Maisy: A Blood Donation Success Story
Shortly after Christmas 2022, Maisy's owner noticed she was feeling under the weather. Maisy hadn't eaten much, had vomited and was feeling lethargic for a few days. Maisy's owner brought her in to see Dr. Balogh because she knew something wasn't right with her soon-to-be 13 year old dog.
During her physical exam of Maisy, Dr. Balogh noticed her gums were pale and the whites of her eyes (sclera) were slightly yellow in color, a condition called jaundice or icterus. She also noticed that Maisy's capillary refill time (how long it takes the gums to become pink again after applying light pressure) was prolonged. These signs led Dr. Balogh to believe that full bloodwork was needed to investigate what was going on with Maisy.
Maisy's complete blood count (CBC) – which lets us look at red and white blood cell counts as well as platelets – revealed that she was moderately anemic (not enough red blood cells) and had a severely decreased platelet count (thrombocytopenia). Her chemistry panel showed an elevation in bilirubin, which is a byproduct of the breakdown of red blood cells, suggesting that Maisy's anemia was coming from red blood cell destruction. Dr. Balogh then examined some of Maisy's blood on a slide and found evidence of agglutination, which is when the red blood cells start to form clumps because of antibodies building up on their surface. This, combined with the bloodwork results, confirmed that Maisy's body was destroying her own cells.
Immune-mediated hemolytic anemia (IMHA) is when the body attacks its own red blood cells and can be triggered by many things, but often no cause is found. A similar condition called immune-mediated thrombocytopenia (IMTP) is found when the body attacks its own platelets. When both auto-immune diseases occur together, it's called Evan's syndrome, which we now knew that Maisy had developed.
Maisy was hospitalized and started on corticosteroids to regulate her immune system and hopefully stop it from continuing to destroy her blood cells. Over the next two days, however, her red blood cell counts continued to drop. Because of the severity of Maisy's anemia and platelet counts now, a blood transfusion was indicated or she likely wouldn't survive. Our staff called any client they could think of who had a dog that was large enough and healthy enough to donate blood until they found one who was available to come in. The donor dog was lightly sedated and one unit of blood was collected, which was then slowly given to Maisy over several hours. Blood transfusions must be done slowly and the recipient's vitals must be monitored frequently to check for any transfusion reactions, which indicate that the patient's body is rejecting the blood. Thankfully Maisy handled her transfusion very well and maintained her red blood cell counts for a few days in the clinic before she was discharged for monitoring at home.
Maisy has been re-evaluated in the clinic several times and her red blood cell counts continue to improve and remain steady. She's eating and drinking well, has good energy and is feeling playful again. Hopefully Dr. Balogh will be able to taper Maisy off of corticosteroids, but some dogs with IMHA and IMTP need lifelong therapy to prevent a relapse.
Conditions like IMHA and IMTP are, unfortunately, relatively common in dogs and cats. Blood transfusions aren't always necessary but when they are, finding blood donors can be difficult and blood banks are expensive and difficult to maintain. Your dog or cat can save a life – if you have a pet who meets the donation requirements, please consider signing up for our Blood Donor List here.