IMHA in a Labrador Retriever

Dahlia, a 9-year-old spayed Labrador retriever, was presented with acute lethargy and anorexia. She had been receiving oral carprofen at 2.23 mg/kg every 12 hours and oral tramadol at 2.6 mg/kg every 12 hours to control osteoarthritis (OA) pain, along with monthly flea and tick and heartworm preventives. Physical examination revealed pale, icteric mucous membranes, tachypnea, and tachycardia. Immune-mediated hemolytic anemia (IMHA) was diagnosed based on findings of regenerative anemia (PCV, 18%; normal, 35%-45%), RBC macroagglutination, spherocytosis, mature neutrophilia (25 870/L; normal, 3000-11 500/L), and moderate hyperbilirubinemia (2.9 mg/dL; normal, 0.1-0.4 mg/dL). No significant abnormalities were evident on thoracic radiography or abdominal ultrasonography. Tick-borne disease testing and urine culture results were pending. Hematuria, pyuria, and gram-negative bacteriuria were identified on urinalysis.

IMHA = immune-mediated hemolytic anemia, OA = osteoarthritis