AIHA
Auto-Immune
Hemolytic Anemia
Last updated 1/8/09
Early in 2006 Rosie fell ill. The usually bouncing dog had spent most of the day snoozing with mom, who was nursing a migraine. I thought that perhaps she was just acting a little sympathetic. But when she refused her nightly cookie, I became frightened and immediately began to check her vital signs. Using the lethargy as an indicator, the first thing I did was to check the color of her gums, they were so pale they were almost white. That was all the diagnosis needed to bundle her up and rush her to emergency.
Rosie was diagnosed with AIHA. The cause of this disease is not really known, nor is there a cure. Essentially the body starts attacking its own red blood cells leaving the animal weak and fighting for oxygen. Deprived of oxygen, organs can start to shut down and the entire body suffers a long list of damage. An average of 65% of all dogs never survive the initial episode of AIHA. Those that do, often live no longer than 2-3 years further. It can be a disorder unto itself or an indicator of some deeper problem such as cancer.
Rosie spent 2 weeks in the hospital and received two blood transfusions. Her PCV (packed cell volume, red blood cell count) went down to 15 at one point. A normal dog should range 40-45. She is a tough little dog though and seemed to bounce back fairly well. Within 4 weeks her PCV was hitting marks near 40. We owe so very much to Dr. Richard Martin, specialist in Internal Medicine at Brentwood Pet Clinic. His dedicated concern an care for her was paramount to her survival. We had another dog with this disease and Rosie has done much better comparatively, so we are keeping high hopes that she will continue to be one of the lucky ones that beats the odds.
Rosie will be on theraputic doses of immuno-suppressants and steriods for a very long time, and will have to be monitored closely for the rest of her life. We have been told that certain environmental products can trigger episodes of this disease and monitoring her exposure to them will be critical. She will no longer receive yearly vaccines and her vet will excuse her from rabies vaccinations generally required by the state. Since we live in a very metropolitan area and she lives "in" the house, her chances of exposure to rabies is very slim and we will take every possible precaution to protect her from any slight chance of exposure. Becasue she was exposed to some of the suspected triggers just before she became ill, we are hopeful her episode may have been due largely to the external triggers and that she will fare better than most.
Update:
Rosie
is about 4 months out now. Her PCV continues to have great numbers and
her meds are being slowly reduced. On her last visit I asked that a full
blood panel be run to check for several things: First, to see if the therapy
was affecting her liver and spleen. Second, to see if there was any indication
of other disease for which AIHA may have been symptomatic. Third, given
what she has been through as a general "check up". Also, I asked
for full body xrays as a visual check for underlying tumors or other abnormalities.
So far, so good! Always take that extra step rather than take a chance
and regret it later!
Please read the list of environmental triggers that can be dangerous to dogs and visit some of the links below to read more detailed information about AIHA. I have chosen some incredibly detailed sites that provide well researched information rather than repeat it here.
18
months out and doing great!
6 Years and no relapse!
AIHA Risk Factors:
I have been asked to post a very simple list of "at risk" conditions
here several times, here you go!
- Breeds at risk:
- Lahso Apsos, Dachsunds, English Sheepdogs, American Cockers, Irish Setters, Springer Spaniel, Poodle, Shih Tzus and any cross breeds.
- Other factors for risk:
- Any breed that has or may have cancer, or organ disease or disorder, especially liver disease.
- Any breed over the age of 8. This is when the complications of old age arise and the risks above are more likely to present.
- Female dogs are more likely to develope AIHA and other auto immune diseases.
- Any breed that may have been exposed to things that are known to trigger AIHA. Remember that exposure is not a guarantee, it increases risk...why take the risk? Most of the triggers are things that you dog can live very happily without or there are safer alternatives, the exception being vaccinations. Do not avoid having your dog vaccinated unless your vet feels the animal is past the age where he needs some of them. If you have a dog that may be predisposed (has any above risks) for AIHA, monitor them carefully after vaccinations (for several weeks). Also, speak to your vet about eliminating uneccessary vaccines after age 6-8.
AIHA triggers:
- Veterinary shots including rabies and general vaccines. If your dog has recently received vaccines and behaves unusually more than 24 hours afterward (effects may appear weeks later) see your vet! Lethargy, pale gums, lack of appetite, excessive panting and urination are just some of the signs that your dog is not well. Many vets no longer recommend general vaccines (except for rabies) after middle age unless your dog is kennelled regularly or visits dog parks.
- Flea sprays and shampoos whose chemicals cross the skin barrier. To be safe use only Frontline and Advantage types and make sure you get the real USDA approved thing! Boric acid powder or other "fleabuster" type carpet powders are ok too. Never mix different types of flea preparations!
- Yard pesticides and weed killers of any sort. Many dogs tolerate them well. But they can kill some dogs within days. My dog is more important than my flowers. I use other methods to edge and weed. A good soap solution may take more time and effort to apply for pests, but is safer for dogs, especially for a dog with AIHA.
- Onions and garlic: Onions especially are toxic to dogs. For dogs with AIHA, or at risk, they can easily trigger an episode. Eaten raw or in "bites" of prepared food from the table, they can cause sickness and death. I believe there is nothing wrong with giving my dogs "people" food in small amounts, as long as I am careful that it is not seasoned or prepared with toxic additives. Don't take risks with something that your pet will never miss in his diet.
- Living outside: Dogs with AIHA should be walked and exercised as tolerated....and get fresh air, but it is a good idea not to leave them alone in the yard for long periods. An insect sting or bite can trigger an episode and kill them. Treat them like family and include them in your daily life for as long as they live, it's what they want and what we owe them.
- Infections, bacteria, dental health: Any infection or bacterial intruder can trigger an episode of any auto-immune disorder. A common entry point is the mouth, it connects the outside of the dog to most of the insides! Bacteria from tooth decay and gum disease can be deadly. The gentle (awake) form of cleaning might be safe for a healthy dog, but will not always clean deeply enough. Consult with your veterinary internist and weigh the benefits and costs of anesthesia-assisted cleaning for dogs with AIHA. (Cancers that start in the mouth can spread fast and be devastating, check Fido's mouth regularly for any bumps or spots and see your vet!)
The links below are to highly informational sites maintained by others who have had dogs with AIHA or vet info centers.
Meisha's Hope-AIHA-Great Research Fund here!