Idiopathic immune-mediated hemolytic anemia in dogs: 42 cases (1986-1990)

Alan R. Klag From the Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.

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Urs Giger From the Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.

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Frances S. Shofer From the Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.

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Summary:

Forty-two cases of Coombs' positive or agglutinating immune-mediated hemolytic anemia (imha) in dogs were reviewed. Dogs ranged in age from 1 to 13 years, with a mean age of 6.4 ± 3.4 years. The majority of dogs (74%) tested positive for IgG antibodies without complement. Spherocytosis was seen in 67% of the dogs, but hemoglobinemia and hemoglobinuria were found in only 10%. Marked bilirubinuria was found in all the dogs. A significant seasonal incidence was observed, with 40% of all cases diagnosed during the months of May and fune. Severe anemia, with pcv ≤ 20% was observed in 37 dogs (88%). Sixteen dogs (38%) had moderate to severe reticulocytosis and 12 dogs (29%) had mild reticulocytosis. Thus, the absence of reticulocytosis should not be used to rule out a diagnosis of imha. Concomitant mild to severe thrombocytopenia was observed in 28 dogs (67%). A mortality of 29% was observed during hospitalization. Risk of death was significantly increased in dogs without marked reticulocytosis, those with lower pcv, and dogs with serum bilirubin concentrations ≥ 10 mg/dl. In severe cases of imha, rapid and aggressive supportive therapy is required.

Summary:

Forty-two cases of Coombs' positive or agglutinating immune-mediated hemolytic anemia (imha) in dogs were reviewed. Dogs ranged in age from 1 to 13 years, with a mean age of 6.4 ± 3.4 years. The majority of dogs (74%) tested positive for IgG antibodies without complement. Spherocytosis was seen in 67% of the dogs, but hemoglobinemia and hemoglobinuria were found in only 10%. Marked bilirubinuria was found in all the dogs. A significant seasonal incidence was observed, with 40% of all cases diagnosed during the months of May and fune. Severe anemia, with pcv ≤ 20% was observed in 37 dogs (88%). Sixteen dogs (38%) had moderate to severe reticulocytosis and 12 dogs (29%) had mild reticulocytosis. Thus, the absence of reticulocytosis should not be used to rule out a diagnosis of imha. Concomitant mild to severe thrombocytopenia was observed in 28 dogs (67%). A mortality of 29% was observed during hospitalization. Risk of death was significantly increased in dogs without marked reticulocytosis, those with lower pcv, and dogs with serum bilirubin concentrations ≥ 10 mg/dl. In severe cases of imha, rapid and aggressive supportive therapy is required.

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