(December 19, 2021) The beginning….
One of the 10 pawcasso dogs; Rocket, doesn’t feel well. I got a call, Rocket doesn’t want to eat or drink since this morning. I decided to pick her up so I can closely monitor her in case needed to go to Emergency. She doesn’t act like herself. She is usually very hyper, but today she is not moving around much. She certainly doesn’t feel well.
(December 20, 2021)
8:00AM Rocket drank plenty water on her own. Still doesn’t want to take any treats or anything else.
8:05AM she vomited all the food she last ate on Saturday night.
8:30AM I took her out to potty, she pooped and peed. I collected the fecal to have them tested if needed.
I have an appointment for her to be seen by a Vet later today. Right now she is resting. Room heater is on for her.
10:50AM Rocket drank some more water when I put the bowl right in front of her. Since she puked all the water she drank earlier, she need to stay hydrated.
Still lethargic and not acting right.
12:54PM note: Rocket has a Vet appointment at 4PM today.
She is not getting worse nor better, still doesn’t want to eat, drank water at 10:50AM when I put the water bowl in front of her. Remain lethargic. Gum color is still pink.
Will request an X-Ray. At least they will let me in the exam room with her, so that’s somewhat a relief.
3:16PM note: Getting ready for taking Rocket to the Vet.
Not knowing what is wrong with her is the hard part.
She has been staring at the wall and at me for hours.
Hopefully they can figure out what may be the cause of it.
From X-Rays, no blockage can be seen. They took 4 X-Rays. There is some unclear area in her stomach that may indicate inflammation in there. We are going to get more info on Rocket from her blood work, but the result may take 24-48 hours.
The Vet suggested to have fluid injection that will slowly releasing anti nausea and fluid into her body. I agreed. We don’t get any prescriptions at this point, until we get the blood results.
Vet said she should start eating at 7PM with the anti nausea injection he gave Rocket.
8:30PM Rocket drank some fresh water I put in the bowl.
9:20PM I have been trying to give rice and boiled chicken, beef broth, goat milk, salmon treats,
Nothing changes
Called the ER, they advised to wait and see.
10:50PM I took Rocket outside to do her business before bed.
She didn’t want to get up and walk, so I had to carry her outside.
However once she was outside, I put her on the ground and she walked 15 ft, then pooped and peed on the grass. Poop still looks pretty normal to me.
Had to carry her back in.
Another long night with no sleep for me.
(December 21, 2021)
3:00AM she was slightly shaking. I took her in the bathroom and we both sat in front of the bathtub with running hot water. Room heater is on. She stopped shaking. Not drinking not taking any treats.
Called the ER, they still say wait and see. Their rule of thumb, minimum 24 hours not eating or drinking. As long as gum color is pink, just watch, wait and see.
I took her out to potty, she peed and took her back in the room and have her setup with room heater on.
4:50AM I am just sitting here watching her. She is lying down on her bed.
I have her with me now, cracked 2 eggs and use my syringe 
to suck only the egg yolks to get in her stomach.
Hopefully she will be better. If not, I will take her to the Emergency.
There is only ONE Emergency vet clinic, serving 4 nearby towns here. They have always packed and waiting period can be 3-5 hours. They are good, I used them before, but they tend to screen the level of emergency in order to take patients in. I called them twice to get Rocket in earlier, they kept suggesting me to wait till 24 hours passed.
The need of Emergency clinic is high, but when another (great) clinic tried to fill in the void, they didn’t make it. So the clinic I am going to take Rocket in today WAS a short term ER clinic that saved Sharky when he had pneumonia. They are just operating as a regular Mon – Sat 9-5 clinic now. 
As soon as the clinic open, I spoke with the vet, blood work results are all normal.
So, if we want to be extreme, yes we can hospitalize her and have all kind of tests.
BUT, how if she is just actually have some simple gassy stomach and just need a little more time to get back to her normal self?
Or, how if this all are PSYCHOLOGICAL issues??
I declined hospitalization at this point.
I keep the 2 o’clock appointment for reassess.
I requested the vet to dispense appetite stimulation pills, I asked my volunteer to pick up the pills now.
I took Rocket out to potty 20 minutes ago. I got a new toy and encouraged her to play. She did. She chased the toy I threw a few times in the yard. I made 3oz Honest Kitchen goat milk and served it warm. Took 5 minutes to encourage her to drink it but she did.
(December 22, 2021)
Not the Birthday picture I planned to post.
Rocket is sick so the others cannot celebrate their birthday either. Just not fair for Rocket if we do.
I will write more details later. I am behind with everything at my work because I have Rocket with me here. 
Rocket asked me to write a letter to Santa:
Dear Santa,
My name is Rocket.
Today, I turned 5. I haven’t been feeling well for days, so I cannot go out and celebrate my birthday as planned.
My brothers and sisters can’t celebrate either; they were told that everything should be equal for everyone here.
Santa, while it doesn’t feel good to be sick, I managed to stretch it a bit longer. It feels good to have this quiet time, away from every barking dog at the other place I stay. No barking here, no loud noises, music all day long.
I dream to have a room like this all for myself. I heard from my brothers and sisters, there are a group of people working on the Raise the WOOF project, and will get each one of us a tiny room with our own couch to sleep on, a TV to watch, and soft music to listen to.
Dear Santa,
Please tell me that’s true.
Respectfully,
Rocket 
(December 23, 2021)
Morning note: She was less restless last night.
I got a few hours uninterrupted sleep that I needed.
At one point, she moved closer to me and stayed all night on that spot.
She peed and pooped a few drops of diarrhea (which was predicted by the Vet on our last visit).
She ate 3 small (boiled) chicken strips.
I plan to replace her water with chicken broth today.
For some reason ALL Honest Kitchen broth powder I usually used on dogs, are OUT OF STOCK. I checked 5 different stores within 20 miles.
Evening note: I don’t want to speak too soon, but I noticed Rocket’s demeanor has improved today.
I caught her walked around sniffing the room, while I left her by herself for good 10-15 minutes.
She managed to get up from her bed and actually came when I called her this evening.
She ate 3 pieces small boiled chicken strips for breakfast, 2 pieces for lunch, 2 pieces at around 4pm and 1 piece just now right before I gave her 30mg Cerenia. She drank water and 3oz chicken broth.
Many caring hearts have been holding Rocket in prayers since Sunday. Many of you probably have no idea who is Rocket. She is one of the pawcasso dogs.
They are living at a boarding facility since they were returned due to behavioral issues. Her video when she is in good spirit and health is available on here. Scroll down to the pawcasso dog #8 from the top.
She is one hell of athletic dog, I want her to be back like the Rocket I know. She is improving today, hopefully will keep improving. This picture was taken earlier this year.
(December 24, 2021)
10:30AM note:
She slept thru the night and I only had to take her out 2 times, at around midnight and at 4AM. Breakfast she ate 2 boiled chicken strips but she refused the rice part.
This morning she started with regular water, went potty, peed a lot and a little (diarrhea) 
. I am going to pick up some Honest Kitchen turkey broth and beef broth that I asked my local pet store to order a few days ago. Hopefully that will help her eating the rice part she consistently denied. She ate the boiled chicken strips but not the rice part.
She doesn’t want to drink the chicken broth I made, maybe because it’s tasteless. So we will see how Honest Kitchen broth do the tricks. I ordered both just in case she is being picky.
I am going to hold off the appetite stimulant pill again today.
2:18PM note: I was facing the other wall, gathered her bowls and prepared for her new batch of Beef bone broth and mix with rice a little bit.
When I turned around, she was caught crawling closer to my sponge 
mini cakes I enjoyed with my black coffee.
I asked her, “What are you planning to do, Rocket?”
She looked the other way, playing innocent.
I guess the yummy smell from the cake was inviting.
5:22PM note: Earlier today, I picked up my special order at our local pet store. The Honest Kitchen beef bone broth and the Honest Kitchen turkey bone broth. I ordered them a few days ago.
Honest Kitchen Beef Broth powder with turmeric, once again delivered the tricks! No I don’t get paid for this statement. Heck, they didn’t even donate a single canister to us! 
I strongly recommend every household with dogs and cats keep 1 canister at home. Since it’s in powder form, you don’t have to refrigerate and last longer than liquid form.
She cleaned the bowl. It was only 2oz per serving but it is packed with good nutrition.
(December 25, 2021) It’s Xmas Miracle! Rocket is feeling much better today. Here she is posing with her Xmas Santa Hat.
(December 26, 2021)
I think it’s safe to say Rocket has finally fully recovered. Her was SOLID and she ate her breakfast a 4oz Honest Kitchen Turkey broth with turmeric mixed with 3/4 cup of her regular kibbles.
She wanted to stay a little longer outside but I rather not push my luck. We stayed outside for about 10 minutes while she is enjoying the first snow this year.
You know when a dog is getting better.
Rocket killed her favorite “duck”.
RIP 
(December 27, 2021) Pictured here is Rocket at noon today.
For 6 full months, Rocket was doing well… then the Relapse…….
(June 29, 2022)
Rocket may need to go back to the Vet tomorrow.
She refused to eat again, acting okay and alert but I don’t want to wait till the weekend to be worried about her. I just made an appointment for her to be seen by my regular Vet; Dr. Takashima.
(July 01, 2022)
I am in disbelief. Rocket needed to be hospitalized after her bloodwork results showed that she was very anemic.
I am in disbelief because I didn’t think it would be this serious. My Vet called me at lunchtime and told me she needed to get to the Emergency clinic. He even made the phone call himself to the Emergency Vet Clinic to accept Rocket in immediately (you know in here it is quite impossible to get in the Emergency Vet Clinic unless your pets are literally on their last breath). So my Vet initiated the call, addressed his concerns to the ER vet on duty and then called me to bring Rocket in right away.
I followed all the instructions precisely, I left work and got Rocket in time. The timing was perfect, she got the last slot available to get the abdomen ultrasound tomorrow. Apparently the ultrasound is done by a third party that will come to each ER clinic and only filling in 4 slots/clinic/day. Normally it wiould take a couple of weeks to get scheduled for abdomen ultrasound unless your dogs are dying.
I didn’t know this information until now. So timing is very crucial especially the next “business day” after today is Tuesday after the Holiday.
Physically Rocket looks okay. I didn’t even think anything of it, except I wanted to get her be seen before the long holiday weekend.
Without the bloodwork we would never know she is having regenerative anemia, and the number is way below normal range.
The Emergency Vet called me not to long ago, he doesn’t know what should we expect, so it’s a waiting game till we can get the abdomen ultrasound results.
I don’t want to assume much, I am aware of a number of possibilities. At this point I can only pray, hoping for the best outcome. I asked if they can reassure me to get her back tomorrow, they said they can’t answer that without the abdomen ultrasound.
Rocket is definitely a tough cookie. She looks strong on the outside. But something inside is not right.
(July 02, 2022)
I went to the ER clinic this morning with a box of fresh baked French bakery goods for the ER staff. I handed the box to the front desk staff and asked if I could take Rocket out to walk around and potty on the grass.
Rocket doesn’t like her kennel dirty, she will prefer holding her pee or poop instead of dirtying it up, and I certainly will not want that. I know the ER staff are very busy and Rocket is a dog reactivate type. I don’t see any chances of them to take every dog out to potty outside. I just wanted to make things easier for them and minimize unnecessary stress for Rocket as well. I spent 45 minutes with her, got her peed and pooped.
No words on when the ultrasound can be done yet.
(July 04, 2022)
Rocket’s demeanor has slightly improved, she perked up when I brought her a box of toys. She picked up this toy and walked around with it. She didn’t do her signature kitty scratches, but I take any improvement I can get. She still doesn’t want to eat, regardless she was given appetite stimulant by the Vet. Next step is getting my regular Vet to evaluate all the tests and advise the next needed tests to figure out the issue. Her RBC will be retested on Wednesday or Thursday.
So far, extensive bloodwork and 2x retest with the same result, abdomen ultrasound, chest X-rays, 4X test and blood smear were all done. There are 2 doctors at the Emergency Vet evaluating her case, but still have no answers on why her spleen is big and keeps eating the red blood cells. No tumors or blood leakage are detected from the ultrasound result. There will be more tests that need to be done to figure out what is going on with Rocket.
(July 05, 2022)
We will retest red blood count tomorrow, please pray for Rocket. She still doesn’t want to eat regardless the Vet administered appetite stimulant since Saturday.
I left a voicemail to my regular Vet, asked him to evaluate all the tests done by the Emergency Vets, mentioned that the ER vets are just as puzzled as I am.
I also booked an hour consultation in person on Thursday afternoon, so I can actually sit down and have a through discussion on what the next steps should be.
Rocket seems to be in good spirit, she walked around more willingly.
(July 07, 2022)
Yesterday, I had a phone call – after Dr. Takashima looked at all the reports, comparing notes from both clinics and I was handed with a diagnose that Rocket suffers a life threatening disease Immune Mediated Hemolytic Anemia. This is a deadly disease that usually goes unnoticed. Left untreated, the mortality rate is between 30%-70%, within just 1-2 months of diagnosis.
I refused to believe Rocket really has this horrible disease. How could it be? She is not in the common breed list that usually gets this disease. She never was over-vaccinated (one of the common causes of this disease), she doesn’t get exposed to any chemicals or toxin, never got stung by any bees, the common causes are just not there. So, I insisted to get another blood test just to be sure.
The result is in yesterday noon. She is still very anemic, slightly improved from the first day she was admitted to the ER hospital.
I argued, her demeanor has improved significantly…. can the diagnosis be wrong?
Then, at 4PM yesterday in the doctor office we have a little over an hour discussion, with Rocket’s presence.
1. We looked at the gum, pale pink – no improvement since last week, regardless all given medications.
2. Her appetite has slightly improved (she willingly ate 12 squares dehydrated beef liver treats, but that’s about it). The other stuff had to be forced fed into her mouth.
3. Her energy level is very low, but she is TRYING HARD to be normal, she is always willing to pick some of the toys I brought for her & walks around with it. She wants to be a tough girl she is known for, but since her red blood cells are very low… she just can’t be half of what Rocket should be.
I asked the doctor, so now what? How bad is it, I wondered. He said, he can’t tell, because this is still an unpredictable disease that can relapse even after aggressive treatments. There are drug options, first defense drug is high dose prednisone and in most cases of IMHA, this drug is being prescribed for long term use. I personally have a problem with that approach, prednisone’s side effects is not pretty if being used for long term, especially with the suggested high dose. I told the doctor that…. firmly.
So, what is the chance the doctor is wrong? Less than 50%.
And, how if the doctor is right? I will not be able to get Rocket to any Internal Medicine Specialist right away, the waiting list is consistent between 6-8 weeks. IF the doctor is correct, I may jeopardize Rocket’s chance to survive with my stupidity.
I finally gave in, I agreed with high dose prednisone twice daily dose for several weeks to start with. We will redo another blood work on Tuesday next week. I am aiming to get the dosage reduced significantly over a period of time. I think this is the most logical approach with Rocket’s stats.
In the meantime, I will call VCA to make an appointment with their internal medicine specialist.
I will order some natural supplements from NHV in Canada; designed specifically for certain medical conditions, I want to help Rocket able to balance the western medicine with some holistic approach.
I will do whatever it takes to make sure Rocket can beat this disease.
This picture was taken yesterday after the Vet appointment. This is her favorite duck toy. I am glad I got a total of 9 ducks for her several months ago. Thanks Emil for getting her one & special thanks to Crystal for hunting down 8 more for Rocket. She really loves this toy.
For the next 3 weeks, follow up blood work will have to be done every 3-4 days to monitor her anemic condition & to see if the drug is working.
I have learned so much about the IMHA disease these past 24 hours. I am sharing some information if anyone would like to know more.
The reason why the mortality rate is up to 70% because the symptoms are kinda similar with so many other different illnesses.
And in my area, you cannot get the abdomen ultrasound right away, waiting period could take up to 2 weeks, UNLESS your pets are physically dying. My Vet knew I wouldn’t be able to get Rocket to the ER without his interference. He made the call himself and spoke with the ER Vet on duty, then he called me to bring Rocket in. My Vet has a great reputation, his referral will never get rejected. Unfortunately, that privilege is not available to most pet owners, including myself.
With IMHA, it is critical to get the dog to the Vet before they collapse. If I listened to my husband and another staff, Rocket would have not been seen in time. She wasn’t that sick, I literally just wanted to get things done before the long holiday weekend.
Little dd I know that I would be dealing with a serious and deadly disease like this.
I will be fighting this battle together with Rocket. Prayers brings miracles. I certainly believe Rocket will be able to beat this disease and she will be able to live normal again.
(July 09, 2022)
Just when I hoped things were getting better, then of course the opposite happens.
Rocket is having horrible liquid diarrhea since last night. It happened about 20 times already. The ER doctor wants to stop prednisone, our regular Vet will not be back till Monday. I honestly am having a hard time in deciding what to do with conflicting approach from two different doctors that are handling Rocket’s case together. Considering I will be relying on the ER clinic this weekend, I probably should follow their instructions or they will not want to handle Rocket’s case.
(July 10, 2022)
We got the stool report!
At 5PM, Rocket finally had the first bowel movement since last dripping diarrhea at 3:18PM yesterday.
The first 60% part was pretty solid, the last 40% was still soft. But hey, any improvements is good news!
The only thing that hasn’t changed yet is the pale pink gums. I am not sure why it is.
I am reviewing some Internal Medicine Specialist on the list I received from one of the ER vets who adores Rocket. I will start making phone calls on Wednesday after we have the next bloodwork result. 
(July 11, 2022)
Rocket has a solid stool at 5:48PM but the color is dark. Considering she ate only chicken and pumpkin these past few days, I would expect the lighter color stools. From my understanding, this is one of the symptoms on IMHA dogs. But at least the diarrhea episode is over now (I hope). We are continuing the half dosage prednisone for now.
Pictured today: Rocket’s expression on the uncertainty.
(July 12, 2022)
Rocket looks really exhausted today. She was panting a lot even though it wasn’t that hot here today. She is restricted from too much activities too.
She ate all her food each time, probably because of the prednisone.
Her primary Vet, Dr. Takashima, said wait till Friday to get another blood test.
(July 17, 2022)
Yesterday Rocket went in for the follow up visit with Dr. Takashima. Her demeanor is almost normal, the Prednisone seems to be working, although slowly because the dosage was cut to half due to her severe reactions to the original dosage. Her red blood count is improved from 14 to 17 last week and now at 24. Normal RBC is minimum 36.
Rocket will have to stay on the Prednisone for long term, preventing the relapse. It is a no win situation if we cannot get her off Prednisone because she will start developing diabetes and Cushing disease as the result of long term use of Prednisone, and that’s almost a guarantee.
Next bloodwork is scheduled on 7/29.
I am going to start adding sardines twice a week into Rocket’s diet.
(September 01, 2022) Rocket manage her RBC within normal range with prednisone every other day. However, her platelets number seems to going down the first time.
(September 23, 2022)
Rocket torn her ACL this morning. We brought her to the Vet right away, she is being treated with laser treatment, because she is on prednisone (to manage her IMHA disease), which cannot be combined with Rimadyl.
She is in pain, we are giving her pain meds tonight. She does not want to put any weight at all on that leg.
I am worried, torn ACL don’t heal by itself. Body may adjust but the injured leg will never make it normal again without repair surgery. That’s not good for an athletic dog like Rocket. With her IMHA disease, she won’t be able to benefit from drugs like Rimadyl, which is significant to help with inflammation. 
Our awesome Vet – Dr. Gregg Takashima – retired on October 31, 2022.