From:
Bruce Williams, DVM
Date: 2001-04-10 19:45:00 UTC
Subject: AIHA (Dr. Williams back online, but a bit slow)
I have returned, although my connection is now through NetZero, as my
ISP is down since Friday. Hopefully, hey will get it straightened
out soon, as 28.8 baud is a difficult adjustment to make.
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