28th February - Phoebe still ok!

Good news is Phoebe still seems pretty stable. Not any discernible signs of improvement in her gum colouration, but I realise this will take time. I really hope that Phoebe will improve soon, it is quite sad to see her with such low energies, she was such a lively dog!

27th February - A day at home!

Phoebe seemed about the same today. She is still very tired most of the time, but she does have quite a healthy appetite! She woke Kath up in the early hours of the morning as she needed the toilet! She has been pretty good at letting me know when she needs to go out, but because of the amount she is drinking it is sometimes difficult for her to control her bladder.

26th February - Another visit to the vets!

Phoebe seemed about the same this morning, no real progress, but no deterioration. We were at the vets in the morning. The vet gave her a check over (she did not like having her temperature taken!). The vet informed me that her heart rate was still high as would be expected. She needs plenty of rest as her heart is running the equivalent of a marathon every day. The vet thought that her jaundice seemed to be less ans that there was a hint of colouration in her gums (I could not see this myself). The vet took some blood to check Phoebe's PCV (Packed Cell Volume - Red Blood Cell Count). I asked the vet a few questions:

1. Would long term use of the steroid drug shorten Phoebe's life expectancy?
2. Does Phoebe need a gastroprotectant drug?
3. Can Phoebe use anti-flea treatment?

The vets answers were:

1. Yes, though her quality of life up to that point would almost certainly be good. There is a chance that Phoebe will only need around three months of treatment, however nothing is certain. The fact that she showed 2 of the 4 factor points of IMHA suggests that long term treatment may be needed. If long term treatment is required, the steroid drug would be given on alternate days to allow her liver and kidneys to rest.
2. At this stage, it is not of major importance. However it would be required if treatment is long term.
3. Not worth thinking about at this point. However treatments from shops will be far too strong for her, but there are prescribed treatments that may be suitable.

I took Phoebe back home. Now usually if I open the front door Phoebe would bolt out the door like a bolt of lighting and run all over the place investigating other peoples gardens and usually taking about 15-20 minutes before I could get her back. However today she did get out the front door and rant to a garden opposite us (only running at c30% her usual speed). It took me just a few seconds to retrieve her as she at worn herself out. I was very worried when she ran out, this would not help her recovery and it could have been terminal for her if she got lost. I decided I should get her condition inscribed on her tag, just in case this does happen again.

I heard from the Vet again during late afternoon. The Vet informed me that Phoebe's PCV count was up to just short of 15%. The vet has hoped her count would have doubled from 9% to around 19-20%. However any improvement is a positive thing. I had hoped for more than 5-6% increase, especially as there was likely to be sum residual effect from her blood transfusion.

Phoebe urinated on the carpet again today, she has not done this since she was really ill last week. She is drinking a huge amount at the moment, but she is usually pretty good at letting me know when she needs to go out. Hopefully this is just a one off. I find myself very paranoid when she does an 'out of character' action, always thinking the worse!

Hopefully there will some more improvement in her health tomorrow, but I know this will be a slow process.

22nd February - 25th February - At home

Phoebe has been fairly stable through this time. Although she still is only running on c30% normal energy and still has no colour in her gumbs. I find myself worrying about everything she does.
Phoebe has got her appetite back to some extent, but is drinking c8x her usual fluid intake (this can be a side effect of the drugs she is taking). Phoebe seems very clingy, following me where every I go in the house whe she is awake. She is spending a lot of time sleeping though.
I find myself worrying about her contantly, it would be nice to see some physical progress.
I was approved for member ship of the CIMDAsupport email group and promptly posted to the group. The group has been amazingly helpful and informative, this gives me some hope for Phoebe's future.
We will be back at the vets tomorrow, so hopefully we will get a better idea of Phoebe's progress and prognosis.

21st February - Back at the Vets

Phoebe seemed fairly stable today, she had certainly not deteriated which was a good sign. We were back at the vets where Phoebe was given another steroid of injection. The vet also explained that the best course of action would be to give Phoebe high dosages of steroids to suppress her immune system, this treatment would be reduced if her body respnds well to it. However the treatment was expected to last from 2-3 months or the rest of her life. The vet also said that although there was a chance she could survive this, there was also a chance she would not.
The vet gave me enough prednisolone (steroid) to last Phoebe another five days (5mg tablets - 3 to be taken in the morning and 2 in the afternoon). We booked another appointment for the following Monday.
I took Phoebe home and treated her like royalty.

20th February - A day at the Vets

Phoebe was still very sick but was back at the Vets first thing the morning. Phoebe was still very sick. The vet informed me that they had not got the blood test results back but from a sample he had tested she was seriously anaemic with a red-blood cell count of around 9%. Phoebe needed a blood transfusion right away.
I had to leave her at the vets and thankfully one of the staff had brought her dog into the practice to donate blood. Without this transfusion Phoebe would have died.
It was a long and worrying day, the vet phoned me at lunchtime to let me know that Phoebe seemed to have responded to the treatment and was a bit more lively than she had been. However the blood results were not in yet, so there was still no diagnosis.
At about 1600hrs the vet phoned me to inform me that the blood results were in, so I made my way to the surgery.
On arrival the vet informed me that the blood results indicated that Phoebe had has Immune Mediated Haemolytic Anaemia. The vet gave her a strong injection of steroids and asked me to bring her back the following morning.
As soon as I saw Phoebe, I was amazed how much better she looked. Phoebe was wagging her tail and hand had a spring in her step. I realised this could only be temporary, but even so it was nice to see here with at least some energy again.
The vet gave Phoebe another steroid injection and asked me to bring her back again the following morning.
Once home I was able to search the Internet to find some information on this illness. I found the following links really useful:

http://www.provet.co.uk/petfacts/healthtips/autoimmunedisease.htm
http://www.vetnet.co.uk/aiha/aiha_dog2.html
http://www.cloudnet.com/~jdickson/

I also found this support group:
http://pets.groups.yahoo.com/group/CIMDAsupport/
I applied to join this group, and would later find it invaluable.

17th February - 19th February: The first signs of illness.

Hi,

First I should introduce you too Phoebe, here she <<-------

Phoebe first showed signs of illness on Saturday 17th Feb (2007) though at this stage she just looked depressed, I assumed she may have eaten something that did not agree with her rather than any serious illness. By Sunday (18thFeb) she appeared to have perked up again, so I was less concerned. However on Monday (19th Feb) she seemed to have gone down hill and was quite lethargic and drinking/urinating alot. At this stage I thought that she may have a kidney infection andphoned a friend for advise, he suggested that I should get her to the vetsasap as had lost a dog to renal failure.Phoebe was now stumbling and getting dis-orientated. I phoned the vets immediatly and booked her in that day.

When the vet examined her, he informed me that Phoebe was seriously ill. she was very aneamic (her gumbs were white) and at this time he was not sure ofthe cause, though he suspected cancer or IMHA. The vet took some blood to be sent off to the lab and gave her an anti-biotic and steroid injection.

I took her home that night, she seemed so ill that I did not expect her to survive the night, this was really bad.

How Phoebe could go down hill so fast was really worrying, I would be devestated if I lost her.