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Immune-Mediated Hemolytic Anemia:  IMHA

Jazmine and her family, after surviving IMHA.

Jazmine developed life-threatening Immune Mediated Hemolytic Anemia, known as IMHA. This deadly disease can be controlled and now she lives a normal, happy life.  

 

Thank you to her family for sharing her story.

This story and photos are shared by permission and special request from Jazmine's family in the hope of saving more IMHA patients with this valuable information for pet owners.

IMHA, or Immune-Mediated Hemolytic Anemia, is caused by the body’s own immune system attacking the red blood cells and destroying them.  This process can happen slowly over time, or can happen rather quickly and be very life-threatening, such as the case with Jazmine, a 3 year old female Weimaraner.  

 

Jazmine became very weak and developed difficulty breathing over a short period of time, leading her family to take her to a Helena vet for care.  The veterinarian there diagnosed her condition but was unable to provide 24 hour care for her for a blood transfusion, so she was referred to Alpine Animal Clinic instead.  

 

Dr. Heidi Wampler at Alpine Animal Clinic tested Jazmine’s blood and found that she was not only destroying her red blood cells (RBCs), but also her platelets which are critical to blood clotting.  Normally, dogs have RBCs between 37-62%;  Any RBC value below 20% is considered life-threatening, particularly when it occurs very suddenly, such as in Jazmine’s case from her body actively destroying her RBCs at a quick pace.  Platelets are normally 148-484, and Jazmine’s were very low, making it very difficult for her vascular system to prevent pathologic internal hemorrhaging.  Jazmine was in very critical, life-threatening condition upon admission to Alpine’s hospital.  

Jazmine at her 6 month recheck for IMHA and IMTP at Alpine Animal Clinic.
For more than 2 years, Jazmine is doing great! She is so energetic it's hard to catch a photo.

Medications and dosing varies from patient to patient, with some doing very well on minimal medications with others doing poorly on lots of medications. 

 

Jazmine does extremely well on a combination of daily Cyclosporin and very small doses of every-other-day prednisone. 

 

She has been very stable on this regimen for more than two years without side effects or problems.  

Jazmine visits Dr. Wampler at her 6 month recheck in 2015.

This story and photos are shared by permission and special request from Jazmine's family in the hope of saving more IMHA patients with this valuable information for pet owners.

Jazmine continues to do well (she is hard to contain for a photo!) and here she is at her 2 year recheck in 2017.

IMHA is the destruction of red blood cells. IMTP, Immune-Mediated Thrombocytopenia, is the destruction of Platelets, which are the building blocks of blood clots.  Dogs can have immune disease against one or the other, or they can have disease against both. 

 

In Jazmine’s case, she was destroying both. 

 

IMHA and/or IMTP can be very difficult to reverse and many patients can continue to deteriorate rapidly and die.  Oftentimes, however, with powerful I.V. medications to rapidly suppress the immune system, patients can recover, particularly when the destruction is caught early and when they are supported aggressively with a Blood Transfusion. 

Upon admission to Alpine Animal Clinic, Dr. Wampler gave a combination of several powerful immune-suppression medications to try to stop the immune destruction of the RBCs and Platelets.  The destruction of Jazmine’s RBCs and Platelets was very severe, but it is fortunate she responded well to the powerful combination of medications given to her by Dr. Wampler and also that she responded well to the Blood Transfusion.  Throughout the first night Dr. Wampler gave Jazmine her transfusion and completed it very early the next morning.  Jazmine’s family was relieved and happy to get that early morning phone call with an update that she was improving and had survived the night!

 

Over the next few days, Jazmine’s condition stabilized and improved with careful, diligent monitoring and aggressive treatment.  Eventually she was discharged from the hospital.  Over the past 2 1/2 years her medications have fluctuated somewhat depending upon how well Jazmine is responding, but her immune disease has been very well controlled and she continues to lead a very happy, active and normal life today.  Our goal has always been to get our patient to the lowest doses of medication possible to minimize side effects and cost, while still maintaining excellent control of disease.  

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Check your dog or cat for this:

Yellow color in the sclera of the eye in this dog with IMHA.

Yellow color in the eyes, known as "jaundice" or icterus.

Yellow color of the mucus membranes of the mouth and inside ear flaps.

Jaundice or icterus of the mucus membranes in the mouth of this dog with IMHA.

You might also see:

  • weakness

  • difficult or labored breathing

  • trembling

  • inappetance

Blood transfusion taken from one donor dog to be given to another dog.

Blood transfusion provides RBCs, Platelets, and clotting factors in severe IMHA or IMTP.

Intensive Care is often necessary and continues throughout the night at Alpine Animal Clinic with highly trained staff and veterinarians to give expert care.

Overnight intensive care for blood transfusion in IMHA and IMTP.
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