This Changes Everything

Ginger Ale and SodaPop in my office last March

I am having trouble making myself write this one, so bear with me.

Last Wednesday, SodaPop stopped eating. As I am always worried of a repeat of the Soda's Great Hunger Strike of 2001, I began to watch her very closely. She deteriorated rapidly, regurgitating water she drank, acting very odd (creeping around like she was in trouble) and becoming dull and lethargic. I cooked--yes, COOKED--rice and hamburger mixed with a tasty Gerber turkey/vegetable paste but she would only eat about a tablespoon from my fingers. By 8 p.m., she had a frightening pale look to her gums, labored breathing, and was running a temperature of 104.5. The normal high end for a dog is 102.5. So I drove quickly (do I ever drive slowly?) to the emergency clinic I trained at but recently decided not to work at. After four hours of bloodwork, ultrasound, bloodwork, radiographs, bloodwork, and God knows what else I'm forgetting, she was diagnosed with Ideopathic Immune-Mediated Hemolytic Anemia.


If you don't know these terms, in real language it means that we don't know why (ideopathic), but her body is attacking (hemolyzing) her own blood cells (immune mediated) to the point where she is severely anemic. It is a bad thing to have. The info the vet printed out for me stated in no uncertain terms that "IMHA is a very serious disease associated with a high mortality rate." (Veterinary Information Network, Inc. 2009)

A lot rested on the volume of her red blood cells. The Idexx machine wasn't working right so the packed cell volume (PCV) kept coming up severe, around 15. The normal low range for canines is 43. The veterinary technician repeatedly came up with 20-25. Techs are more reliable than machines. So, no blood transfusion at this stage, but we have to stop the process. If we don't stop it, she dies. She can also die by throwing a clot, which the vet said can be recognized if the dog drops dead in mid-walk.

She said it with much more sympathy than I write. She was great, actually. She was one I had trained with. Soda was given injectable steroids, and we were to start oral steroids, aspirin for clotting, and an antacid teh next day. She will be on steroids for months. In the next few days I was to to monitor Soda's temperature and take her back in for more--you guessed it--bloodwork. They said we'd know in two to five days if the prednisone was working. If it doesn't, there are other drugs and other avenues. It's a little blind since we don't know the cause, but the good news is that the ultrasound and radiographs ruled out obvious causes such as cancer and internal bleeding. "Scary things" as the vet put it. Since she knew me, the vet let me assist in every procedure, which Soda and I both appreciated. I took radiographs, held for the ultrasound and all the bloodwork. I think that made it much less stressful for Soda, which was good as we were trying not to elevate her temperature. She also worked hard to keep the costs down. You can imagine it was still very significant, though she has quite a ways to go before she catches up with Ginger's bill.

I put Soda and Ginger to bed around 1:30 a.m., and tried to follow, but I had 8 pages of not-very-encouraging information floating around in my head. I listened to Soda's labored breathing until I fell asleep.

Whatever happens, everything changes for Soda now. To survive the disease, she will need strong meds (steroids) that will radically affect her body. She becomes a walking time bomb, a canine landmine, who can succumb at any moment to a small group of clotted cells.

Soda turned nine years old in January.



Soda and a moose friend resting on Cocoa's blanket last year

The Veterinary Information Network recommended a couple of sites that owners have dedicated to this disease:

www.cloudnet.com/~jdickson/
www.peppypaws.com/LillisLegacy.html