Kira’s Story: a battle against IMHA
Kira had a tough start in life, having been left on a balcony in Spain, battling against the inevitable sun burn and all the problems associated with neglect. In July 2020, Kira was rehomed and given a new start in life with a family in the UK. All seemed well until August, when her owners noticed she was very lethargic and also breathing extremely fast.
At their local vets, they discovered she was severely anaemic. A healthy dog would have a PCV (a way of measuring how many red blood cells there are in the blood) of between 37 and 55%. Kira’s PCV was just 10%, about a quarter of what it should be, making her markedly anaemic so she was given an immediate blood transfusion.
Twenty-four hours later Kira deteriorated again and was referred to the RVC Small Animal Referrals Hospital. A simple blood test showed that her blood cells were agglutinating (clumping together) and that once again she was very anaemic. These two signs together led to an immediate immune mediated haemolytic anaemia (IMHA) diagnosis.
IMHA is very easy to diagnose, but sadly much harder to treat and we do lose dogs to this disease - just two out of three dogs survive after initial diagnosis. In dogs with IMHA, the immune system attacks the dog’s own red blood cells. Examining an affected dog’s blood under a microscope you can very quickly see the effects with many so called ‘ghost’ cells indicating ‘empty’ red blood cells, damaged by the disease. You can often also see very young red blood cells that the bone marrow has released early to try and compensate for the anaemia.
IMHA is a common reason that pets are referred to the Emergency Referral Service at the RVC Small Animal Referrals Hospital. These patients are then managed by the Critical Care of Internal Medicine services. The first challenge is not necessarily the diagnosis, but the treatment and the crucial first days as they wait for the medication to take effect.
Kira was immediately put on a course of immunosuppressive drugs and anticoagulants to help rebalance her immune system and put a stop to blood clots that can occur as a result of the disease. Over the first three days, she also received four blood transfusions from three different RVC blood donor dogs. These blood transfusions gave Kira the time she needed to fight the disease while waiting for the treatment to start taking effect. For the owners, and the clinicians, these first five days were extremely worrying.
However, a little after a week later, Kira was well enough to return home and over the course of the coming weeks Kira returned to normal health with her PCV improving at each check-up. Thanks to continued treatment and monitoring of her condition as well as her medication levels, Kira is living a good life, running around with the usual energy of a dog her age and simply loving life.
Louise and Lloyd, Kira’s owners, reflected on a worrying time for their beloved pet: “Kira was only with us for just under a month before she got sick. It was hard as we were asked a lot of questions about her previous medical records and if she was acting out of character and we just didn't have the information; Kira was a new dog to us that hadn't had the chance to settle at home and for us to get to know her character.
“We felt so helpless, but the RVC was very understanding and reassuring. They kept us updated daily on Kira’s prognosis. Kira was underweight when we rescued her and continued to lose weight whilst ongoing treatment. RVC recommended a hypoallergenic food and now Kira has gained approximately 7kg and now weighs 28kg and her PCP level is currently 42%. “We are so thankful to all the staff at RVC for saving Kira’s life. She is such a happy, playful dog that loves a cuddle, and we are so pleased she has been given a second chance in life from being rescued to her forever home to getting the treatment she needed.”
The RVC funds research into IMHA, looking into new treatments and new ways to both diagnose and treat so that the prognosis for more pets is more positive. Your support is making a real difference to these pets and their loving families. For recent news on the ACT-funded research, please read our update provided by the clinical research team.