Prognosis in canine idiopathic immune-mediated haemolytic anaemia

Abstract

About 50% of dogs with idiopathic immune-mediated haemolytic anaemia (IMHA) dogs die in the first 2 weeks after diagnosis. It was shown that mortality risk is associated with the presence of hypercoagulability, inflammatory response, and liver and kidney failure. Evidence suggests that tissue hypoxia due to severe anaemia is pivotal in the development of a left shift followed by leucocytosis and the presence of disseminated intravascular coagulation which are present in the majority of these dogs. Analysis of the literature as well as a study on the efficacy of azathioprine as part of a protocol with prednisolone revealed no evidence to support the efficacy of immunomodulators in addition to corticosteroids in the treatment of IMHA. However, three months of immunsuppression was sufficient in most dogs to maintain remission of IMHA. Future therapeutic studies should aim to minimise activation of inflammation and coagulation since these are the risk factors that determine the high short-term mortality.

About 50% of dogs with idiopathic immune-mediated haemolytic anaemia (IMHA) dogs die in the first 2 weeks after diagnosis. It was shown that mortality risk is associated with the presence of hypercoagulability, inflammatory response, and liver and kidney failure. Evidence suggests that tissue hypoxia due to severe anaemia is pivotal in the development of a left shift followed by leucocytosis and the presence of disseminated intravascular coagulation which are present in the majority of these dogs. Analysis of the literature as well as a study on the efficacy of azathioprine as part of a protocol with prednisolone revealed no evidence to support the efficacy of immunomodulators in addition to corticosteroids in the treatment of IMHA. However, three months of immunsuppression was sufficient in most dogs to maintain remission of IMHA. Future therapeutic studies should aim to minimise activation of inflammation and coagulation since these are the risk factors that determine the high short-term mortality.