Moustache, the standard poodle puppy, was full of playful energy until, one day, he wasn’t.
He was brought into the Weedon surgery one Monday morning very lethargic and on examination he was found to have very pale gums and a high heart rate.
He was admitted for further investigation and was found to be quite severely anaemic. The next question was whether he was bleeding internally, not making enough red blood cells or destroying his red blood cells. Further blood and urine tests were performed and it was looking increasingly likely that Mou had a condition called auto-immune haemolytic anaemia (AIHA), where the body’s immune system attacks the red blood cells and destroys them.
One of the tests for this involves putting a drop of blood on a microscope slide with a drop of saline. If the red blood cells all clump together it is known as auto-agglutination and confirms the diagnosis of AIHA, which is what happened with Mou’s sample.
Though we see a few cases of this disease every year it is very unusual in an 8 month old puppy. A specialist was contacted for advice and, given Mou’s age and the desire of most puppies to chew everything in sight, it was recommended that we check that he hadn’t eaten anything metallic which could be the underlying trigger. So, Mou was sedated and abdominal x-rays taken but no metal was seen in his gastrointestinal tract. Tests to rule out other underlying causes such as lungworm were also done.
Moustache was diagnosed with primary, idiopathic, AIHA, which means it didn’t appear to be secondary to any other problem. He was started on high doses of two different drugs to suppress his immune system and stop it destroying his red blood cells. He was monitored very closely over the next days and weeks as sometimes red cell levels drop so low a blood transfusion is necessary.
Within 2 weeks Mou’s red cell count was just back within normal limits and continued to rise. After he had had normal levels for 4 weeks we started to very slowly wean him off the drugs, keeping a close eye on his red cell count. Almost 6 months to the day after diagnosis we stopped his medication altogether, a practically text book response!
There is a risk of coming out of remission with this disease so Mou will continue to be closely monitored, by his owners and at the surgery, but he is now back to being his lively, bouncy self!