IMHA - any advice / experiences please

[Champagneforeveryone]

DDog1 is currently in the vets and very poorly. Initially this was pancreatitis which has now become what is believed to be IMHA.

As a family we are very conflicted. Until this, DDog1 was healthy and happy albeit approaching 13. The pancreatitis has knocked him about and the vets long term outlook for recovery from the IMHA sounds quite bleak.

The vet is all for pushing forward with steroid treatment (which he has already started) but we are driving ourselves crazy over whether this is the right thing to do. We've been advised that he will need months of nursing / rehabilitation which in itself is not a problem, but we feel the chances of him regaining a decent quality of life are low after it all.

Any advice or experience would be greatly appreciated

We've been advised that he will need months of nursing / rehabilitation which in itself is not a problem, but we feel the chances of him regaining a decent quality of life are low after it all.

You know your dog better than anyone. There is also no right answer to situations like this but ultimately if I had to put my dog though a long regime of treatments and recovery for only a small chance of a decent quality of life I would choose to PTS.

I have lots of experience treating IMHA once you get the dose of immunosuppressive drugs right they do really well. Yes they take drugs for months, but they live pretty normal lives apart from occasional trip to the vets to check blood count.

So sorry you are going through this with your dog. I have been in a very similar position myself and it’s so hard to know what to do. (My dog didn’t have IMHA, he had IMT/ITP (Immune Mediated Thrombocytopenia) which is destruction of the platelets, rather than the red blood cells.)

I’d strongly recommend joining the IMHA Facebook support group. It is run by people who are very experienced in IMHA and have a lot of collective knowledge about the treatments and prognosis. Everyone on there is really supportive. I honestly don’t know how we would have got through it without them.

IMHA FB Support Group

Is your dog under an Internal Medicine Specialist? Some vets are experienced in dealing with IMHA and others seem to barely know what it is, so if yours is at all uncertain I would ask for a referral. Our boy was inpatient at a well known veterinary hospital under a leading specialist for the first week and we’re sure he wouldn’t have recovered if he had stayed at our vets - who are great - and thankfully admitted immediately that they didn’t have enough experience to help him and advised us to get him to the vet hospital immediately.

Our boy was 5 when he developed IMT/ITP and we lost him when he was 7, but after he came out of the hospital he had over 12 months of being happy and living a good life before he started to go downhill again. (Unfortunately, he had another condition that complicated things and meant he didn’t respond properly to the treatment.)

Ultimately decisions regarding care/treatment will be down to honest discussions with a vet you can trust and your own knowledge and feelings about your dog. Every case is different. IMHA is nasty, but not necessarily a death sentence, there are effective treatments and some dogs do very well and go on to make a full recovery, but you do need to have some honest conversations about the treatments/meds, side effects etc and realistic prognosis for your dog.

Do join the facebook group, they will be able to support you through the discussions and decisions and they really know their stuff, as well as having lived through it themselves, so are able to understand how you are feeling.

Thank you everyone, I really appreciate your help.

If it was one of our younger dogs then we would press ahead, it's DDog1's age that gives me most concern. He used to be a working gun dog and recent attempts to make him take smaller and more manageable walks (as advised by the vet) have been met with outright indignation. The idea of prolonged rest and recuperation is not a palatable one (though thanks to Covid, far more manageable - every cloud and all that ) particularly as it just seems unlikely he could ever regain anything like his current fitness, which he will find intolerable.

Added to this there's also the financial aspect. We routinely do not insure our older dogs as the premiums are so high and we have always said we would limit what we put them through as they got older. We have a small pot for him and also keep a credit card for vets bills that need paying before they can be claimed back, but we are already at £800 with no change on the horizon. I desperately don't want this to be a decision driven by money, but there will come a point where we have to say enough is enough.