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To answer the request of many of you pet owners, below is the copy of the post on my FB page. The aim is to inform as many blessed IS owners, and raise the awareness of these immune system diseases currently popping up in the UK and help you to protect your fur babies.
This is a long story but after hearing that there are quite a lot of auto immune system diseases popping up in the UK right now, I choose to share a journal detailing Mac’s AIHA journey so far, hoping it could help another pet owner to save their beloved fur babies.
Indeed, Irish Setters (with 9 other breeds) are genetically predisposed to primary AIHA (primary in this case means no known cause).
Unfortunately, AIHA as well as all other types of auto immune diseases take time to be identified, and in case of anaemia, time we do not have.
Back to the 1 of May, my birthday boy was celebrating his 4th birthday, and his best present of course was to go out with his dad for a 2 to 3 hours run on the beach and dunes. Mac is a boy with incredible stamina, full of energy, happiness and fun. For Mac, life is just wonderful, always in good health and does not know the face of his vet as he never had anything wrong in 4 years. As one of the consultant vets told me later on; Mac is a very strong boy.
Then suddenly Mac stopped eating. The first day I just acknowledged it, although he was not eating his meal he never said no to a treat. However, when the fast was continuing the next day, I started to be concerned and was closely watching my dog. Beside not eating, he was still the same bouncing around boy, but when day 3 of fasting started, as expected his energy started to decline. I got into worry mode and decided to go to the vet first thing on that morning of the 3rd fasting day.
Tuesday 5 of May. Strangely enough, that very morning, I was with my telephone in hand and ready to dial the vet number when my phone rang. It was Dorothy Park. Never ever Dorothy phoned me on the morning, but she wanted to involve us in a Setters rescue fundraising car boot sale and was running short of time in her call’s list. I informed her I was on the point to phone the vet about Mac, and explained all the symptoms. The symptoms were mainly a lack of appetite, starting his 3rd days without eating and being a bit lethargic, which is never to be seen with Mac. “Right” Dorothy said, let me phone to make the appointment – Dorothy is well known and the vet knows that it is not a panicking pet owner phoning but someone with over 35 years of experience in breeding setters. Hardly 5mn later, she told me the time of the appointment and that she will meet me there.
After examination, the vet thought that Mac’s belly was a bit sensitive and that he was probably having crystals in the bladder, so urine sample was sent to the lab. Most dogs refuse to eat when they are in pain, injections of antibiotics and anti-inflammatory, then back home. But that day Mac was getting more and more lethargic, I could see the difference almost by hours.
Wednesday 6 of May. That morning Mac didn’t want to get out of bed (my bed) to do his business. I gently lead him out, and luckily he peed against a white wall and just beside me …. I could see that the urine was colour of the rust, reddish brown and very dark. I look at his eyes and the white part was yellow and so was his gum. I was convinced my boy was suffering from poisoning (ticks, lepto, etc.)
When I took him back home, the poor mite was standing in the middle of the lane, not moving, not responding to me, I had to lead him inside. I rushed to the phone, took an emergency vet appointment and phoned Dorothy who said she will meet me there again. Mac was lowering his head very low and hardly had the energy to jump in and out of the car. A different vet was working that day and she took a blood sample, sent it to London, informing us that we will have the results first thing next morning, but this time she kept Mac at the clinic to monitor the evolution and put him on the drip as he was seriously dehydrated.
Thursday 7 of May. The results of the blood analysis were arriving one by one and by lunch time that day, the vet phoned me to say that they need to do a blood transfusion straight away as the lab results are showing that Mac was very anaemic. However, his liver and kidneys were perfect.
Things were getting seriously wrong, from having crystals in his bladder to being anaemic in one day, this was a bit hard to understand. That evening, the vet told me that she is still investigating what could be the cause and sending more blood to London to confirm her diagnosis. More results expected on the morning of the next day.
Friday 8 of May. That morning when I phoned, again a different vet was working that day and to resume our conversation, she said that Mac was so very critically ill, that I should come to discuss with her the way to say goodbye and nicely let him go!!!!
I froze and couldn’t trust my ears, so I said: are you telling me that my boy is dying? She confirmed I understood properly, adding that the blood’s results are showing an auto immune system disease and he was far too anaemic to survive. How come a bouncing boy could die from anaemia within 3 days???
Nothing was making sense, David was away for a week, I desperately needed someone to tell me that I did not hear properly. I phoned Dorothy Park and let the message on her answering machine – Mac is dying!
Five minutes later Dorothy phoned me back to know more, I was so devastated that I am still not sure what I told her, so she phoned the vet and 10mn later Dorothy phoned me back saying – right Chantal, get ready, I am coming to pick you up and we are taking Mac to Earlswood veterinary referrals hospital in Belfast, I am taking my young boy Charlie to give Mac more blood.
Today I can definitely say that this very decision of Dorothy Park and her active participation have saved the life of my boy!!!! If it wasn’t for Dorothy Park, my boy would have crossed the bridge by now.
She knew where to go and what to do in an emergency crisis. That day, I realise how very important it is to have the support of a breeder. Breeders – good ones of course, have seen and dealt so many times with so many problems, they know their breed and are the most precious ally a pet owner could have. Do not worry if your breeder lives far away from you, Mac is a Thendara boy, the son of Jingles and brother of Jagger, Dee & Jeremy are based in England but Mac lives with us in Northern Ireland, so not really possible to help me physically. Any good breeders will always help you, so I would strongly advice all pet owners to contact their closest breeder and start a good relationship with them. Luckily for us Dorothy Park is a local breeder, she knows very well the breed and the line, and very important, she lives only 15 mn away from us.
Mac arrived at the hospital around lunch time Friday 8 of May (day 3), extremely anaemic, put straight away in the intensive care section and declared by the Belfast consultant Ian Millar as very critically ill, but by this time the type of auto immune system disease was finally fully identified …. AIHA - Auto Immune Haemolytic Anaemia , one of the most critical auto immune system disease, and for Mac it was paired with a serious jaundice.
“AIHA is a disease in which an animal’s immune system destroys its own red blood cells. Antibodies produced by the immune system to fight pathogens instead target the body’s red blood cells and destroy them. Red blood cells are necessary to carry oxygen to the tissues of the body, and animals cannot survive without adequate oxygenation of all of the body’s tissues.”
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The adequate oxygenation is measured with a test called PCV. The PCV or “Packed Cell Volume” is calculated in % and ranges from 45 to 55% in large dogs like Irish Setters. It takes a full year for a puppy to build its immune system to that level.
For a young Irish setter male, 50% is a good average. Mac was so anaemic his PCV (red blood cells count) was 7%. To give you an idea, at 6% for a large dog like the IS, the lack of oxygen which is carried to all the organs by red cells, make the blood thick and clots are forming everywhere and consequently the animal die very quickly. To avoid the risk of clots, Mac was given aspirin and the first week his stomach had a very hard time, no food and plenty of medications ….
Mac’s case was so critical, he couldn’t have survived the day without another blood transfusion.
Thanks to brave young Charlie (Redclyst Jean Valjean Lestannons) from Dorothy Park, turning into a dog blood donor, it gave Mac one more day of life, a bit more time allowing the strong auto immune suppressor medication to start its work and preventing the red cells to be destroyed systematically. After the blood transfusion, that evening, Mac’s PCV (Packed Cell Volume) went up from 7 to 10%.
The consultant wasn’t happy with this result, so a medicine specialist consultant was called and they change Mac’s medication. Mac was then on a massive dose of corticosteroids to suppress the immune system faster, hoping that his immune system would stop soon killing its own red cells.
That Friday afternoon, when we left Mac at the hospital, we drove home with a rather sleepy Charlie boy – blood dog donors are lightly sedated to keep them quiet during the process. But as soon as she was home, busy bee Dorothy Park was contacting local Setters owners to find more blood to buy more time for Mac. Fortunately Mac was rhesus positive and could take any blood. The response was amazing; everyone was ready to drive even up to 2 hours one way just to give blood to Mac. I never realised I was surrounded by such a wonderful Setters community. I am extremely humble and grateful for all the support and help Mac received.
Saturday 9 May – The medication was not yet working and Mac’s PCV dropped down to 8% during the night. Early morning the hospital phoned directly to the owner of one of Mac’s blood donors. This time it was Liz Boal (Mac’s groomer and handler) who has 1 girl - Madison (Sabrejil She Who Dares), the same age as Mac. It is important that the dog donor is young and not on any medication. Madison is so much like Mac, as bouncy and full of energy as normal Mac.
When Liz and I arrived at the hospital, my boy was lying flat on his side, eyes open but not moving, not responding to his name, nor to my touch, totally lifeless. An horrible and nightmarish image which, I am afraid, will stick in my mind for ever.
We left super energetic Madison with the staff and went for a coffee. We were called back 20mn after instead of 2 hours like for Charlie. I froze again, something is wrong, Liz was ready to drive back home and take another of her girls. We went directly to Madison and Mac and to my total amazement, this “She Who Dares” girl was done in no time and came out of the vet room bouncing and jumping. I needed to see that as a good omen, that Madison must have given some of her punch and dynamism to Mac. The taking of the blood from Madison lasted less than 20 minutes, and the transfusion to Mac was done in 3 hours. Mac’s PCV went up to 14% that evening.
Although Dorothy Park found plenty of dog blood donors, the vet informed me that he wants to stop giving Mac more transfusion. Mac had 3 transfusions already, surely it gave Mac new good red cells to carry oxygen everywhere on his body but at the same time it was also stimulating his white cells to kill more red cells …. The transfusions were given to Mac to buy time until the medication kicked in, but not as a solution and for the vets it is a very delicate balance to manage.
To make things more difficult, Mac was far too weak to drink or eat, so, on drips and fed by tube directly in his stomach. In addition to the weakness, unfortunately nothing could stimulate his appetite.
Sunday 10 May – Mac’s PCV dropped down from 14 to 12, then 10 and stabilised at 8%. At that point, the only hope was that the medication started to do its job. I beg the vet to give him a fourth blood transfusion, although he was very reluctant knowing that it wasn’t a solution, he agreed to do it as the last resort if it came to it. For the time being, Mac was in the intensive care room supervised 24 hours a day by specialised nurses and the medicine has to start working.
Sunday evening, suddenly there were little signs that the medication started to work!!!!! The signs were so subtle that it took 2 days and many tests to be absolutely sure. Mac’s PCV was still very low, oscillating between 12 and 8%, but at least not going lower. New worry though, the ultrasound were showing that his kidneys were enlarged but this was explained from the harsh medication and returned to the normal size before he was given the permission to leave the hospital.
From that day on, I was hanging after all minute signs, like drinking again, his first piece of chicken fed by hand after being fed with a tube for days, lying down with his head on his front paws instead of only lying flat on his side, lifting his head, being able to stand up (shakily) for 1 or 2mn, walking 3 meters out of his crate, his first mini meal by himself, getting out to do his business, getting out at least 5mn to take the fresh air as the nurse said, etc. every little signs was raising my hope but the boy was still on the intensive care room and classified as very critically ill.
Then the miracle happened, suddenly Mac’s PCV went to 15, then 18 and one day to even 22%. Nevertheless, we spend 14 very long days anxiously waiting the glorious moment when the vet told us – Mac is out of the critically ill zone!!!!!! Meaning SAVED
14 long days and 14 long nights since the local vet called me to say goodbye to my boy and the consultant team of Belfast hospital declared Mac out of the critically ill zone ….. It seemed like centuries! David and I were smiling to everything; the clouds, walls, etc. and of course so many tears of joy running along our faces!!! We knew that even though, anything could happen, Mac having no immune system working to protect himself - we also knew what will happen soon …… the boy will come back home!!!!
Saturday 23rd of May, Mac was transferred from the Intensive care unit to a new room with a much bigger crate. At that point they have reduced the frequency of the PCV, his blood cells count was done only once a day.
Tuesday 26 of May, Mac had a battery of tests and everything came back even better than expected. His PCV was at 35%, liver and kidneys ok, he had lost some weight of course, now at 28kg, but has gained a monstrous appetite and thirst now, due to the steroids. He needs to go out every 2 hours, days and nights, as well as being fed every 4 hours, etc. The good news is that they had already reduced twice his corticosteroids, so the boy was ready to go back home, and home he went on the afternoon of Wednesday the 27 of May!!!. He was away from the 6th, 2 days in Coleraine clinic and 20 days in Belfast hospital!!!
We were informed that the next 6 months/1 year will be quite intensive in care, Mac cells count will still be done once a week, that he will have once a month a big check up at the hospital, but the boy is alive and with us, so life is wonderful again. The local vet team call him Mister Miracle.
A bit of info about this AIHA, what is this horrible disease?
As said, Mac has AIHA (Auto Immune Haemolytic Anaemia). The anaemia makes it the worse of all the auto immune system disorders. This disorder can be classified as primary or secondary. Primary means no known cause, or idiopathic (that is with no known trigger/cause). Secondary means there is an underlying cause.
There is NO CURE, it is a life time condition and both, primary and secondary form can and most probably would come back again.
AIHA - Auto immune haemolytic anaemia can be either a primary or secondary disease. If it’s a primary disease or idiopathic, there is no underlying cause that can be identified. In secondary AIHA, the immune system produces red blood cell antibodies in response to an underlying condition such as cancer, chronic inflammatory disease, a drug reaction, or exposure to an infectious agent. Newborns can acquire this disease from their mother’s first milk, which is colostrum, although this is pretty rare.
The surface of the red blood cells becomes altered by an underlying disease process or a toxin. These alterations catch the attention of the immune system, which sees them as foreign invaders or pathogens. The immune system targets the altered red blood cells and destroys them through a process known as haemolysis, either within the red blood cell vessels or as they circulate through the spleen or liver.
Some of the known underlying triggers for secondary autoimmune haemolytic anaemia are infectious agents like leptospirosis, babesia, ehrlichia, and the feline leukemia virus. Also heartworm disease, IBD, certain drugs like the sulfa drugs, heparin, and quinidine, hypersensitivity reactions (for example, to bee stings), and vaccines can all over-stimulate the immune system and cause AIHA.
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In the case of Mac, we simply don’t know what has triggered the disease, which is seriously annoying as the probability for AIHA to come back is very high.
What about contacts with other dogs?
We have two IS, Mac and Darwin who is 10.5 years old and has a very fragile liver. So I asked no less than 4 vets and consultants if I should have a full blood test done for Darwin before Mac is coming back home. The answer was very clear – NO – the AIHA is an individual internal disease, like thyroid or heart problems, it cannot be passed to other dogs or humans. It is a genetic condition. However, the dog affected should avoid contact with other dogs at the beginning since part of the initial treatment is the suppression of its own immune system. The AIHA dog should be protected from anything carried from humans and dogs.
As usual, one cannot avoid thinking, could it be hereditary. However, all the consultants and vets I have asked were very strong at disregarding this option. It is not hereditary but purely genetic and individual. For AIHA, unfortunately Irish Setters and some other breeds mentioned below are simply genetically predisposed.
Breeds predisposed to primary immunodeficiency disorders include basset hounds, Cardigan Welsh corgis, Jack Russell terriers, Beagles, German shepherds, Chinese shar-pei, Doberman pinschers, dwarfed Weimaraners, gray collies, and Irish setters.
However, there is an increase of evidences linking vaccines to AIHA – which I could accept, but it was absolutely not the case for Mac as he had no booster since 3 years. http://www.labbies.com/aiha.htm
Below are some links you may wish to read, but please do not believe all what is written on internet, check with several vets and go for scientific evidences.
I will end this post by thanking so very much Dorothy Park and her Charlie boy, Liz Boal and hyper Madison She who Dares, and of course all the wonderful super vets and their team from Earlswood in Belfast, without whom Mac would have not been here today.
During this period, I was like a zombie and couldn’t speak to anyone. My mind was in complete deny and I wanted everyone to think of Mac only as the bouncy happy boy he always was. I couldn’t utter any words such as sick, very ill, and even less “dying” although it was part of the reality. I wanted to think of Mac only alive and happily bouncing around as I am a believer in positivism and that our thoughts create our reality. Well nuts I am anyway, but new quantum physics studies support this idea, although I haven’t a clue about Quantum physics, this is the domain of David.
However, behind the scene, without me knowing it really, there were a net of wonderful friends, informed by Dorothy & Liz, and today I would like to thank them so very much for all the support, willingness to give your dogs’ blood, sending prayers and positive thoughts, crossing all your fingers, etc.
A special thank you to Mary and her prayers to St Francis of Assisi, and to Brian who had a good word with St-Anthony and consequently knew the very first day that my boy will be alright
I send you all the energy of my love and my deepest gratitude.