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Immune Mediated Hemolytic Anemia Complications

Petey Shaved for Ultrasound

Petey’s treatment for Immune Mediated Hemolytic Anemia  (IMHA) would prove to be a complex one. His follow-up was scheduled for August 31. Thankfully, things at that point did not get worse, his medication was unchanged, and his drains were scheduled for removal on September 4th.

After the removal of his drains, we continued to monitor his progress and scheduled a follow-up appointment for September 14th.  In the days prior to the follow-up he seemed a bit lethargic, and his appetite dwindled. We discussed this at the recheck, and as normal, a CBC (complete blood count) was performed. The news we received was not positive. His hematocrit was 21, down from 31 the week prior. He was given another ultrasound to rule out or confirm any other complications.  A blood clot in the vein to his spleen was discovered. The only way to remove the clot for certain would be surgery and we were all in agreement (including his vet) that it would not be a good option as he would likely not survive the surgery.

Our only other option was to give Petey daily heparin (anticoagulant) injections. At this point we needed a miracle. I tried to prepare for the worst, and contacted Forte Animal Rescue to give them the sad news. They are an amazing Rescue Group, and like anyone familiar with Petey’s story, huge supporters. I wasn’t prepared for the news and my heart sank, but I wasn’t ready to give up hope. When I left the office with Petey, our new regimen was:

Baytril (antibacterial) 136mg tablet once per day, Metronidazole (antibiotic) 500 mg (1/2 tab twice per day). Imuran (immunosuppressant) 50mg 1 tablet every other day. Prednisolone (corticosteroid) 20mg, two tablets every other day, Lasix (diuertic) 50mg ½ tablet daily, Baby Aspirin ¼ tablet daily, Heparin (anticoagulant) injection .4ml every twelve hours, subcutaneously. Prilosec (acid reducer) tablet, 1 per day.

I created a daily chart and used two pill organizers to keep his medications straight. Getting him to take that many pills was a challenge that involved pill pockets, peanut butter, deli meat and an occasional piece of cheese. The next week would be the telling week, and as grim as it was, I still had to hope for the best.  To be continued….

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