Johnny&Tessy:Callie, Tessy doesn't get the milk thistle anymore because all her chem numbers are normal. Her doctor didn't think it was needed but I think I might put her back on it anyway. Like you were saying....it can't hurt anything.
Sounds to me like your vet really doesn't understand what milk thistle *does*. It is largely a PROTECTANT. Not just to detox the liver. It literally protects the liver, and to a lesser degree the kidneys, from the drugs. So keeping her on it is a good thing. I have an extra pound bag of it -- and I'm HAPPY to mail it to you if you want. It's just the bulk herb (no capsules) -- but mine don't object to the taste of it at all. Have you tried giving it to Tessy just in her food (literally dumping the caps?). There are about 2 oz of milk thistle in a bottle of milk thistle capsules (about $20 US) ... and I pay $12.75 for a whole POUND of it (16 oz) -- email me your address. I get it from http://www.leavesandroots.com -- but you can get your next pount there if it helps. I seriously can send it to you tomorrow!
That doesn't mean I'm saying your vet is dumb -- please understand that. Often vets may know of "Marin" (which is the milk thistle super processed into a pharmaceutical) -- and it is PRICEY. So the vet likely is apt to say "we don't need it" any more to try to save you money. But likely the vet doesn't understand the herb (which many vets wouldn't know herbology) and so may not really see the benefit. The herb literally has less side effects than the super-processed Marin may have so it's way more benign and yet *more beneficial* than the vet may realize.
Johnny&Tessy: I've considered D-Mannose on o many occasions but Tessy takes a cranberry extract that is also supposed to be pretty good.
I gave both -- both are a form of glucose, but in particular, the D-Mannose doesn't get absorbed by the body (it's literally magnesium in a sugar form, believe it or not). But it literally bonds with infection cells and makes them too slippery to adhere to the urinary tract. BOTH d-mannose and cranberry work that same way. D-Mannose is just a little bit ... "more" is probably the best word. Nowfoods IS a Canadian company -- you ought to be able to find it easily. But you can use both if you want. I did with Billy (and UTIs were **the** worst side effect for him).
Johnny&Tessy: Another thing I don't understand is how a vet can't tell if there is still destruction going on or not.
When they look at the blood under a microscope, there is literally a particular way that destroyed red blood cells look. In other words, they look for the destroyed cells which will still be visible. You can tell when you look at one if it's "alive" or "destroyed" (and that looks different than a red blood cell that has "died" and just hasn't been removed as waste by the filtering process). Red blood cells DO have a life-span. In other words, they typically live for about 2-4 months in the body (I think that factoid is accurate) and they will ultimately die of 'old age'. But when they get killed by the immune system, there is a specific way that they look.
THAT is what the vet looks for to calculate if blood is still being killed. And if they see NO reticulocytes (baby red blood cells) in the blood they then wonder if blood is being killed in the bone marrow (ie, it never makes it TO the bloodstream before being killed). That's what they look for when they are first evaluating the blood to see what "type" of IMHA it is and how it all works.
Does that make sense? My vets up at U of Florida were great at teaching me all that stuff -- when we were trying to determine if we needed to do a bone marrow aspirate I wanted to know what that would tell them that bloodwork wouldn't. And that was when they explained to me that they were looking for *destroyed* RBC where-ever they were to be found in order to determine where the immune-system was most active (and that also helped ruled out a cancer diagnosis)
We've had a bit of respite here thankfully. Last year just before Christmas was when it all really cranked up.
FWIW -- and for those keeping track -- we had a fella posting for a while in another thread who has a pit bull (a sweet female jokingly named "Killer") who had both IMHA and diabetes (which made meds difficult). She's doing really well but they're concerned she may have developed another problem concurrently. Her human is a college professor up in Washington State. He's been emailing me, but has never posted on this particular thread. But I was telling him that sometimes you get all sorts of weird readings which can look like bad stuff, and often pan out to just be IMHA-drug weirdness. Sometimes ... sometimes not.
But I'm really glad you updated about Tessy.