Hemolytic anemia is a serious illness that can affect canines of any breed. In its mild form, this condition requires only timely medication. If it becomes severe and life threatening, the dog needs complete and undivided attention from the owner. Hence, it is important to understand in detail, what exactly is this disease, and how to cure it.
Hemolytic anemia is a type of anemia, in which the red blood cells get destructed prematurely, due to a variety of factors. This leads to a shortage of functional red blood cells, which may result in hypoxia and even death. It is a relatively uncommon condition in canines.
Types and Causes
Hemolytic anemia may occur due to various reasons. It can be hereditary and congenital, and may start showing symptoms quite early. It can be acquired due to some disease or exposure to toxins. It is important to know the underlying cause, so as to chalk out an effective treatment plan.
Membrane Defect Hemolytic Anemia: This condition is caused due to defective membranes of the red blood cells as found in sickle cell anemia, hereditary spherocytosis, and hereditary elliptocytosis.
Hemoglobin Defective Hemolytic Anemia: This type of hemolytic anemia occurs due to malfunctioning or unstable hemoglobin in the red blood cells, as found in thalassemia.
Autoimmune Hemolytic Anemia: In this condition, the immune system of the dog is involved. 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: This is one of the rare causes of hemolytic anemia. It is induced due to an infection or use of certain drugs. This occurs in severe cases of hemolytic uremic syndrome, septicemia, pneumonia, disseminated intravascular coagulation, etc. Certain drugs can induce the immune system to make antibodies against the red blood cells, thereby causing hemolysis. These include drugs such as dapsone, levodopa, penicillin, quinidine, etc.
- Fatigue: Due to the depleted levels of oxygen, hemolytic anemia causes weakness, fatigue, and severe lethargy. Your canine may get tired after running short distances. He may start panting or sit down suddenly, after running.
- Jaundice: In some cases, bilirubin levels shoot up due to excessive destruction of red blood cells. This leads to jaundice. Due to the high rate of red blood cell breakdown, bilirubin may accumulate in the blood and is excreted through urine. So, dark urine is one of the most serious symptoms of this condition. Raised levels of other enzymes may also help in diagnosing the condition.
- Hypertrophy of the Spleen: Due to the increased rate of destruction of red blood cells, the spleen size increases, and the condition 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 worsening of the condition.
- Breathlessness: Breathlessness is one of the initial symptoms of hemolytic anemia. The dog shows rapid breathing (tachypnea) after routine activities like running.
- Depletion of Folate Levels: Continuous destruction of red blood cells leads to depletion of the folate levels.
- Miscellaneous symptoms: Fever, seizures, hematuria (presence of blood in urine), and peripheral neuropathy, are some of the symptoms that occur towards the last stages of the disease.
Tests and Diagnosis
- 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.
- Coombs Test: This test is also called the antiglobulin test or direct Coombs test. It is the most preferred test to confirm autoimmune hemolytic anemia in dogs. This test checks for the presence of antibodies that cause premature destruction of red blood cells.
- Hemoglobin Electrophoresis Test: This helps to detect hemoglobin instability, especially in case of membrane defect hemolytic anemia.
- Radiographs: In certain cases, radiographs and ultrasound examinations may prove helpful in confirming this disorder in dogs.
- Miscellaneous tests: This medical condition may cause variations in the levels of certain pigments and enzymes. So, certain tests are conducted to detect such variations. Bilirubin, lactate dehydrogenase, and urobilinogen show elevated levels, while the level of haptoglobin goes down in dogs with hemolytic anemia.
The treatment plan has to be formulated after a detailed analysis of the case at hand. The course of treatment may differ depending on the severity of the case, the type of hemolytic anemia, and various other factors. So, a veterinarian must pay special attention to the symptoms before starting the treatment.
Use of Corticosteroids: These drugs are commonly used for treating autoimmune hemolytic anemia in dogs. Prednisone is one of the commonly used steroid. Although this is not a definitive treatment, it helps to control the severity of the disease. Corticosteroids as well as immunosuppressants prevent further destruction of red blood cells by hindering antigen-antibody reactions. However, the right dosage is very important. So, these drugs must be prescribed by a certified veterinarian, as overuse can lead to side effects. If steroids fail to bring the condition under control, stronger drugs such as azathioprine, cyclophosphamide, and cyclosporine are prescribed.
Blood Transfusion: In severe cases, when the hemoglobin level of the dog falls drastically, blood transfusions may become a necessary part of treatment. But before transfusion, the blood must be typed and matched to prevent any adverse reaction. Transfusions should be given only in very severe cases, as introduction of foreign proteins may worsen the condition in some dogs.
Intravenous Immunoglobulin: Human intravenous immunoglobulin contains immunoglobulins, which are 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 to improve the condition of the dog by generating less antibodies against the red blood cells.
Administration of Folic Acid and Intravenous Fluids: Normally, ongoing hemolysis of red blood cells can lead to depleted levels of folic acid. So, the dog may require additional folic acid. The exact dosage is to be prescribed by the veterinarian. Intravenous fluid administration helps to prevent dehydration and aids in maintaining electrolyte balance.
Treating any Underlying Disease: In some cases, hemolytic anemia may develop as a complication of some other disease like infectious mononucleosis, pneumonia, malaria, septicemia, etc. In such cases, it is always important to get rid of the underlying disease as soon as possible. Certain chemicals or drugs may lead to hemolysis of red blood cells as a result of allergic reactions or poisoning. In such cases, rush your dog to a veterinarian as soon as such a reaction ensues, because the animal may require a stomach lavage or an intravenous drug to counter the effects of the drug or poison.
Thus, it is very important to take proper care of your dog, if it has hemolytic anemia. Prevent the dog from indulging in strenuous physical activities and excessive playing. Provide adequate nutrition to your canine, along with the proper prescribed medication. After all, like they say, dog is a man’s best friend, and you’d do anything for your best friend, wouldn’t you?