Gaston, a cattle dog cross, had just moved from New Zealand when something began to go awry. Just a month after moving to Victoria, Gaston started to show signs of illness, losing his appetite and acting very listless. On the day of his visit to the clinic, Gaston began to pass very dark coloured redbrown urine. Something was definitely amiss.
On examination, Gaston had pale gums with a definite yellow tinge and he was very clearly feeling unwell. Analysis of his dark urine showed that, even with the very dark red colour, there were no whole red blood cells leaking into his bladder. These signs together are very suggestive of “hemolysis” or breakdown of red blood cells within the circulation. Pale gums are often a result of anemia or lack of circulating blood that can be as a result of blood being broken down, lost from bleeding or problems with production of the cells. A yellow colour to the gums and ‘sclera’ (whites of the eyes) is a sign of jaundice that can be caused by liver problems or from the byproducts of red blood cell destruction. These byproducts then pass through into the urine to give the urine a dark redbrown colour.
Further blood samples were taken to assess Gaston’s red blood cells and general body function. From these we were able to deduce that, overall, Gaston’s organ function was good.
Interestingly, Gaston’s blood began to clump together very soon after we collected the samples, forming a little spotted pattern on a slide. This “clumping” is a different process to “clotting” where the blood forms into a gel, the normal process that stops us from bleeding continuously.
The clumping was caused by antibodies that Gaston’s immune system had incorrectly produced against his red blood cells. These antibodies began to attack and destroy his own blood!
Gaston was diagnosed with immune-mediated hemolytic anemia (IMHA). This disease can be triggered by a variety of concurrent diseases or it can be “idiopathic”, meaning that we have not yet worked out what causes the problem. Luckily, the big boy had enough reserves of blood to sustain the oxygen supply to his vital organs and did not require a blood transfusion. Gaston was started on immunosuppressive therapy to reduce the hyperactive immune response against his red blood cells. He began to feel much better within a few days of starting treatment.
Gaston is still in the process of primary treatment of IMHA. We are hoping to reduce the medication he is taking to the point that, ideally, he does not require further medication and continues to be stable. Recurrences of IMHA can occur and some patients require ongoing, low dose immunosuppression to control the disease. We will keep our fingers crossed for our gentle giant Gaston and hope that you will cross fingers for him as well.
This case was a good example of how the most vague signs of change in our pets can be the first indication of serious disease. If left untreated, Gaston’s immune system would have continued to destroy his red blood cells to the life threatening point. It is always easier for us to treat disease in the early stages rather than later in a disease process. “Better safe than sorry” is a very good motto to be taken with our furry family members as they cannot tell us what they are feeling or when something is wrong. Our vets are here to treat critical patients like Gaston or, at the very least, give you the peace of mind that your pet is at the best of health.