Immune Mediated Hemolytic Anemia (IMHA)
· Immune-mediated
hemolytic anemia is a condition where the patient's
immune system begins attacking
its own red blood cells. What occurs on a microscopic
level is that the branch of the immune system that
produces antibodies begins to direct them against
the patient's own red blood cells.
· The
red blood cells become quickly coated with tiny
antibody proteins, essentially marking
these red blood cells for destruction.
· The
symptoms of Immune Mediated Hemolytic Anemia (IMHA)
can appear suddenly or gradually. The
signs are usually related to the lack of oxygen.
· The
dog becomes usually weak, lethargic with increased
heart and respiration rate because
the heart has to work the heart has to work harder
Pale mucous gums, ears, eyelids may be observed.
· The
dog also may appear to be jaundice. The dog may
also show signs of wasting. Even with
normal eating although there may be vomiting or abdominal
pain or/and Owners may blood in the urine or stool.
The urine may be dark orange or even brown. There
may be a loss of appetite.
The spleen enlarges as it finds itself processing
far more damaged red blood cells than it normally
does.
· There is some thinking that vaccination can trigger
IMHA. Insect bites have also been implicated. Both
have been temporally associated with the development
of AIHA. The relationship between recent vaccination
and IMHA development is one of the factors that has
led most universities to go to an every 3 year schedule
for the standard DHLPP vaccine for dogs, rather than
the traditional annual schedule.
Could have helped her?
Heparin, a natural anticoagulant, may be used
in hospitalized patients (or in patients with
predisposing factors for embolism) as a preventive.
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The Titer Test
Since Ginger’s
death I NOW know there is a test called the Titer
test. If I had known about
that we would have gladly had it run to see if she
needed a booster.
· The term “titer” refers to
the strength or concentration of a substance in a
solution. When testing vaccine titers in dogs, a
veterinarian takes a blood sample from a dog and
has the blood tested for the presence and strength
of the dog’s immunological response to a viral
disease. If the dog demonstrates satisfactory levels
of vaccine titers, the dog is considered sufficiently
immune to the disease, or possessing good “immunologic
memory,” and not in need of further vaccination
against the disease at that time.
· Let’s
urge these clinics like Vetco and the ones that
they hold outside of Albertsons
to run Titer tests instead of just shot gunning our
pets with potentially deadly over vaccinations.
Several
of the credentialed sources I have spoken to since
Ginger’s death tell me, “oh
yes, we never vaccinate our older pets”…..
Other complications:
This particular complication is the leading
cause of death for dogs with IMHA (between
30% to 80% of dogs that die of IMHA die due
to thromboembolic disease). A thrombus is a
large blood clot that occludes a blood vessel.
The vessel is said to be thrombosed. Embolism
refers to smaller blood clots, spitting off
the surface of a larger thrombus. These mini-clots
travel and occlude smaller vessels thus interfering
with circulation. The inflammatory reaction
that normally ensues to dissolve errant blood
clots can be disastrous if the embolic events
are occurring throughout the body.
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