Immune Mediated Hemolytic Anemia (IMHA)

Sometimes they will just seem sick and not interested in food (Image Source)

Immune mediated hemolytic anemia (or IMHA) is a condition where the body begins to attack and destroy the circulating red blood cells. Sometimes there is another underlying disease process that is causing the body to over-react and attack the red blood cells, but sometimes a cause is never determined. This condition can be very serious and not all patients will respond to treatment. It is important to implement aggressive treatment very quickly to improve the likelihood of a positive outcome.

Some owners may notice pale or light yellow gums (Image Source)

Symptoms at home may include weakness, lethargy, and decreased appetite. You may notice that the gums or tips of ears have turned a light yellow color. This is from the bilirubin that would normally be contained inside the red blood cells. Overall they may just act off and not like themselves. Once at the clinic, blood work can show if anemia is present. Again, the cause may not always be apparent, but we need to try to rule out as many causes as possible. This may require additional testing such as x-rays or ultrasound. If no cause is determined that treatment for IMHA may be initiated.

Depending on the severity of the anemia, a blood transfusion may be necessary. This may need to be done at a referral hospital under strict supervision. Other treatments will include medications such as steroids and cyclosporine that will help reduce the over-activity of the immune system. Sometimes antibiotics are also added to help further decrease the over-activity of the immune system. Treatment may last for months. Depending on the severity of the condition, any underlying causes and the patient’s response to treatment.

Once quick test in the hospital is the slide agglutination test. If clumping is noted IMHA is much more likely. (Image Source)

Once patients are stabilized, typically medication will be slowly weaned and eventually stopped. Again, this could be many months of treatment. Also future medications and vaccinations will have to be carefully monitored and timed so as not to over excite the immune system. Once a patient has had IMHA it is important to monitor for symptoms again. It is possible to have recurrent issues and if severe patients do not always survive treatment. For more information on this condition please visit the following website here.