September 14, 2010
Autoimmune Hemolytic Anemia – A Serious Disease All Dog Owners Should Be Aware Of
By Cindy Andrew
It was Labor Day weekend 2009 when my husband and I commented on the fact that our 8-year-old buff Cocker Spaniel, Sophie, seemed to be acting particularly lazy. She had also vomited and wasn’t eating. These things aren’t terribly uncommon for her, but what concerned me was that the vomit was green instead of its usual yellow. When we had friends over and she barely got out of bed, we knew something was wrong. So Tuesday we took her in to see our vet, Dr. George Martin at Plantation Pet Health Center in Frisco.
As soon as he examined her, Dr. Martin got a very troubled look on his face. Tests confirmed what he suspected – autoimmune hemolytic anemia (AIHA) – a life-threatening disease that often strikes Cocker Spaniels, and particularly middle-aged female Cockers.
Canines, like their human companions, are predisposed to developing many different autoimmune conditions. AIHA is one of the most common. AIHA is a disease in which the body attacks its own red blood cells. Dogs suffering from AIHA will have a lower-than-normal number of red blood cells within the blood – called anemia, hence the lethargy. It’s important to remember that red blood cells carry oxygen to the cells and remove carbon dioxide. The normal range for the packed cell volume (PCV) or hematocrit is 37-55% (the ratio of the volume of packed red cells to the whole blood).
The prognosis for dogs diagnosed with AIHA is guarded and mortality rates are high. In patients that survive a hemolytic crisis, life-long treatment may be needed and the disease can reoccur.
I’m so glad my husband, who’s an RN, was there at the appointment with me and was able to follow everything Dr. Martin said. At the time of her diagnosis, her hematocrit was 21. If it had been much lower she would have needed a blood transfusion, which would have made her prognosis much more grim. With transfusions comes the risk of adverse reactions to the blood (rejection). Dr. Martin prescribed a very high dose of prednisone, a steroid that suppresses the immune system, helping to prevent red blood cell destruction, but it has undesirable side effects, including weight gain, excessive thirst and urination and osteoporosis.
Another symptom of AIHA is that the lips, gums, and eye margins appear pale (or yellow in the later stages of the disease) – which Sophie was exhibiting, although I’m ashamed to admit I hadn’t noticed.
As in humans, autoimmune diseases in canines occur as a result of genetic and environmental factors. Dogs who are genetically predisposed develop AIHA when they’re exposed to certain environmental triggers, such as vaccines or bacterial infections. In Sophie’s case, I had taken her in for her regular vaccines only a couple of weeks prior to her getting sick. So on top of everything else, I was wracked with guilt because I felt like I had made her sick.
(Due to concerns that over-vaccinating can cause autoimmune problems, many university veterinary programs now recommend vaccinations every three years rather than yearly. In addition, dogs who have been diagnosed with AIHA should never get vaccines as the risk of the disease is much greater than the risks associated with not vaccinating. However, the fact that Sophie is no longer receiving vaccines means that we have to be careful about her exposure to other dogs.)
Sophie’s diagnosis understandably scared me. She was only 8 years old. I couldn’t lose her yet! And I was concerned that even if she did survive, how would the disease affect her quality of life? My cuddle bug was so weak and medicated those first few weeks she couldn’t even jump up on the couch to get in my lap. It broke my heart. I worried the Sophie I knew and loved was gone forever.
Thankfully the prednisone worked and with every checkup her hematocrit got a little higher. Once she stabilized and Dr. Martin felt we were out of the woods, he slowly began to decrease her dosage and she came out of her fog. We followed up with regular blood tests and her hematocrit held steady.
In March, six months after her diagnosis, Dr. Martin said he thought we could try taking her off the prednisone completely. Again, we followed up closely with blood tests and the results were good. We’ve just passed the one-year anniversary of her diagnosis and she’s doing great and back to her old self and her pre-prednisone weight, although I still obsessively check her gums and tongue to make sure they’re nice and pink.
I’m so thankful for the excellent care Sophie received by Dr. Martin and the staff at Plantation Pet Health Center, and I’m so thankful to still have her in my life because I know other dogs and their owners have not been so lucky. Seeing her run and play with her new Cocker brother Hagen just about makes my heart burst with joy.
I want to share Sophie’s story with all Cocker Spaniel owners and prospective owners because of their predisposition to the disease and because it’s so important to be aware of the warning signs. If you witness any of the symptoms mentioned above in your dog, please seek veterinary assistance immediately.
