Patient of the Month - Cookie

One evening in August concerned parents Joulia and Maneli, brought Cookie, a four year old Maltese Terrier, to the Adelaide Animal Hospital.

Cookie presented to Dr Steph with the owners concerns that he was being quiet and keeping to himself. Earlier that day he didn’t want to eat anything, especially his favourite treats! In addition to this abnormal behaviour, Cookie’s owners noticed that his urine was a different colour.

After arriving at the clinic, Cookie underwent a thorough physical examination. The only abnormality noted was the colour of Cookie’s mucus membranes (gums). Instead of being a nice healthy pink, they were pale with a yellow undertone. Cookie had a screening blood test that revealed a very low red cell count (anaemia) and an elevation of Bilirubin (a waste product). This waste product, when building up in the blood, is responsible for the Jaundice (yellow) colour of the gums and skin. A specific blood test was sent to the pathology laboratory, confirming that Cookie had Immune-Mediated Haemolytic Anaemia (IMHA).

IMHA is a condition where a patient’s immune system starts to attack their own red blood cells. The rate of red cell destruction is faster than the body’s rate of production, leading to dangerously low levels of red blood cells (anaemia). There are a number of diseases/conditions that can trigger IMHA, including some medication, allergic reactions, and certain types of cancers. However, most of the time there is no apparent cause. This was the case for Cookie, after having an abdominal ultrasound to rule out any under-lying causes.

After Cookie’s diagnosis was made, he was started on immune suppressive medications. These medications are designed to stop the body from attacking his red blood cells. In addition, Cookie also had to have a blood transfusion to replace the destroyed red cells. He had to be monitored in hospital for five days before he, and his red cells, were stable enough to go home.

Since going home with medications, Cookie’s red cells have continued to improve. He has to visit the hospital on a regular basis for blood tests and medication monitoring. Now, after three months, Cookie’s red cells have stabilised and he can start the gradual process of weaning off his medications.

 While there is still some way to go before his treatment is finished, his family are very happy to have a brighter, treat loving boy running around causing mischief!

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patient of the month
Immune-Mediated Haemolytic Anaemia

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