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Anna, Pet Expert/Biologist
Category: Pet
Satisfied Customers: 11455
Experience:  40 yrs.: herps, pocket pets, rabbits, poultry, dogs, horses. Biology degree. Vet assistant.
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I have a 6yr. Old rat terrier who I took to regular vet

Customer Question

I have a 6yr. Old rat terrier who I took to regular vet today for rabies and "yearly" corona, parvo and DHLP vaccines. Also had lab work prior to having teeth cleaned. Was told red blood cells moderately low (in 20's level). All other labs normal. So vet rechecked x3 times with no change. Redrew blood to send to higher level lab. My concern is I told vet of my dog having recently demonstrating weird symptoms i.e.: shivering at times, hypervigilant, lethargic, and loss of appetite. Vet told me it could be anxiety, age changes in brain etc. I came home and googled dogs symptoms and discovered many reports of same symptoms and more all possibly related to trifexis which my dog receives. I should get lab results tomorrow... I read all of the different types of anemia in dogs and became very concerned. Is there any cure or antidote for this type reaction. I read of one dogs owner being told by a Holistic vet to give liquid dandelion and liquid milk thistle which gave good results. Any help, suggestions, or recommendations would be very appreciated. Sincerely, ***** ***** XXX XXX XXXX or XXX XXX XXXX XXXXXXXXXXXXXXXXXX I am happy to pay for services.

Submitted: 1 year ago.
Category: Pet
Expert:  Anna replied 1 year ago.

Hello and welcome, Virginia. My name is ***** ***** I'm a biologist with a special interest in canine health. I have used holistic medicine with my own dogs for many years. I'm sorry to hear about this problem.

The most serious of these symptoms you are seeing is the anemia. Trifexis has been linked to immune mediated hemolytic anemia, which is what I suspect you read about. No studies have been done on it, and no statistics are kept on the incidences of certain diseases in pets, but IMHA is considered fairly common. We do know that certain breeds are more prone to it, and that it occurs more often in middle-aged and older dogs, and more often in females. Some studies indicate that it may be more likely in dogs with certain blood types. There are several different causes - some cases are genetic, some are a symptom of certain types of cancer, toxins can cause IMHA, modified live virus vaccines have been linked to it, and so have certain antibiotics and heartworm preventatives (including Trifexis). The following links have more information on IMHA, including which dog breeds are prone to it.

This one includes a list of possible treatments, and all the etsts needed for a positive diagnosis:

There is no official antidote for Trifexis. The dandelion and milk thistle you read about can help the body clear itself of toxins. I would discontinue the Trifexis, and go ahead and give those herbal remedies. When the drug is cleared from your dog's body, those other symptoms should diminish, but if your dog has IMHA, these measures will not be enough. Corticosteroids are usually the first line of treatment. I had a dog several years ago who developed IMHA. He was treated with steroids, and I gave him iron-rich foods. We were able to reverse the anemia. It is not always fatal.

I know you are worried, but at this point, we can't be sure your dog has IMHA. There are many other types of anemia. Further testing is needed. It's possible your vet ordered some of those tests, so you may know more tomorrow. My first recommendation to you would be to get a second opinion. Be sure to tell this vet all the symptoms and your concerns about Trifexis. However, I'll warn you that most vets (other than holistic ones) are very hesitant to blame a medication for anything. Regardless, it's your decision about what kind of heartworm preventative you use. The older ones, such as Interceptor, are tried and true.

If you would like to see a holistic vet, this site has a directory of them. Just click on the "Find a Vet" tab at the top:

In summary, I would discontinue Trifexis (it will stay in his system for about 30 days), consider the dandelion and milk thistle, and get a second opinion. If you have more questions, let me know in a REPLY. I hope your dog will be fine.


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