The Reality of a Dog With IMHA

IMHA dog

I check my dog’s gums for any change in color from their usual pink to reddish healthy hue to anything that slightly resembles pale. This routine is performed nightly in conjunction with bedtime teeth brushing.  The reality of a dog with IMHA means life changes, but it can be managed. I fear those four letters more almost as much as I do the Big C. In this case, I am referring to IMHA, or Immune Mediated Hemolytic Anemia. Break that down and basically it means the body’s immune system destroys red blood cells.

IMHA is a chronic disease, often fatal, and something that I’ve read time and again of which Cocker Spaniels are the poster breed. According to most websites and veterinary literature, breeds that are more prone to the disease, in addition to Cockers, are Poodles, Basenji, West Highland White Terriers, Old English Sheepdogs, and Irish Setters, but any dog can be affected.

As a member of one of the biggest online Cocker Spaniel forums, it is with a heavy heart that at least once every few months a member reveals their dog is affected—and then the battle begins—sometimes with victory and many times the disease wins.

vetWith all of this information and all of these resources I’ve consumed over the years, the idea of blogging on the topic came to a head when an industry friend’s dog was diagnosed with IMHA. The dog is not a Cocker, not any of the typical breeds affected, and the dog is that of famed veterinarian, Dr. Patrick Mahaney. Mahaney is a regular contributor to petMD.com and has documented his dog’s journey. The road has not been easy, but Mahaney has taken an integrative approach to Cardiff’s treatment by using a combination of Western (conventional) and Traditional Chinese Veterinary Medicine (TCVM). You can follow Cardiff’s journey and Mahaney’s treatments and blog posts here or here.

The doc admits he is a “highly-informed pet owner, so any deviation from his normal is highly scrutinized for potential causes and outcomes,” and this is what pet parents must do in order to thwart this disease early on. IMHA, you see, is best battled when caught early on: As in, get the dog to the vet right away if the gums or pale, white, or yellow. That is one of the signs, but not the only and certainly not textbook for all dogs.

Reality of a dog with IMHA

What Causes IMHA?

In most pets, the underlying cause of disease is never identified. Some experts believe IMHA may be caused, in part or because of, infection, vaccination reaction, drug side effects, or even cancer.

As a dog mom whose first Cocker Spaniel developed a mast cell tumor (cancer) at the site of then-yearly vaccines. You can read about our mast cell cancer journey here. (note: we beat it)!

Dogs that have been diagnosed with IMHA should not be used for breeding, and it is preferable to avoid breeding their close relatives as well. If you are seeking a dog from a reputable breeder, ask about IMHA in the line and any screening.

In some cases, it is believed there is an underlying problem: something that triggered the reaction. This is where my ears perk up and I take notice. And yours should, too.

Some theories of cause of IMHA include:

  • Drugs used for treatment in the dog of another condition. Implicated drugs include penicillins, trimethoprim-sulfa, and methimazole.
  • Cancer can cause a reaction and IMHA may result.
  • Insect bites.
  • Spot-on flea and tick preventatives

In one report, IMHA is observed in dogs with increased antibody titers to viral antigens, which seems to indicate that recent vaccinations or viral infections may be implicated in those cases. An association between IMHA and recent vaccination (<30days) has been established, but the cause and effect relationship between IMHA and recent vaccinations hasn’t been widely accepted by the veterinary community.

dog_vaccines
Photo courtesy Dr. Laurie Coger.

Why Should Dog Parents Care About IMHA?

The signs and symptoms may be subtle, and any dog can be affected.

I read a post similar to this on a Cocker Spaniel forum about 5 or 6 years ago:

“DeeDee is still hospitalized but doing reasonably well. Her RBC was holding at about 28 to 30. She is still receiving hyperbaric chamber treatments along with numerous meds. Marsha has been bringing her food and she is starting to pick at stuff but not really eating/drinking all that much (this is typical since the patient is exhausted as well as the meds often making the tummy iffy).”

The dog never made it home. She passed later that week.

The posts became more frequent and it seemed to this expert-level Cocker mom that IMHA is an epidemic. The more we know as pet parents, the more vigilant we can be in fighting it, and at the very least in getting a proper diagnosis sooner than later.

cocker spaniel

What Are the Symptoms of IMHA?

Symptoms include, but are not limited to, and not all dogs will experience these (nor all at once, though some may):

  • Weakness/lethargy
  • Dark orange or brown urine
  • Yellowing (jaundice) of mouth and/or eyes
  • Labored (heavy) breathing

 Get to the Vet

If any of the above occurs, time is essential, so get your dog to a veterinarian. One of the tests that a vet should run if gums are yellowed or pale is a packed cell volume blood test. In this test, blood serum will return to an off-white color in the tube if the result is normal; a bright orange color indicates hemolytic anemia.

NOTE: Of the dozens of dog parents I’ve connected with over the years who have/had a dog with IMHA, each of them report different initial symptoms, including:

  • Did not eat or even if they did not eat all of their food (note: not eating could be a sign of a lot of things. Get a blood panel done as a start)
  • Seemed a little “off”
  • Lethargic and not wanting to play as usual
  • Labored breathing

If your dogs have black gums, you can also check their eye membranes. Gently pull up (or down) on the lids and look under the lids. It’s similar to checking for pink-eye.

So everyone’s dog is affected differently but acting quickly to get the dog to a vet is essential. This disease, and its symptoms, can come on slowly, but more often, it comes on very quickly.

brush dog teeth
This what my dog’s gums look like normally. Do you know what normal gums look like in your dog?

What Dog Parents Say

Here are actual quotes from dog parents who have a dog diagnosed with IMHA:

I can say that this disease is very tricky. My dog had his first episode in June 2009 and then a second in July of 2010. The first episode,  there were no signs at all…had he not jumped off and hit his eye accidentally I probably would have woke up to find that he had crossed over, his platelets when I took him to the vet for the eye was 1%. He was in the hospital 6 days and had a platelet transfusion. The second episode was exactly like the symptoms say, weak, not eating and very worn out. We got him to the vet thanks to Cherished Cockers and his RBC was way down, he was there 5 days had a whole blood transfusion and thank god has been okay since then. I check his gums 2-3 times a day all the time. He probably gets tired of me doing it but I still do it.

I lost my little angel, Lily, on the 24th of October from IMHA. I don’t think there was anything I could have done to save her. It hit so quickly, and hard, I don’t think anything would have helped her fight it. She had a transfusion, which didn’t take. Her gums, eyes, and tongue had all turned yellow, and at the end even her belly skin was tinged. It was just terrible. And she went from healthy to very ill so quickly!

I’m thinking the reason Penny contracted the disease was to do with her yearly boosters. The needle bent due to her wiggling and the vet was very new. I guess I’ll never be 100% sure but something seemed off about the whole event, her booster was in late December and soon after she stopped eating as much, it took a while and then her gums went pale on February 13th and she was admitted on Valentine’s Day and stayed in intensive care for two weeks and she had to return a week after she was allowed out after contracting a rather nasty virus.

I am currently fighting IMHA with my pup, Annie. She was also started on prednisone and and antibiotic. By the end of the first week my vet also added cyclosporine which is what transplant patients take to prevent organ rejection. She is currently on those along with azathioprine which is a chemo drug. She has also had two transfusions – one of gamma globulin and the second of blood. She is also on a liquid aspirin which is important with IMHA since you need to avoid blood clots. Thankfully she is doing well now and starting to cut down on the pred. This is a horrible disease and if caught early and fought aggressively you can beat it.

So you can see that everyone has a path that is different, but it is a disease that can wreak havoc. It is, however, a disease that is treatable and manageable, with an overall guarded prognosis.

cute dogs

Treatment

Dogs can and do survive despite a diagnosis of IMHA. It is not a guaranteed death sentence. Dispel any thought of that immediately, as a good attitude, a dedicated veterinarian who understands the disease, a specialist who can assist, and a plan in place are all needed. It can be costly and it is a disease that requires diligence on the pet parent’s behalf.

Dr. Patrick Mahaney’s dog, Cardiff, is proof of a dog living (and thriving) with IMHA and a cancer diagnosis, too. I encourage you to read his story and the recommendations of things he has done with Cardiff. Talk to your veterinarian and ask questions. Keep a journal/log of any incidents, when they occurred, anything that surrounded the incident, etc.

Treatment isn’t easy and it is ongoing, and it includes, but is not limited to:

  • Blood transfusions
  • Immune system suppression (immunosuppression) with corticosteroid hormones and potentially advancement to stronger immune suppressive medications, including azathioprine and cyclophosphamide. These are very serious drugs reserved for serious diseases and do have side effects to be discussed with your dog’s veterinarian.
  • Repeat visits and close monitoring of your dog
  • If those gums change in color, get to the vet ASAP. Blood transfusions are needed when the red blood cell level is critically low.

Secondary Complications

Treatment of IMHA is one battle and the side effects of those medications can wreak havoc. According to MarvistaVet.com, here are some of the secondary issues:

IMHA slides

Costs

Vickie Olesker Oppenheimer is an incredible resource on this disease, as a Cocker Mom who has faced this illness with her own dog. She sees this time and again in Cocker Spaniels and is a wonderful resource of information on the Zim Cocker Spaniel Forum. She says, with regards to cost:

“This – like most serious diseases – is expensive! I’m talking about a $10,000 bill in five days – the FIRST five days. Medications ran $400 a month after that for a year. If you are someone that says you tuck away a little each month, consider how much you need to put away monthly to cover that bill. Thankfully we have pet insurance and received reimbursement.

I pay $214 each month to cover five dogs, two cats with a $500. deductible per pet, 80% reimbursement and 100% drug coverage. Research plans and find one that suits you. The only way we could have paid for both Annie and Jennie in that year would have been to put almost $2,000 a month away for them. Is that realistic for you?”

For me, yes this is realistic. I save for my dog. I have pet health insurance for my dog. I look at my dog as a family member and this is what I would do for a family member. And most of you would, too.

cocker_veterinarian

Prognosis

I am not a writer who believes every fact or statistic she reads. Survival rates run the gamut, but dogs can beat this disease. A diagnosis is not a death sentence.

IMHA patients need very close monitoring. Red blood cell counts must be rechecked every 2 to 3 weeks and medications and treatments will fluctuate depending on blood work results. After stabilization, a basic blood panel and urinalysis should be performed every 4 to 6 months for good.

Here is an entire website for reading on success stories of IMHA diagnosed dogs.

Bottom line: There is hope and if this was my dog, I’d fight for him or her period. Love is love.

If My Dog Acquired IMHA

In all honesty, if my dog ever acquired IMHA, I’d be on a consult with the famed Dr. Jean Dodds, Dr. Mahaney, a specialist in the disease, and in regular contact with my dog’s veterinarian.

If your dog is diagnosed, I recommend you ask to join the Zim Cocker Spaniel forum and read the many resources from folks dealing with it first hand or who have dealt with it.

Never give up. Dogs depend on us for their care and overall well being. This can be dealt with, there are resources, and you are not alone.

dog writer

Citations, Sources, and Further Reading:

Veterinary Partner, The Pet Health Library: http://www.veterinarypartner.com/Content.plx?A=1390

Marvista Vet, http://www.marvistavet.com/html/body_imha.html

IMHA information: http://id3424.securedata.net/peppypaws/IHMA&AIHA.html

Dr. Patrick Mahaney: Cardiff’s Blog: http://www.patrickmahaney.com/cardiff-blog/

petMD: http://www.petmd.com/dog/conditions/cardiovascular/c_dg_anemia_immune_mediated

Vickie Olesker Oppenheimer with special gratitude

Note:  I am not a veterinarian but I am a dedicated and educated dog mom. You should always seek veterinary care and talk to your vet about your dog’s health.

 

Comments

  1. I’ve never heard of it. It’s good to be informed though, so you know what you’re dealing with, if your pet has it!

  2. This article is GREATLY needed — IMHA Awareness is the biggest tool in the arsenal to fight IMHA. My Billy (yep, a buffy English cocker) onset 9 years ago. Back then it took me weeks to even find ONE buffy cocker who had survived. Meisha’s Hope website showed that. Billy survived **and THRIVED (six transfusions the first month though. Expensive? oh yeah). Like is mentioned above I also used TCVM (and if anyone wants help trying to hook up with a TCVM vet feel free to email me). But a couple of things I’d really like to stress:

    The absolute BEST above description of onset is “seemed a little off”. If you can catch this EARLY your chances of heading it off with less trauma are far better. Even a teeny tiny bit “seems just a little queasy” (but may be eating FINE) … but truly “just a little off” — go to the vet PLEASE.

    Vet Schools — they can be **the** absolute best place to go. Often far far cheaper (and far better than many) than specialists. It’s honestly worth a 4-6 hour drive and can save you literally many thousands of dollars to go to a vet school.

    This is an auto-immune a/k/a immune-mediated disease. That means that the body itself is killing the red cells (and sometimes platelets). That’s what the big drugs do — they are immune-suppressors. They have mega side effects. You cope with them. You mitigate damage by protecting the liver with things like milk thistle. The dog is sick for a good long while and it takes you many many months (six months at the very least is best to wean off the drugs — with my Billy it was 18 months).

    So you seek wise help — like TCVM — to cope with those side effects and protect the body as best you can so the drugs don’t take a permanent toll on the body.

    And you never give up. My Billy had his BEST years post-IMHA. He was a rescue who had a zillion problems … but he survived and thrived. A mutual friend who has an IMHA dog gave me this link. You absolutely ROCK for bringing awareness to IMHA because we can’t fight what people don’t know about. I’m not a vet — I’m just another dog mom who has found passion in fighting IMHA.

  3. My dog had this and he did survive it. He had 2 transfusions and tons of medicine. He was within 12 hours of losing his life when the 3rd drug started to work. It was a year ago May 29th 2014.

    I believe his was brought on by dental that was done and they didn’t get all of the infection.

    It was the worse 8 weeks of my life and I check him every day to make sure his gums are pink.

    • My dog had it few years ago. He was half dead already, the vet said maybe two more days. I didn’t give up, out of desperation I researched the internet and read about aloe vera juice. Started giving him about 1/4 cup by mouth with a syringe three times a day. He didn’t want it but I forced it into his mouth. I didn’t know how much to give him so I guessed. He is about 15 pounds Pekingese. Let me tell you, he started to get better the next day. After one week he was back to normal, like nothing ever happened. Up to this day my vet calls him the miracle dog and she still can’t believe it that he is alive.
      Aloe vera juice, NOT gel, juice is what saved my Riley. Aloe vera builds new red blood cells, people cure themselves out of leukemia with it.

  4. Thanks for sharing this important information. I am not a dog owner but I am sure that this info will come in handy to those that are. Thanks for sharing awareness and being an advocate for our four legged friends 🙂

  5. My 7 year young Standard Poodle was suddenly covered in deep purple, nearly black bruising all over his body. I happened to be giving him a bath when I was horrified to find these bruises everywhere. His coat is so full and thick, even with brushing I wouldn’t have seen them. “Humphrey” came from a reputable breeder that shows their dogs, and does all the necessary genetic background testing before they breed their dogs. This is one of the things that a dog cannot be tested for beforehand… I called my regular vet, who was booked full for about 5 days. The receptionist said it sounded like ” age spots.” My gut instincts (and Facebook friends) told me otherwise. When I took him to the vet the following morning, after an ultrasound and extensive blood work they found he had 0 platelets. He was put on Chemo and medications and seems to be doing well, 11 days later. Bruising is all gone, good appetite, alert, though a bit quieter than usual. Had I waited the 4 days for my regular vet’s appointment, Humphrey would have been dead. Tomorrow is his first follow up exam… and I’m very curious as to what they will do and find. The last 11 days Humphrey hasn’t been allowed to wear his collar, eat crunchy foods, no bones to chew on, no teeth brushing, or playing around with my other 2 Standard Poodles. Luckily he’s been a bit quieter than usual, which has made life a bit less stressful during this heartbreaking time. Humphrey has had his usual vaccinations.. the last one was Leptospirosis, back in November 2014, after I instructed the vet NOT to. I’m fuming. Humphrey isn’t allowed any more vaccinations, EVER. Also no more monthly Heartworm preventative tablets. Please follow your gut instincts.. if you seriously feel something is wrong with your dog, get him to the vet asap. I did. and it saved Humphrey’s life. Twice. 17 months ago he was suddenly very sick and was diagnosed with IBD. My other Standard was also diagnosed last August with Addison’s. Better to be safe than very sorry…

  6. My shepherd mixed breed recently faced IMHA. His symptoms were pale gums and falling over with pre-seizure like activity but caused from lightheadedness. We got him into the vet within a week of his first fall and a week after that he required an emergency blood transfusion. I believe our quick response was key in battling this as he is now in remission! It has been three weeks since the transfusion and his rbc count has gone from 15% to 35%. We used GoFundMe to help raise money for his transfusion and medication because, as this blog clearly points out, it is an expensive treatment. I hope others can find this resource helpful too.

    • WOW, Amber – good for you for acting fast. I am sure your due diligence and getting your dog to the vet so fast was key to his improvement. We have our paws crossed that all continues to go well. Please keep us posted.

      • Thank you Carol,
        We had a checkup at the vet today and his blood work turned our really good! All of his levels are in the normal range and we are starting to slowly decrease his medication. We are looking forward to participating in Dog-N-Jog on Sunday to benefit the Humane Society of the Greater Kansas City.

  7. My dog died from this disease yesterday. I wish I knew of about this disease earlier. It was brutal and my baby girl tried her best to eat her meds and food. In a matter of two days (after noticing the symptoms), IMHA destroyed her organs and she had severe case of jaundice, her urine was practically blood. The best decision was to let her sleep peacefully and pain free. I wanted to keep her and fight along side her but we caught the symptoms too late… I don’t know if or how or when I will get over this, but I know I am going to miss her and keep her close to my heart forever. Please, spread the word so others don’t have to lose their furry friends to this awful disease.

    • I feel for you deeply. I lost my lab/shepherd mix in Jan. He was diagnosed with IMHA afew days before thanksgiving and put up a hell of a fight. I said as long as he was willing to fight and not suffering I would fight with him. Right before christmas i took him in for a follow up rbc count and to have the vet, not his usual, check a small mass at his armpit. She diagnosed it as edema, fluid buildup, and he went home. It spread down his leg into his paw and it wasn’t until he hit it that it was determined to be an abcess. I don’t know if he was septic from the infection or if the imha got him but on January 6th I made the call that his suffering wasn’t worth waiting around hoping for one more good day, so with his normal vet by my side I let him get the rest he deserved. It’s the not knowing that kills me and brings me to tears even now. Had the abcess been caught right off would he till be here doing well with a 38%rbc and happy energy.

  8. My 7 month old Goldendoodle was diagnosed with IMHA about 3 weeks ago. He has been sick the week before, he was unable to open his eyes and when he did they were rolled back in his head. I decided to take him to the vet and when I did they said that he has a fever and that he obviously had some kind of infection so they started him on several antibiotics. A few days after being on the antibiotics he was back to his old self. A couple days after that I let him outside like I do every morning and that is when I noticed that he his legs would just give out on him. I walked him around a little and then I saw that his gums were extremely white. When I called the vet they urged me to bring him in immediately. After many tests they diagnosed him with IMHA. They told me that his red blood cell count should be between 35 and 40 and his was at 10. At this point he was unable to walk all together and could barely even lift his head. After several days in and out of the vets office and local pet emergency clinic we decided that we needed to do a blood transfusion and start him on several medications. One of those medications is called Mycophenolate. This is a chemotherapy type drug that shuts down the immune system. After the blood transfusion it brought his red blood cell count up to 16. It wasn’t exactly what they were hoping for but they said I needed to wait 72 hours for this drug to kick in. Over the next several days his red blood cell count began to drop again and got back down to 12. After the 72 hours passed they said that he would need to have another blood transfusion. They explained to me that a 2nd blood transfusion was much riskier than the first one because dogs do not have the antibodies that humans do to accept new blood. They told me that I would need to take him to a facility that could cross match his blood type and that would decrease his risks. I took him to Blue Peal in Louisville. They explained to me that he was on all of the right medications and that they would do a 2nd blood transfusion and that his red blood cell count would need to get up to at least 25 and it would need to stay there before they would allow him to go home. They started the blood transfusion and when they tested his red blood cell count afterwards his count was at 27. They kept him for 24 hours and when I went to pick him up it was up to 30. 2 days later I took him back to his normal vet and his red blood cell count was at 35. Its been one week since then and he gets his blood count done again tomorrow. I can tell sometimes that he gets tired but he definitely has his spunk back and is doing much better.

    When I found out that he had IMHA I was looking everywhere online trying to some answers and understand what exactly it was. I was told many times that most of the time dogs do not make it through this. They told me that my dogs red blood cell count is about as low as they had ever seen. I was devastated. I hope this helps someone else looking for some answers and a little hope because although it is a TERRIBLE disease it cant be beat.

    • Olivia – One of the best resources I have found for IMHA assistance has been from a Cocker Spaniel forum and I would recommend going over, joining it (free) and searching IMHA. Many Cocker parents deal with dogs with IMHA and there is a lot of solid info and experience there. here is the link:

      Blessings to your dog and please keep us posted on his progress. He will continue to make it with your due diligence and staying on top of this. You sound like a great dog mom. https://www.zimfamilycockers.com/Forums/

      • Hi Olivia,
        In the article above, Carol mentions Dr. Dodds with hemopet.org. On their website you can upload any of your dog’s test results and get a thorough consultation for $150 which may seem like a lot at first but if you are working with vets who don’t specialize in this disease it is worth it! In addition to the website that she mentioned in her previous message, I also found support through http://www.secondchanceaihadogs.com and they too were able to provide some information based on the test results that I uploaded. It may seem a bit “out there” but I am taking Dean to a vet who specializes in Traditional Chinese Medicine. This is a great supplement to your regular veterinary care and they can suggest some great herbs and diet modifications to protect your dog’s liver from the damaging side effects of the medications needed to fight this disease. Praying for the best for you and your goldendoodle.

        • Amber, that means so much that you took the time to write and share this very valuable info. I believe in and follow the teachings of Dr. Dodds religiously. She is such a pioneer.

          I you don’t mind my asking, what is Dean seeing a traditional Chinese medicine specialist for? Keep us posted and many hugs.

          • I have scrutinized all possible causes of Dean’s IMHA and haven’t found any risks that he ingested poison, tick tests turned up negative, no chemicals on the lawn, no recent vaccines, etc. He also doesn’t appear to carry any of the genes of breeds that are commonly diagnosed with this disease although he is truly a mutt and we really have no idea what breed(s) he is. We are visiting the TCM vet for three reasons: 1) There is a chance that Dean is allergic to something commonly found in dog food (i.e. gluten) and a TCM vet can provide information for diet modifications specific to his issues. 2) With all the medications Dean has been on for the past four months, his liver levels are really high and we are looking for some herbs/supplements to protect his liver. 3) Ten days ago, Dean’s blood test showed some drops in HTC and RBC so we went back on the cyclosporin which had recently been discontinued. While waiting for a week to pass before we could test his blood in response to the reintroduction of cyclosporin, I sort of had a “freak out” or a “meltdown” in fear of losing him or needing another blood transfusion and decided I would try anything. While I was up to 3am one night researching anything and everything about IMHA and AIHA, I came across Traditional Chinese Medicine and that next day I impulsively made an appointment with one in town. Luckily, we reintroduced the cyclosporin quickly enough to prevent the need for another blood transfusion but I consulted with Dean’s vet and she is completely on board with supplementing with TCM to manage any possible food allergy and to protect his liver. Acupuncture is also an option that may stimulate the bone marrow’s production of reticulocytes but there is little to no research on this. We visit the TCM vet tomorrow so I will let you know what I learn.

          • Sending paw prayers, Amber. I am vacationing at the time, so pardon any delays in replying. But yes,please do keep me posted on how things go. You are a great dog mom and so on top of this! Give Dean a tummy rub from us.

      • Our chihuahua was diagnosed with IMHA. Her RBC was down to 21 when the diagnosis was made. We started her immediately on BioAlgae F3+ and a very nutritious raw food diet along with Prednisolone. She is weaning off of the Pred and she started taking Mycophenolate . Her RBC is up to 42 now. She has had swelling of the liver since we put her on the Prednisolone and the Mycophenolate has caused bloating. I really feel that the Algae and the raw food diet has helped her immensely. I think she might not have survived this if we hadn’t done this. The meds from the vet are very harsh and she doesn’t like taking them. She enjoys her raw food diet and the algae and even comes to tell me that she’s ready for her green medicine 3 times a day at the exact right time. I wanted to put this out there for anyone who is going thru this with their little precious pup. I hope it helps.

        • WOW that is fantastic that you figured this out and have it taken care of. Congratulations! Long and happy life!

  9. Dean and I visited a vet today who specializes in Traditional Chinese Medicine (TCM). I’m going to do my best to share what I learned but there was so much information that you absolutely must consult with a vet before adding any (and I mean ANY) herbs or supplements to your dog’s diet when fighting IMHA. Yes, acupuncture can stimulate a dog’s bone marrow to create the reticulocytes that become red blood cells but herbs and Chinese medicines can do this too and so much more. In Dean’s case, she believes he carried an underlying predisposition for anemia that was triggered by vaccines as well as a diet high in processed foods which was also preventing his recovery. No matter how good the ingredients are in a bag of commercial kibble or canned food, the food has been processed to the point that it has lost some nutritional value. Because vaccines are meant to last a year or more, he is now on some medications to cleanse his system and restore his digestive health which has been ravaged by the immunosuppressants he has been on to keep him alive. He is still on the prednisone and cyclosporin and both our regular vet and the TCM vet are working together to track Dean’s test results. Dean will never again be vaccinated (this is not just my opinion but recommended from the vet) except with a specialized form of the rabies vaccine. We are preventing fleas and ticks with the Soresto collar as opposed to anything topical or ingested. Without the required vaccines he won’t be able to go to the doggie daycare down the street and dog parks are too great a risk. Despite all of this, my baby is still alive and we are enjoying every minute of our time together.

  10. My 8 year old Shih Tzu has this God awful disease.The first incident was in 2011 when we walked into the bathroom and found a dog pad drenched in blood.We rushed her to vet and then specialist in R.I. who in my eyes is a miracle worker.She was in ICU for 5 days and had 2 transfusions.I dreaded each call and prayed a lot.My baby Ali was full of life and playing as usual before this happened.It came on quickly and suddenly.She was on prednisone and other medications for months.Itwas very expensive but more costly in emotional distress.I am a retired teacher and my 2 dogs are my kids.The worrying was hell on earth.But slowly my spunky girl made it after several months of loving care at home.Just when we were told by our vet that she was very unlikely to have a reoccurrence it happened again in 2014.Back to the specialist for 4 more days of ICU,transfusions,and medications.Again my miracle Ali recovered after several months of care and medication at home.Sadly,as I am writing this I noticed a tinge of red blood in her urine.I am terrified,angry,and unimaginably sad.It is late so tomorrow to the vet.My baby has gone through so much.We have decided that if it happened a third time we would help her cross the Rainbow Bridge. Yet everything in me cries to try one more time.I know in my heart it was because as a young puppy she was given too many vaccinations at once as she passed out.This was after only a few weeks with me.I thought they had killed her.To this day I know her IMHA was due to too many vaccinations at once.Please do not let this happen to your dog Insist the vaccinations be spread out.The research mentions this as a possible cause but then says there can be no proven correlation. But I know better.I hate this disease.

  11. My 5 year old male pit bull was just diagnosed five days ago. Platelet count is up to 147 from 37 five days ago. H&H are 4.3 and 13.6, RBC is 1.97 – dropped from 5.7, 17.29 and 2.66. He received a steroid shot five days ago and is on Pred 20mg bid. The vet added Imuran today after I called and cried stating I have to watch my dog die because I can’t afford to take him to VSS in St. Louis. The vet said he needs a transfusion, but no one in Cape Girardeau has any blood. I need to ask about aspirin and maybe Tagamet. I took the week off and don’t let Tucker out of my sight. We sleep with him and I hold my hand over his heart all night long while praying. The guilt I feel for money determining whether or not he makes it is unbearable. We maxed out Care credit with my other dog that just had TPLO surgery and then went into renal failure.

    Thank you for this article, it gives me some hope. Please let me know if you have any other suggestions for me to ask my vet about.

  12. My 10th month old rescue is the light of my life. I am single and 42 and adopting him was the best decision of my life. He was strong playful and healthy up until 2 months ago when he started limping. Was diagnosed with Pano and seemed to be on the mend. A week ago though he took a nose dive has lost a ton of weight and after multiple vet visits we think he has AIHA. I am sick to my stomach – he was just admitted and will start the aggressive treatment of steroids and antibiotics. The doctor is good but gave me a less than 50% chance of his survival. I literally saw yesterday that his normally heathy gums and beautiful white teeth were now yellowed pale and bleeding. Obviously straight to the vet and this is where I am now. I am so distraught and upset and all I can do is pray he’ll pull through. He was so healthy and amazing and I am so shocked that if this is such a danger that it’s not a typically administered test! What if he had this all along and not pano as they said?!? Wtf good are the vets then? He is my soul mate and my love – I have been sleeping with him on the floor for a week now and only can pray he pulls through. This forum is comforting but of course I am blaming myself – he is vaccinated – I was told I had to if he was to go to daycare, dog parks etc. is that really what did it? I am just sitting by the phone now waiting…please say a prayer for Sawyer and I

  13. My 8 year old shah tzu Lola was diagnosed a month ago and it has been a battle. She made it after 3 blood transfusions and many nights in the hospital. We still have not figured out what caused the IMHA. Since she is a lap dog the only symptom was the brown color of urine and then I checked her gums. At one point her blood level was 8. She continues to take two medications. I almost gave up hope. I am so happy we helped her. She continues to improve everyday.

    • Gosh I am glad your Lola is okay. Sometimes you may never know what set the IMHA off. Is she vaccinated regularly? Sometimes even a vaccine can do it. Healing paw prayers coming out, Emily.

  14. My 5yr old Italian Greyhound Louie was diagnosed with IHMA on 9/29/16. I rushed him to the vet after noticing his white gums. His PCV was at 12% & received a blood transfusion that day. After the transfusion & 2 days in hospital care his PCV reached 26%. They allowed him to come home. His medications consist of a 10mg tab of Pepcid every 12hrs, 20mg tab Prednisone every 12hrs, 2mg asprin every 24hrs, & 100mg tab Doxycycline every 12hrs. His follow up check on 10/04/16 showed his PCV declined to 20%. All of his test results came back negative. Our vet stopped the Doxycycline and started him on 25mg tab Cyclosporine. At his next follow up on 10/6/16 his PCV increased to 22%. We’ve been pushing along & Louie has remained stable. At today’s check up (10/14/16) his PCV has declined to 19%. The vet said it’s still early to tell if the cyclosporine is working or if we will need to change to another medication (Mycophenolate)
    Louie was recently vaccinated on 09/07/16 & I wonder if this is what caused the IHMA. Our vet said she can’t confirm this, but another vet we’ve seen at this same hospital told me to “Never vaccinate my dog again”. I am on an emotional roller coaster at this point & I am learning that it is a day by day process. Please feel free to comment with any advice. We will continue to fight this awful disease & hope for a full recovery. This blog has been incredibly helpful, & I appreciate everyone’s stories. Thank you!

    • For starters, don’t blame yourself. If I were in your position, I would choose to titer my dog and only vaccinate as absolutely necessary and required by law. We follow the advice of Dr. Jean Dodds, who really is a pioneer in the vaccine world and she has been such a resource for so many.

      We have blogged about vaccines and you can search our site.

      In the meantime, we do know a lot of pet parents who have dogs with IMHA and they have beaten it. Are you seeing a specialist for it???

      Your feedback is very much appreciated and we are keeping Louie in our thoughts and prayers. He is young, has a very diligent dog mom in you, and you are on top of this. There is also a Facebook group that I know is valuable for many dog parents dealing with IMHA in their dog: https://www.facebook.com/groups/6228146980/

      • Thank you for the link, I will look into that. Yes we are seeing a specialist. I appreciate your time, & prayers. We’re staying positive and will continue to fight!

  15. We just lost our sweet Jack yesterday. He was fine on Friday, Saturday morning he was lethargic and his urine was brown. I took him to our vet, she ran a blood test and diagnosed it. We then went immediately to the Pet ER. His blood count was at 29 at our regular vet, but had dropped to 21 by the time the vet at the ER checked his blood. She started a transfusion and he had four transfusions in less than 24 hours. He was losing the blood as fast as they could put it in. The vet recommended an infusion so we did that. There was no improvement. His blood dropped to 13, he was having trouble breathing. We were losing him right before our eyes. The vet said his case was very severe and aggressive. We had to make the horribly painful decision to let him go. We are absolutely heartbroken… To have him with us one day and gone two days later is incredibly painful. Jack was only nine years old. He was a beautiful sweet Maltese. I will never have another dog like him. After reading some of these posts I think that maybe we gave up too soon. But he just wasn’t responding at all to anything… I am heartbroken…

    • So sorry for you lose. I have a 4 yr old Maltese/Yorkie 5 lbs and he was diagnosed on Monday 2/6/17
      with this horrible disease. This is day 3 and I don’t really see much change after being on medication for 3
      days. We go back on Monday for more blood work. I’m really concerned due to his size and pray
      we start seeing some change in the next day or two. Thank you for your story.

  16. My little Elly Mae was just under 4 years old when she threw up in the house one morning. She never has an accident. When I went to clean it up, I looked at her and threw the cloth down, and rushed her to the Hospital. The Vet called me back within the hour and told me to look up IMHA on line. I thought I would never stop crying. He told me that she was the worst he ever saw. She was hospitalize for a week, and came home with 5 different meds to be given to her 3 times a day. This was extremely expensive. Without the 4000 dollars hospital bill, the meds were more than 300 dollars a month. Now two years later she is well and the joy of our life. Elly Mae is a West Highland Terrier. By the way she is now on meds for pancreas problems, and still is a happy dog. They have told us that this sometimes happens because of the massive drug program that she needed to save her life.

  17. I just found this article and was glad to find it informative and helpful. My boy Jasper, a dachshund, was diagnosed w/ IMHA in 2013 at the age of 4, about one month after his yearly vaccines. He was showing signs of lethargy, loss of appetite, dark yellow urine, and the dreaded pale (almost white) gums. I know my dog and I knew something was wrong, so I took him to his regular vet immediately. She took xrays and did some bloodwork and suggested I put him on a multivitamin and bring him back in 2 weeks. Ummm, no. I took him to a NEW vet the next day and he was diagnosed with IMHA. I was devastated and angry all at the same time. He was started on meds, which we had to change out several different times because nothing seemed to be working. His immune system was attacking the few rbc his marrow was producing and even after a bone marrow aspiration they could not figure out why. At one point his hematocrit levels were down do 19% and they were considering a transfusion. So in a last ditch effort they put him on Cyclosporine in addition to the Prednisone and that did the trick! Granted, it was not an overnight fix, but his numbers started to rise. It took a full year and a half of meds and bi-weekly cbc workups and tlc to get him to where he is now. In January 2015 we finally got the all clear from all meds and tests and his numbers have been holding steady ever since! (We get cbc checkups every 6 months as a precaution)

    IMHA is not a diagnosis I would wish on any dog or their owner. It was emotionally and financially draining. I spent over $4000 that I was not prepared for and without the help of friends and strangers I would not have been able to save my baby. There were many nights I would go to sleep thinking he might not wake up with me in the morning, and the feeling of having to leave him to go to work and worrying that he would die while I was gone was almost too much to bear. I also know that he could relapse at any time, and that the next time we may not get the same outcome.

    • Our paw prayers and thoughts are coming out to you that all is okay and that Jasper continues to be stable. Thanks for sharing your story with us.

  18. My 4 year old Corgi got IMHA this past December. It has been the worst thing you could go through with your little angel. She is such a hyper dog and loves to eat all the time. But all of a sudden she woke up one morning not wanting to eat, move, bark or even go to pee. By night time, I took her to the emergency and they told me her blood counts were at 17% when they’re suppose to be around 45%. She had 4 blood transfusions while at the hospital for 9 days. We almost had to put her down since we saw her suffering at the end. Thank God that the double blood transfusion worked all of a sudden. But this was such a horrible experience I hope I can forget soon. But most important is that if we had not had the funds in our credit cards, she wouldn’t have made it due to the cost for this $18K. There was no sign before that day for me to realize she was getting sick. It just happened one day. So I urge everyone to purchase pet insurance with no limits of coverage if your pet is as important to you as mine are to me. She is still in recovery since it’s only been six weeks since her red blood cells went up to normal. She’s still on medications. But it also helped when we purchased a homeopathic medication which we got through the internet once I searched about this desease and found out the survival rate was 50-30%. It’s called Blue Algea. You can read about it if you search in the internet. I was desperate to safe my girl. I believe wIth the help of the meds, the homeopathic solution and all my prayers made a miracle to safe her. Unfortunately this changed her completely. She’s more hyper,especially at night.! She breathes so fast. Plus she’s gotten mean to the rest of the animals and she breathes so fast when she goes in the car anywhere. I don’t know why.

  19. My dog contacted IMHA and was only 3 years old. We did all we could do to save him. He spent 9 days in the hospital only to come home one night and passed away the next morning. We had 9 medications for him and he only got to take one dose. In my mind they knew he wasn’t going to make it but the played on our heart strings and wallet. $8000.00 later my dog is in a box setting on my table. Just be aware of what you are told by the Vet.

  20. We have just had to make a very hard decision. our GR has been in hospital. for 11 days now. vets said it is an immune deficiency. His RBC was very low and he wasn’t producing any platelets. not sure if this is IMHA but seem as it is.

    He had a blood transfusion on Friday his RBC is up abut platelets 9%. we are going to visit him tomorrow to spend some time with him and to say goodbye. he isn’t even 2yrs yet. we are heartbroken. All the info I put in leads to same conclusion IMHA.

    Good piece to read. it can happen to any dog or cat I believe..

  21. In August, 2016, I lost my very beloved mini Doxie named Rosay. It’s been 10 months, but I sit here, now, with tears streaming down my cheeks as I write this message. Vivacious, Energetic, Perfectly Healthy, Bouncy, Fun, Caring, Lovable, Spirited, Very Healthy, Beautiful and Loving Rosay. She was 10 yrs. old. Never sick a day. Then, in that early June/2016, my Rosay just seemed a bit “off” …. so to the Vet we did go: not our regular vet, but a Canine Internist/Specialist from Oakland Veterinary Referral Services in Michigan. Rosay was diagnosed with IM/HA. Had NO idea what that was …. and I was positive she would recover. I read everything I could about IM/HA. Rosay had three Transfusions, a number of Hospital stays, pills/pills, special diet, TLC and everything else, but Rosay died in my arms in less than three months following her diagnosis. My other mini Doxie, Rosay’s Pal Dutchess, spent her early years in/out of Veterinarian Care for one thing or another. I always hoped Dutchess would make it to 9 or 10 years old. Today, Dutchess is flourishing at 11.5 years old … is healthy as can be … a great “little one”. Vet gave her a great report, she has a slight heart murmur, exercises with me daily, keeps her “girlish Doxie figure” and I pray I will have her for a longer time. Love my Dutchess ….. Miss my Rosay so/so much: we were so/so connected. And she knew it, too. After Rosay died, I had lots of flickering lights, phone disconnects when sadly talking about her on the phone, there were pennies in my paths, a “whosh” or two on my rear legs, such real life seeming dreams of Rosay, and more. Then, a final and very sad farewell dream, and all abruptly stopped thereafter ….. around the mid/end of February. What happened? I think Rosay went over the Rainbow Bridge. I will always Love you Rosay … Love You Forever. You made me believe in a spiritual world and know we will meet again.

  22. Unfortunately I don’t have money laying around to pay 10,000 bucks. I just don’t want to see her in pain. So far she is getting an immune boost, iron, and pain meds for her joints. She still very hungry and gets happy when is meal time. She also has hip dysplasia and torn LCL’s, for the life of me you think I have money to take care of her ailments?? I don’t. I just hope when she goes is without any pain. She has given me the happiest of ten years. I guess I will see her at Rainbow Bridge! so sorry my little girl…. so sorry

  23. I too have dealt with this horrible disease for 2 years with my now 14 year old Norwegian Elkhound. Please go to http://www.optimumchoices.com to find out loads of info and to order the Biopreparation for animals. I believe it has helped saved my dogs life…along with a mostly homemade diet and constant monitoring of her health. My dog was so bad initially that her numbers would not even register on her bloodwork..Learned a great deal from this site also – http://www.australian-shepherd-lovers.com…(I hope I’m not infringing on anything by writing this!…They are just so helpful, I wouldn’t want anyone to miss the information!) I am forever grateful to the owners that posted real info that I could use. I said I have tailored their plan to fit my needs, especially using the Biopreparation because it is a very expensive regime to follow. The costs have dropped because of weaning my dog SLOWLY from her meds AND with vet’s guidance.. My dog was on Prednisone and antibiotics for 1 1/2 years along with my version of their diet. She relapsed last summer because of gastrointestinal bleeding I feel was directly related to prolonged Prednisone use. Was told by an emergency vet to euthanize her…but she pulled through…thank you God! She went on Sucralfate to help heal her intestinal tract and I feel she should have been on it all along. I am wondering if anyone has used Slippery Elm to combat ulcers in digestive tract? Please respond if you have any experience with this!!!
    Note: my dog never received a transfusion…vet has seen bad experiences with them. Sort of explained it this way….the dog’s body is fighting against its own immune system and although a transfusion may replenish new red blood cells, it sort of says “Woo hoo!” now I have LOTS of cells to destroy and basically goes to town on the new ones too with a vengeance, ultimately destroying all cells in the process. PLEASE!!!!DO NOT TAKE MY WORD FOR THIS OVER YOUR VET’S ADVICE. I AM NOT A VET!!! YOU MUST COME UP WITH A PLAN ALONG WITH YOUR VET! EVERY CASE IS DIFFERENT! SOMETIMES A TRANSFUSION IS THE ONLY WAY TO KEEP A DOG ALIVE…YOU MUST DECIDE FOR YOURSELF IF THIS IS TRUE IN YOUR PET’S CASE!We think my dog actually acclimated to the anemia and that was why she survived her ridiculously low numbers initially. We also do not know if her onset was caused by a tick-bourne illness or (I suspect) over-vaccination at an advanced age (Plus using the chemical based Heartguard and flea and tick medications) She has not received a vaccine or those meds during her treatment and never will again!
    Good luck to all fighting this and bless all the furbabies who have it!

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