Immune-mediated hemolytic anemia (IMHA) is a potentially deadly condition in dogs. You may also see it as autoimmune hemolytic anemia (AIHA) or autoimmune anemia. Regardless of what you call it, in this disease involves the destruction of red blood cells by your dog’s own immune system gone rogue.

Your dog’s red blood cells are responsible for transporting nutrients and oxygen to cells throughout the body, as well as picking up carbon dioxide, waste products including dead or damaged cells, and toxins. Your dog needs adequate red blood cells to live.

Normally, your dog’s body has a nice balance between new red blood cells being manufactured in the spleen and bone marrow and worn out or damaged cells being removed by the spleen. When the immune system destroys red blood cells faster than they are produced, your dog will become anemic.

What Causes IMHA in Dogs?

Unfortunately, the most common causes idiopathic, which means that the reason for the disease is never determined. American Cocker Spaniels have the highest risk of all breeds, which suggests a genetic predisposition.

Potential secondary causes abound, with tick-borne diseases at the head the list, followed by drug and vaccine reactions. Other potential causes include bee stings, snake bites, viruses, bacteria, and even cancer.

Signs of IMHA in Dogs

Any of the signs listed below justify a trip to the veterinary clinic. While IMHA can be treated, it has a high mortality rate. The sooner the treatment starts, the better the chance for a successful outcome.

Clinical signs you may notice include:

• Weakness
• Lethargy
• Pale gums
• Jaundice (ears, gums, groin)
• Small pinprick hemorrhages in the groin (called petechia)
• Nose bleeds
• Rapid breathing
• Racing heartbeat

Treatment for IMHA in Dogs

Some quick bloodwork will be done to verify that the problem is IMHA, and then treatment will start. At a minimum, most dogs will require intravenous (IV) fluids and some corticosteroids, and/or immunomodulating drugs. That generally means prednisone and a medication like cyclosporine. Expect your dog to spend some days in the hospital. Blood transfusions are frequently required, often more than one. In severe cases, stem cell therapy has been tried.

If an underlying cause is identified, treatment is aimed at clearing that up as well as treating the immediate symptoms. Sadly, even with rapid treatment, up to 50% to 70% of dogs will die. For those dogs who get released from the hospital, there is a relapse rate of about 15%. Most dogs will remain on at least some medications for life. Frequent rechecks are important to try and catch any relapse early on.

Can You Prevent IMHA in Dogs?

There is no real way to prevent IMHA other than regular preventive care, avoiding parasites like ticks, trying to avoid bees and snakes, and doing regular physical examinations to catch any cancers as soon as possible.

Know your dog’s family health history. For example, if littermates have had drug reactions, avoid those medications for your dog. Astute observation by you for any symptoms and responding right away increases your dog’s odds for a positive outcome.

It’s not uncommon to come across a lobulated pink or white growth on your dog’s skin, especially if he’s older. These bumps might be on his face, legs, or body. When you touch them, they may feel a bit oily and may even have a slight oily discharge.

These are likely sebaceous adenomas, which are benign tumors of the sebaceous (oil) glands of the skin. They range in size from tiny to about an inch in diameter.

These benign growths are most often found on middle-aged or senior dogs. Cocker Spaniels, Poodles, Miniature Schnauzers, and terrier breeds are most often affected. It’s wise to ask your veterinarian to look at any new growths, of course, but unless they look irritated, red, are bleeding, or are in an area that’s causing the dog to lick or chew at it, it can usually wait till your next visit.

Sebaceous Cysts in Dogs

Sebaceous cysts tend to be singular, smooth, and round. They are white or light pink, like sebaceous adenomas, they also may appear dark or pigmented. They may be found anywhere on the body, but the head is a common site. Some may even form along eyelids, where the eyelash follicles are. Schnauzers are often affected by sebaceous cysts.

These cysts occur near sebaceous glands in the skin, which are full of sebum, an oily substance that helps to lubricate and protect the skin. If a sebaceous gland becomes blocked, a cyst can form. The contained sebum becomes thicker and, if the cyst is opened, the contents are grayish and thick (like toothpaste).

Diagnosing Growths on a Dog

Diagnosis of both types of growth is generally done via observation. If your veterinarian has any concern, she may do a fine-needle aspiration to look at the cells under a microscope. Although rare, removal via biopsy is done with laboratory evaluation by a pathologist.

While both conditions may be unsightly, they usually do not present a serious health problem. If the cyst or adenoma ruptures, secondary bacterial skin infections may occur. Topical treatment such as cleaning with antibacterial solutions or wipes is generally all that is needed.

Removing Skin Bumps on a Dog

Most dogs ignore these cysts and adenomas unless one gets injured. At that point, the dog may lick or chew on the site. (It can be a challenge for groomers to avoid clipping these growths on dogs who have a lot of them.)

If your dog is chewing or licking at any sebaceous cysts or adenomas, you may choose to have them surgically removed. Depending on the size and location of the growth, this might be done by electrocautery, or it might require surgery. Recovery is rapid, but you will need to keep your dog from licking at the healing site.

Preventing Canine Skin Growths

There is no set way to prevent sebaceous cysts and adenomas. Bathing predisposed dogs with an anti-seborrhea shampoo may help, especially for cyst development. Keeping your dog clean and well-groomed may help. Diet has not been shown to be a factor.

Just remember that, while they may be unsightly, these growths are benign, which should be a relief to you!

Discospondylitis in dogs occurs when a bacterial or fungal infection travels to the spine. The infection might just be at one point in the spine or could be at multiple spots at once. Note: Discospondylitis is different from spondylosis in dogs. While discospondylitis is an infection, spondylosis is a degenerative disorder of the bones in the spine.

How Discospondylitis Happens

Usually, the bacteria or fungi access the dog’s spinal discs via the bloodstream. An infection starts somewhere else in the body, such as in the mouth, on the skin, or in the urinary tract, and then the infectious agents hitch a ride in the blood. As blood circulates through the body, the bacteria or fungi may stop in the spinal discs and start up a new infection there.

Another cause of discospondylitis is a migrating foreign body, such as a grass awn or foxtail. These barbed awns can enter the body a variety of ways and then slowly move through tissue. The trail left behind is the perfect opportunity for infectious pathogens to follow along.

The third way that a dog can develop discospondylitis is after trauma to the back, such as a bite wound, getting hit by a car, or in rare cases secondary to back surgery.

Who’s at Risk?

Any dog can get discospondylitis, but large and giant breeds are the most often affected. Examples include the Great Dane, German Shepherd Dog, Boxer, Rottweiler, Doberman, and English Bulldog.

Chronic skin infections, having an immune system disorder, or being on immunosuppressive medications may predispose a dog to spinal infection.

What Discospondylitis in Dogs Looks Like

The symptoms of discospondylitis are non-specific, which means they can look like a variety of injuries and illnesses. Possible symptoms include:

• Pain
• Stiffness
• Reluctance to move
• Avoidance of jumping and/or stairs
• Flinching when touched
• Fever
• Poor appetite
• Weight loss
• Lethargy

If the infection has caused the disc to swell and put pressure on the spinal cord, the dog may also have neurological deficits such as stumbling or dragging one or more paws. Over time this can progress to limb weakness, muscle loss, and even paralysis.

Exact symptoms can also vary depending on the location of the infection site(s). Discospondylitis most commonly occurs in the thoracic and lumbar spine regions along the dog’s back.

Getting a Diagnosis

Diagnosing discospondylitis in dogs can take a while. The same symptoms can result from a variety of conditions, which means your vet needs to parse through all the potential causes.

X-rays are the simplest way to make a diagnosis. The catch is that it takes three to six weeks after symptoms start for bony changes to be visible on an X-ray. It may take a couple rounds of X-rays to see evidence of discospondylitis.

Advanced imaging such as myelography, CT scan, MRI, or bone scintigraphy can pick up signs of discospondylitis sooner. These procedures usually require a trip to a specialist.

Once discospondylitis is on your veterinarian’s radar, the next step is to identify the bacteria or fungus causing the infection. Your veterinarian may take blood and urine samples to culture, and will test for brucellosis. In some cases, a spinal tap to take a sample of cerebral spinal fluid may be necessary. This can be done under anesthesia by a specialist.

Rarely, the infected disc itself may be cultured. This requires surgery done by a specialist and is usually avoided because of how invasive it is.

Treatment

Treatment for discospondylitis often takes six to 12 months to clear the infection. Your dog will receive an antibiotic or antifungal medication depending on the type of infection, with the exact medication determined by the culture and sensitivity testing. Fungal infections are generally more difficult to eradicate than bacteria.

Your dog may also receive pain meds to keep him comfortable.

In some cases, it may be necessary to do surgery to debride damaged tissue, flush out the area, and relieve pressure on the spinal cord. This procedure should be done by a board-certified specialist.

Most dogs show improvement within two weeks of starting treatment. If your dog does not improve at that time, your vet will reassess and determine a new plan. Serial X-rays can be helpful to track healing of the bones in the spine over time.

Bacterial discospondylitis has the best prognosis. These dogs may relapse during the treatment period, but usually the infection can be fully treated.

Fungal discospondylitis has a more guarded prognosis. Many dogs respond to treatment, but others do not. Some dogs require lifelong medication to control symptoms and keep them comfortable.

Discospondylitis due to the bacterial infection brucellosis cannot be cured. This disease requires lifelong medication and careful management because it can be passed to humans and other dogs.

For all types of infection, severe neurological symptoms indicate a worse prognosis.

If your dog is diagnosed with discospondylitis, it is important to be diligent with medications for the full treatment period. Six to 12 months is a long time to give meds, but if it can get your dog back to his normal life, it is worth it!