Big Bear Award – Sweepy

Sweepy, a 10 year old black and white cocker spaniel, was brought to see Ian Stroud at Vet4life in November 2012. In just a few days Sweepy had gone from being a bright and happy dog to becoming very quiet and sleeping a lot. He was also refusing all food. When Ian examined him he found that Sweepy was lethargic. His gums were also pale and jaundiced.

yellow-gums-dog

Sweepy’s Story

Ian knew Sweepy was critically ill and so he admitted him straight into hospital for emergency treatment and investigation. Blood tests were immediately run in the clinic. Haematology results revealed a very low red blood cell count. Sweepy was severely anaemic.

Anaemia can be due to several causes including blood loss or red blood cell destruction (haemolysis). To test for haemolysis Ian mixed a drop of Sweepy’s blood with a drop of saline on a microscope slide. Rather than evenly dispersing when diluted, Sweepy’s blood cells immediately formed irregular clumps; a sign of haemolytic anaemia. Sweepy was suffering from a severe case of Immune Mediated Haemolytic Anaemia (IMHA).

IMHA occurs when the immmune system attacks and destroys the body’s own red blood cells. IMHA may occur secondary to a range of underlying diseases such as infections, toxins or cancers. In dogs the large majority of cases are idiopathic, meaning that no underlying cause can be identified. The disease is usually seen in middle aged female dogs and certain breeds, including Cocker Spaniels like Sweepy, are more commonly affected.

In IMHA the patient’s red blood cells are either destroyed within the circulation or removed by the spleen. As red blood cell numbers fall, the oxygen carrying capacity of the blood is reduced, often to critical levels. Patients may develop lethargy, weakness and collapse. The gums may appears pale or, as in Sweepy’s case, yellow with jaundice. Jaundice occurs due to build up of the red blood cell break down product bilirubin in the tissues. As the disease progresses internal organs are adversely affected by poor oxygen supply (hypoxia). The kidneys can also be damaged by the products of red blood cell breakdown. IMHA can rapidly lead to very severe life threatening illness and potentially fatal complications such as blood clots.

Sweepy had a severe anaemia and therefore required urgent and intensive treatment in order to save his life. Fluids were given intravenously to support his circulation and to dilute the potentially toxic products of haemolysis. He was also started on therapy to suppress his immune system and halt the destruction of his remaining red blood cells. Supportive therapy was started with pain relief, gut protectants and special nursing care.

Sweepy rapidly responded to treatment. His owner visited him regularly in hospital to give him a little extra TLC and try to tempt him to eat. Although some severe cases of IMHA may require a blood transfusion Sweepy’s positive response to treatment meant that this was avoided. After two nights in hospital he was a lot brighter and much to our delight he finally began to eat again. On his fourth day in hospital he was much improved, his red blood cell count had increased significantly and he was deemed well enough to go home.

Sweepy will require several months of immunosuppressive therapy for IMHA. His red blood cell count needs to be checked regularly and he requires daily medications. He remains bright despite his condition and has responded excellently to his treatment so far.

Well done Sweepy for remaining brave through what has been such a traumatic time.

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Vet4life

Veterinary Surgeon at Vet4life
Ian Stroud is a highly experienced small animal veterinary surgeon with over 15 years working in practice. He has particular interests in several areas including minimally-invasive surgery, orthopaedics and oncology (cancer treatment). He currently practices in Teddington, Shepperton and Surbiton where he is the director of Vet4life.
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5 Responses to “Big Bear Award – Sweepy”

  1. Col Harkirat Singh

    I have a lovely Cocker Spaniel about 13 years old. He had developed inflammation and swelling on both his cheeks / jowls. [Left Maxilla regiin nostril]. He has bad breath and severe tartar growth on his teeth. Initially a couple of oral blisters / ulcers were visible but have since subsided. The swelling has gone down partially after a couple of antibiotic and anti-inflammatory shots by our vet. I am worried about the results of his bloodwork which is clearly de-ranged

    Hb 9 g/dL
    Total RBC Count 4.8 million/cumm
    PCV 24 %
    MCV 50 fL
    MCH 18.75 pg
    MCHC 37.5%

    TLC 216P0 /cumm
    Neutrophil 79%
    Lymphocytes 19%
    Eosinophil 2%
    Basophil 0
    Monocyte 0
    Segmented Neutrophil 64
    Band Neutrophil 15%

    Platelet Count 246000 /cumm

    Apart from saline drip, he got a shot of ceftriaxone and pantaprazole.

    I don’t have a diagnosis. The bloodwork indicates infection. What do I look for?

    Reply
    • ian stroud

      Hello Col,

      Thank you for your comments, I have just seen them so sorry about the late reply. I hope your Coker Spaniel is continuing to have an excellent response to the medication.

      In the UK we use a very different measuring system for our lab results eg mol/l rather than g/dl. You have also not included the reference ranges for your particular lab so taken together it would make commenting on the lab results quite difficult.

      It sounds like the treatment your vet started has worked. Have you spoken to your vet with your question and any concerns you might have? Infection can be difficult to diagnose just on lab results alone and many things can cause similar blood results eg. cancer, autoimmune disease and inflammation. Perhaps some imaging such as x-rays might help to establish more of a diagnosis for you?

      I hope he continues to be well but keep a close eye on him and if anything changes, get in touch with your vet.

      Best wishes

      Ian

      Reply
  2. Col Harkirat Singh

    Further to my last communication, my dog’s other parameters are

    Blood Urea Nitrogen 11 mg/dl

    Total Protein 10.1 g/dl
    Albumin 5.0 g/dl
    Globulin 5.1 g/dl
    Albumin : Globulin 0.98
    SGOT /AST 30 U/L
    SGPT /ALT 39 U/L

    Blood Sugar (Random) 96 mg/dl

    Reply
  3. Janet Ellice

    I took my 12yr old female R/Collie for a dental yesterday . All was fine but her blood work showed she was slightly anaemic . The vet said that at this point she is fine and to have her rechecked in a couple of months , however i have noticed for quite a while now that she pants all the time and sleeps a lot , her appetite has always been a bit poor but she has a good balanced diet . She had a glyoma 3yrs ago but has been cancer free for the last two and a half years . I am concerned that if i leave her for that length of time she maw become very ill . Can you please advise me on what to do ? Thank you in anticipation .

    Reply
    • Vanessa Waite

      Hi Janet! If you would like to send in the blood results, we can certainly take a look at them for you. Re-checking the bloods is a great way of seeing if there is a true anaemia or not.
      Older dogs to tend to sleep more and may pant, but we would be happy to have a look at her for you!

      Reply

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