25th May

Phoebe's PCV is still hovering around the 40-45% mark which is really good. Phoebe's Prednisolene dose had been reduced to 7mg every two days, although her ciclosporine dose is remaining the same for the time being.

4th May

Phoebe had her weekly visit to the vets today. Her PCV was still around the 41% mark, which is brilliant! Her Vet has reduced her pred dosage to 7mg/day. Things are looking really good for Phoebe at the moment!

1st May

Phoebe's last PCV result was at 41%, so she is still very stable. Phoebe is pretty much back to her usual bouncy self! Her vet want to keep her on the same meds for another week or so, but will the look at further reductions!

19th April

Well I was being paranoid after all! Phoebe was back at the vets today and her PCV is up to 42%! This is great news as I have been very worried about her this week. Her vet wants to keep her on the same dose of medication for another few weeks at least.

17th April 2007

Phoebe seems to have gone a bit quieter over the past few days, her gums seem slightly paler also. I could be being paranoid of course, but I am a bit concerned about her. She is due back at the vets on Thursday, so we should know more then.

12th April - More good news!

Phoebe as been on her reduced dosage of Pred for a week now, and she seems to be doing really well. She was back at the vets today for another PCV test, the result was an amazing 40%. This is superb news, her vet wants to keep her on the same meds for the next couple of weeks before (all being well) reducing it again. It is so good to see her looking and acting so well, especially as things were looking very bad for her just a few weeks ago.

5th April - More Progress

Phoebe was back at the vets again yesterday. Her PCV has risen 1% since Monday to 36%. Our vet has decided to drop Phoebe's Prednisolene dosage down to 13mg/day (She weighs 13kg). Phoebe will stay on 50mg/day of Cyclosporin for the next couple of weeks along with Antepsin 2g (3 per day) and Zantac Suspension 150 mg (twice daily). I guess this will be the telling time, hopefully she will continue to increase or at least hold her red-blood cell count where it is presently. The medium-term aim is hopefully to have the lowest possible maintenance dose of Prednisolene and give it to Phoebe alternate days to give her kidneys and liver some rest bite. Phoebe seems to be doing really well, she has a fair bit of energy. However she is still snoozing a lot. I am still limiting her exercise to a brief walk into the garden, though I am hoping that it will not be long before I can start taking her for short walks as I am sure she is getting a bit bored with the garden!

2nd April - The only way is up baby!

Phoebe is continuing to do really well, she still has significantly more energy than she had a few weeks ago. Though she does need to rest a lot which is understandable! We went to the vets for another PCV test and her red-blood cell count is up to 35% which is excellent. We are back for another test on Thursday.

30th March

Phoebe is doing really well, she has loads more energy! She had a trip to the vets and her PCV is now at 33%, this is excellent news as her Red-blood Cell count is increasing fairly rapidly! We are back at the vets on Monday, so hopefully we will have a further increase.

26th March - SUPER PHOEBE!!

Phoebe was at the vets today and her PCV is now at 26%! She is looking much better. The Vet was really pleased and said that he did not need to see Phoebe until next week. However for my own piece of mind I have booked her in for another PCV test on Friday - Hoping for a stress free weekend!

It is really great to see Phoebe improving, it is still early days but things are looking really good for her!

25th March

Phoebe seems to doing pretty well at the moment. She has a relatively large amount of energy at the moment, well it comes in bouts (she is still sleeping a lot in between)! We are back at the vets tomorrow, so fingers crossed there will be another increase in her PCV!

23rd March

Phoebe was back at the vets this morning and her PCV is now up to 20%. There is still evidence of red-blood cell breakdown but this also seems to be reduced. This is good news, but we have been here before so the next few blood test will give a truer picture I guess.
In addition to the medication Phoebe is currently on, she is also on 50mg/day of Cyclosporin.

Things are looking a lot more positive than they were last week, but we still have a long way to go!

20th March

Phoebe's PCV was still around the 16% mark today. She is still holding her own, though she does have less energy than she has had recently. Phoebe is back at the vets on Friday, so we should no more then.

19th March

Phoebe had another blood test today and her PCV has dropped to 16%. This is really not the news I was hoping for today. I was expecting it to have dropped slightly as I felt she had less energy this morning, but I had not anticipated such a reduction.
The vet suggested that Phoebe's antibodies may be reacting to the transfused blood that is still in her system, so the dramatic drop in her PCV may not be as bad as it sounds. Her blood results from last Thursday showed that she is producing new red blood cells, but at a very slow rate. Phoebe is back at the vets tomorrow morning for another blood test.The vet is considering using some alternative immuno-suppressant drugs and a series of injections to help stimulate the bone marrow to produce new blood cells.

Sorry this post is not as up-beat as my last, but I am very worried about Phoebe.

16th - 18th March

Phoebe seems to be be pretty stable on the whole, though I thought she may have had slightly less energy on the 18th of March. She is still being very sneaky with her medication, pretending she has swallowed the tablets when she hasn't! We are back at the vets tomorrow, we should get the results from her blood tests taken last Thursday and the vet will take another PCV test.

15th March - More positive progress!

Phoebe was at the vets again this morning for another full blood analyses. We should get these results on Monday. Her PCV is now at23.5%! This is excellent news, fingers crossed it will continue to rise.
I know it is still early days and the next few weeks will be the crucial time, but I am feeling really optimistic for Phoebe. Phoebe has now got some colour back into her gums and has so much more energy. That said, she thinks she has more energy than she actually has. She was very excited this morning jumping about and wagging her tail. Phoebe really enjoyed the interactions at the vets (apart from having blood taken!) but has been flat out snoozing since we got back home.Phoebe by her very nature is a very excitable dog, but I am trying to keep her calm where possible as I know how imperative rest is to increase the chances of recovery.
It is so good to see her making good steady progress!

14th March

Phoebe seems well today. I have fed her on small quantities of bland food today to allow her stomach to settle down. she is keeping her food down and her diarrhea seems to have subsided.
Phoebe has more energy today, she is constantly wagging her tail and following me around. Though she does tire quite quickly and is sleeping a lot. There is more colour in Phoebe's gums, they are still pale but distinctly pink tinged!
We have a visit to the vets tomorrow, I am hopeful of another rise in her PCV! It is so good to have her back home again!

13th March - Phoebe's Home!

We picked Phoebe up this morning, she seemed very bright and was very excited to see us! Her PCV is still at around the 21% mark.

Phoebe is the brightest she has been since becoming ill. However since coming home she has been a lot quieter and has been sick three times and also has diarrhea. I am sure I am being paranoid now, but after feeling initially positive about her progress I am now very worried again. I just called the vet that has been looking after Phoebe at the Edinburgh Royal Dick and he suggested that I laid off feeding her until tomorrow to allow her stomach to settle again. Phoebe has been through a fair bit this past week and a 3 hour car journey has probably not helped her stomach! If Phoebe is still being sick tomorrow morning I will take her to her vet for piece of mind.

I feel I have been very lucky with both my local vet and the vet who looked after Phoebe at the hospital, they have both been very helpful and caring, always happy to speak to me if I have anything I am worried about.

12th March

I heard from the Vet this afternoon. Phoebe seems to be doing fairly well. The Vet said that she was a lot brighter today and her PCV is up to 21%. This is excellent news as it is the first time her PCV has increased post-transfusion. Phoebe's blood tests today also showed that her bone-marrow is producing new red-blood cells. The rate at which the new red-blood cells are being produced is quite slow, but it is a step in the right direction!
What is more we are able to pick her up tomorrow, I can't wait!
Thanks to some very good friends we have managed to get together enough money to pay her hospital bill (thanks very much, you know who you are!).
I am feeling more positive now than I have since Phoebe first fell ill, though I know she has a long way to go.

10th March

I have heard from the Vet again this afternoon. Phoebe is stable, her PCV has showed no change from post-transfusion yesterday (19%). Phoebe has her appetite back again, and has a lot more energy. I just hope that her bone-marrow kicks into action soon. I asked the vet about thyroid issues and he did not seem to think that this was likely with Phoebe's condition. I am really missing her, I wish I could see her to give her a cuddle! Providing there is no negative change in her state I will not hear anymore news until Monday afternoon once her full blood results will be available, it is going to me a very long wait!!

9th March

I am glad we gave the go ahead for another blood transfusion. The vet was very worried about Phoebe this morning as she seemed very low. Today she has had her second blood transfusion which has been successful (PCV is up to 19%). A bone-marrow biopsy was carried out on Phoebe this afternoon and the results did not identify and growths. The bone marrow did not show any real new red-blood cell growth. So sort of good news and not so good news. We still do not know what is causing the IMHA. They are keeping Phoebe in over the weekend and monitoring her PCV level, she will have another full blood analyses on Monday. The big hope is that the blood transfusion will help in giving the bone marrow a chance to start creating new cells. I really hope she shows signs of recovery soon as we are beginning to run out of options.

8th March

I am missing Phoebe loads at the moment. Her PCV is still at 8% today, though amazingly she is holding her own. Phoebe is having her blood type matched today and will have a blood transfusion tomorrow. This will allow her to have a bone-marrow biopsy later in the day. We should know more by tomorrow evening.

7th March

The vet phoned me today as he is quite worried about Phoebe. Her blood results confirmed that she has IMHA. Her PCV was at 9.1% when the blood was taken, this is the lowest it has been. The blood test results also showed no evidence of red-blood cell generation suggesting a bone-marrow problem. The vet has referred Phoebe to a specialist in Edinburgh.

We took Phoebe to Edinburgh to the small animal hospital. Phoebe is staying at the hospital for the next few days for some tests. Her PCV is now at 8%.
The vet will be carrying out a bone-marrow biopsy tomorrow morning, this will hopefully identify the cause of the IMHA.

Worrying times and a quiet house!

5th March

Back at the vets today. I had to leave Phoebe at the vets today, so that she could have some blood taken, we should find out the results on Wednesday. Phoebe's PCV count has worryingly dropped to 10%. Phoebe seemed quite shaken today after her visit to the vets, but seemed to settle down once she was back home.

4th March

Phoebe seems about the same today, though Kath thought she may have been a little unstable on her feet this morning. Phoebe has not had much energy today, however she is still eating well. We are back at the vets tomorrow morning, I am hoping for some good news!

Not much change in Phoebe today, but I am really worried she may not pull through. I really hope that I am wrong, but she does not seem to be making any positive progress. Phoebe is still eating well (she is putting on weight) and drinking lots, but she has a real lack of energy. I may be being paranoid, but I thing her jaundice may be getting worse. I will see what she is like in the morning, if I think she is deteriorating further I will call the vet.

2nd March - At the vets again.

Phoebe was at the vets first thing this morning. Her PCV test showed a count of 12% , this is a worrying decrease from the last test. The vet prescribed the same dosage of Pred (25mg/day) and another 25mg/day of Azathioprine. Phoebe will be back at the vets on Monday to have a full blood analyses. There is some concern that the IMHA may be caused by a bone barrow problem. If Phoebe does not respond to treatment there may not be much that can be done for her. I am very worried.
Phoebe is still drinking lots, but she still has a fairly strong appetite. She seems to have about the same energy levels as yesterday. I really hope she starts to respond to treatment soon, it would be great to see her getting back to her normal self.

Tired Phoebe

I have been a bit concerned about Phoebe today, she seems to have even less energy. Phoebe has been eating ok today, so I guess this is a positive sign. However she seems to be very lethargic today and her heart seems to be racing. This is perhaps just paranoia, but I cannot help worrying. I am taking her to the vets first thing tomorrow morning, so hopefully we will no more then.

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.