On the morning of Thursday, the 21st we woke up with a very lethargic and sad-looking puppy. Indie, our 11-month old Beagle/Terrier mix, was not acting like himself when the night before he seemed just fine. He had to be coaxed downstairs to go out when usually he's the first one up in the morning. He was very lethargic and just stood in one place looking at me with his ears back; and then promptly vomited up his undigested dinner from the night before. I took him outside to go to the bathroom and it appeared that there was blood in his urine (SCARY!). I brought him back inside and called the vet and Matt, my husband, took him in to see the doc about an hour later.
The vet said that Indie had a fever and was dehydrated. They gave him antibiotics and an IV and the fever went down. They also said that he was auto-agglutinating, which meant that his body was attacking his own red blood cells. They decided to run a panel of blood work to rule out infections and tick-borne illnesses while he spent two nights with the vet. We visited him on his second day at the vet and he seemed happy to see us and ate some food, but was tired. At this time his PCV (pack cell volume) count was around 16/17. The PCV count measures the proportion of blood volume that is occupied by red blood cells. The normal PCV count in dogs is 37-55. Indie was anemic at this point but not in serious danger.
Early Saturday morning we got a phone call from the vet shortly after they opened saying that Indie was in really bad shape and needed an emergency blood transfusion. His PCV count was at 8. How his PCV count was allowed to get down so low that it was an emergency situation and that he was beginning to suffocate makes me very angry, but that is another story. We were told to come to the vet and pick him up so that we could drive him to the emergency clinic at the NC State Veterinary School for a transfusion. Matt and I picked up Indie and drove him to NC State, wondering the entire time if he was even going to make it because he looked that bad.At NC State he received an emergency transfusion and oxygen and we were able to see him afterward. I've never been so happy to see his tail wag; he looked sooooooo much better. Later that day he received another transfusion.
Indie was in the ICU at the NC State Veterinary Hospital from Saturday, the 23rd, through Thursday, the 28th. During his stay he received a third transfusion, lots of drugs and steroids, had an ultrasound, and had a spleen aspirate to rule out cancer while they ran various tests trying figure out what sent his immune system into overdrive. We drove over twice every day to visit with him. It was a very emotional and stressful week.
On Thursday, the 28th, Indie's PCV count had been holding steady around 19/20 for over 48 hours so he was allowed to come home to recover. He was diagnosed with idiopathic Immune-Mediated Hemolytic Anemia (IMHA). This means that nobody has any idea what caused his body to begin attacking his red blood cells. He was sent home on activity restriction with lots of meds, including Heparin injections. Friday, the 29th, Indie returned to the hospital for a blood panel screening and his PCV count was 21/22; he will return to the hospital again on Monday, the 1st, for another blood panel screening.In the meantime, Indie is still attacking his red blood cells but at a MUCH slower rate, which means that the steroids and immuno-suppressant drugs are beginning to take effect. He will remain on the drugs and activity restriction for quite some time until a marked improvement in his PCV count has been shown and maintained. He will still be on the drugs for some time, if not permanently. Since Indie has been home he has done A LOT of sleeping, which is great. We are all happy to have him home. Unfortunately, we are by no means "out of the woods" yet. Thirty percent of IMHA patients fully recover and never relapse, another 30% recover and then have relapses later in life, and then another 40%
never leave the hospital. Thankfully it seems that we are not in the later 40% (knock on wood). The good news is that once an animal recovers from IMHA he has great quality of life with no lingering effects from the incident. Once Indie gets his PCV count out of the anemic range he will feel just like his usual rascally self.So, that's where I've been. It's been a long and stressful week with me thinking lots of positive thoughts to help out Indie and not cause undo stress on the little one growing inside of me. I should be able to remove my Etsy shop from vacation mode starting this week and be able to get back into work while keeping an eye on Indie. I will also continue to keep you updated on his progress with hopefully lots of good news.
PS - If you have a pet, I strongly encourage you to look into pet insurance. We have a policy for both Indie and Kasey with Petplan and we honestly never thought we would have to use it for Indie. Pet insurance has been a life-saver, literally.
**UPDATE** As of Tuesday, February 2nd, Indie's PCV count is up to 35! Hooray!
