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Immune Mediated Hemolytic Anemia


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Hello All,


I am a new member to this website and have a VERY important question for all who see this post.


I have a 6 year old Border Collie, named Zoe, who was recently diagnosed with IMHA. Actually, she was diagnosed just two days ago with this disease after rushing her to the emergency vet due to lethargy and a loss of appetite. The vet performed a complete blood count (CBC) and a packed cell volume (PCV) test on her, which indicated that her red blood cell count is very low. Also, her blood autoagglutinated, which is also a tell tale sign of IMHA. She spent the night in the ER on an IV of steroids and, once she was stabilized, I took her home and she is currently on oral steroids.


In the last two days, I have been continuously researching this disease to try to figure out what's going on in her little body. From my research, I've found out that, for some reason, her immune system is attacking and destroying her own red blood cells. This disease can kill in just a few days and the mortality rate ranges from 20% to 80% depending on the study. Although this disease can strike any breed, from what I have read, border collies are not predisposed to develop IMHA.


Has anyone heard of this disease? Familiar with it? Ever heard of it in a border collie?


If anyone has any information about IMHA or suggestions for treatment, etc., please let me know.


Thank you in advance for any and all feedback.

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I hate to say that I do.

This is my 4th generation BC. None where even as much as linebred. Always bred to new bloodlines and she just popped up with it one day. None of the other dogs has ever had any problems except some OCD in the shoulder.

She stays on Pred and I try to keep any kind of stress down to a miniumum. Not easy as she is very much dominant and likes to cause stress for everyone else. I keep her on the lowest dose that seems to keep it in check and take her in for occaisional tests.

There seem to be new treatments available but the costs are outragous. They are actually talking like there are chances of putting the disease in remission. For me it is a constant terror and I am always on the lookout for any signs of change in attitude and behavior.

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An expert on IAHA is W. Jean Dodds DVM. She'd be the one I'd want to talk to if I had a dog with this. Her website/contact info is on this page http://www.itsfortheanimals.com/HEMOPET.HTM Hemopet is her organization that provided an interational blood bank for pets.


Predisposing factors for developing AIHA are listed combinations of one or more of: untreated hypothyroid, recent vaccination, hormonal stress, immune compromising disease exposure. Dogs particularily at risk are dogs with dilute and/or primarily white coats.

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Thank you to you both for your responses.


G. Festerling: Do you mind if I ask you what your BC's PCV level was at the time of diagnosis? Zoe's level was at 30, which seems to be okay, but the normal is above 45. She seems to be improving, jogging around at times and walking slowly at others, but definitely moving around more. Also, the color in her gums seems to be coming back. Are these signs that you noticed when the disease went into remission for your BC? I'm grasping at straws trying to figure out how she's doing between blood tests.


Lenajo: Thank you very much for the link. I'll definitely check it out.

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Hi there!

When we just rechecked her the other day because she was just not acting right her count was down to 26. My vet was very concerned.

I give her liver. I cook it because I am worried about the raw end of it. So I am probably not getting full benefit but still something.

Her color is always a good but not failsafe indicator. She looked pretty good last time. I always check her uring but again this is only an indicator after things are already not so good.

The best thing for me is her behavior, I know where you are coming from though. When this first started I was so anxious and worried that I would loose her any day now that I put just even more stress on her with my worries. It has been two years now and so far she seems to handle the Pred just fine. I do give her milkthistle also to help her liver function as the pred can be a bit harsh.

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Thanks again for the update. Zoe was checked again this morning and her count was down to 20. I'm very worried, like you said, but hoping for the best. I'm sorry to hear that your dog's count was at 26. I don't know if you're religious at all, but I'm Catholic and, actually (and unbelievably) found a priest that blessed her today. I'm not sure if you would be into that sort of thing, but it makes me feel better. I'll include your pup in my prayers too.


You give your dog liver? I haven't heard of that before as a good practice for this disease. My vet told me to feed her canned food (she usually gets dry) so we've been giving her beef and chicken, but not liver. Is this something I should do for her? Also, I'm not familiar with milkthistle either. Do you know of a resource I could look at for other things to do for her?

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Thanks so much. I am sorry to hear about your girl.

Did they do a tick screen? I can't spell the disease but that is one of the things we did as well. So first line we put her on 20mg Pred once a day for 10 days and then slowly cut it down. She did get a IV shot of steroids at the vet as well. Then we also put her on Doxi just in case that there was an infection going on. That was unfortunatly not the case. Would probably been better. This was enough to stabilize her. We then put her on liver and chicken liver. The idea being that it helps with the production of the red blood cells. She loves it and again I was amazed how fast she responded. For about two day I initially thought that I would loose her since she was very weak, almost staggered when walked. Now she is much better for the most part.

The milkthistle is just another supplement. I also put her on some vitamin C in the beginning. Just a low dose.

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I don't know if you're religious at all, but I'm Catholic and, actually (and unbelievably) found a priest that blessed her today.
I have a big lump in my throat right now. (My dogs actually have St. Francis medallions tucked away in their tag silencers.)


Sad to say, I too have cared for a dog with IMHA. He was the best dog ever. He spent a week in critical care at what was then one of the top veterinary hospitals in the country, got transfusions [controversial for IMHA then --- are they still?], somehow battled back from death's door, and enjoyed eight happy, active months before the disease returned. (He died in December 1997.) I'm assuming (hoping/praying) that treaments have improved during the years since his death. I remember that he was on prednisone the whole eight months.


I wish I'd known then what I know now... The thyroid connection, for one thing: looking back, I suspect he was hypothyroid, but he was neither tested for it nor ever treated. The vaccine connection --- here are some links:


Vaccine-associated immune-mediated hemolytic anemia in the dog.


For dogs, most annual vaccines may be unnecessary.


Here's an interesting essay, with references.


Even onions, for Pete's sake --- now I'm paranoid about 'em beyond belief. I read an article a few years back about a Rottie that developed HA and almost died after eating ground meat mixed with chopped onions. (The author/Rottie owner was a veterinarian.)


And you've probably already visited this link:


Autoimune Hemolytic Anemia in Dogs---Discussion and Information about this condition.


There's a forum and much more. Your Zoe is in my prayers. Let me know if any of the links don't work. Best of luck --



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Bless you, Bless your Zoe. My first BC, Calvin had issues with his health/prostate at 8 yrs, and I was getting doing pre-anesthetic bloodwork to have him neutered (please, no condemnations on why he wasn't neutered sooner)when we found out his PCV was about 18%. Needless to say, no surgery, and ironically, he was crashing at the time, but I didn't know it. Calvin was really REALLY laid back, but would rally for whatever interested him, this was his demeanor his whole life. I felt like a complete moron for not picking it up, but in hindsight, the signs were there.

As for stablization, he had IV fluids and pred., then an ACTH stim. test, tick panel, Coombs test, T3T4 tests, ended up with a splenctomy and was regenerative (producing red blood cells). What he ended up with was about a 25-30% "normal" PCV, but had problems with being on longterm steroids (mainly Pred.), including Azathioprine (very expensive), Baytril AND amoxicillin just to keep his immunity issues in check. I spent over 18K on him in a little over a year, and I work for a vet hospital. His main DVM was an internal med specialist at a referral hospital near us, and she was great. Calvin was also supposed to enter into a study (the now late)Dr. Bernie Feldman was doing up at VaTech on IMHA dogs, but I lost him in May 2002, after a long, hard year of illness.

Looking back, I wouldn't have done anything in treatment any differently. I vaccinated annually, now I don't but every three years or check titers. I watch out for ticks, use Frontline pretty seriously. I look at gums a LOT. At his worst, Calvin had a PVC of 10%, but he rebounded. Calvin went to trials with me until the end, all bandaged up for his calcinosis cuticus (sp) that took all his elbow skin away. He loved his life, even sick, and enjoyed taking his last puppy, Simon, under his wing (Calvin loved puppies and was horribly defensive of them to other dogs). ps-Simon was not his offspring, just "his", Calvin never was bred.

None of his kin ever had this affliction that I was aware of, and none of my other dogs has. We've had several other dogs in this hospital with it, among them a Cocker Spaniel named Lucy I adored who lived to be 13. Lucy got Calvin's Azathioprine leftovers after he was PTS.

Read up all you can on it, but every dog is different, every case different. This is a real idiopathic mess. My heart goes out to you, and certainly my prayers.

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I lost my beloved Moss(registered BC) just last year after a 6 month battle with IMHA. Ironically one of my best friends Aussie was just diagnosed this fall but is Rallying quickly and now has normal blood work after just a couple of months.

This is the BEST link and forum for the disease...




it can be expensive and very much a emotional roller coaster... BUT dogs DO survive !!!! Most importantly find a vet that has alot of experience treating the disease as it is not text book and all dogs respond differently.

Moss went in to emerg. with a PVC of 19, he was lethargic and pale he crashed FAST! It dropped within 2 days to 9 and after a blood transfusion and meds stabalized at about 28-29. He spent 2 weeks in the emerg. Unfortunately he had alot of complications from the meds and we were never able to get him normal... he relasped after another 5 months with meds changes and drops trying to get things going and we made the decision to put him to sleep at that time... he fought a hard battle but in the end he really did not have the strength to continue the fight and we were unable to find the right meds or combo's of to help him. We did many tests to look for underlying causes ie. cancer ect.. but nothing was ever found. It was very difficult.

We spent about 15 000 in vet bills.... I wouldn't trade that 6 months for anything.


My friends dog Newman went in with a PVC of about 26. In 4 days he went down to 11 and was given a blood transfusion. He then quickly stabalized and his PCV rose fast. He did have a slight setback with one of the meds supressing his White cells to almost nil. but it was lowered and he quickly bounced back. He also developed a slight head tilt and some balance issues they thought he may have had a small brain clot but seems to be recovering from this also... only time will tell.

He went to a normal PCV within 1 month and is well on his way to a full recovery. Since my friend has discovered that there is a number of dogs from this kennel with Immune mediated diseases , I believe 8 ... half of those having had IMHA. I am not sure if all survived.


Feeding liver will not help as the anemia is due to destruction within not a lack of iron...


Milkthistle DEFINITLY is good!!! We did home cook also to help detox.

Always check with the vet depending on the drugs being used as some can act adversely to extra suppliments!


I wish you the best and send all my good thoughts!!!



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Hello all,


Thank you for all of your information and well-wishes. Unfortunately, we had a turn for the worse yesterday. Zoe's PCV dropped to 14 and she was transfused. When they tested this morning, her PCV was at 29, but she is still not eating. When we spoke to the emergency vet yesterday, he had no good news. We are waiting for the results of another PCV that will be performed at 4 today. Hopefully, she will stablize; however, we are preparing ourselves for the worst.


I will keep all updated on her condition and thanks again for your thoughts and prayers.



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Jen keep up your positive thoughts and stay strong... some dogs do require more then one transfusion. Also this is a good sign the PCV went up, it may drop a little before it settles and hopefully those meds will kick in.

We visited Moss at least 3 X a day while in emerg. he would only eat for me Not even dad!

I didn't get in till day 2 after his transfusion so he didn't eat much for at least 24-48 hrs. So I went in and hand fed him 3X a day. He had only eaten dry food for his entire life but while he was sick we got creative as he had a horrible apetite and already didn't have much reserve on him as he was a very lean and fit dog.

Trippet(green tripe) is GREAT for them and they LOVE it!! Also we used the Merricks stews ,lightly cooked chicken, fish. Scrambled egg ect.. He LOVED the salmon roll over We just wanted to get food into him!!!!

Chris is a chef at a steak house so he brought him some YUMMY treats Also once he was home we made him chicken broth that we froze into cubes for him and he LOVED that. Once the pred kicks in they are always hungry. This is the scary part of this disease it is about putting out the fire before the forest burns down.... :rolleyes:

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Hi all,


Another update:


Her PCV was checked again at 5pm today and it had fallen from 29 to 24. We are hoping that is from all of the liquids she has been on today as well as a small drop in red blood cells. However, her platelet count dropped today and this is also not a good sign. Hopefully, its not as bad as it sounds.


When we arrived around 6 to visit, she did eat a little bit (a small container of yogurt and a piece of pizza) and she looked a lot better. Also, they still have some blood left over for another transfusion if her PCV drops again. They will test her again at midnight tonight and the decision will be made then.


Again, thank you for all of your thoughts and prayers and for the positive stories. They have kept us somewhat optimistic about her recovery.


Happy New Year to you all and stay safe.


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Coming in late on this as the dogs and I are just back from visiting with relatives.


I don't have anything useful to add except my very good wishes. It is a horrible condition. In 2001, I lost my first Border Collie to it at age 12 and three-quarters. He crashed very quickly - apparently fine on a Sunday - trialling in Obedience and enjoying it, then a bit off on Tuesday, more so on Wednesday - enough for me to take him to the vet, then very bad on the Thursday. The vet diagnosed IMHA, but since the treatments are so aggressive, wanted to have a pathologist confirm the diagnosis before she started treatment. I took him home for the night, but unfortunately he died the next morning. From memory, his PCV went from 36 down to 18. I did not have a necropsy done, but in his case, I don't believe it was vaccine related, since it was some 5 months after his annual C5. At his age, it could well have been a tumour on his spleen.

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Thank you for your well-wishes. I appreciate all stories related to this illness as all of the good stories are what keeps us going right now. I am sorry to hear of the loss of your border collie. I agree, it is a terrible disease.


To all of you, I want to thank you very much for all of your prayers as it appears they have worked at the moment! Zoe's PCV this morning at midnight was at 30%, the highest its been since she was diagnosed. The internal medicine specialist saw her today (I haven't received word on the results yet), but it looks like we may have made it through the rough start. We are hoping we can take her home today.


Again, I want to thank all of you for your encouraging words, prayers, and well-wishes. I am so thankful that I found this board as all of your storise have kept up our hopes for a full recovery. Hopefully, we are on our way!


I will keep you updated as time goes on.


Thank you,


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Oh, I'm so pleased to hear that. I was worried when it had been a few days. It does seem as though you have made it through that first critical stage - and from what I remember reading, that is a very hopeful sign.


Very best wishes coming to you and your Zoe from a hot and sunny land of OZ.

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Sorry I missed this earlier. My old dog Molly, who just turned 14 yesterday, was nearly killed by IMHA twice a couple of years ago, and remains on a low dose of prednisone to this day, and will probably be so for the rest of her life.


Her PCV bottomed out at 14. She couldn't stand to pee, and often fell over if she tried to walk. She stopped eating for a week or 10 days. We never transfused her or put her in an oxygen tent or any of those more heroic measures.


At the time she fell ill, my regular vet happened to also be an ACVIM, and his old Border collie had died from IMHA, so he recognized it almost immediately and knew exactly what to do.


I think it was almost a month from the time that we took her in before her PCV got back over 25, which seemed to be a magic number for her. Below 25 she walked like a drunk and panted constantly. Above 25 she was relatively steady on her feet.


In the first few weeks, the vet said that we should expect to see her get worse before she got better. It takes a while for the steriods to fully supress the immune system. Perversely, it's the very health and strong immune systems of Border collies that makes IMHA particularly difficult to treat in these dogs.


Living with her when she was on high levels of prednisone (80 mg a day for the first few weeks) was very difficult. She ate everything in sight, drank tons of water, had lots of accidents, and had to go out all the time --three or four times a night. We backed off the dose as quickly as we could and precipitated another crash about six months after the first one.


Now she's on 10 mg prednisone every other day, and it's keeping her in check. Last fall we tried to drop her dose to 10 mg twice a week, and she started to slip, so I think we've found a maintenance level. Although at this stage in her life it's hard to tell without running lab tests whether the weakness we see when we decreased the steroids is from IMHA or increased pain of her arthritis. Whatever -- the prednisone keeps her happy and fairly mobile and the dose is low enough that she doesn't have all the horrible side effects.


FWIW, my vet theorized that Molly's IMHA might have had something to do with a past case of Lyme disease. She was on the Lyme disease vaccine from Fort Dodge until she was eight years old, when she developed all the symptoms of Lyme disease although she tested negative. A round of doxycycline seemed to cure her then. When she became anemic four years later, she had a fairly high titer for Lyme disease and my vet thought that perhaps her immune system was attacking the red blood cells because they were carrying the Lyme antigen protein or something screwy like that. We'll never know for sure, I guess.


Anyway, the next few weeks to three months will be tough on you and Zoe. It sounds like you caught it earlier and turned it around quicker than we did, and I hope that's a good sign. Just wean her off the prednisone very, very slowly, even though she will be a bear to live with for a while.

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  • 11 months later...

Hi I was wondering if anyone else has had the Immune Mediated Hemolytic Anemia (IMHA) in there Border Collie. I have a friend that has a Blue Merle 3yr old Border Collie that is currently in the Vet hospital with this condition. She is on 40mg Prednisone AM and Pm.

I have searched the internet but it has not been very helpful. Awaiting your replies. Thanks Averil

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I am thrilled to report that my girl is still going strong. We have her backed down even more on the pred now. Granted, she is getting stiffer due to the steroids doing their damage on the joints but it is managable.

Hope your friends dog will do ok.

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