Chewie goes critical

Early Morning

The doctor called us this morning and Chewie's condition went critical.. her counts fell from 13% to 10% overnight and her breathing was very labored and heart rate elevated again. I don't know how much more of this rollercoaster ride Jolie and I can deal with.. I know it is worse for Chewie but the hope we were riding on yesterday has come crashing down.

Chewie needs another transfusion. The crappy part is that there isn't any blood left from the first donor (that supplied two transfusions worth of cells). This means the doctor has to perform a cross-match and try to find another donor that doesn't cause more agglutination than is presently going on inside her. Each time a new donor needs to be found, the risk during transfusion is high.

Jolie and I have started talking about how long we are going to prolong this cycle of transfuse, dip, transfuse, dip, etc. At what point is this a futile effort? At what point are we being selfish?

To help us answer these questions we needed to talk to the doctor about the effectiveness of immunosuppressive drugs and the results of the tests that were submitted on Friday.

Afternoon

After the transfusion, Chewie's HCT counts went to 15%. This is the highest they have been since before Friday. Nice! Back up the rollercoaster of hope for us... We are expecting a fall this time however, so hopefully we will be more prepared than yesterday.

We talked to the doctor about the efficacy of the drugs she was on. According to our doctor:

• 33% of dogs suppress within 72 hours
• 33% of dogs suppress from 72 hours - 1 week
• 33% of dogs do not suppress

We also got the results of all of the tests and they confirmed that she has primary Autoimmune Hemolitic Anemia. This means that there isn't some secondary infection causing this, and mainly that the Coombs test came back positive.

So here is where we are..

1. Chewie has primary IMHA (Auto-immune mediated anemia) or AIHA.
2. Her marrow is still producing new red blood cells (at a very high rate)
3. She has a 66% chance of suppressing within a week.

Since we have gone 72 hours, her odds of suppressing (and surviving) have dropped to 50/50. Jolie and I have made the call to stick with the program for the entire week.