Family, Fur, Feathers, Fluff and Fuzz, Pets, Where the Heart Is

My Absence and the Beast They Call IMHA

My last post, March 7, 2019… before life got more complicated than we thought it already was in the midst of building a house while living with my parents. In addition, work was progressively getting busier as more people discovered that there was a pediatric walk-in clinic in town, yet I still managed to scrape together some blog posts from time to time.

When Eliott and I decided to take one last trip, one last vacation, before we had full on farm responsibilities, we knew it would be a while before we were able to take week long trips again…if ever. What we didn’t expect was that it would be our last solo outing in general without significant time constraints for the foreseeable future.

While on vacation, my mom informed us that Mac our mini schnauzer had been acting like his back was bothering him and that she had taken him to our vet where he had been prescribed some pain medication after all his labs and X-rays returned normal. No big deal, this was something that had occurred from time to time in the last few years when he landed funny jumping off the bed or couch; at 11 and a half he was not a young pup anymore.

The Calm Before the Storm

A week after we returned home in the beginning of June 2019, we had a fairly normal morning. Eliott had taken care of the chickens, dogs, and horse while I went to work my 5-hour shift at the walk-in clinic. During all that Mac had been running around the yard, barking at the chickens and generally enjoying himself that morning. When I returned from work that was not the case. Mac, who usually met me at the door whooping and hollering that I’d left him ALL. DAY. LONG. was sleeping on the couch when I walked in. Except he wasn’t, I quickly noticed his eyes were open with not a peep or movement to announce my arrival. I quickly called around and got him in with a vet, but my worry deepened when I changed and I put my shoes on in front of him (a sign that signaled “outside” and joy for him), still with no response.

After getting him off the couch, Mac still didn’t want to even lift his head.

At the vet they discovered that he was anemic (nothing life threatening at this time but his levels were low), he had high blood sugar and an enlarged spleen with a possible mass in his abdomen. They had us start insulin and recommended following up the next day with an Ultrasound at an animal hospital in the nearest city. We made the appointment and took our baby home.

Holding him at home after the 1st Vet Appt.

That night Mac continued to get worse, unable to walk steadily or support himself while he urinated and he was seemingly disoriented. Between 2 and 3 am we took him into the Emergency vet where they gave him a short acting insulin to lower his blood sugar (which had spiked) and IV fluids. After returning home, we slept with Mac’s bed between us on our bed for 5 hours as he continued to worsen again. I was unsure if we were even going to make it to our appointment later that morning before we lost him as I prayed and cried and prayed some more, and probably didn’t actually sleep a wink as I repeatedly checked his breathing through the wee hours and on our drive into the city at 9am.

Mac sleeping between us on his bed and a soft bath mat
On our way to the vet in the city for the ultrasound

There the vet diagnosed him with IMHA (Immune Mediated Hemolytic Anemia) and pancreatitis, in addition to the other issues the prior vet had found, but thankfully no mass. For anyone reading this that isn’t medical, IMHA basically means that his immune system was recognizing his own red blood cells as a foreign invader therefore attacking and killing them off. There are several things that have been known to cause IMHA but we will never know what caused Mac’s because several of these things had been introduced to him in the last 2 months. These include: vaccinations within the last 2 months (he’d had his at the end of April), chemicals (my parents had put a Seresto collar on him while we were gone), and tick-borne illness (he returned positive for this as well when the vet checked him).

By this time Mac was starting to have a hard time breathing. The vet told us that it was a 50/50 chance that he’d make it, but that he was convinced it would be worth the try and that if he made it past 48 hours the odds were more in our favor. The treatment was an oxygen cage, a blood transfusion, immune suppressant medication, steroids and IV fluids. In my medical mind, Mac was suffering and I knew that all those things they were going to try would ease that pain and suffering even if they didn’t work. So, with Nationwide Pet Insurance at our side, we decided to give it a go. It was one of the longest 48 hours in my life up until that point. But we made it. What we didn’t know is that we were far from being home free.

Mac in His Oxygen Cage

Over the next several months we had to make a lot of changes to our household. It was the best of times in that we were able to move into our own newly constructed home, but we were working on this home ourselves as we constantly cared for our newly diabetic and recovering IMHA dog. He was unable to be left at home for more than an hour or two as his high blood sugar induced frequent urination. He was also on steroids which kept his blood sugar elevated. Mac also had to have regularly scheduled low fat meals 12 hours apart with injections of insulin in addition to his daily steroid, immune suppressant medication and blood sugar checks.

Mac’s Weekly Care Sheet

We went along in this manner positive and hopeful as we slowly saw improvement in our boy from June through the end of September when we began to notice that Mac could not see as well at night anymore. He was finding the door to the basement instead of to our bedroom after late night trips outside and running into things outside while he was out in the dark. The blindness progressed rapidly. In a matter of two weeks he was running into things in the house in the daytime. He could no longer follow us from room to room as he desired, and would sit in the middle of the living room barking for us until we came to get him. Mac was sad and depressed, sleeping most of the day and night except when he needed to go outside and generally just not enjoying his life anymore unless he was being snuggled by us; we just couldn’t stand to see him like that.

The Beginning of Vision Loss

At our next scheduled follow up, we discussed the new events with our specialist who diagnosed Mac with diabetic cataracts and recommended a trip to the state university’s veterinary hospital for a consultation with a small animal eye doctor. She felt that if they could remove the cataracts, Mac’s quality of life would improve tremendously and our boy would be happy again.

However, once at the eye doctor, they informed us they wanted us to be followed by their own internal medicine vets in order to get Mac’s blood sugar more regulated prior to attempting any type of surgery. We worked with them for a few months in the hopes that we would be able to work toward vision for Mac.

Sleeping at our first eye doctor appt

Those few months were hard. Though we had changed his medication regimen and started making him prescribed homemade and low-fat meals, Mac continued to progressively worsen. He lost more and more weight, though we increased his feeding amounts weekly to try to bridge the gap. The depression continued to worsen and I had purchased a wearable dog carrier to keep him with me while I was doing chores and housework to keep his stress and anxiety down as he would constantly bark for me if I wasn’t beside him. Then he started getting other acute illnesses. Emphysematous cystitis, another round of pancreatitis, UTIs, diarrhea from unknown cause which progressed into bloody diarrhea and acute hypovolemic shock requiring another hospitalization for Mac.

Mac in his wearable carrier

Mac almost died for the second time in 7 months on our way to the university vet with that last one. It was then that we asked the internalist the hard question for what seemed like the millionth time, but this time we were more specific. “We are worried about his quality of life progressively worsening. At this time do you even see a possibility of getting to the point where we can have his cataracts removed because that is why we agreed to put him through this in the first place.” The internalist responded that he was unsure. That night, we made a difficult promise to ourselves and to him. Mac was sad, Mac was not getting better, and with each illness he recovered less and less to his former self.

Home after his hospitalization from hypovolemic shock
We promised that we wouldn’t let him continue like this. We promised that if he got ill again, we would let him be at peace. It was the hardest decision I’d ever made in my entire life. We were so hopeful when he was almost like a new dog after his hospitalization, but when the antibiotics ran out, he returned to how he’d been right before this last illness, if not worse.

Two weeks after his hospitalization, he began to have diarrhea again. Being late at night we knew there wasn’t anywhere to take him but the Emergency vet, where they could at least help us make him more comfortable. He received IV fluids and some antibiotics, which did the trick for comfort level, and the next morning I made a phone call to one of my high school friends who’d become a vet and recently moved back home to practice. We had decided that we wanted him to be at home surrounded by us and comfortable when we let him go and my friend was willing to make a house call for us. My friend also agreed that it was probably time to let him rest and that since he did well while he was on antibiotics, we could spend the next few days loving on him and making his last few days with us the best we could.

Unless he got too hot, Mac slept with us at night.

Those last days we did nothing but cuddle, love, dote on him, and give him his favorite foods and treats. When it was time for him to go he was so tired and ready that he remained relaxed through the entire process, not even flinching for the injections. He went peacefully, falling asleep in my arms.

I let go of my first baby on January 27, 2020 at approximately 5:30pm. It was without a doubt the hardest thing I’ve ever had to do thus far in my life. I have cried more tears since June 11, 2019, than I think I’ve ever cried before, maybe even cumulatively up to that point. In fact, I’m weeping as I write and edit this almost exactly 12 months later. Most people who don’t have animals won’t understand, some even with animals may not. I lost a piece of me that day.

The point of my sharing this with you all is:

1. Maybe other people out there who are going through this know they aren’t alone
2. It is a rare illness from what I gather, and perhaps I can make you aware of the signs and symptoms so that maybe you can ask “Could it be IMHA” before it progresses to the point it did for us.
3. It is apparently even rarer for a dog to develop diabetes concurrently with IMHA, which makes the entire treatment process more complicated and more difficult to recover from. So, I share so that you may be better able to make quality of life decision for your dog earlier on in the process if you know the possible outcome.
4. Life has been complicated and sad the last several months. It happens, that’s what life on this world is. Though I may not have been posting, life was still happening here. The house was still getting worked on, the farm animals were still being cared for and learning was happening.
5. Though I missed blogging, taking care of Mac and loving him was our top priority. I wouldn’t trade any of the time we spent loving him, caring for him or snuggling with him for the most successful blog in the entire world. Don’t take your furbabies and other loved ones for granted ya’ll. Their time with us on this earth is FAR too short.

In Loving Memory of my Soulmate Dog

Mac Johnson

October 2007 – January 27, 2020

Mac as a Puppy
He ALWAYS looked at me like this ❤️
My Cuddle Bug
My Handsome Boy

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