How to help pet with IMHA
January 28, 2010 3:37 PM   Subscribe

My cat has Immune Mediated Hemolytic Anemia. YANAV, but please tell me your experiences with a pet diagnosed with IMHA.

I understand that IMHA is more common in dogs than in cats. I also get the general idea of what the disease is doing to my Stinky. Please let me know how or if you got your pet through IMHA (I understand that the survival / recovery rates are not in my favor). Stinky is a 4-year-old domestic short hair. She was diagnosed with IMHA after emergency services for heart failure back in December. She's had one blood transfusion since then and is great afterwards. She's on 15 mg of prednisolone and 25 mg of cyclosporine per day. I missed two doses of cyclosporine last week (I feel terrible...I know this relapse is my fault) and she spat out her cyclosporine yesterday, which I found today while cleaning.

Her relapse consists of two days of lethargy, pale gums, lack of appetite and general moping. Please tell me if, from your experience, this is it; if I need to seriously consider putting her down or finding a new trust-fund owner. I know I need to take her to the vet, but please expand your answer beyond that because I don't have $1500 for the hospital / doctor / transfusion fees this time.
posted by motsque to Pets & Animals (3 answers total) 1 user marked this as a favorite
I work in emergency small animal medicine as a technician for 20+ years. Am not a vet.
This is a bad disease and we don't know what the heck starts it up or keeps it up. As you noted, this may not come out to be in Stinky's favor. Sometimes it seems resolved after the initial episode, sometimes it keeps coming back. I know it costs alot to treat with no guarantees. She is pretty young to be whomped by such a bad problem, sometimes we suspect there is something else compromising the immune system ...(?)
Don't blame yourself for missing the medicine, of course it may actually been a factor but also may not have (she might have done this anyway). Just don't beat yourself up over it, is all, because I'd bet my house that the missed medicine didn't CAUSE the relapse (although now you will never know, sorry).
Ask the Doc how to handle it with no money. Take up the meds again? Just see what they say. There may be a clinic in the area that can/will help on payments or (?). You may want to try to apply for Care Credit, if your clinic takes it.
Once her PCV gets below 12% there is alot of trouble with breathing. I think that must be pretty darn hard for most of us mammals, it makes most of us panicky and can seem to snowball (get worse and worse, like a snowball getting bigger going downhill ... ) that is probably when I would consider euthanasia. As long as she is still eating/drinking/peeing/pooping you have reason to hope, even with a super low PCV. But the misery of not being able to oxygenate herself will be pretty overwhelming at a certain level and I would not put her through much of that.
I have seen a few thousand miracles in my years in the business, so give her the best chance you can, and then do her the favor of euthanasia if it should be done. And don't forget to forgive yourself.
Good luck.
posted by bebrave! at 7:22 PM on January 28, 2010

Contact Meisha's Hope
Joanne knows a lot about going through this with dogs -- she is sort of a lay authority and support group all in one. I bet she might know something about IMHA in cats (or know someone who does).
Full disclosure: I work for a charity affiliated with Meisha's Hope.
posted by fieldtrip at 9:19 PM on January 28, 2010

Response by poster: Thank you both. I went to my regular vet (rather than the $1500 hospital) for a transfusion and it turns out her liver / kidney is failing (again). It might be from an infection, which would be an ok-prognosis, or from the steroids, which would be a really bad prognosis.

I've never had to make a euthanasia decision before. Thanks to you both for your suggestions.
posted by motsque at 1:53 PM on January 29, 2010

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