Immune Mediated Hemolytic Anemia

Anemia is defined as a low red blood cell count. Red blood cells are the cells of the body that transport oxygen to all organs. When that value is low that indicates that an animal’s organs are not receiving the oxygen necessary to function properly or efficiently. Therefore, the clinical signs will be lethargy, weakness, anorexia, and pale gums.

Immune mediated hemolytic anemia (IMHA) is a type of anemia in which the body’s own immune system is attacking red blood cells and lysing/breaking them apart creating an anemic state. Generally, this disease has a rapid onset thus rapid presentation of weakness. Other blood cells can also be decreased with this disorder including platelets, which are the cells responsible for clotting blood. Certain breeds of dogs are predisposed to IMHA, including Doberman Pinschers, Cocker Spaniels, Miniature Poodles, and Old English Sheepdogs. Feline Leukemia positive cats are predisposed to IMHA.

If you notice your animal is very lethargic and the gums are pale, do not hesitate to call the veterinarian. This could be a life or death situation. Several blood tests will be necessary to make a diagnosis such as CBC, chemistry panel, agglutination tests, Coomb’s test, tick borne disease panel, and a heartworm test. A urinalysis as well as fecal analysis, X-rays and ultrasound will be utilized to formulate the appropriate diagnosis. All of these tests are required because certain other conditions such as parasites (tick-borne diseases, heartworms, hookworms), drug therapies (cephalosporins, Sulfa drugs, NSAIDs), certain cancers (hemangiosarcomas), and trauma can also present in the same manner as IMHA and need to be ruled out prior to initiating treatment.

Depending on the severity of the anemia, treatment for IMHA is generally with steroids or immunosuppressant drugs. Some animals will require hospitalization and blood transfusions. Again depending on the severity of the disease, 66% of affected dogs have a favorable prognosis with appropriate therapy. FeLV+ cats have a poorer prognosis.