My dog was treated at Tufts just over a year ago for Immune Mediated Hemolytic Anemia. His RBC was down to 13 and he rallied back. After the transfusion he was at 22 and at discharge (3 days after being admitted) he was at 25. He did dip back down to 21 that first week, but steadily climbed after that. He was treated with prednisone and azathioprine with great results. Though cyclosporine is commonly used to treat cases of IMHA, it was my understanding given discussions with the doctors at Tufts that at Tufts they prefer to treat with azathioprine (unless other health factors preclude doing so) due to results they have had with it.
We were seeing some not-so-nice side effects from the prednisone and weaned off that a bit earlier than the usual protocol called for. Even though he was eating, he was wasting away and had lost over 10 pounds. Interestingly enough, he had been holding steady around the 38-39 mark for a long while, but when we discontinued the pred, he rose to 42 immediately. I felt sooo much better once he got into the 40's. He started gaining the weight back right away as well.
Right from the beginning I asked my vet if there were any dietary changes I could make to help, and I got no real answer. I sort of expected as much, but was hoping for something. I needed to be actively doing something, not just sitting around waiting between blood draws. I chose to add a Vit C supplement to his diet and also added cooked liver to his meals. Liver is a good source or iron and the vit C aids in the absorption of iron. My vet agreed that it wouldn't do any harm, but she doubted whether it would do any good either. My feeling was that if his body was destroying his RBCs then the least I could do was feed him things that would help him make new ones. I don't know if I was just grasping at straws, but it made me feel like I was doing all I could. I think my guy liked the fact that he was getting liver atop his meals while his sister just got plain old kibble.
Just the other day I was remembering how for months I got up at 2am for potty breaks while he was on the prednisone so that he wouldn't have an accident in the night. I don't miss that at all. I still stick a white napkin under his pee stream once a week to look for biliruben, and I'm always checking the color of his gums. It is such a devasting condition, and I am always a bit worried it will rear its ugly head again. I am thankful every day that he is happy and healthy now.
I wish you the best, and hope Rudy shows improvement. Hang in there. This thing can be beaten, so don't get discouraged.
