The first steps
in treating AIHA are to stabilize the dog and suppress the immune system
so that the destruction of the red blood cells can be slowed down or
stopped completely. Your vet will most likely administer high
doses of corticosteroids (prednisone) for its anti-inflammatory and
immunosuppressive action. The dosage may vary somewhat
(higher), but a general guideline will be about 1 mg per pound of body
weight per day divided into 2 daily doses. This treatment is generally
continued until the dog is in remission and then the dosage is slowly
decreased over a period of several months until the dog has been
successfully weaned off of the medication or has reached the lowest
"maintenance" dose that will control the disease.
withdrawal of the medication could lead to a relapse. It's
important that the dog have a blood test before every medication change
and that, if the dog is on more than one medication, there is only one
medication change at a time. Changes should be limited to
approximately 25% of the prescribed dosage and should only be attempted
once every 3-4 weeks.
treatment is not successful in some dogs. Unresponsive cases may
require more potent immunosuppressive medication or other therapies in
addition to the corticosteroids. These alternate therapies may
include Azathioprine (Imuran), Cyclophosphamide (Cytoxan), intravenous Gamma Globulin, Danazol
or Winstrol (anabolic steroids), Cyclosporine or Leflumonide (Arava).
cases might also benefit from having a thyroid screening panel run on
the dog. Thyroid issues can be an underlying problem with AIHA
positive dogs or it is possible for the disease itself to cause thyroid
gland damage. If the dog does have a thyroid issue, putting it on
thyroid medication could improve its recovery.
very important that you discuss with your vet and that you fully
understand the side-affects and long-term health risks of your dog's
medications and treatment. Corticosteroid treatments are, in
themselves, detrimental to the dog over long periods of time. Side
effects can range from increased drinking and appetite, with more
frequent urination and weight gain, vomiting and diarrhea, to muscle
wasting, behavior changes, elevated liver enzymes and pancreatitis.
Two serious side affects with Azathioprine are bone marrow suppression
and an increase in the susceptibility to infection.
your dog recovers, it's a good idea to keep a close eye on his urine.
This can be an early indicator of further problems. The urine
should be a regular, yellow color. A brownish color or signs of
blood are not normal and you should get in touch with your veterinarian
immediately. If you are having trouble seeing the urine, you can
lay down some white paper-towels for the dog to eliminate on or you can
try sliding a paper plate under the dog just before it starts to urinate.
if your dog is diagnosed with AIHA, there are a number of other health
issues that you should address with your veterinarian. These
can include the need for continuing heartworm and flea/tick preventative
and/or yearly vaccinations or worming. You should be sure
and discuss any changes or additions that you would like to make in your
dogs health care with your veterinarian BEFORE they are implemented.
Due to the seriousness of this disease, changes that may seem minor or a
normal part of his routine care, can end up causing serious set-backs.
clinical course of AIHA is different for every dog. The disease
can range from mild in some dogs to fatal in others. Mortality
rates, as a whole, will range from 20%-50% but are generally higher for
dogs with very sudden and severe cases of the disease.
complications can also be responsible for complicating recovery or
causing death. Some serious complications of recovery include
pulmonary blood clots caused by the release of coagulants into the blood
from the breakdown of red blood cells and kidney failure due to kidney
damage from fragments of destroyed red blood cells.