DISCLAIMER: This page, and other pages on this site, has been compiled by Joanne Dickson who is not a veterinarian. Information sources include: The Merck Veterinary Manual (8th edition 1998); Veterinary Drug Handbook (3rd edition Donald C Plumb) and Baillieres’s Comprehensive Veterinary Dictionary (D.C. Blood and Virginia P. Studdert).

This page is a substitute for proper diagnosis and/or treatment of AIHA. It is intended to foster discussions between owners and their veterinarians.

AIHA - Blood tests

Q: What is PCV, is it the same thing as hematocrit and what is the normal range for the PCV?
A: PCV stands for packed cell volume; the percentage by volume of whole, unclotted blood occupied by the erythrocytes (red blood cells). The terms PCV, HCT and hematocrit are basically interchangeable. The normal PCV reading in the dog is 37-55.

Q: What is the normal white blood count (WBC)? What does an elevated white count indicate?
A: The normal white blood count in the dog is 6-17. An elevated white count indicates a possible infection, very common in AIHA dogs because of the suppressed immune system.

Q: What are reticulocytes and why are they important?
A: The reticulocyte is the stage just before an immature erythrocyte (red blood cell) becomes a mature red blood cell. It is a little larger than a mature red blood cell and because it contains small fragments of DNA and other materials has a bluish-red coloration. Reticulocytes are important in evaluating anaemia; if we see lots of them, it may mean that the body is compensating by releasing the cells too early, but is also encouraging in that the body is able to compensate.

Q: What is a Coombs test?
A: The Coombs test is the blood test that confirms the diagnosis of AIHA. Its results are either positive or negative. This test should be done at the time AIHA is suspected, however some dogs with AIHA will be Coombs negative.

AIHA - Use of Predisone

Q: What dosage of prednisone should my dog be on?
A: At the onset of the disease, a dog should be on at least 1 mg per pound per day of prednisone split into two doses. For example, a 60 pound dog would have two 30 mg dosages each day. The dosage should be decreased very slowly over a period of several months; Too quick reduction increases the likelyhood of a relapse.

Q: When and how often should the prednisone be reduced?
A: Once the disease is in remission, the dose of prednisone can be lowered by 25% to 35% every three to four weeks until a control level is found. Blood tests will be done before each prednisone dosage reduction. If the dog is receiving more then one immunosuppressive drug, changes to dose or frequency will be managed one drug at a time.

Q: What are the side effects of prednisone?
A: Prednisone side effects include increased thirst and urination; increased appetite and weight gain; dull, dry haircoat; increased panting, vomiting, diarrhea; elevated liver enzymes; pancreatitis; muscle wasting; and behavior changes such as depression and lethargy.

Q: The prednisone is not working, what other drugs are available for the treatment of AIHA?
A: When prednisone alone is not effective in the treatment of AIHA, many vets add azathioprine (Imuran) to the treatment regime. Azathioprine is used in humans as an anti-rejection drug after organ transplants but has proved successful in the treatment of AIHA in dogs because, like prednisone, it suppresses the immune system. As azathioprine takes several weeks to start working, it is often used as an adjunctive therapy with prednisone. Azathioprine side effects include bone marrow suppression and increased susceptibly to infections. Other drugs used in the treatment of AIHA are cyclophosphamide (Cytoxan); cyclosproine; and the anabolic steroids Danazol and Winstrol.

AIHA - Recovery prospects

Q: What is the mortality rate for autoimmune haemolytic anaemia?
A: Mortality rates range from 20% to 50%, but increase where onset is sudden and severe.

Q: How long should I expect my dog's recovery to take?
A: Each dog will have a different recovery time; some respond well to the drugs show a rapid recovery; other dogs will respond much more slowly and may need a variety of drugs.

AIHA - Vaccinations

Q: My dog is due for his vaccinations, should I give them?
A: Only healthy dogs should be given vaccinations. AIHA compromises the immune system and vaccinations could trigger a serious relapse. Some veterinarians recommend never vaccinating an AIHA dog again. The entire subject of vaccinations; their effective duration; and relationship with the immune system should be discussed with your veterinarian before proceeding.

This page copyright © 1998 - 2007 Joanne Dickson. All rights reserved. Last updated on February 27, 2007