Veterinary Clinical Medicine-I (General and Systemic)

IMMUNE MEDIATED HEMOLYTIC ANEMIA ( IMHA )

• Autoantibodies against RBCs, often secondary to drugs, vaccines, infectious diseases, neoplasia.
• Cockers, poodles predisposed; middle aged female dogs atre prediposed.

Clinical signs

• Vomiting, diarrhea, icterus, labored respirations.
• Varying degress of signs based on degree of anemia.

Diagnosis

• Decreased PCV, thrombocytopenia, proteinuria, modearte to severe regenerative anemia, spherocytes, autoagglutination.
• Leukocytosis, neutrophilia. Coombs test if haven’t already seen autoagglutination.
• Osmotic fragility, bilirubinemia, hgburia, organomegaly.

Treatment

• Treat underlying condition if it can be identified. Corticosteroids are used. Immunosuppressives such as Azathioprine (Imuran), Cyclophosphamide (Cytoxan), Cyclosporin (Neoral), Danozol and Transfusions provide temporary relief.
• Heparin can be considered. Recheck PCVs Q8-12 hrs. Splenectomy if anemia is nonresponsive to immunosuppressives.

Complications

• Renal failure due to poor perfusion, DIC, pulmonary thromboembolism, concurrent IMT (Evan’s Syndrome).
• Note: Rouleaux disperses with saline, hemagglutination does not occur here.