To the best of my knowledge, the exact cause of this disease is unknown. It appears that Clostridium species bacteria may be part of the cause. The disease is more frequent in small breed dogs but can occur in any dog. I am not sure what the general impression is among veterinarians, but dogs that have this problem seem to have a high risk of getting it again in our practice.

Most dogs respond very well to treatment with fluids to restore hydration. In some cases it is necessary to give plasma to correct loss of protein and antibiotics to combat the suspected Clostridium infection. In a few dogs, it is necessary to give fast acting cortisones to counter shock, which is a problem due to the very rapid onset of dehydration in dogs with HGE.

It is generally necessary to totally restrict oral food and water for one or two days when treating this problem. This makes hospitalization necessary for several days for most dogs with HG.

THROMBOCYTOPENIA SYMPTOM #2

Contains another symptom -VASCULITIS (Vasculitis has to do with the injury to the lining of the blood vessels. Read the first paragraph below as it further describes it..

Refers to an abnormally low blood-concentration of platelets, which are blood cells that promote blood clotting after injury to the lining of the blood vessels. When the concentration of platelets becomes too low, bruising and bleeding may occur. Dogs with blood platelet concentrations of less than 40,000 per micro liter of blood are at risk for spontaneous bleeding.

• Small red spots on the white parts of the eyes (sclera), the gums or the skin
• Bruises on the skin (ecchymoses)
• Nose bleeds (epistaxis)
• Bloody urine
• Bloody stool

• A complete medical history and physical examination. Your veterinarian will ask about previous vaccinations and drug administration as possible factors in the development of thrombocytopenia.
• A complete blood count (CBC or hemogram) including a platelet count to identify thrombocytopenia and anemia that may arise from bleeding
• Serum biochemistry tests to evaluate for abnormalities in other organ systems and to evaluate the general health
• Urinalysis to evaluate for infection, bleeding (hematuria) or protein loss that may occur as a complicating problem in some causes of thrombocytopenia
• X-rays of the chest or abdomen to evaluate for the presence of other diseases such as infections or cancer that may be associated with thrombocytopenia.
• Specific tests for infectious diseases, like tick-borne diseases such as Rocky Mountain Spotted Fever or ehrlichiosis.
• Bone marrow aspiration to obtain a sample for laboratory analysis if there is concern that your dog's bone marrow may not be making adequate numbers of platelets or may have been invaded by cancer. This procedure often is performed under sedation with a local anesthetic to numb the biopsy site.
• Other tests of blood clotting. Body-wide abnormalities in coagulation (disseminated intravascular coagulation) can result in massive consumption of platelets.
• Immune system function tests if an immune-mediated disease is suspected. In this case the body fails to recognize the platelets as part of itself and attacks them as if they were foreign invaders. The body may consider the platelets as foreign invaders if they become coated with certain drugs or infectious agents.

• Unless your dog is bleeding, only the underlying cause of the thrombocytopenia is be treated. If a specific cause can be treated successfully, the blood platelet concentration soon returns to normal.
• Corticosteroids (cortisone-like drugs) are often used to stop the immune system from destroying platelets.
• Antibiotics, especially tetracyclines, often are prescribed until specialized test results for infectious disease are available. Tetracycylines are chosen because they are effective against bacterial agents called rickettsia that may cause thrombocytopenia, as in ehrlichiosis and Rocky Mountain spotted fever.
• It is difficult to increase platelet numbers adequately by transfusion, and transfused platelets do not last very long, few days at most. Transfusion of whole blood, which contains plasma and all blood cell types including red blood cells and platelets, or packed red cells, which contains red blood cells without plasma, may be necessary in the event of life-threatening hemorrhage or if your dog is anemic from previous blood loss. Platelet-rich plasma is difficult to prepare and is not widely available for dogs.

IMHA Symptom #3

(Many of the dogs dying after receipt of the shot were diagnosed as having IMHA by their vet and are at record with the FDA from people filing adverse reactions reports).

Auto-immune mediated anemia (IMHA) is a disease in which the body's immune system, which is designed to attack and kill germs, attacks and kills the body's own red blood cells. The attack begins when antibodies, which are molecules made by the immune system to target germs, instead attach to and target the animal's own red blood cells for destruction. The red blood cells carry oxygen to the tissues, and the animal cannot survive without adequate oxygenation of the tissues.

The causes of IMHA remain largely unknown. While some cases of IMHA may be associated with a triggering event (cancer, infection, and perhaps even vaccinations), these events do not explain why the immune system misdirects its arsenal of weapons against the animal it is meant to protect.

IMHA occurs more often in dogs than in cats, in middle aged animals (3 to 8 years old), and in females rather than males. While any breed can be affected, certain breeds develop IMHA more often than others do, such as the cocker spaniel, springer spaniel, poodle and Old English sheepdog.

IMHA is a rapidly life-threatening disease. Even with appropriate treatment, this disease can be fatal.

What To Watch For

• · Pale gums
• · Yellow tinged gums or whites of the eyes
• · Dark or dark yellow urine
• · Tiring easily, weakness
• · Lethargy

Diagnosis

Your veterinarian will recommend the following tests:

• · A complete history and medical examination. Be prepared for questions about any medications your animal may have received, when the most recent vaccinations were given, and questions about the color of urine and stool.
• · Complete blood count (CBC) should be performed on all dogs suspected of having anemia (decreased number of red blood cells), regardless of the cause.
• · A "packed cell volume," or PCV, is a quick and simple test for the number of red blood cells present.
• · Reticulocyte counts allow the veterinarian to determine if new red cells are being made in appropriate quantities.
• · A serum biochemical profile and urinalysis may be performed to give clues as to possible causes of the anemia.
• · A saline agglutination test is a simple blood test that may show if the red cells are clumping together.
• · A Coombs test is often indicated. A sample of your pet's blood is incubated with special reagents to look for evidence of an immune reaction to the blood.
• · Radiographs, ultrasound examinations, or blood tests for infectious diseases may be indicated in some patients. These examinations may help rule out causes of anemia other than IMHA, or may help identify triggers that preceded development of IMHA.

Treatment

• Corticosteroids (such as prednisone, prednisolone, or dexamethasone) are the mainstays of treatment for IMHA. They suppress the immune system's attack on the red cells.
• In the most severe cases, or those cases that fail to respond to corticosteroids, other immunosuppressive agents may be utilized. These include drugs such as azathioprine, cyclophosphamide, cyclosporine, danazol, or leflunomide.
• Intravenous immunoglobulins, a product made from human blood, has been used with some success in a few cases of IMHA.
• Plasmapheresis, or the process of removing antibodies from the blood, is very rarely available to veterinarians, but may be possible in some special hospitals.
• Because the spleen is responsible for removing many of the antibody targeted red cells, splenectomy (removal of the spleen) may benefit some animals after initial treatment and stabilization.
• Supportive care is essential to the successful treatment of IMHA. Such care may include transfusion, nursing, and medications.
• Transfusion of either whole blood (cells plus the liquid plasma) or of packed red blood cells (cells only after the liquid is removed) may prove life saving.
• Administration of a blood substitute (Oxyglobin) provides the ability to carry oxygen to the tissues without administering blood itself.
• Complications of IMHA include the formation of blood clots. Heparin is a medication that helps prevent formation of these clots.
• Intravenous fluids may be indicated to prevent dehydration in some pets.

Home Care and Prevention

It is crucial to administer all prescribed medications as directed. Even a few missed doses can have serious consequences.

• · Allow the pet to limit his activity. Anemic animals should not be encouraged or expected to engage in active play.
• · Provide adequate nutrition. Encourage the pet to eat a well-balanced pet food, but your veterinarian can suggest appropriate enticing treats for the animal that refuses food.

Because we do not understand what causes IMHA, there are no known preventive measures. If an animals gums are noted to be pale or white, and the animal appears weak, seek emergency veterinary assistance.

How to Read Lab Tests