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Hemolytic Anemia in Dogs

Hemolytic Anemia in Dogs

Hemolytic anemia is a serious dog illness that can affect canines of any breed at any age. The severity of it can vary from being mild, requiring only timely medication to being life-threatening, requiring complete and undivided attention from the pet owner. Hence, it is important to understand in detail, what exactly is this disease and how to cure it.

Hemolytic anemia in dogs, is a type of anemia, where the red blood cells get destructed prematurely, due to a variety of factors leading to a shortage of functional red blood cells, which may result in hypoxia and even death. It is a relatively uncommon dog health problem.

Types and Causes
Hemolytic anemia can occur due to various reasons. It can be hereditary, which is present from birth and which starts showing symptoms quite earlier on, or it can be acquired due to a disease or due to toxins. It is important to know the root cause underlying the disease, so as to reach a proper diagnosis and thus, chalk out an effective treatment plan.

Membrane Defect Hemolytic Anemia: This condition is caused due to defective membranes of the red blood cells. This includes sickle cell anemia, hereditary spherocytosis and hereditary elliptocytosis.

Hemoglobin Defective Hemloytic Anemia: This type of hemolytic anemia occurs due to malfunctioning or unstable hemoglobin in the red blood cell. This is one of the main hemolytic anemia causes. This type also includes thalassemia.

Autoimmune Hemolytic Anemia: In this condition, the immune system of the dog is involved, where the body starts generating antibodies against the red blood cells, by wrongly identifying them as foreign bodies. This leads to destruction of healthy red blood cells.

Induced Hemolytic Anemia: One of the rarer hemolytic anemia causes is, when its induced due to an infection or drugs. This occurs in severe cases of hemolytic uremic syndrome, septicemia, pneumonia, disseminated intravascular coagulation, etc. Also, certain drugs can induce an allergic reaction, which manifests itself as hemolytic anemia in dogs. These include drugs such as dapsone, chlorates, etc.

Hemolytic Anemia Symptoms
Mentioned below is a list of hemolytic anemia symptoms found in dogs:

• Fatigue: Due to depleted levels of oxygen, hemolytic anemia in dogs typically manifests as weakness, fatigue and severe lethargy. Your canine may get tired after running short distances. He may start panting or suddenly sit down after running.
• Jaundice: It is often seen that in hemolytic anemia, bilirubin levels shoot up, due to the excessive destruction of red blood cells. This typically manifests as jaundice. Due to this high rate of red blood cell breakdown in hemolytic anemia, bilirubin levels may even accumulate in the blood and be excreted in urine, leading to darkening of urine. This is one of the most serious symptoms. There are also raised levels of other enzymes in dogs hemolytic anemia, which help in diagnosing the condition.
• Hypertrophy of Spleen: Due to overload on the spleen, for the increased rate of destruction of red blood cells, the spleen increases in size, which is known as splenomegaly. However, on most occasions, the bone marrow cannot keep up with the fall in red blood cell count, thus leading to eventual worsening of the condition.
• Breathlessness: Breathlessness is one of the first symptoms. The dog shows rapid breathing (tachypnea) after even routine activities like running.
• Depletion of Folate Levels: Due to continuing hemolysis, there is a depletion of folate levels, which is one of the hemolytic anemia symptoms
• Miscellaneous symptoms: Fever, seizures, hematuria (presence of blood in urine), peripheral neuropathy. Most of these symptoms in dogs, occur towards the last stages of the disease

Tests and Diagnosis
Here are some tests that can help you diagnose the problem:

• Peripheral Blood Smear: This test will normally reveal fragments of red blood cells, which are ruptured. In case of hereditary spherocytosis, the blood cells maybe smaller and rounder. Reticulocyte count is often elevated.
• Packed Cell Volume Test: This is a relatively simple, and quick test which helps in finding the number of red blood cells present.
• Coombs Test: This test is also called the antiglobulin test or direct Coombs test. It is the perfect test to confirm autoimmune hemolytic anemia symptoms. This test checks for the presence of antibodies that cause premature destruction of the red blood cells.
• Hemoglobin Electrophoresis Test: This helps to test for hemoglobin instability, especially in cases of membrane defect hemolytic anemia.
• Radiographs: In certain cases, radiographs and ultrasound examinations maybe helpful in confirming the presence of hemolytic anemia.
• Miscellaneous tests: There are certain tests that check for pigments and enzymes, whose levels are altered in hemolytic anemia. Bilirubin, lactate dehydrogenase and urobilinogen show elevated levels, while the levels of haptogloben go down in hemolytic anemia

Treatment Options
Hemolytic anemia treatment has to be formulated after a detailed analysis of the case at hand. The treatment plan will differ depending on the severity of the case, the type of hemolytic anemia present and various other factors. Hence, it is imperative that a veterinarian pay special attention to the dogs signs and symptoms before starting the treatment.

Use of Corticosteroids: Many steroids are very helpful in cases of autoimmune hemolytic anemia in dogs. These normally form the mainstay of hemolytic anemia treatment. Ideally, steroids should suffice in treating autoimmune related hemolytic anemia, at least in the early stages of the disease. Prednisone is one of the commonly used steroid. Although this is not a definitive treatment, it helps bring the severity of the disease under control. It must only be prescribed in the right dose by a certified veterinarian, as overuse of this drug can lead to prednisone side effects in dogs. If steroids fail to bring the condition under control, then stronger drugs like azathioprine, cyclophosphamide and cyclosporine can be used. At later stages danazol can be administered, after tapering down the dosage of corticosteroids.

Blood Transfusion: In severe cases, when the hemoglobin level of the dog falls drastically, blood transfusions may become a necessary part of hemolytic anemia treatment. But before transfusion, the blood must be typed and matched to prevent any transfusion reactions. Transfusions should be given only in very severe cases, as the introduction of foreign proteins can intensify the situation in some dogs.

Intravenous Immunoglobulin: Human intravenous immunoglobulin contains immunoglobulins, which is extracted from human blood plasma. It is used in certain canines which do not respond to other therapies.

Splenectomy: This is a surgery which is done to remove the spleen. It is occasionally recommended for non-responsive cases of hemolytic anemia. It helps improve the condition of the dog by generating less antibodies against the red blood cells. It is a rare option in hemolytic anemia treatment.

Administration of Folic Acid and Intravenous Fluids: Normally, ongoing hemolysis of red blood cells can lead to depleted levels of folic acid. For this, the dog may require additional externally administered folic acid. The exact dosage is to be given by the veterinarian. Also, often intravenous fluid administration is indicated for dogs, as this helps prevent dehydration and also aids in maintaining electrolyte balance.

Treating any Underlying Disease: In some cases, hemolytic anemia maybe a complication due to some other disease like infectious mononucleosis, pneumonia, malaria, septicemia, etc. In such cases, it is always important to get rid of the main disease present as soon as possible, as this will help automatically abate the severity of the disease and bring about a significant improvement in your dogs health. Also, certain chemicals or drugs may lead to hemolysis of red blood cells as an effect of an allergic reaction or poisoning. In such cases, as soon as such a reaction ensues, rush your dog to a veterinarian, as he may require a stomach lavage or an intravenous drug to counter the effects of the drug or poison.

Thus, it is important to pay attention to dog care when your canine has hemolytic anemia. Do not overstress the dog by excessively playing with him. Try to limit his physical activities. Provide adequate nutrition by giving your canine good dog food, along with the proper prescribed medication. And of course, visit the veterinarian regularly as it is a grievous condition, and you should do everything you can to cure it. After all, like they say, dog is a mans best friend, and youd do anything for your best friend, wouldnt you?

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