This past Friday, one of our dogs, Tasha, presented after a day of not
eating with pale mucous membranes and a slight yellow tinge.  Fearing the
worst, I took Tasha over to Charlie Weiss' and we confrimed my immediate
and worst fear - autoimmune hemolytic anemia - a disease that has no
definitive etiology, no prevention, and as of yet, no effective treatment.
After 48 sleepless hours and every treatment that we could think of,
including a liter of synthetic hemoglobin (currently retailing at about
$1200 a liter), we could not save her.  Needless to say, we are devastated.
 
AIHA is also a disease of ferrets which we have also discussed on this
list.  AIHA is essentially identical to that seen in Tasha and other of
her species - unremitting destruction of the red blood cells by the bodies'
own mechanisms, with an unrelenting progression toward organ failure and
death.  What causes it?  We don't know - probably a number of things.
Vaccinations, antibiotics, drug reactions - anything and everything.
Something turns the body against it's own cells -
 
People tend to think we know a lot more about this disease in dogs than
we do in ferrets, and wonder why we don't do more with AIHA in ferrets.
Basically, we don't have a direct test (known as a Coomb's test) to detect
antibodies in ferrets, but that's about it.  We pulled the test on my dog -
she was dead before it came back.  We knew it was AIHA as soon as the blood
results came back, or maybe it was after the second CBC - her PCV dropped
by 33% in 18 hours.We do the same treatments in dogs as in ferrets, and
unfortunately, they don't often work.
 
AIHA is still relatively uncommon in domestic species, and luckily for
us.  The hematocrit drops like a rock, and we pump steroids, and other
immunosuppressants and it rarely responds.  Doesn't matter which species.
As we were applying heroic measures to Tasha, a member of the species in
which we know the most about AIHA, two other dogs in the clinic were also
being treated for this disease.  None survived.
 
One day we will know more about AIHA.  But today, we must still consider
it a diagnosis with one of the poorest prognosis around.
 
With kindest regards,
Bruce Williams, DVM
[Posted in FML issue 3408]