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    Immune Mediated Hemolytic anemia in dogs - causes and treatment
      
    The function of the immune system in a dog’s body is to recognize and destroy foreign
    substances and pathogens. Sometimes this system can go awry due to one reason or
    the other and starts attacking the body’s own cells. Conditions caused by such self-
    destructive responses are known as autoimmune or immune mediated diseases.

    The immune system normally removes and destroys red blood cells that are four months
    old. New red blood cells are produced in the bone marrow to replenish the loss. Immune
    mediated hemolytic anemia is a condition where the immune system starts destroying red
    blood cells more than the bone marrow can produce.

    It is not difficult to explain how this comes about to happen. Certain foreign substances
    like toxins, parasites and drugs, which the immune system must destroy sometimes cling
    to red blood cells. In its attack on the foreign agents it happens to harm the red blood
    cells also.

    Red blood cells marked for destruction and coated with antibodies circulate through
    liver, spleen and bone marrow. The iron in them is sent to the liver for recycling.
    The liver finds that it has to process more iron than it can handle. This causes jaundice,
    a typical symptom of liver disease in dogs .

    Red blood cells carry oxygen from the lungs to the different parts of the body.
    Inadequacy of red blood cells (anemia) causes ‘oxygen starvation’ leading to some
    symptoms that are similar to liver disease in dogs such as lethargy, loss of appetite
    along with other symptoms of unwillingness to exercise depression and panting.

    Immune mediated hemolytic anemia can be classified as primary or secondary.
    Laboratory tests do not reveal any fundamental cause behind a primary condition.
    Secondary disease, however, is caused when the immune system unknowingly
    destroys its own blood cells while fighting an underlying condition. This could be
    a disease like cancer or an infection or exposure to a toxin or drug.

    Platelets (thrombocytes) are tiny bits of protoplasm in blood, which are responsible
    for blood clotting. Immune Mediated Thrombocytopenia is a disease in which the immune
    system starts destroying platelets. This leads to excessive bleeding from the gums, skin
    or nose and occasionally through feces or urine. Excessive loss of blood may also cause
    severe anemia. At times both immune mediated hemolytic anemia and thrombocytopenia
    may occur together.

    Treatment involves suppression of the immune system so that the red blood
    cells or platelets (in case of thrombocytopenia) are spared from involuntary attacks.
    The most frequently used drug is prednisone, a steroid hormone that works as an
    immunosuppressant. The drug is continued along with constant monitoring till the
    tests reveal a significant improvement in complete blood count.

    Long term use and higher doses of steroids have accompanying side effects that include
    increase in thirst and urination, predisposition to urinary tract infections, re-distribution of
    body fats and symptoms associated with Cushing’s syndrome. If the response is missing
    or too slow, stronger immunosuppressive agents are used, which are serious drugs and
    have a different set of more serious side effects.

    Like feline liver disease, immune mediated hemolytic anemia too is more prevalent
    in dogs than cats but its prevalence can be equally devastating in both cases. If an
    underlying condition is discovered, it is vital that an attempt be made to correct that
    problem concurrently with treating the immune disease.
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