Immune-mediated hemolytic anemia (IMHA)
We are seeing a fairly larger number of patients with immune-mediated hemolytic anemia (IMHA) in our Fort Worth office at this time. This is a devastating disorder of the immune system, where cells and molecules that normally work to protect our beloved pet’s bodies are destroying their red blood cells. It results in anemia, that can be severe. This disease is seen year round, but for some reason, we see a higher incidence in spring and fall.
Most patients have this disorder for no apparent reason (called primary or idiopathic). A few patients develop this disorder secondary to some other disorder, most commonly a cancer or infection. Even though this happens less than 5% of the time, we are obligated to look for these conditions in all patients because if a disease is present, it must be addressed in order to effectively deal with the IMHA.
Most patients require aggressive treatment. There are many controversies regarding treatment at this time, and many internal medicine specialists disagree over the best way to treat. A group of academic internists have come together to produce a consensus statement on the best ways to diagnose and treat this disease, and they presented their compilation at the ACVIM Forum in Seattle in June 2018. While overall, I support the consensus statement, each patient is an individual, and treatment must be tailored to each patient.
At VSNT, we believe in aggressively treating the disease by suppressing the immune system. If you treat it aggressively early on, it is our belief that the patients are able to get out of the hospital sooner. The treatment for IMHA entails a lot of medications, for a very long time. It is likely that they will be on medications the rest of their life. Depending on the type of IMHA, the chances for long term control are about 65-80%. If we can get them through the first ten days, most dogs do very well. It is our goal at VSNT to get our patients home as soon as possible to be normal again! This is a disease that takes a lot of follow up.
It would be great if we as a profession, knew more about what causes this disease. If you have concerns about this disease, please contact your veterinarian or VSNT.