IMHA. What is it? Why should dog owners care about it? Let me start by saying that prior to April 17, 2015, I had never heard of IMHA, or Immune Mediated Hemolytic Anemia. In some ways, I wish I still didn't know about it. I am going to tell you the story of how I came to learn about IMHA, and how it changed my life, and my dog's life, forever.
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| Benelli as a puppy, climbing on the woodpile. She was less than a year old. (2015) |
It was April 2015, and my boyfriend and I had a trip planned to the mountains to celebrate our anniversary. My mom was staying at my house to take care of my teenage son and our two pups, Benelli and Remy. A couple days before our trip, I noticed that Benelli had not finished all of her dinner, but I wasn't worried about it. My dogs eat twice a day, and it wasn't unusual for Benelli to turn her nose at her food, especially when we were getting towards the bottom of the bag of kibble. I store the kibble in a plastic airtight container, but it seems she could just tell when the food had been opened for a few weeks. She was acting normally, playing with Remy and being her usual affectionate and silly self.
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| She was right around a year old in this picture (2013) |
The next morning, Benelli ate most of her breakfast, but did leave several kibble behind. I still thought nothing of it, since I assumed she was just being picky because we were nearing the bottom of the bag. That evening, she again ate most of her food, but left some behind. At this point, I was a little annoyed that she wasn't finishing her food, but didn't think there was anything wrong. We left the next day for our trip. I had long suspected that my boyfriend was going to propose on that trip on our anniversary, and I was looking forward to it. We ended up coming home before he could propose.
My mom, who was staying at my house, called to let me know that she was really worried about Benelli, because not only was she refusing food, but had refused to drink and water and was acting lethargic. As if that wasn't enough, my stepdad was sick and had been hospitalized, so we rushed home on April 17, 2015 so she could go to the hospital. When we got home, Benelli did not even get up to greet us, though she pitifully wagged her tail from her position on the dog bed. I knew then that something was really wrong, because she
always greeted us at the door. I had called my vet on the way home and made an appointment, so after a couple of hours home, we took her in for her appointment.
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| I had a really hard time saying no to her beautiful face, |
At the veterinarian's office, the vet examined Benelli and noted that her gums and lips were very pale, and took some blood. A few minutes later, the vet let us know that Benelli's red blood cell count was very low, and she needed specialty emergency care. The vet called a local specialty hospital and arranged for Benelli to be admitted with a referral. We hurried her to the specialty vet and they took her back within a few minutes. We completed a lot of paperwork while waiting for her diagnosis. The vet took us to a quiet corner and told us that Benelli had something called IMHA, or Immune Mediated Hemolytic Anemia, and that it was incredibly serious. Red blood cells have the important job of carrying oxygen to cells all over the body and they also help remove carbon dioxide from the body. When a dog (or person for that matter) is anemic, there are less red blood cells than normal to do the job. When the anemia is immune mediated, it means that the body's immune system is attacking and destroying it's own red blood cells. In Benelli's case, her body was producing antibodies to attack her red blood cells, treating them like it would if they were a virus or bacteria.
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| This was taken on her trip to the mountains with us, July 2014. |
Benelli required canine blood transfusions. Prior to this trip to the emergency/specialty vet, I had never once thought about canine blood transfusions. There is a shortage of canine blood because owners don't know about canine blood transfusions or blood banks, and so don't have their pets donate. Blood transfusions are very expensive, partially due to the low supply of available blood. They gave Benelli two blood transfusions overnight, and called me around 6:00am on the morning of April 18, 2015 to let me know that her red blood count had increased a little bit. This was welcome news, and I felt like things were heading in the right direction and she would be okay. I've never been more wrong.
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| Another pic on our mountain trip in July 2014. |
When we went to visit her in the hospital a couple of hours later, Benelli was led out of the treatment area. She wagged her tail, but was moving very, very slowly. It was obvious she was in pain, and it broke my heart to see her so excited to see us but unable to get to us as fast as she wanted. We were led to a visiting room where we could sit with her and spend time with her. The vet came in and asked my boyfriend and I to come out of the room. We did, and left my teenage son in the room with Benelli. The news was grim. Despite the transfusions and medications, Benelli's red blood cell count had dropped lower than it was when she was admitted. The vet confirmed that Benelli was in a lot of pain, as her organs were shutting down. We talked about treatment options. We could continue to transfuse blood and pump her full of medication, but she would have to stay at the hospital. Treatment would be around the clock, but even so, her chance of survival was slim since her red blood cell count was dropping faster than they could be replaced, her major organs were shutting down, and she was in pain. My mom and stepdad had arrived to visit and were in the visiting room with my son and Benelli.
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| This is Benelli (R) and Remy (L) on their first trip to the mountains together, July 2014. |
I had already signed the papers authorizing euthanasia, because I couldn't stand to see her in pain. I didn't want to end her life and wanted to keep fighting for her, but the vet explained that we were looking at thousands and thousands of dollars to put Benelli through hell, and she most likely wouldn't survive it. Signing her life away on that sheet of paper was the single most hardest thing I have ever done in my adult life, and to this day, I feel guilty for it. I know I did what was best for her, because I couldn't put her through pain and suffering. So, we gathered around her on the floor, and spent time loving on her, telling her how much we loved her, and crying our hearts out. After a couple of hours, the vet came into the room and administered the injections to put our sweet Benelli to sleep, and she crossed the rainbow bridge in our arms. We spent a little more time with her, before going home in a haze of grief and loss. About a week later, the hospital called to let us know her urn with her ashes was available for us, and my (now-husband) brought her home where she belongs.
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This was taken about two weeks before she died. I often like to just snap pictures
while hanging out in the yard with my pups. I had no idea this would be the last picture of her before she would be
on her deathbed. I do have some pictures of her with family, taken in that little room
where she died, but we would prefer to remember her this way. |
I spent a lot of time researching IMHA, and trying to figure out what symptom I missed or how I could have known that she had something seriously wrong. The only early symptom was that she wasn't finishing her food, and I attributed it to her normal behavior at the end of the bag. Other symptoms did develop, but I wasn't aware of IMHA and didn't recognize them. I hope you never has the misfortune of crossing paths with IMHA, but these are the symptoms so you will be more informed than I was. Perhaps it will make a difference in the life of your furbaby.
- Increased thirst and urination in some dogs
- Melena (Black feces due to hemorrhage in gastrointestinal tract)
- Petechia (red, purple spots on the body due to minor hemorrhages)
- Ecchymoses (skin discoloration in patches or bruises)
There is a lot more to IMHA than I'm covering in this blog - like how some breeds are predisposed and females are more likely to suffer from it than males. I urge you to read up on it so you can catch it early if it happens to your dog, and hope you never need that knowledge. The links listed under "Sources" below are great places to start.
Sources:
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