IMHA...

It would have been okay with me

 if we never had to know what these letters stood for...

After several very stressful days, Sheena's symptoms have been officially diagnosed. The Internal Medicine  vet we were referred to has narrowed it down to IMHA or Immune-Mediated Hemocytic Anemia. We were told some pretty scary possibilities on Friday afternoon...tumor, cancer, internal injury, hematoma, internal bleeding, exploratory surgery etc...While all these things were being tossed around, our puppy was getting weaker, more anemic and possibly losing her blood somewhere. I have a lot of issues about how things were handled last Friday when we took her to the local vet clinic we had chosen when she had her ear infection in January. Things could have been handled better, but I am grateful that he sent her across the street that evening to stay overnight at the Urgent Care Animal Hospital.  Though no one seemed to be able to read an xray...they did get her stabilized and began talking "untrasound" versus opening her up for exploratory surgery! They also referred us to a specialist who seemed to be able to diagnose Sheena rather quickly once she had the information! I cannot believe it took us three days to get to that point, but at least we did. I can only hope it has something to do with Sheena's will to live and perhaps her Mommy and Daddy (especially Daddy!) being very observant, knowing our girl and recognizing that something was not quite right. Thank goodness Sheena has always been a good eater, and when she skipped a meal it alarmed us enough to call the vet and take her in. 

The girls on Saturday morning after we brought Sheena home from the Doggy Hospital.

 On Sunday afternoon.

Side by side.

Sisters.

Best Buddies.

(Mommy loves this picture!)

 A kiss on Sheena's ear.

We have been stressing

"gently" and  "slowly"

more than ever.

 Playing...

On Monday we took her in for the ultrasound. Lots of blood was taken, lots of questions were asked. The ultrasound had good results! No tumor, no mass of any kind and Dr. N. said she really did not feel there was evidence that she had been bleeding internally. With the red blood cell count still about half it should be and not replenishing itself as it is supposed to, she started talking about "autoimmune disease" and "infectious diseases". It seemed as though Sheena's body had had some reason for her immune system to kick in and begin killing off something...virus?, infection?...not sure but it apparently began attacking its own red blood cells in the process. While it was good to finally have a diagnosis, even a suspected one on Monday which was confirmed on Tuesday, it was still alarming. It is a potentially fatal disease. Common, but often fatal...especially if you read the information online like I did Monday night! I was a mess. I did not sleep. I talked to the doctor at length about it on Tuesday morning...have I mentioned how wonderful she is?...and she alleviated a lot of my worst fears. Yes, it IS potentially fatal, but it is a highly individualized disease. The dogs (or other animals) get such different levels or degrees of it and the treatment and survival rates vary greatly.

Here is our Little Valentine on Monday before leaving for the ultrasound. We have not officially celebrated Valentine's Day yet, but I did put her little heart dress on her. We went to Applebee's for lunch while Sheena was being tested. Rachel got her very own little "shot glass" dessert as I call them. It has been such a difficult week  and she has done pretty well considering. She's had a few moments where I figured the stress was getting to her too, but she is hanging in there. I think she has been a little jealous with all the extra attention

Sheena has been getting, but then her compassionate, nurturing little self comes through and she is right there taking care of her too. She has been telling everyone lately that, "Rachel's doggy's name is Shee-Shee!"

 Being gentle...

 Our precious girls...

 Hug!

Yes, Mommy had tears in her eyes while taking these pics.

This was right before we left for the ultrasound appointment.

So...as of today...Sheena's illness has a name! Her red blood cell count is holding steady. We are taking her in every 24 hours for a PCV test. That is a Packed Cell Volume count to check her red blood cell levels. They should be between 40 and 50 and hers are still in the low to mid 20's. They did a chest xray to check for fluid around the heart to rule that out. They have sent for a bunch of infectious disease tests to be run, and they aspirated her liver to make sure all was okay there. (it is!) Dr. N. started treatment yesterday right after the liver aspiration. Sheena is on several meds...prednisone to suppress the immune system to allow her body to replenish the red blood cells, doxycycline (antibiotic for any infection), low dose aspirin to help with any potential blood clots, and pepcid AC for her tummy because of all the other meds! Poor thing. She seems to be doing okay so far though. She is eating again...kind of loving the special rice/chicken/chicken broth meals Mommy is making especially for her! Plus the prednisone will cause an increase in appetite. We no longer see the alarming colors in her urine and the other. Yay! She is still tired (anemia) but we have seen signs of the Sheena we know and love here and there since yesterday. Very encouraging! We are watching her closely for the signs of the anemia worsening. So far, so good! If it does, a blood transfusion may be needed.

So the plan is to continue meds, monitor the PCV levels and when they get to a certain percent then start weaning her off of the prednisone while making sure her body continues to make and not destroy the red blood cells. This can be a long road and just depends on her response. It truly helps with treatment if they can find out the underlying cause, so they are still trying to do that. Please keep her in your thoughts and prayers and we'll just keep hoping for the best!