non-regenerative anemia/PIMA
Hi all,
I’m hoping for some advice.
Winston (8) has non regenerative anemia/PIMA and has been on prednisone for over 14 weeks and cyclosporine for over 8 weeks with no change. We have a second opinion scheduled for May 26 and honestly are at a loss of what to ask/how to advocate for him.
Timeline:
Nov 26, 2025: yearly check-up and bloodwork were normal. Healthy, no concerns.
Early Feb 2026: my husband started noticing Winston seemed lethargic and was losing weight.
Feb 10, 2026: took him to our vet who confirmed anemia (white gums, PCV 19). We were referred to a specialist. He got a transfusion, bone marrow aspirate/biopsy, and a lot of testing done.
Results came back negative for:
- FeLV (including bone marrow)
- cancer
- bone marrow cancer
At that point they ruled out everything except autoimmune/PIMA, so he started prednisone on 2/12. Before discharge he needed another transfusion. PCV after transfusion was 21.
March 17: recheck at specialist and his PCV was 10. We had to rush him to another ER because they didn’t have compatible blood available. He got a 3rd transfusion there, and their internal medicine specialist recommended adding cyclosporine. PCV after transfusion was 17.
April 14: recheck showed PCV 14. Since he wasn’t showing distress, specialist said to continue meds and give them more time to work.
May 15: PCV was down to 9. Specialist said she really isn’t seeing any response to treatment. Our options were:
- replace prednisone with chlorambucil (but one side effect is bone marrow suppression which scares me)
- or euthanasia
We had literally just lost our elderly dog a few days before this appointment, so we chose a 4th transfusion and scheduled a second opinion.
At this point he’s had the following with no improvement:
- 4 transfusions
- prednisone for 14+ weeks
- cyclosporine for 8+ weeks
Are we missing anything? Should we be asking anything specific at the second opinion? I don’t understand why we can’t find a cause for the PIMA/non regenerative anemia.
Would really appreciate hearing from anyone who has dealt with something similar.
Any help/guidance would be appreciated. I don’t think I can handle losing another animal so quickly. :(