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What is Immune Mediated Hemolytic Anemia (IMHA)?

Squishy and Me

March 24, 2003 – August 6, 2013
“I have sent you on a journey to a land free from pain, not because I did not love you, but because I loved you too much to force you to stay.”

I’d like to blog about something different than the usual programming posts I normally do. This post is near and dear to my heart. I originally posted this earlier today to a website I made dedicated in the memory of my dog Squishy. In light of that, the following is a rehash of what I posted to help promote awareness of the Immune Mediated Hemolytic Anemia (IMHA) disease. If you have a pet I hope this can be of help to you. If you would like to know more about my wonderful dog please visit Thank you.

What is Immune Mediated Hemolytic Anemia (IMHA)?

About a month ago, July 6, 2013, my dog Squishy was diagnosed with Immune Mediated Hemolytic Anemia (IMHA). Immune-mediated hemolytic anemia is a condition when your pet’s own immune system attacks its own red blood cells. The part of the immune system, that produces antibodies, begins to direct the antibodies against your pet’s own red blood cells. The red blood cells are coated with Y-shaped antibodies that mark them for removal or destruction. When too many red blood cells are destroyed your pet then is said to become anemic, they will feel weak and cold (Squishy experienced this). Since the red blood cells are being destroyed internally and not externally, you will notice that your pet will become yellow-tinged (jaundiced). Good indicators that this is happening, as well, is that you will notice that your pet’s urine will turn to brown or dark orange, this is due to large amounts of bilirubin (iron containing by-product of red blood cells destruction) being present in your pet’s liver. When red blood cells become old and inflexible, they are removed from circulation. The iron that they contain is recycled in the liver. If too many red blood cells are destroyed, the liver becomes overwhelmed with bilirubin (yellow pigment). When this occurs, bilirubin overflows out everywhere (skin, eyes, gums, and coloring the urine). This is known as Icterus (also called Jaundice).

Immune-mediated hemolytic anemia is a serious disease that is associated with a high mortality rate. With that said, if you find any indications of this disease immediately see your veterinarian now. Do not wait till tomorrow, do it now. Reason why I state “now” is because your pet may have 2-3 days of life left if not treated immediately. I was fortunate to extend Squishy’s life for an additional month (diagnosed on July 6, 2013) by taking medications of Predisone and Doxycycline. I’d like to state this, this disease can “just happen” with no apparent cause (certain conditions such as infections or cancer can trigger this response). It’s not yours or your pet’s fault. 60-75% IMHA cases state that there are no real apparent causes to why this happens. My veterinarian confirmed this, he stated it just happens. So, don’t beat yourself up over it. You and your pet did nothing wrong. Just enjoy as much time you and your pet have together. Cherish it.

Signs you should notice

IMHA can suddenly appear or may be gradual and progressive. The gradual and progressive symptoms happened to Squishy (when being treated for initial signs of dark orange/brown color of his urine)

  • Urine becomes dark orange or brown
  • Stool may show presence of blood
  • Gums are pale/yellow-tinged, no longer pink
  • Whites of the eyes become yellow-tinged
  • Your pet becomes weak/lethargic
  • Lost in interest of food
  • Vomiting
  • Abdominal pain
  • Fever may happen

Caring for your pet with IMHA

  • Stay diligent on administrating your pet’s prescription, do not miss prescribing dosages! If you miss the scheduled dosage, do not give additional medicine to “make up” missed dosage. Continue same dosage routine and notify your veterinarian of missed dosage.
  • Watch for signs of infections, appetite loss, vomiting, lethargy, diarrhea and urinary incontinence. When your pet is on Predisone (a class of Corticosteroids) to treat IMHA, it suppresses the immune system, so they become more prone to infection.
  • Keep them feed on a well-balanced diet, so they may receive the proper nutrition needed. Ask your veterinarian about recommended foods. Being on high doses of Predisone, in early stages of treatment, you will notice a huge increase in appetite and some weight gain in your pet.
  • Limit your dog’s activity until he recovers.
  • DO NOT MISS A VETERINARIAN VISIT! Be sure to bring your pet to all scheduled visits and blood tests. I highly emphasize to stay on track with blood tests. The blood tests will tell your pet’s progression through recovery. You will have frequent visits to the veterinarian.
    Expect every 3-4 day visits initially, then being tapered down to 1 visit per week. Your vet will start dosage in high levels, and later taper off as your pet’s red blood count reaches normal.
  • Expect to take your pet outside every 2-3 hours to urinate. Squish and I went through this, even in the late hours (12am, 3am, and 6am). I would continue to do this for Squishy, every day without hesitation, if it meant keeping Squish with me longer. :(

More information on IMHA

Hi, my name is David. I am a .Net, Windows Phone, Windows 8 developer. I created @gogetter for Windows Phone

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