Auto-immune haemolytic anaemia in a horse

A case of auto-immune haemolytic anaemia (AHA) in a 7-year-old, pony gelding is described. Diagnosis was based on a strong, positive reaction to the direct Coombs antiglobulin test and the presence of erythrophagocytosis and spherocytosis in peripheral blood smears. The condition was complicated by an infected haematoma, posterior paresis and urinary incontinence. The triggering mechanism behind the antibody response against the red cells is unknown.     

Autoimmune haemolytic anaemia in dogs

The clinical, haematological and immunological findings in 24 dogs with Coombs' positive haemolytic anaemia are described; 33% were Old English Sheepdogs. Dogs with intravascular haemolysis had a shorter history of illnesses, more severe clinical signs including vomiting, jaundice and fever, and had a poor survival rate compared to dogs with extravascular haemolysis. The anaemia was severe and regenerative in 18 dogs, and was characterised by spherocytosis and microscopic red cell agglutination, with leukocytosis. Serum IgG levels were elevated in 20 dogs, and changes in IgM, IgA, C3 and C4 were found. Antinuclear antibody was also demonstrated in 13 dogs, of which 7 were Old English Sheepdogs. It is suggested that a distinct multisystem autoimmune syndrome exists within the local Old English Sheepdog population.     

Compensated immune mediated haemolytic anaemia in a dog

Summary: A dog which presented with anorexia and fever was found to have strong IgG Coombs'positive immune mediated haemolysis but only marginal anaemia. The abnormalities detected included marked spherocytosis, polychromasia and mild hyperbilirubinaemia. The major presenting signs disappeared after glucocorticoid therapy. Compensated idiopathic immune mediated haemolysis was diagnosed.     

Autoimmune haemolytic anaemia in eight horses

Autoimmune haemolytic anaemia was diagnosed in eight horses on the basis of a positive Coomb's test. The disease was considered to be idiopathic in three cases and secondary to another condition in five. The clinical signs included dullness and depression, pyrexia, jaundice and haemoglobinuria. In addition to anaemia, haematological evaluation commonly revealed auto-agglutination of red cells and anisocytosis; reticulocytosis and an increased mean corpuscular volume were less commonly observed. Four horses were successfully treated with dexamethasone, but the other four were destroyed or died because of the underlying disease.     

Immune-mediated haemolytic anaemia associated with a sarcoma in a flat-coated retriever

A seven-year-old flat-coated retriever presented with a history of lethargy, dyspnoea and inappetence of several days' duration. Clinical examination revealed pale mucous membranes and tachypnoea, and haematology demonstrated marked autoagglutination. Thoracic radiographs revealed an increased opacity in the perihilar region. The owners declined further evaluation and the dog was treated symptomatically with immunosuppressive doses of prednisolone and azathioprine. The dog's demeanour improved, although it was eventually euthanased seven weeks later because of dysphagia and worsening dyspnoea. Postmortem examination revealed a widespread, poorly differentiated sarcoma involving the lungs, pericardium, thoracic lymph nodes and spleen. Immune-mediated haemolytic anaemia is a well recognised condition in dogs and is occasionally associated with neoplastic conditions. This is the first case report to describe immune-mediated haemolytic anaemia associated with a diffuse, poorly differentiated sarcoma.     

Antigen specificity in canine autoimmune haemolytic anaemia.

Autoimmune haemolytic anaemia (AIHA) is the most common clinical manifestation of autoimmunity in the dog and generally presents as a profound, regenerative, Coombs' positive anaemia of acute or chronic onset. The disease pathogenesis involves formation of erythrocyte-specific autoantibodies of the IgG and IgM class that may fix complement resulting in intra- or extravascular haemolysis. Western blotting and immunoprecipitation studies using autoantibody eluted from the erythrocytes of dogs with AIHA have demonstrated specificity for erythrocyte glycophorins and the membrane anion-exchange molecule (band 3). Autoantibodies specific for the cytoskeletal molecule spectrin have been identified in serum by ELISA. The specificity of autoreactive T-cells has been examined in vitro using bulk cultures stimulated with a panel of autoantigens including intact erythrocyte membranes, purified glycophorin and spectrin fractions and a panel of overlapping 15-mer glycophorin peptides. Control responses to ConA and recall (vaccine antigens) and non-recall (KLH) antigens were measured in the same system. PBMC obtained from dogs that had recovered from AIHA consistently proliferated in response to erythrocyte membranes, with occasional responses to spectrin or glycophorin. PBMC from sone clinically normal dogs also responded to erythrocyte membranes. PBMC obtained from dogs closely related to AIHA cases gave the most consistent responses, including proliferation when stimulated by the glycophorin peptides. These data suggest that normal dogs harbour erythrocyte autoreactive lymphocytes, and that these cells may be primed in dogs recovered from AIHA or having genetic susceptibility to the disease.     

Idiopathic systemic granulomatous disease with encephalitis in a horse

A 14-year-old standardbred mare with clinically suspected acute bronchitis was killed because of rapidly progressing central nervous disturbances. Necropsy revealed systemic granulomatous inflammation and vasculitis involving the lungs, thoracic lymph nodes, ribs, and liver. In the cerebrum there was a severe subacute bilateral encephalitis and malacia predominately affecting the white matter, and vasculitis with perivascular infiltration of lymphocytes, macrophages, and giant cells. A causative infectious agent could not be detected by Ziehl-Neelsen, Grocott, or Giemsa stains, by periodic acid-Schiff reaction of tissue sections, nor by bacterial and fungal cultures. Therefore, idiopathic systemic granulomatous disease (ISGD) was diagnosed and an immune-mediated pathogenesis was suspected. Inflammatory involvement of the brain has hitherto not been reported in cases of equine ISGD. This case seems to be an uncommon variant of ISGD with encephalitis and lack of dermal involvement.     

Immune-mediated haemolytic anaemia and thrombocytopenia associated with Anaplasma phagocytophilum in a dog

A 10-year-old, crossbreed dog was presented with a history of severe lethargy, pyrexia and inappetence of several days' duration. Clinical examination revealed pallor of the mucous membranes, petechiae, generalised lymphadenopathy and effusions in multiple joints. Laboratory evaluation showed severe anaemia and thrombocytopenia, with positive in-saline agglutination and the presence of antiplatelet antibodies. The DNA of Anaplasma phagocytophilum, an endemic granulocytic rickettsial parasite, was detected by PCR. A poor response to doxycycline and immunosuppressive therapy with corticosteroids was seen. Euthanasia was performed after the development of disseminated intravascular coagulation. Postmortem examination demonstrated changes consistent with the development of disseminated intravascular coagulation and infection with granulocytic ehrlichiosis. This case documents the presence of canine granulocytic ehrlichiosis caused by A phagocytophilum in the U.K., and highlights the range of clinical signs and clinicopathological abnormalities that may be observed in infected dogs.     

Evaluation of platelet activation in canine immune-mediated haemolytic anaemia

Objectives : To establish whether heightened platelet activation is a common feature of canine immune-mediated haemolytic anaemia, and to evaluate the hypothesis that platelet activation plays a role in the pathogenesis of thromboembolism. Methods : Using whole-blood flow-cytometric analysis, the proportion of activated platelets and platelet-leucocyte aggregates in blood samples from 14 dogs with immune-mediated haemolytic anaemia and 14 healthy dogs was calculated. General linear models with binomial errors were used to compare groups. Results from the immune-mediated haemolytic anaemia-affected dogs were then correlated with established risk factors for thromboembolism in canine immune-mediated haemolytic anaemia, D-dimer concentration and antithrombin activity. Results : There was a strong correlation between platelet activation and severe thrombocytopenia, with heightened platelet activation being observed predominantly in severely thrombocytopenic dogs. Clinical Significance : Dogs with immune-mediated haemolytic anaemia, particularly those with concurrent severe thrombocytopenia, are likely to have heightened platelet activation, which may play a role in the pathogenesis of thromboembolism.     

Immune-mediated haemolytic anaemia in 110 dogs in Victoria, Australia

Objective   Evaluate the survival and prognostic indicators (i.e. breed predilection, season, blood transfusion, and the prevalence of autoagglutination) of dogs with immune-mediated haemolytic anaemia (IMHA) in Victoria, Australia.
Design   Retrospective study of 110 diagnosed with primary IMHA at the University of Melbourne Veterinary Clinic and Hospital.
Results   In total, 80 of the dogs (72.7%) were discharged from hospital and 48 of 65 (73.8%) dogs available for follow-up were known to be alive at 1 year, giving an overall 1-year survival of 48 (50.5%) of 95 dogs for which survival data were available. Regarding breed, 80 (18.2%) of the 110 dogs were Maltese-breed dogs compared with 81 (7.4%) of 1100 control dogs (P < 0.001). Springer Spaniels (P = 0.02), Hungarian Vizslas (P = 0.02) and Airedale Terriers (P < 0.001) were also over-represented compared with the control sample. There was no evidence of an association between the occurrence of IMHA in dogs and season in this study. Receiving one or more blood transfusions did not affect survival to the time of discharge from hospital. On initial blood smear examination, 57 (51.8%) of the 110 dogs had spontaneous autoagglutination and its presence was associated with decreased survival to discharge from hospital (P = 0.03). Packed cell volume, white cell count, platelet count and serum total bilirubin on admission had no effect on survival to the time of discharge from hospital or 1 year later.
Conclusion   Dogs with IMHA have a guarded prognosis as only half are still alive 1 year after the acute event.     

Idiopathic aseptic pericardial effusion with cardiac tamponade in a horse

This report describes the successful treatment of pericardial effusion and cardiac tamponade in a 10‐year‐old Hanoverian gelding. Pericarditis and pericardial effusion are uncommon conditions in horses. Although many potential causes for the effusion have been described most cases are classified as idiopathic. The most valuable diagnostic procedure for the detection of pericardial effusion is echocardiography. Pericardiocentesis and drainage of the fluid were carried out in this case. At one year follow‐up there were no clinical signs of recurrence and the horse has returned to his previous level of athletic performance.     

Post-parturient haemoglobinuria in cattle: A Heinz body haemolytic anaemia

Abstract

Extract

During the late summer and spring of the four years 1967 to 1970 many dairy herds throughout the Northland region? ? The Northland region is here regarded as that part of the North Island of New Zealand lying north of Auckland city. There are about 600,000 dairy cattle in this region. experienced outbreaks of a form of post-parturient haemoglobinuria. Clinically the disease was indistinguishable from that reported overseas. In 1970 the first cases occurred in mid-July and the incidence declined sharply towards the end of September, although in both 1969 and 1970 cases were still occurring towards the end of October. In some herds over 40% of the cows showed clinical evidence of the disease. Younger lactating cows, particularly 2- and 3-year-olds, were the more severely affected and most cases occurred 2 to 4 weeks post-partum. The most characteristic clinical feature of the disease was an anaemic state. Practising veterinarians reported that affected animals frequently showed haemoglobinuria, hyperpnoea, pyrexia, icterus, anorexia and decreased milk yield (either singly or in combination), and that occasional animals died with the disease. Intercurrent infectious disease (usually mastitis) was present in some of these fatal cases, while in others there was a history of forced exercise (usually droving with dogs) immediately prior to death.     

Concurrent immune-mediated haemolytic anaemia and severe thrombocytopenia in 21 dogs

The medical records of 21 dogs with concurrent immune-mediated haemolytic anaemia (imha) and severe thrombocytopenia (defined as an automated platelet count of less than 50x10(9)/l, confirmed by the examination of a blood smear) were reviewed. Their mean (sd) age was 5.8 (2.5) years. When compared with the 24,759 dogs in the hospital population for the same period Airedale terriers and dobermanns appeared to be over-represented with odds ratios of 22.5 (95 per cent confidence interval [ci] 5.2 to 97.9) and 7.6 (95 per cent ci 1.8 to 32.7) respectively. The median duration of the dogs' clinical signs was seven days, with a range from one to 17 days. Eleven of the dogs had a history of a tendency to bleed, and 15 had evidence of bleeding when examined. Twenty of the 21 dogs had been treated with glucocorticoids, nine with vincristine, and seven with azathioprine. Their median stay in hospital was four days, with a range from one to 17 days. The median period for which they survived after admission to hospital was five days, with a range from one to 558 days, and 16 of the 21 dogs had died or been euthanased within 30 days of their admission.