Signalment: As you are heading up front to lock the door at the end of a busy day, a client rushes in with her dog collapsed in her arms. You grab the dog and rush it back to the treatment area to begin your evaluation. The owner follows you and says the dog was fine this morning, if not maybe just a little lethargic. Come to think of it, he may have had some dark urine for the last few days, but the owner didn’t think much of it. The dog, George, is a 7 year old, male, neutered Cocker Spaniel. Other than a few ear infections, he has been healthy all his life. Oh, and by the way, he was diagnosed with immune-mediated hemolytic anemia (IMHA) a few years ago. The owner gave him the medications until he got better, but hasn’t given him anything for at least a year.
diagnostics-
treatment-
IMHA ( Immune Mediated Hemolytic Anemia) is a disease in which immune system reacts against red cells just as it would against a foreign bacteria or virus. In this disease, the red blood cells are destroyed, anemia results and oxygen delivery to tissues and cells reduces greatly. It leads to number of clinical signs and if left untreated leads to death.
IMHA is of two types primary and secondary.
Primary is most common in specific breeds like cocker spaniel, labrador retriever and miniature schnauzer in which it is presumed to be a genetic component.
Secondary is due to some other conditions like cancer, inflammatory and infections diseases and vaccinations etc.
Common signs include: weakness, jaundice, dark urine, anorexia, tachypnea, vomiting, lethargy, pale gums.
Less common signs are dyspnea, seizures and sudden death.
IMHA diagnosis : It includes
Chemistry profile , complete blood picture ( CBC), coagulation profile, urinalysis, infectious disease titers, chest x-ray , slide agglutination test, ultrasound, comb's test and ANA (Anti-Nuclear Antibody) titer.
IMHA causes many changes on laboratory tests. Depending on the severity and duration of disease the changesay be mild or severe. Ultimately laboratory tests are necessary to confirm the diagnosis. The laboratory changes include anemia, leukocytosis, icteric plasma, elevated bilirubin levels, coagulation abnormalities, autoagglutination, spherocytosis, increased liver enzymes.
Treatment:
It is considered as a treatable condition, in which aggressive medical treatment is required to help dogs with this disease hospitalization is required. The immune response against the red cells must be controlled with immunosuppressive drugs. Blood clot formation must be prevented with thromboprohylactic drugs. Anemia is treated with blood transfusion. Oxygen and fluid therapy are used as supportive therapy in acute presentation.
Animals are often on medications for 6-8 months after the time of presentation of disease.
Other clinical signs, and underlying diseases are also treated based on individual presentation. Vaccinations given prior to disease are to be avoided.
Long-term monitoring recommendations: Generally, CBC evaluation, prior to and after reducing immuno- supressive medications, Depending up on medications used, chemistry values are periodically to be monitored. Slide- agglutination test is specific in assessing the disease. Monitoring is often patient specific and unique recommendations is made.
Though dogs does well after stopping of treatment may not have improved quality of life as some are meant to have life - long therapy...
Signalment: As you are heading up front to lock the door at the end of a...
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