Diagnosis and Treatment Plan -
August 4-31, 2008
At our August 4th appointment, Nancy had an immediate CBC at which time her PCV was down
to 29.7.
Nancy was immediately tested for ticks, cancer and had X-rays and an
ultrasound, as well as a needle biopsy on her huge spleen. Her tick tests and the coombs test
came back negative. She was started on 5mg Prednisolone and doxycycline while we waited for further
test results.
At this time, since her PCV was only 29.7 and I was not convinced that she had AIHA. On August 11th,
she was diagnosed with AIHA, the dreaded blood disease. I was devastated.
On August 7th, 11th, 13th and 16th, her PCV went down each time. Her ultrasound and needle biopsy
didn't show anything remarkable. Her appetite was even worse now and she was getting weaker
every day. She was in more danger every day. To me, she was much sicker than Pippy had been at
this stage. She was now on 10 mg Prednisolone, the doxycycline was discontinued. I bought Pet-Tinic which
she hated and was force feeding her a few bites a day.
On August 18, her PCV was down to 13, so it was decided to do a transfusion. The transfusion went well, Nancy
came home very hungry. Imuran was now added every other day (EOD). She ate well that night,
but about
4AM, she had massive black diarrhea. (August 19) She was very lethargic and I was convinced she was dying. We scheduled
euthanasia, but Dr J talked us out of that. Instead, Nancy saw Dr Drazner and the new diagnosis was drug-induced
pancreatitis! Same as Pippy! However, her PCV went up to 32!! Baytril and amphoral was added and she was NPO for
24 hours. She rapidly improved! She was GREAT for about a week, she ate well!
On August 23, her PCV dropped to 26 and we started to worry, but she was still doing well and eating!
On August 27, the PCV was at 19 and she seemed OK, ate with gusto till August 29.
On August 29, the vets thought she would do better with an increase of cyclosporine.
She was getting weaker and not eating much
Her cyclosporine was increased from 35Mg to 70Mg a day. She immediately lost all appetite
and on August 30, threw up once and didn't look well at all.
On Sunday, August 31, we thought she was going to die. She was completely anorexic,
refused all water, and was extremely weak, could hardly stand up. We called
again for her to be put to sleep. She was only given prednisone the entire day and
that evening she rallied again and started to eat some food!
She had a good night and in
the morning we talked to Dr. Junkas.
September 1st, Nancy was doing great without any meds. Dr Junkas felt
it was one of the meds making her very sick. Nancy
ate very well this entire day. At bedtime, we gave her the
Imuran and Baytril and by morning, she was competely
anorexic again!
On September 2nd, we had an appointment. Her PCV had dropped from 19 to 13
and we were not surprised. She was prescribed
Cerenia and only pepcid, prednisolone and 25 Mg Cyclosporine
for the remainder of the day, provided we could get her to
eat something. It was agreed that Nancy would have a 2nd transfusion on September 3rd.
She was so lethargic and nauseated, we were not able to get her to eat anything
this entire day. We gave her some water with a syringe.
We never got the chance to transfuse a second time. We reluctantly gave Nancy back to God at 11:45AM and ended
her suffering. It is possible that she had another attack of Pancreatitis at this time due to more
bloody diarrhea.
Rest In Peace Nancy
See Nancy's Memorial
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In late July, Nancy became really finicky about eating, at first we thought
it was her usual fussiness, but I noticed her gums were too light and I
called the vet for an appointment.