Autoimmune Hemolytic Anemia in Dogs

Sep 10, 2008 5:11 AM

Guest :

Thank you so much for that article !!!!

Well we love Boxer's too !!!!

We have been feeding the raw diet to our Bullmastiffs for about 5 years now. We switched when one of our females came down with a yeast problem. Once we switched to the raw diet and with proper supplements our female is now yeast free. Probabaly caused by the processed foods. The problem is you have to be taught to feed the raw diet properly otherwise you can really mess up your animal. We learned from someone who has been feeding it for over 20 years.

Have a great day and I will post again on Friday.

Sep 15, 2008 11:54 AM

Elaine Moore :

Comment from Guest:

My little Maltese Pearl was jsut diagnosed with Autoimmune Hemolytic Anemia and is being transfused today after a week of trying to improve her blood tests with prednisone, Cyclosporin, and Dexamethsone. Her blood count is down to 19, although her platelets are up to normal now. She is also taking the antibiotic Baytril, and I see from your article that it can cause this condition. Should we discontinue? After a week of treatment albeit unsuccessful, she is still alive. What are chances of long term survival with treatment, in your opinion? She is only 6 and we love her so much. Thanks for your help.

Sep 15, 2008 12:04 PM

Elaine Moore :

To Pearl's Owners,

I'd definitely ask your vet about the Baytril. Mention that you saw mention online that Baytril can trigger autoimmune hemolytic anemia. If Baytril was being used before your dog developed the anemia, it's a potential cause. If Baytril was started after your dog developed anemia, it may not be a cause but your doctor might not want you to continue it.

The packed cell volume (PCV) is similar to a hematocrit in humans. This is the percent of packed cells compared to total volume. A 19 is low but not critically low. A transfusion is a good way to raise the level to a safer range.

Ask your doctor too about Transfer Factor. This is an immunomodulator that holistic oriented doctors use to help the immune system heal. I was researching treatments for autoimmune hemolytic anemia yesterday and noticed this was what the naturopath doctors recommend, and I saw several accounts of dogs with AIHA responding well to Transfer Factor. Actually, I've seen reports of humans using Transfer Factor too.

I have an article on this site on immunomodulators. They're natural or synthetic substances that modulate or correct immune function. They strengthen weak immune systems and balance overactive immune systems. This would definitely be worth a try and would also help Pearl's response to the transfusion. Keep us posted and best of luck. My thoughts and prayers are with you, Elaine

Sep 15, 2008 12:08 PM

Elaine Moore :

The picture is of our 8 month-old boxer Tiger Lily with Porcupine Quills. Porcupine attacks, bee stings, hornet stings, fleas, ticks, Babesia, and other infectious agents can all trigger an immune response that can potentially lead to immune hemolytic anemia. Prompt treatment of these environmental agents is important and so is watching for changes for several months.

Sep 15, 2008 12:17 PM

Elaine Moore :

Pearl's Owners,

I forgot to answer your question about long-term survival. If you can get her blood count to rise with the transfusion she'll be over the crisis. Then she'd be maintained on the lowest dose of meds needed to keep her immune system healthy. The Transfer Factor has the potential to help her heal and get by without stronger medicines. Dogs can live for years with AIHA once the situation is in control, as long as they don't have a recurrence caused by environmental triggers.

I read of one dog who responded well to treatment and then relapsed right after getting a flea treatment. Most veterinarians recommend not giving vaccinations or flea treatments or other things that could trigger a recurrence. Best, Elaine

Oct 28, 2008 4:05 AM

Guest :

My Chinese Crested was diagnosed with AIHA two years ago and despite being really ill managed to pull through and is now totally medication free. In her case it seems that what caused the initial reaction was raw onions. She ate some of my tuna salad. The breeder had warned me she "didn't like onions". Latterly I noticed that if she had eaten any cooked onion (my leftovers) her red blood count went down. Now I'm onto the onion thing we are tippity top health-wise. I have 2 CCs, the other bitch has no onion problem. Interesting I thought.

Oct 28, 2008 9:44 AM

Elaine Moore :

Hi,
Thanks for writing about your experience with your Chinese Crested. It's very encouraging to hear your dog recovered and it's wonderful that you tipped us off about the raw onions. This is excellent information, and I appreciate your taking the time to share it.

Dec 1, 2008 10:47 AM

Guest :

Hi, I hope you can help me. About this time last year I took in a stray cat (Pompom) who settled in well with our 2 dogs and 3 other cats.
On New Years Eve 2008 our youngest dog, Pip aged 7.5 years, died of this disease.
Today Pompom has died of a very similar disease (blood in urine as his body was shutting down on him).
Could the cat have had this all along and Pip just reacted quicker? Could there be something in my environment (garden? house?) that could trigger this?
I'm really worried that my other cats/dog are now at risk of the same thing and would really appreciate any advice you have.

Dec 1, 2008 11:16 AM

Elaine Moore :

Hi,
I'm so sorry to hear about your dogs. I don't think your cat is to blame unless she's using flea products that they're licking from her. She could also have borrelia and infections in dogs could cause AIHA. You might want to ask your vet about this. Have your dogs received flea treatments, vaccines, or heartworm treatments that might have triggered AIHA? garlic and onions are also reported to cause AIHA in some breeds. I hope you're able to figure out the cause. Best, Elaine

Dec 10, 2008 3:23 AM

Guest :

Thank you for the response. Both Pip and Pom were vaccinated annually and were due for their next booster about a month after death. I do flea treatments (frontline) but not very often, the same goes with worming (drontal). I'm not aware of either of them eating onion so doubt this was a factor. I think we will just have to chalk this up as very bad luck and keep a good eye on the remaining animals.

Jan 19, 2009 7:49 PM

Guest :

Our dog was diagnosed with Auto Immune Hemolytic Anemia. he had a blood transfusion and is now on prednisone and Baytril. I expect he will be taking the prednisone for a while, but the Baytril is almost finished-it was prescribed because our vet thought an infection could have been a trigger. This all happened a week ago. My question is about a raw food diet. We find the argument for a raw food diet for our dog very convincing, but I'm wondering if this would be an ok time to start introducing it. Since he got very sick and was turned off his kibble, we started feeding him boiled chicken and rice. So we thought this might be an ideal time to introduce something new since he is off his regular food anyways. With the prednisone suppressing his immune system, is a raw diet likely to be beneficial, or risky? Any feedback would be welcome.

Jan 19, 2009 8:09 PM

Elaine Moore :

Hi,
Check with your vet, but I'd suggest sticking with the chicken and rice for a few weeks until your dog is feeling better and then slowly start introducing raw foods, adding one thing at a time so you can check for allergic reactions and food sensitivities. I hope your dog makes a speedy recovery.
Also, see my article on Canine Autoimmune Hemolytic Anemia for more informations, comments and reader feedback. Best, elaine

Jan 28, 2009 2:49 AM

Guest :

Hi Elaine, thanks for your article though I read it too late. My beautiful dog, Bobby succumbed to AIHA on Sunday and I'm devastated. It all happened so fast and only now am I learning about it. The animal hospital here in Portugal suspected tick bites and after a blood transfusion from which he started to recover, they gave him an injection of Imizol. 24 hours later he went downhill really fast, couldn't move without losing breath and died. All the research I've done and now, having spoken to the original vet, says that you should give Prednisone. The vet said there was no conclusive evidence it was tick related. I requested another transfusion and they wouldn't give one and now, looking at the medical records, he was only given 3 intravenous feeds and was really thin at the end. Is it possible that Imizol could have caused his death and that he would have been okay given Prednisone instead? Please help or point me in the right directions...Many many thanks

Jan 28, 2009 10:02 AM

Elaine Moore :

Hi,
I'm so sorry to hear that you lost your dog Bobby.
Here's an article on Imizol that you might find helpful:
http://blackgsd.googlepages.com/treatment
Babesiosis can cause autoimmune hemolytic anemia and so can doxycycline antibiotics. I agree that prednisone may have made a difference, but it's difficult to say for sure what caused the hemolytic crisis. Best, Elaine

Feb 20, 2009 4:48 PM

Guest :

Hi, my dog Tessy was diagnosed with AIHA with no underlying causes being found or even looked for. After a week her PCV dropped to 10 and we took her to a local clinic for a transfusion. She seems to be doing better after only a half day of the transfusion but the blood was not screened to find out if it was a match. This is the most depressed and stressed out I've been in my whole life I think. My concern is that after the transfusion she may start to get bad again. Any information can help.

Feb 21, 2009 10:39 AM

Elaine Moore :

Hi,
I'm sorry to hear about Tessy. If she was given donor blood, she was probably given a universal blood type, similar to O neg in humans that's compatible with everyone. The transfusion will help her PCV rise and drugs such as corticosteroids can reduce production of the antibodies that are attacking her red blood cells. AIHA can vary in severity and it has a lot to do with the dog's age and general health. I hope she makes a speedy recovery. best, elaine

Feb 23, 2009 3:36 PM

Elaine Moore :

Here's a post I received from Laurie; she wanted to share the story of her dog's recovery in hopes that it can help others:

Elaine, I do believe this read will be beneficial for those just starting to deal with IMHA, as this is from my experience with my dog Lucia over the last 60 days.

------------------------------------------------

As we have all experienced, IMHA appears suddenly. Your dog is running, eating and doing the normal daily routine...and a couple days later you find yourself at the vet hospital or office with a life threatening disease on your hands. Unfortunately, many loved dogs have succumbed to this disease within only hours or days of being diagnosed. My 10+ year old dog, Lucia, was diagnosed on December 22, 2008. Her pcv was not as low as some of your pets, but at a pcv of 20 she had a blood transfusion. We were lucky to live in Minneapolis near the U of M veterinary hospital. It's like the Mayo clinic for pets. She has been up and down for 2 months on various medications, but she IS on her way to recovery! Don’t lose hope! I'll share my "check list" with the hope that it will benefit others.

1. Get your pet to a veterinary hospital if at all possible or at least someplace that can run xrays, ultrasounds, blood transfusions, immediate CBC blood panels, etc. Unfortunately many vet offices do not have the equipment for full testing. I took my dog to an emergency vet, then 2 days later to my regular vet, and then finally 4 days later (on my own) I took her to the U of M emergency were she was diagnosed and treated.

2. Research the disease on your own and ask every question you can. Get familiar with the different types of meds that can be used for treatment (Prednisone, Azathioprine, Cyclosporine, Sucralfate for stomach ulcers, Famotidine/pepcid AC for stomach acid, etc.). Ask about aspirin to prevent clotting, especially if your dog has agglutination where the blood cells are sticking together.

3. Once your pet comes home, monitor him/her all the time. You must know the basics on how to take their pulse, breathing rate and temperature and know what is normal range for your dog. Keep checking the gums and other membranes for color. Call emergency rooms and talk to vet techs to describe symptoms before racing into emergency. The call is free and may put your mind (and pocket book) at ease.

4. DIET: very important. You may only be able to feed your pet boiled chicken. more to follow

Feb 23, 2009 3:39 PM

Elaine Moore :

Continued from Laurie's Email
breasts for some time (2 weeks or more). Once you start introducing kibble, make sure it is high in protein and low in fillers. Meat should be the top 2 ingredients. I go grain free now, with EVO pet food (the red meat formula at 42% protein).

5. Don’t be afraid to seek treatment elsewhere for second opinions if you feel the need. I acted quickly to take my dog to the U of M vet hospital when a diagnosis was not achieved elsewhere. Once diagnosed at the U of M, I took my dog to my regular vet and a new holistic vet for a check-up. First, my regular vet has seen my dog for 10+ years so he knows what is normal for her and second, the holistic vet introduced me to some herbs and vitamins that were complimentary to the meds my dog was prescribed (obviously, share with all vets what you are giving your pet for meds, supplements…even food and treats). Through all of this, the U of M has been the primary vet care, and I have followed their medication plan, followed-up blood testing there, etc.

6. Blood tests: make sure you keep up with regular blood testing. Plan to do this weekly, if not more often. Don’t get discouraged if the pcv is fluctuating. If it is, ask about adding or replacing meds.

7. Medication side effects: Prednisone is a wonderful drug for so many diseases…but it has many side effects. Ask about these and research them. Too many times I found myself back in the emergency vet room for a $150 visit because Lucia had a potbelly stomach, or was panting excessively or was falling down due to weak leg muscles…all side effects of prednisone.

8. Expense: yes, this is a very expensive disease with blood transfusions, regular blood testing and medications. If you have not found the cause of the IMHA, expect lots of testing.

9. The cause? The disease can be PRIMARY (suspected that vaccinations, bee stings or reactions to some medications can bring on IMHA) or SECONDARY (as a symptom resulting from cancer or some other disease). And…you may never know what caused this to happen to your pet. The disease will be easier to treat if you know the cause. We have not yet found the cause for Lucia’s IMHA, so we’ve spent a lot of money and time testing for cancer, tick disease, etc.

10. As you take care of your dog, TAKE CARE OF YOURSELF. Try to keep your routines as normal as possible, it WILL help your pet.

NOW, after 2 months of yo-yoing with her pcv, meds, and symptoms caused by the meds…Lucia has finally reached a normal pcv level of 43!

Medication Summary:

We tried to introduce Azathioprine along with Prednisone during weeks 2-3 of her disease, but her liver enzymes were too high on this drug. However, her pcv was not climbing or remaining stable on Prednisone alone. Finally (about 45 days into the treatment), we introduced the miracle drug: Cyclosporine. Get ready…it’s $6 per pill, so at two pills a day you are hoping that it kicks in quickly…and that’s exactly what it did! After taking 200mg of Cyclosporine + 25mg of Prednisone a day for 10 days, her pcv crept up to 39 (normal range of pcv is 38-60 for a dog). Her meds were then reduced to 100mg Cyclosporine and 20mg of Prednisone and 5 days later her pcv had risen to 43. WELL within the normal range.

Lucia’s blood is now free of spherocytes (attacked blood cells) and agglutination, so we discontinued the aspirin. That made a huge difference to how she was feeling, as aspirin can be tough on their stomach. We then discontinued the sucralfate and that has cleared-up the remaining upset digestive tract issues. Reducing the Prednisone has greatly improved her muscle coordination, because high doses of long term Prednisone causes muscle weakness.

Here are some other things I practiced, that I DO believe made an impact on her recovery:

• First 25 days, I fed her boiled chicken breasts and ground beef. That’s it. Bland diet. Not even rice. I gave her vitamin supplements w/antioxidants + herbs as prescribed by my holistic vet. Also gave her a couple tablespoons of yogurt a day. Treats: pieces of 100% all beef hotdogs.

• Days 25-35, I introduced EVO dog food, mixing it with the chicken/ground beef and yogurt. Plus vitamin supplements w/antioxidants + herbs as prescribed by my holistic vet. Treats: Bil•Jac liver treats.

• Days 35-45: EVO dog food. (42% protein, no grains) + 2 tablespoons yogurt + 2 teaspoons pure pumpkin (no spices) + 1 teaspoon chopped carrot + vitamin supplements w/antioxidants. Treats: Bil•Jac liver treats. (note: pumpkin is a good source of fiber to keep the digestive system flowing. A little bit of pumpkin can ease constipation, double the dose and you can ease diarrhea)

• Days 45+: EVO dog food + 3 tablespoons EVO canned food (give with pills) + 2 tablespoons yogurt + vitamin supplements w/antioxidants. Treats: Bil•Jac liver treats + Authority heart and immune treats. I also give her real baked bones with bone marrow still in them. One a week, and let her chew on it each night. Must monitor dog when they have the bone. (make sure it’s a USA product!). This is great for removing the tarter on her teeth and helps get rid of bacteria in the mouth. Remember, on the immune suppressive drugs your dog is very susceptible to infections, etc.

At day 40, I also began EFT with Lucia. (tapping on meridian points, to reconnect the body’s energy flow. To learn more about this see emofree.com). I do believe this had an impact on her, as her pcv started rising once I introduced the EFT practice. I’ve taken classes on EFT, so make sure you read things thoroughly before trying this.

We aren’t over this yet, but it is completely remarkable where she is 60 days after her diagnosis/blood transfusion. She can now go for short walks, chase after her ball without falling down and wags her tail all the time. Next week, we go in for another blood test. We’re hoping that her pcv has continued to climb or at least remain stable. If so, I would think that the medications can be reduced even further. Many dogs are on meds for an average of 4 months and some continue on very minimal doses for the rest of their lives to keep them in remission.

Keep the faith, love and positive attitude with your dog during this time. This disease has opened my mind to the power of healing in any and every way. And, it’s made me take notice and action on my own health issues. Lucia and I are planning to have a lot more time together. ~Laurie

May 19, 2009 4:20 PM

Elaine Moore :

Hi Sally,
Your holistic protocol sounds excellent. The only other suggestions I have are to avoid environmental triggers, such as vaccines, chemical flea products, pesticides, garlic, and onion and grapes or any foods your dog may be allergic to. A good multivitamin can also be helpful. There are some topical corticosteroids used in dogs that might be helpful in reducing the itching. And you might want to observe if sunlight improves the itching or worsens it. I think it would help in moderation.

Please keep us posted and best to you, Elaine

May 30, 2009 8:11 PM

Elaine Moore :

Hi,
I'm sorry to hear about Delilah. But while her levels are low, they don't appear to be critical. If she responds well to prednisone, her hematocrit will start to rise. If not, blood transfusions using donor blood or oxyhemoglobin can keep her hematocrit from falling critically low. Delilah's platelets are only slightly decreased and her white blood cell count is low with neutropenia, which can increase her risk of infection. You might want to read some of the tips from others in the comments, especially Laurie's story of Lucia. Best, Elaine

Aug 5, 2009 4:56 PM

Elaine Moore :

Hi,
It's common to treat the other dogs as a preventative measure against their developing infection. Hope they're all fine. Best, Elaine

Sep 18, 2009 9:36 AM

Guest :

Hello Elaine, I hope you can help me. My Chinese Crested was diagnosed with Rocky Mountain tick disease when he was 6 month old. Doctor started him on prednisone. He stayed on medicine for about 4 month, his red blood cells count got to normal level. We took him of the medicine. 3 month later we re-checked his blood and it was low again. WE put him back on prednisone. He is 3 years old and still on the same medication off and on. I am concerned that taking prednisone for a long time can cause a damage of other organs. He takes 2.5 MG every 3 days. I raised concern to the doctor and doctor told me that because of his weak immune system he will be on prednisone for the rest of his life. Can you please give me an advise, what should I do? Thank you for your help!

Sep 18, 2009 9:37 AM

Guest :

Hello Elaine, I hope you can help me. My Chinese Crested was diagnosed with Rocky Mountain tick disease when he was 6 month old. Doctor started him on prednisone. He stayed on medicine for about 4 month, his red blood cells count got to normal level. We took him of the medicine. 3 month later we re-checked his blood and it was low again. WE put him back on prednisone. He is 3 years old and still on the same medication off and on. I am concerned that taking prednisone for a long time can cause a damage of other organs. He takes 2.5 MG every 3 days. I raised concern to the doctor and doctor told me that because of his weak immune system he will be on prednisone for the rest of his life. Can you please give me an advise, what should I do? Thank you for your help!

Sep 22, 2009 12:09 PM

Elaine Moore :

Hi,
Regarding your Chinese Crested (adorable dogs), I think your doctor has shown that the low dose prednisone is needed to keep titers of the destructive RBC antibodies from rising. Some dogs do need to stay on prednisone for life whereas others experience complete remission. I'm not sure you can tell for sure at this point if the prednisone will always be needed but I can see where your vet is being cautious. Once your dog is older the vet might try a trial without prednisone again. For now, at least his AIHA is in good control and the dose is low. It's long term use of high dose of corticosteroids that really causes problems. Best, Elaine