• 1. Stockham S, Ford R, Weiss D. Canine autoimmune hemolytic disease with a delayed erythroid regeneration. J Am Anim Hosp Assoc 1980;16:927931.

    • Search Google Scholar
    • Export Citation
  • 2. Weiss DJ. Bone marrow pathology in dogs and cats with non-regenerative immune-mediated haemolytic anaemia and pure red cell aplasia. J Comp Pathol 2008;138:4653.

    • Search Google Scholar
    • Export Citation
  • 3. Scott-Moncrieff JC, Reagan WJ, Glickman LT, et al. Treatment of nonregenerative anemia with human gamma-globulin in dogs. J Am Vet Med Assoc 1995;206:18951900.

    • Search Google Scholar
    • Export Citation
  • 4. Villiers EJ, Dunn JK. Clinicopathological features of seven cases of canine myelofibrosis and the possible relationship between the histological findings and prognosis. Vet Rec 1999;145:222228.

    • Search Google Scholar
    • Export Citation
  • 5. Klag AR, Giger U, Shofer FS. Idiopathic immune-mediated hemolytic anemia in dogs: 42 cases (1986–1990). J Am Vet Med Assoc 1993;202:783788.

    • Search Google Scholar
    • Export Citation
  • 6. McManus PM, Craig LE. Correlation between leukocytosis and necropsy findings in dogs with immune-mediated hemolytic anemia: 34 cases (1994–1999). J Am Vet Med Assoc 2001;218:13081313.

    • Search Google Scholar
    • Export Citation
  • 7. Weinkle TK, Center SA, Randolph JF, et al. Evaluation of prognostic factors, survival rates, and treatment protocols for immune-mediated hemolytic anemia in dogs: 151 cases (1993–2002). J Am Vet Med Assoc 2005;226:18691880.

    • Search Google Scholar
    • Export Citation
  • 8. Jonas L, Thrall M, Weiser M. Nonregenerative form of immune-mediated hemolytic anemia in dogs. J Am Anim Hosp Assoc 1987;23:201204.

    • Search Google Scholar
    • Export Citation
  • 9. Grimes CN, Fry MM. Nonregenerative anemia: mechanisms of decreased or ineffective erythropoiesis. Vet Pathol 2015;52:298311.

  • 10. Holloway SA, Meyer DJ, Mannella C. Prednisolone and danazol for treatment of immune-mediated anemia, thrombocytopenia, and ineffective erythroid regeneration in a dog. J Am Vet Med Assoc 1990;197:10451048.

    • Search Google Scholar
    • Export Citation
  • 11. Stokol T, Blue JT, French TW. Idiopathic pure red cell aplasia and nonregenerative immune-mediated anemia in dogs: 43 cases (1988–1999). J Am Vet Med Assoc 2000;216:14291436.

    • Search Google Scholar
    • Export Citation
  • 12. Lucidi CA, de Rezende CL, Jutkowitz LA, et al. Histologic and cytologic bone marrow findings in dogs with suspected precursor-targeted immune-mediated anemia and associated phagocytosis of erythroid precursors. Vet Clin Pathol 2017;46:401415.

    • Search Google Scholar
    • Export Citation
  • 13. Weiss DJ. Antibody-mediated suppression of erythropoiesis in dogs with red blood cell aplasia. Am J Vet Res 1986;47:26462648.

  • 14. Weiss DJ. Primary pure red cell aplasia in dogs: 13 cases (1996–2000). J Am Vet Med Assoc 2002;221:9395.

  • 15. Burgess K, Moore A, Rand W, et al. Treatment of immune-mediated hemolytic anemia in dogs with cyclophosphamide. J Vet Intern Med 2000;14:456462.

    • Search Google Scholar
    • Export Citation
  • 16. Weiss DJ, Smith SA. A retrospective study of 19 cases of canine myelofibrosis. J Vet Intern Med 2002;16:174178.

  • 17. Vergara-Lluri ME, Piatek CI, Pullarkat V, et al. Autoimmune myelofibrosis: an update on morphologic features in 29 cases and review of the literature. Hum Pathol 2014;45:21832191.

    • Search Google Scholar
    • Export Citation
  • 18. Ueha S, Shand FH, Matsushima K. Cellular and molecular mechanisms of chronic inflammation-associated organ fibrosis. Front Immunol 2012;3:71.

    • Search Google Scholar
    • Export Citation
  • 19. Balch A, Mackin A. Canine immune-mediated hemolytic anemia: pathophysiology, clinical signs, and diagnosis. Compend Contin Educ Vet 2007;29:217225.

    • Search Google Scholar
    • Export Citation
  • 20. Carr AP, Panciera DL, Kidd L. Prognostic factors for mortality and thromboembolism in canine immune-mediated hemolytic anemia: a retrospective study of 72 dogs. J Vet Intern Med 2002;16:504509.

    • Search Google Scholar
    • Export Citation
  • 21. Klein MK, Dow SW, Rosychuk RA. Pulmonary thromboembolism associated with immune-mediated hemolytic anemia in dogs: ten cases (1982–1987). J Am Vet Med Assoc 1989;195:246250.

    • Search Google Scholar
    • Export Citation
  • 22. Piek CJ, Junius G, Dekker A, et al. Idiopathic immune-mediated hemolytic anemia: treatment outcome and prognostic factors in 149 dogs. J Vet Intern Med 2008;22:366373.

    • Search Google Scholar
    • Export Citation
  • 23. Kidd L, Mackman N. Prothrombotic mechanisms and anticoagulant therapy in dogs with immune-mediated hemolytic anemia. J Vet Emerg Crit Care (San Antonio) 2013;23:313.

    • Search Google Scholar
    • Export Citation
  • 24. Rothuizen J, van den Brom WE, Fevery J. The origins and kinetics of bilirubin in dogs with hepatobiliary and haemolytic diseases. J Hepatol 1992;15:1724.

    • Search Google Scholar
    • Export Citation
  • 25. Helmond SE, Polzin DJ, Armstrong PJ, et al. Treatment of immune-mediated hemolytic anemia with individually adjusted heparin dosing in dogs. J Vet Intern Med 2010;24:597605.

    • Search Google Scholar
    • Export Citation

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Clinical features of precursor-targeted immune-mediated anemia in dogs: 66 cases (2004–2013)

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  • 1 1Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan 48824.
  • | 2 2Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan 48824.

Abstract

OBJECTIVE

To characterize the clinical features of dogs with precursor-targeted immune-mediated anemia (PIMA).

ANIMALS

66 dogs with PIMA.

PROCEDURES

Electronic record databases of a teaching hospital were searched to identify dogs with a diagnosis of nonregenerative anemia between 2004 and 2013. Inclusion criteria included persistent nonregenerative anemia (Hct ≤ 30% and reticulocyte count < 76,000 reticulocytes/μL), cytologic findings supportive of ineffective bone marrow erythropoiesis, and absence of underlying disease. Information regarding clinical signs, clinicopathologic findings, treatment, and outcome was extracted from records of eligible dogs. A regenerative response was defined as a reticulocyte count > 76,000 reticulocytes/μL or sustained increase in Hct of > 5%. Remission was defined as a stable Hct ≥ 35%.

RESULTS

The median Hct was 13%, and reticulocyte count was 17,900 reticulocytes/μL. Rubriphagocytosis was identified in bone marrow aspirate samples from 61 of 66 dogs. Collagen myelofibrosis was detected in bone marrow biopsy specimens obtained from 31 of 63 dogs. Immune-mediated targeting of mature erythrocytes was uncommon. All dogs received immunosuppressive therapy. Fifty-five dogs developed a regenerative response at a median of 29 days, and 40 of those dogs went into remission at a median of 59 days after PIMA diagnosis. Thromboembolic events were confirmed for 9 dogs and were associated with a decreased survival time. Median survival time was 913 days for all dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that most dogs with PIMA responded to prolonged immunosuppressive therapy. Studies to determine optimal immunosuppressive and thromboprophylactic protocols for dogs with PIMA are warranted.

Contributor Notes

Dr. Assenmacher's present address is BluePearl Veterinary Partners, 3412 E Walton Blvd, Auburn Hills, MI 48326.

Dr. Lucidi's present address is Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706.

Address correspondence to Dr. Assenmacher (tara.assenmacher@bluepearlvet.com).