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"Charlie" - American Cocker Spaniel with IMHA

Photo of Charlie

 

The course of veterinary medicine does not always run smoothly...as American Cocker Spaniel "Charlie" Palmer found out recently.

Over a period of a few days, 4 year old Charlie changed from a happy, healthy dog to being weak, collapsed, vomiting and feverish. Then, overnight, he became severly jaundiced.

A number of blood tests rapidly revealed that he had immune mediated haemolytic anaemia (IMHA) -a condition where the immune system gets "confused" and starts to attack and burst it's own red blood cells. Charlie was left with just one third the correct number of red blood cells, leaving him severely anaemic.

The yellow jaundice arose from the pigment that was generated when haemoglobin from the burst cells was broken down.

Usually, treating with high doses of corticosteroids to suppress and "calm down" the immune sytem will control this condition. In Charlie's case, however, the life-saving corticosteroids produced a rare side effect. They created an ulcer in his stomach. This ulcer bled, leading to further loss of red blood cells.

Charlie was re-admitted as an emergency and given a blood transfusion from my own dog "Joskin". To complicate matters further, the ulcer perforated so that his stomach contents and bacteria leaked into his abdomen (peritonitis). Emergency surgery was required to remove the ulcerated area of stomach and thoroughly flush out the infection.

Our next dilemma was how to control the IMHA,as we were loathe to give Charlie more corticosteroids. He also continued to vomit up blood, despite the fact that we could not see any other ulcers in his bowels.

In desperation, Charlie was sent to the University of Bristol, in case he required further blood transfusions.

 

Photo of Charlie

A second transfusion is more complicated than a first one, as cross matching is necessary to ensure there is no transfusion reaction. He was cross matched with several donor dogs at Bristol in case of emergencies, but fortunately Charlie made good progress and did not require any major intervention during his 6 day stay at Bristol.

I am relieved to say that Charlie is now making excellent progress on a different drug to control his IMHA. He and his owners have endured a 3 week roller coaster ride (no wonder Charlie was vomiting!) which is thankfully levelling off at last. At £4500, it was a little more expensive than a trip to Alton Towers. Fortunately Charlie was insured!

Geraldine Young BVSC CertSAM MRCVS

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