill after going in a month previous for a bothersome knee.
She was proscribed metacam and after a month of taking metacam, one early morning she began crying and as I picked her up due to the fact she was no longer able to walk nor lift her head up, she peed all over me.
In a hurry I took her to my local vet where they took her straight to the back and began running blood tests. Her first blood results came back with a RBC of 1.39 HCT of 8.5 and HGB of 3.3.
He came back saying she had an autoimmune disease. He suggested a blood transfusion to help restore some of the red blood cells she lost. After her transfusion her HCT only went up to 10.1. On Sunday I was informed she might need a second transfusion Monday morning. But luckily when he checked Monday her HCT went up to 18.2.
My concern is when will she being feeling better? She can't walk and she's not urinating or defecating. She was prescribed prednisolone and carafate.
Submitted: 1 year ago.
Category: Dog Veterinary
Customer: replied 1 year ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry that your question wasn't answered in a timely manner and I regret that my state board of veterinary examiners won't allow my communicating with customers by phone in this venue. Please stay in this conversation if you wish. Can you upload of all of her test results to our conversation? I understand that you might not have a copy of the results at home but her vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (if you can see such an icon) or by using an external app such as imgur.com or dropbox.com. I assume that autoimmune hemolytic anemia (IMHA) was diagnosed but I'd like to see if certain changes in her red blood cells are present and I need to know if thrombocytopenia (low blood platelets) were also identified.

To answer you directly, 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, severe leukocytosis, or massive thromboembolism. The mortality for dogs with IMHA has been estimated at 20-60%.

Please respond with the additional information and further questions or concerns if you wish.

Customer: replied 1 year ago.
Here are some of the blood work results. I don't have the one where the dr said it went up to 18. I just took her in the morning for a complete blood count. The results won't be in until tomorrow because the dr said he sent them out.
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you. She must be quite a trooper. Thankfully she doesn't suffer from thrombocytopenia (low blood platelets) which would indicate Evans Syndrome - a more severe form of IMHA. The initial (pre-prednisolone) blood smear should be examined for the presence of spherocytes - a RBC shape pathognomonic (particularly indicative) of IMHA. It would have been prudent to test for autoagglutination and ANA prior to steroids being administered. These are additional findings in IMHA. I would like to see a stronger attempt on her part to replace those RBCs she lacks. Her anemia is regenerative which shows that she's making an attempt to replace them; hopefully, the prednisolone will make that regeneration stronger. Please respond with further questions or concerns if you wish.

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