My dog has autoimmune hemolytic anaemia

[Nancy (Spuddie' s Mum)]

My pom Spud (4.5 years old) has just been diagnosed with this condition. His red blood cell count was 9. The vet opted against a transfusion as his immuse system may be attacking his own red blood cells. About three or four months ago he had a very severe attack of Coccidia and was on Albon, the vet said it's possible the sulfa in the albon could have started this. I noticed roughly six weeks ago he was very tired and lethargic, but it only lasted about a day or two and he recovered quickly so I though he just had a virus since it passed. I have never noticed this prior to his bout with Coccidia. He is now on Prednisone, and is also taking a drug in case it's a blood parasite and he is also on a liquid vitamin/iron suppliment. If this is an autoimmune response, can anyone tell me what his prognosis is.

[Marty]

I am no expert on this, but am wondering if Spud received the Pro Heart 6 shot for heartworm prevention.

[Nancy (Spuddie' s Mum)]

No, he's never had that, just the regular Hart Guard. He didn't even get shots this year because of his allergies (he gets them every three years).

[Traci]

What sort of immunological profile did your vet include? (i.e., tick-borne, lepto, ehrlichia, etc)......If no specific testing were done, now is the time to do so, with a full immunological profile to differentiate.

I'd also maybe seek a second opinion, if your vet refuses a blood transfusion because he isn't certain of the cause, he could be delaying vital treatment. Pred and doxycyline (I'm assuming this was prescribed) are mainstays in treating AHA, but when the PCV falls to a dangerous level, additional immunological profiling may be necessary to determine whether it is a blood parasite vs hemmorhage (i.e., spleen).

[Nancy (Spuddie' s Mum)]

Oh dear, this is so "greek" to me now. I had never even heard of this until yesterday. I hope I will know more after the lab sends back the rest of the blood work and hopefully it will be before they close today. Come Monday if there is no improvment (providing he makes it to Monday) there will be more indepth blood work and analysis then.

The drug you named for the blood parasite is the correct name (I checked the bottle). I just wish in the mean time there was something I could do for him, he's just so tired and laying there. Why did this have to happen right on a long weekend when all the vets are closed. Geez.

[Nancy (Spuddie' s Mum)]

The last batch of blood work has come in and the vet confirms that it's Immune-Mediated Hemolytic Anemia. The good part is that she said his bone marrow is producing good solid red blood cells. So I guess now it's just a matter of getting his wild immune system under control. He is brighter this afternoon and is nibbling on some limited ingredients venison and potato kibble. Hopefully he's not going to crash and need an emergency blood transfusion over the weekend, but I know he's far from out of the woods yet.

[k9Karen]

I'm comfused. I didn't think autoimmune hemolytic anemia and drug-induced hemolytic anemia were the same thing. If this is drug induced, I would think prognossis would be much better, since removing the drug should help things get back to normal. I don't know a lot about this type of illness, or it's treatment though. I wish I could be of more help. I hope Spuddie responds to the treatment.


good luck!

Traci - this has me wondering. Is this just a matter of words? You use the term "autoimmune", but said that doxycycline is part of the usual treatment. There would be no need for antibiotics in an autoimmune disorder, since the term autoimmune in and of itself says that the problem is not an infection. Antibiotics, like doxycycline, would be used for infectious hemolytic processes. I know viruses can have sequelae that include hemolytic anemias, but that would not be treated with antibiotics. What in particular would be considered? Something like Babesia or Ehrlichia?

[Nancy (Spuddie' s Mum)]

Actually, I asked that quetion to my vet if I still needed to be giving him the pills for that since this is an immune system problem and she feels genetic as well, but she told me to continue with that treatment as well. I may be wrong, but my thinking is that it's just to be on the safe side?

He is slightly better today.

I found this on an internet search about this disorder, it's a PDF file so you need Acrobat Reader. I found this quite interesting.

http://www.vetmedpub.com/cp/pdf/special ... pure_1.pdf

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[k9Karen]

To be safe - I'd suspect that's it. I glanced at the article you linked, and printed it so I can go back to it later. It looks like an excellent article. I know in humans, autoimmune processes ca be very difficult to differentiate from other immune-mediated sydromes with identical symptoms. I'm sure it's even harder in dogs when it's much more difficult to get a good history. Wouldn't it be great if dogs could talk so they could tell the vet exactly how they feel and when the problem started? Of course, if Alllie could talk, I don't think I'd want to hear what she had to say - she's always fussing at me and is such a bossy little brat!

[Traci]

Sorry Karen.....AIHA, as in, synonymous with IMHA.

Here's a better explaination

Yes, babesia (and other rickettsia) would be an example, as it can cause IMHA.