Tank has immune-mediated hemolytic anaemia (IMHA)

Tank was presented with acute onset jaundice, lethargy and inappetence.

With a careful collection of the patient's history, coupled with a thorough physical examination, the likely diagnoses were prioritised, with immune-mediated hemolytic anaemia (IMHA) on the top of that list. Microscopic examination of a blood smear caught the body's immune cells (white blood cells) in the act of consuming it's red blood cells (pictured) and clumping of the red blood cells (agglutination). Biochemical analysis of the blood showed severe anaemia, a marked elevation of bilirubin (a breakdown product of red blood cells) and elevation of the liver enzymes.

All these findings together made for a confident diagnosis of immune-mediated haemolytic anaemia and the patient was commenced on immunosuppressive medications, blood thinners and aggressive fluid therapy. IMHA is an immune condition which is not uncommon in cats and dogs.

The disease may result due to certain medications, or blood infections including heartworm and tickborne parasites, but in most cases, the cause is not able to be determined (idiopathic). In all cases, the immune system attacks it's own red blood cells. This may occur in the blood vessels (known as intravascular haemolysis) leading to jaundice and anaemia, or within the spleen and liver (known as extravascular haemolysis) which results in anaemia alone. This process leads to a state of increased coagulation resulting in tiny blood clots forming which can wreak havoc in the organs throughout the body causing multiple organ failure.

The condition carries a guarded prognosis but with aggressive therapy in the hospital, patients can make a full recovery. In approximately 30-40% of cases, patients do not require lifelong immunosuppressive therapy.

Tank is now at home recovering from his episode and is visiting frequently for checkups to adjust his treatment as necessary.