Treatment and Prognosis for AIHA in Dogs
Goals of Treating Autoimmune Hemolytic Anemia
When an owner suspects that her dog may be anemic, she should take him to the veterinarian as soon as possible. Autoimmune hemolytic anemia (AIHA, also called immune mediated hemolytic anemia, or IMHA can be very serious, as it is caused by the dog’s immune system targeting and destroying its own red blood cells. Left untreated, and even sometimes with appropriate treatment, an estimated 40% to 60% of dogs with IMHA will eventually die from the disease. Treatment should be swift and aggressive. The primary therapeutic goals are to correct the anemia so that the dog’s red blood cells can once again transport oxygen to all of its tissues in a normal fashion, and to correct any identifiable underlying disorders that are contributing to the RBC destruction, while maintaining the dog's health until his red blood cell supply can be replenished.
If a dog's IMHA has already become life-threatening, blood transfusions may be necessary to stabilize him so that the veterinary team has time to determine the primary cause of his condition. In acute cases, this transfusion is usually of packed red blood cells, one component of whole blood. Transfusions can be tricky and even dangerous, because they add more red blood cells for the immune system to destroy and can lead to an even more aggressive immune system response.
Drug therapy has proven to be an effective treatment for IMHA in some cases. Your veterinarian may prescribe a corticosteroid, such as prednisone or dexamethasone, to suppress the dog’s immune system in an attempt to slow down its attack on red blood cells. These medications are given in high doses either by injection or by mouth. If the dog's condition does not improve, stronger immunosuppressive drugs, including chemotherapeutic agents, can be added to the mix. These might include drugs such as azathioprine and/or cyclophosphamide, and new medications may be brought on the market as well. These are usually not a first treatment choice, because although they are stronger, they also have the potential for more adverse side effects.
Intense treatment is necessary for a good outcome in dogs with autoimmune hemolytic anemia. In mild cases, full recovery may be possible, although it is uncommon. In most cases, long-term or even lifelong treatment may be necessary. Relapses are common. The prognosis basically depends upon the underlying disorder. Only a veterinarian can determine the best course of treatment for a dog suffering from this disease.