Here we are at the beginning of a new year. Most of us are busy making resolutions and putting away holiday decorations. While we at Atlantic Animal Hospital are working on those same tasks as well, we are very excited to announce our first Companion Animal of the Month for 2009... Dewey Karl Schultz.
Dewey is the grand-dog of Don and Lindy Bird. He is living with his grandparents while his parents are working in London. This six year old Bichon-Poodle mix thinks he's in charge of the house. Don says that Dewey can be quite bossy for such a little dog, and when reminded that he isn't the boss, he'll sulk for a bit. But otherwise, he's a happy camper.
Dewey's favorite activity is Grandpa-assisted flight. The moment that Don picks him up to prepare for flying he is transformed into Super-Dewey, zooming around the house faster than a speeding Frisbee. When not incognito as the Canine Crusader, Dewey enjoys fetching his toys-- especially ones that squeak. He will tear into one just to get out the squeaker with the exception of his favorite squirrel. Don loves the expression on Dewey's face when the squirrel toy is squeaked; however, interest in it will immediately fade if Dewey spots someone eating. He also enjoys relaxing by the swimming pool and playing the occasional round of Scrabble with Don.
Dewey is quite the gourmand. He loves his grandma Lindy's home cooking. She cooks a special doggie diet just for him which he really seems to enjoy. Turkey is one of his favorite dishes, so Thanksgiving is a fantastic holiday for him. Don says that Dewey is not a beggar but he is a crumb shark. Any morsel dropped from the table that barely hits the floor is snapped up by Dewey.
Aside
from the occasional bout of dermatitis, Dewey was generally a healthy little guy
until this November when he became lethargic and didn't want to eat. A few days
later, he began vomiting and having diarrhea. He became jaundiced, which means
that his gums, eyes, and skin turned yellow in color. Dr. Sukhija hospitalized
him and immediately ran lab tests including tests for tick-borne diseases and a
Coomb's test which identifies antibodies coating red blood cell surfaces.
Results indicated that he was severely anemic and many of his other blood values
were out of range. Dewey received a blood transfusion which was performed to
replenish the number of red blood cells in Dewey's blood. He began to show some
improvement, but he still refused to eat. After spending the night in the
hospital on intravenous fluids and medications, he began to stabilize. Although
he wasn't out of the woods yet, he was able to go home and spend Thanksgiving
with his family.
Dewey's lab results returned showing an autoimmune condition called Immune-Mediated Hemolytic Anemia, also known as Autoimmune Hemolytic Anemia. IMHA or AIHA is a condition in which the immune system attacks and destroys the body's own red blood cells, or RBCs. The cells are seen as invaders and the immune system responds by attaching antibodies to the RBCs which marks them to be destroyed by the spleen. The spleen becomes enlarged by the increased number of RBCs it has to process, and the liver becomes overwhelmed trying to recycle the iron (bilirubin) taken from the destroyed RBCs. This is what causes jaundice. If left untreated, the RBCs would become so depleted that there would not be enough of them to carry an adequate oxygen supply throughout the body.
IMHA can be caused by drug reactions,
cancers, or blood parasites from tick bites, just to name a few. In
Dewey's case, tick-borne diseases and parasites were ruled out as causes.
Treatment of IMHA involves restoring RBC levels and stopping the immune system
from continuing to destroy them. Dewey's anemia is being treated with an
iron-rich supplement called Pet-Tinic. The blood transfusion that he received,
along with the Pet-Tinic, will help raise his red blood cell count. Prednisone
is currently being given to suppress his immune system which should help prevent
it from attacking his red blood cells. Prednisone can be harmful if used long
term. It can adversely affect liver and kidney function, and can cause the
adrenal glands to atrophy and stop producing hormones on their own. After Dewey
becomes more stable, he may be given a medication called Azathioprine to work in
conjunction with Prednisone, or even replace it entirely. Treatment with these
medications varies patient to patient. If Prednisone doesn't give the desired
effect, Azathioprine may. The goal is to suppress Dewey's immune system just
enough to stop it from destroying his red blood cells without the undesired side
effects of vomiting, diarrhea, infections, and liver toxicity.
Because these immuno-suppressive drugs can have potentially dangerous side effects, their dosages will be tapered down to the lowest possible effective dose for long term use. Although using these drugs for extended periods of time can shorten a pet's lifespan, in Dewey's case they are actually extending his life. Without immuno-suppressive therapy, it is unlikely he would live for longer than a few weeks. Most patients are on these medications for six to eight months after recovering and then weaned off of them. Some will need this therapy for the rest of their lives. Regardless, most will have a good quality of life.
This is great news for Dewey and his family. There is always a risk of relapse, so he will need frequent blood testing to keep a close eye on his disease status and ensure that the medications aren't harming his liver and kidneys. His long-term prognosis is still guarded, as it would be with any autoimmune disease, but he has a good quality of life. He is already feeling much better and should be providing his family with plenty of love and entertainment for quite some time to come.
--Written by Jennifer Liggett (Client Advocate)
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