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Jax is a 6yo Bichon mix who started acting ill in late April/ early May of 2022. He was becoming lethargic and was losing his appetite. He began vomiting and became disinterested in food or water, losing about 5 pounds in a few weeks.
He was declining and was taken to the emergency clinic and hospitalized where he received a blood transfusion right away. There, he was still unable to eat much because he was constantly salivating, smacking his lips, and panting. He got all the usual testing done, including radiographs, 4dx test to check to tick borne diseases, blood smears, biopsies, and bone marrow aspirates. It was determined he had IMHA. He even developed PICA from the anemia, and was found to have rocks and sand in his digestive tract. At this point he was non-regenerative, meaning that his body was unable to produce enough new red blood cells to keep up with those being killed. He was started on prednisone. His PCV had started down around 15% and had reached 30% after the blood transfusion. Jax was discharged and headed home. His PCV hovered in the mid-20's throughout May.
About a month later in mid-June he once again became lethargic, started vomiting, and wasn't eating. His owners noticed he was pale as well. When they checked his PCV, it was down to 11%, so another blood transfusion of packed red blood cells was ordered. He was hospitalized for a few days so he could be watched.
Meanwhile, his owners had found Safari and called to find out if Jax was a candidate for stem cell therapy. They lived "just up the road" in Dallas, and came to see us here in Houston for stem cells. When a pet is critical or their PCV is dropping quickly, we recommend 2 rounds of cells 12-24 hrs apart, which is what we did for Jax.
Jax was happy to take some rotisserie chicken from Katie while waiting for his second round of stem cells. He hadn't eaten for a few days, and perked up after his 2nd round of stem cells. We are happy to report that his PCV that was down to 11% at one point in mid-June was 36% by mid-July!
Even Jax is smiling after some delicious chicken and a second round of stem cells!
Stem cell therapy is a useful weapon in the fight against immune-mediated hemolytic anemia (IMHA)
*Reprinted from Veterinary Practice News, published July 9, 2021
By Steven Garner, DVM, DABVP
Derp, an eight-year-old Jack Russell terrier, was treated with stem cell therapy for his immune-mediated hemolytic anemia (IMHA). Photos courtesy Safari Veterinary Care Centers
Derp the Jack Russell is one lucky dog. His owner practically grew up in her dad’s veterinary clinic and became a veterinary technician, so she knew what to do when Derp was lethargic and vomiting after he’d been just fine the day before. Following a trip to the veterinarian, Derp was diagnosed with immune-mediated hemolytic anemia (IMHA).
He was immediately given a blood transfusion and put on immunosuppressants. For the next few weeks, Derp and his owners found themselves riding an emotional and physical roller coaster so common with this disease. Low PCV values are often followed by blood transfusions, which temporarily raise these values that may once again plummet and be followed by more transfusions. After his sixth transfusion, Derp’s owners decided to try plasmapheresis. Unfortunately, Derp developed transfusion related acute lung injury (TRALI) and was subsequently placed in an oxygen cage.
Getting desperate
Prognosis was bleak and Derp’s owners knew they had to find something else to keep him alive. Searching online to find anyone who had information on treating this deadly disease, they discovered stem cell therapy was an option.
After a thorough case evaluation and consultation, followed by an overnight shipment, Derp was able to get stem cells intravenously right there in his local veterinary hospital. After the stem cells, no more transfusions were needed. Derp’s lungs cleared up, and his PCV continued to rise to normal levels.
I have been a veterinarian in the Houston area for a few decades and began utilizing stem cell therapy in my clinical cases over the past five years that go beyond the traditional applications for arthritis and joint issues. After getting past my initial skepticism of stem cells and realizing there was real science behind them, I became intrigued.
Intrigued enough that five years later Safari Veterinary Care Centers has one of the fully equipped, state-of-the-art stem cell labs outside the university system that enables us to treat cases that reach beyond run-of-the-mill arthritis. The Safari lab is the result of a thirst for knowledge and quest to more effectively treat disease along with a healthy financial investment. How do you culture and grow enough cells for therapy? How many stem cells given intravenously are effective? How do you count the cells, let alone know if the cells are still alive? These and many more questions drove me to study existing research and obtain the knowledge to treat more complex conditions and diseases, including IMHA.
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Moving forward
Many veterinarians could be intimidated by a case of fulminating IMHA, and many refer these cases to specialists. IMHA and immune thrombocytopenia (ITP) are challenging diseases without cut-and-dried treatment protocols.
Blood transfusions can buy the pet time until immunosuppressants take effect, but neither transfusions nor drugs treat the underlying cause of the immune reaction that results in the anemia. Stem cells do, however, treat the underlying cause and are showing real promise in the clinical setting. How so?
The fully equipped clean stem cell laboratory at Safari Veterinary Care Center in League City, Tex., enables Steven Garner, DVM, ABVP, and his team to culture, grow, count, and store stem cells.
Mesenchymal stem cells (MSCs) exert powerful immunomodulatory effects by both cell-to-cell contact and by secreting powerful chemicals.1 When administered intravenously, the cells begin working immediately. IMHA targets the red blood cells, and this reaction occurs within the blood vessels or in the spleen and is designated as intravascular or extravascular IMHA respectively.
When the reaction is intravascular, literally billions of red blood cells are tagged by antibodies each second. Tagged red blood cells are killed by the activation of Complement. Complement is called this because it complements the immune system. Complement creates holes in the red blood cells allowing fluid to leak in which causes them to burst. How can stem cells help? The action of Complement is blocked by Factor H. Stem cells produce Factor H constitutively; that is, they make Factor H regardless of need.2,3,4 Intravenous stem cells can quickly stop the tagged red blood cells from being destroyed. But that’s not all stem cells do. Stem cells also direct the formation of Regulatory T-Cells (tReg cells).4 Regulatory T-cells are a specialized group of white blood cells. Their job is to create immune tolerance of the red blood cells. These T-cells limit the production of anti-red blood cell antibodies by tolerating the presence of the body’s red blood cells (see “Immune tolerance.”)
With extravascular IMHA, “nibbles” are bitten off the surface of the red blood cells by macrophages as the red blood cells pass through the spleen and liver. This process of phagocytosis removes whole red blood cells from circulation while creating spherocytes from the partially nibbled cells. Stem cells downregulate this phagocytosis of macrophages.4
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These actions of stem cells effectively stop the red blood cell destruction in IMHA within the first 24 hours. Therefore, to more effectively treat the disease and save more lives, stem cell therapy would be best used early in the pet’s treatment plan while waiting for medications to take effect and especially in severe cases that are not responding to blood transfusions. Not only do stem cells treat IMHA, they also prevent it from returning by creating lasting immune tolerance. Memory T-cells act to remind the immune system to tolerate the red blood cells and not to attack them again in the future.4
Stem cells are poised to revolutionize both veterinary and human medicine and dogs like Derp are proof that stem cell therapy is a useful weapon in the fight against IMHA.
The challenge for veterinarians is getting access to stem cells in emergency situations. While processing adipose tissue and using the stromal vascular fraction cells works for inflammatory disease, immune-mediated diseases need pure stem cell cultures. But dogs like Derp cannot wait weeks for their cells to be cultured; they need donor cells immediately. Will veterinary hospitals of the future have their own stem cell labs, or will daily stem cell deliveries be available along with the antibiotics and painkillers of today?
IMMUNE TOLERANCE
What is immune tolerance? Normal tissues all are labelled with the major histocompatibility complex. Any tissue without the major histocompatibility complex is attacked. However, the body can tolerate foreign tissue in special circumstances. A fetus is tolerated by the mother. The gut tolerates the presence of billions of bacteria. Red blood cells have jettisoned the major histocompatibility complex along with the nucleus, but they are not normally attacked.
Why? Immune tolerance. The immune system has a special group of white blood cells called regulatory T-lymphocytes whose function is to protect these groups of cells that would normally be attacked. The biochemical factors produced by the regulatory T-lymphocytes (tTreg cells) prevent red blood cells from being attacked. As the red cells age, they naturally lose the protective barrier and are removed from the circulation. If we don’t have enough tTreg cells protecting the red blood cells, then we will lose red blood cells faster than we can produce them, as in IMHA. One function of stem cells is to induce the production of new tTreg cells. This offers hope of a cure rather than lifelong immunosuppressive treatment.
Steven Garner, DVM, ABVP, owns and operates what has been termed “the most productive veterinary hospital in the world” at Safari Veterinary Care Centers near Houston, Tex. He founded Safari in 1984 with a vision to develop a model for veterinary practice in which a private practice veterinarian could practice the level of medicine taught in veterinary school. Today, Dr. Garner is among the leaders in the veterinary industry, practicing advanced regenerative medicine after embarking on a quest in 2015 to learn all he could about stem cell therapy.
References
Kyurkchiev, Dobroslav, Bochev, Ivan, et al. Secretion of immunoregulatory cytokines by mesenchymal stem cells. World Journal of Stem Cells. 2014; Nov 26; 6(5):552–570.
Mesenchymal Stem Cells Inhibit Complement Activation by secreting Factor H. Tu, Zhidan; Li, Qing Li; et al. Stem Cells and Development. 2010; Nov 19(11):1803–1809.
The Complement Inhibitor Factor H Generates an Anti-Inflammatory and Tolerogenic State in Monocyte-Derived Dendritic Cells. Olivar, Rut; Luque, Ana, et al. The Journal of Immunology. 2016; May 15;196(10):4274-90.
Conversion of Peripheral CD4+CD25- Naive T Cells to CD4+CD25+ Regulatory Tcells by TGF-B Induction of Transcription Factor Foxp3. Chen, WanJun; Jin, Wenwen Jin, et al. The Journal of Experimental Medicine. 2003; Dec 15;198 (12):1875-86.
In April of 2021 Daisy, an 8-year-old Bichon-Shih tzu mix, was diagnosed with primary intravascular IMHA. She was so critically ill that the day she first was taken to her vet, her owners were told that her Packed Cell Volume (PCV) was down to just 5%! She was hospitalized that day, started on immunosuppressants, and given her first transfusion of packed red blood cells.
For the next 8 days her PCV would come up to the low- to mid-twenties after each transfusion of packed red blood cells yet drop below 15% within 24 hours. Her veterinary team would transfuse her blood again when it got down to 13 or 14%, which occurred ELEVEN more times in just over a week!
Moreover, she was also given two human immunoglobulin treatments but neither had the effect everyone was hoping for. (In essence, IVIg floods the body with antibodies to fool the immune system. This treatment does not halt the production of antibodies and therefore does not cure the problem, so the effects only last a short time.)
It was becoming clear that the regimen traditionally used to treat IMHA was not working. Her owners were getting desperate to save her and began looking for alternative treatments.
One exceptionally long, agonizing week later, Daisy’s owners found Safari online and contacted us to inquire about using stem cell therapy. At this point, it was imperative to help Daisy survive. After her records were reviewed, her case evaluated, and her doctors consulted, stem cells were overnight shipped to Miss Daisy in the hospital. Since she was not responding to any traditional treatments, she was sent two rounds of cells to be administered within 12 hours of each other. The day they arrived she had just received her twelfth blood transfusion, just NINE DAYS after her diagnosis.
The day after she received her both stem cell infusions, we got the good news that her PCV was up to 23% and that she had gone just over 24 hours without needing more blood for the first time since she arrived at the hospital! A day later her PCV had dropped a bit to 18% so two more rounds of stem cells were shipped out. She had now gone over 48 hours without needing a transfusion. After these next two rounds of stem cells were administered her PCV climbed to 25% and Queen Daisy was discharged to continue recuperating at home.
As these pictures can attest, she was given a grand send-off with balloons, streamers, cake, party hats, leis, and yummy donuts!!
One week after her discharge from the hospital, Daisy’s PCV was up to 35%, and almost a month later was up to 46%. Another month and a half later, Daisy’s PCV is holding steady, and her veterinary team continues to reduce her medications. She is down to just 5 mg of prednisone and is doing well!
12-04-21 *update from Daisy’s owners: "Daisy continues to be excellent. Her last several PCV results (every 2 weeks she is tested) have been in the 44-48% range. She is now off all of her IMHA meds (with the exception of one immunosuppressant which has been cut in half). The expectation is that she will be completely off this last one in the next few weeks. Again, we cannot thank you enough for helping our Daisy!! Daisy has probably had some of the best months of her life lately!"
Peabody’s owners brought him all the way from Colorado to Safari for stem cell therapy this week for a painful knee. He had been holding his hind leg up after playing in the yard and his orthopedist diagnosed a possible partial cruciate tear. Peabody’s parents wanted to avoid surgery since Peabody was still young - under two years of age - so they made the trip to Texas.
A ruptured anterior cruciate ligament is not always an obvious condition. Radiographs sent from Peabody’s vet showed no musculoskeletal abnormalities and a cranial drawer sign test was negative (see illustration below), so an MRI was done here at Safari. Dr Garner suspected the iliopsoas muscle may have been injured from the pet’s normal gait being thrown off (i.e., limping to protect the painful knee) so the pet’s lower back was imaged as well.
The MRI images revealed three findings: partial rupture of the left cranial cruciate ligament, inflammation of the left body of the ilium of the pelvis, and inflammation of the left iliopsoas muscle.
Peabody likely injured his iliopsoas muscles from limping on a partially torn CCL ligament in his knee. When the cruciate ligament is injured, the pet’s normal gait is thrown off – it changes to accommodate the painful knee. This in turn affects other muscles, just as we do when we experience pain in our backs or knees: limping or trying not to put too much weight on the injury causes us to put a strain on muscles that aren’t normally used in that way.
What are the iliopsoas muscles? The iliopsoas muscles are the main muscles that flex and externally rotate the hip. Think of the dog that is urinating; these are the muscles essential for lifting the hind leg outward. In fact, pets that have injured these muscles may stop hiking their leg when they urinate.
Stem cells were injected into the muscle to help with damage from the stress of continuous use of the muscle. In other words, these muscles are used so often by the dog that they never really get a chance to rest and heal. Stem cells support the healing. Stem cells were also given in the knees to help heal the partial cruciate tear. Because the pet will favor the bad knee which puts a strain on the good knee, stem cells are injected into both knees. Finally, stem cells were injected at the location of the bruised and swollen ilium bone. Healing should take about 6 weeks.
The bone in the body of the ilium is hyperintense. This brightness is typical for inflammation on this T2 scan.
Meet Tomac! Tomac is a beautiful 2-year-old English Springer Spaniel who was hospitalized after being diagnosed with IMHA in December of 2021. He had already had 3 blood transfusions in as many days and the hospital cautioned that a fourth may be needed because his PCV had dropped from 25% earlier in the day to 18% that evening. By 2:00 am, Tomac’s PCV had dropped to 14%. His owners were desperately looking for a way to stop this vicious cycle and learned that stem cell therapy was an option for treating IMHA. They gave us a call, and since they lived just a few hours away, decided to discharge Tomac and bring him to Safari.
Upon arrival Tomac’s PCV was down to 13%, and it was apparent that he needed blood, so a 4th blood transfusion of packed red blood cells was given. Next, he got his first transfusion of stem cells. During this time, Tomac was kept on his immunosuppressants and stomach protectants, even while getting his stem cells. This is because we want to stop the killing of the red blood cells as soon as possible, and the medications help with this.
Tomac went back home that night with the expectation of not only needing more blood, but of having a 2nd round of stem cells shipped to their vet for administration if his PCV didn’t rise quickly. The next day, his PCV had again dropped, this time down to 10%, and a 2nd round was needed sooner rather than later. He also needed more blood, so his vet administered both packed red blood cells and stem cells. The following day his PCV had risen to 18% and he was passing urine that was a more normal color, and not as dark as it had been. In the next few days his PCV continued to rise and Tomac gained interest in playing with his ball outside. He was still tired, but more alert and active. A week later, his PCV was up to 34% and he has been doing well since then!
Jade, a 5-year-old Pitbull mix, suddenly began having eye problems in early 2021. She was diagnosed with Dry Eye, or keratoconjunctivitis sicca with a Schirmer Tear Test result of 2.0 mm/min on one eye and 1.0 mm/min on the other. In dogs with tear production less than 5 mm/min, reestablishing near normal tear production is usually quite difficult. She was started on Cyclosporine and Tacrolimus drops 3x day along with artificial tears with the hope that her eyes would clear up in 3 weeks. While the disease can be managed with this course of treatment, the pet unfortunately needs to remain on the meds for life. This means that pet owners must bear a high cost monthly as well as clean discharge from the pet’s eyes and place drops daily for the rest of the pet’s life. A final option for pets who do not respond to medical management was also discussed with Jade’s owners: a bilateral parotid duct transposition. This is when the duct of a salivary gland is surgically relocated from the mouth to the pocket below the eye, which results in the eye being kept moist with saliva instead of tears.
Jade’s owners were not satisfied with this news. Because of the dry climate where she lives, Jade was extra miserable, so her owners were anxious to take care of the problem. Besides the fact that the drops didn’t seem to be helping much, they hated to see their baby so uncomfortable. She had stopped playing, was visibly uncomfortable, and was forced to wear a cone because she’d scratched the skin around her eyes raw. On top of this, her owners had to physically restrain her to place drops in her eyes multiple times a day – sometimes hourly – and remove the discharge from her already sore eyes. They decided to look for a better option for their girl. After some online research they found that Safari is able to treat this condition using stem cell therapy and gave us a call.
Jade's Dad drove her to Safari in Texas from Colorado for stem cell therapy. Although she’d been suspected of having KCS, Dr Garner determined her symptoms and inflammation were more typical for immune mediated marginal granulomatous blepharitis. Blepharitis is an inflammation of the eyelid that can have many causes. In Jade's case, her immune system was attacking her eyelids, and like an allergic reaction, this was causing her to squint, have itchy eyes, and discharge. Like KCS, blepharitis is quite uncomfortable for the pet and doesn't go away on its own. Either the pet must stay on immune suppressing drugs for life or somehow have their immune system reset back to normal to stop the attack. As it turns out, stem cells are the key to returning the immune system to its normal state.
As with KCS, immune mediated blepharitis is commonly treated with topical steroid medications in an effort to turn off the immune system. In Jade’s case, stem cell therapy was used to reset the immune system back to normal, addressing the root cause of the problem. Two injections are made into each eye - one into the dorsal lacrimal gland and one into the gland of the third eyelid. Her eyes had been so uncomfortable before the stem cell injections that the ligaments around her eyes were pulling them back into the socket as much as possible for protection and the whites of her eyes were no longer visible. A week after the first round of stem cells her owners could see the whites of her eyes again and reported that she was much more comfortable with each passing day.
Three weeks later another round of stem cells was administered. At this point her immunosuppressants had been discontinued. Her owners noted that her eyes look better and need less lubricant every day. She was less itchy.
Just 27 days after the first round of stem cells (and 1 week after the second round) Jade’s eyes were open wide – no more squinting! and glistening. She was happy, doing well, and back to her old self. According to her owners, “I see moisture on her bottom lid many times during the afternoon. She is happy and so comfortable. Jade and our family are so thankful for Dr. Garner and the Safari vet team in Texas. Jade has tears and we couldn’t be happier!”
Six-year-old corgi "Ben" presented with signs of collapse from poor respiratory function due to fluid in the chest cavity. The buildup of fluid was determined to be chylothorax which is the accumulation of excess chyle in the chest cavity. Chyle is a white colored liquid made of absorbed fat and lymph from the intestine that normally drains into the cisterna chyli of the thoracic duct. Chylothorax occurs when the thoracic duct drainage is blocked releasing the chyle into the chest cavity. This can be a fatal consequence as the lungs become collapsed and the pet is forced to breathe with only part of the normal lungs. Drainage of the chest fluid is essential at this point.
The chest was drained of fluid and the fluid looked like milk. The fluid was analyzed and found to have 50% of the cells to be lymphocytes and an exceedingly high triglyceride content (much higher than plasma) at 1976 mg/dl. These results indicate that Ben’s diagnosis is chylothorax from a ruptured or malformed thoracic duct. A chest tube was placed to drain the chyle. This is a special tube with a port under the skin to allow intermittent drainage of the chyle fluid without undue stress to Ben. Ben was then scheduled for a CAT scan to see where the problem was with the thoracic duct.
Benito the Maltese was diagnosed with ITP or Immune Mediated Thrombocytopenia on New Year’s Eve 2017. ITP is a condition where the immune system attacks its own platelets because they are erroneously seen as foreign invaders that must be eliminated.
Current medical protocol to treat this type of immune disease is to find a combination of steroids to suppress the pet’s immune system, thereby stopping the attack. Benito responded well to Prednisone for his ITP and was eventually weaned off because steroids are hard on the body.
About a year later he relapsed and was put back on Prednisone. He recovered once more and was weaned off his meds again 5 months later. Unfortunately, he relapsed yet again 3 months later and was admitted to the hospital with a reading of zero platelets. This time his hematocrit also dropped to 14% indicating anemia; possibly also immune mediated. He was started on Mycophenolate and given Vincristine to help his body produce more platelets.
Two days later his platelets were still reading zero and his hematocrit remained at 14%. Benito’s mom called Safari and after reviewing her case, we overnight shipped stem cells to be administered intravenously. The day before the cells arrived Benito received a blood transfusion and his pcv had come up a bit to 24% but his platelets still did not register. He received his I.V. stem cells that afternoon and by 9:00 that night his platelets were up to 11k. The next day his platelets went from 96k to 116k the following day, and back into the normal range a few days after that.
His pcv and platelets have remained in the normal range since June of 2020. As of a few days ago (March 2021) his mom reported that he is now off all his medication. He fought through this terrible disease and is staying strong!
Getting stem cells early on in the treatment of your pet’s IMHA or ITP is important and can make the difference between life and death in some cases. It can also save the expense and harsh side effects of multiple blood transfusions. The earlier the cell destruction by the immune system is stopped, the easier and more quickly your pet can recover.
We know that with immune mediated hemolytic anemia and thrombocytopenia the red blood cells or the platelets are being attacked by the pet’s own immune system. Treating immune mediated disease with drugs can temporarily stop the disease but can take weeks to begin working. These same medications suppress the immune system to stop the attack, but they do so by tamping down the entire immune system, leaving the pet unable to fight off illness. These medications also cause some fairly serious side effects that can even cost the dog its life. Blood transfusions and platelet replacement therapy can temporarily replace the elements of the blood your pet is missing, yet they cannot keep these components from being killed off by the immune system. They can also ramp up the immune system, which is just what we don’t want with these diseases.
Stem cell therapy stops the destruction of the red blood cells in the bloodstream, the spleen, and the liver. This action is immediate; there is no lag time. As the stem cells are introduced into the bloodstream, they emit chemical “instructions” that do a number of things to halt the immune system’s attack. First, they produce something called “Factor H” which acts like a shield to coat the red blood cells so that they cannot be killed. Second, they produce “Regulatory T-cells” which prevent new cells from being tagged for destruction in the first place, stopping the disease process. Third, they cause the production of “Memory T-cells” which serve to remember the red blood cells as “good cells” in the future instead of “bad guys.”
Therefore, unlike drugs, stem cells begin working immediately, do not shut down the pet's entire immune system - only the killing of the platelets or red blood cells, and have no ill side effects. Instead, stem cells are potent anti-inflammatory agents and can turn off the inappropriate immune reaction without leaving the patient susceptible to other infection. They are all natural and do no harm to the body. The earlier the cells are given, the sooner they can shut down the attack and return the immune system to normal. Don’t wait until the last minute to get stem cells for your pet as a last resort; doing so can cost you more than just time and money.
Bella is a 2-year-old female Shih Tzu who started feeling run down in January 2020 and didn’t have much energy. She was diagnosed with IMHA. Her packed cell volume, or pcv, was at 29%, which was below the normal range. (For females, normal is between 37% and 48%. For males, between 45% and 52%.) Pcv is a measure of the oxygen carrying capacity of the blood, because red blood cells are the oxygen carriers. So if the pcv is low, the organs aren’t getting enough oxygen which makes the pet feel super tired and sluggish.
Bella's doctors did a blood smear on a slide and looked at it under the microscope. They suspected spherocytes and explained that this confirmed that her red blood cells were being attacked and killed. Once a red blood cell has been attacked it changes shape and becomes sphere or globe shaped. This is because the red blood cells have been “stabbed” and once cut open, all the fluids in the blood stream rush into the cell, inflating it like a beach ball. These “beach balls” are called spherocytes. Therefore, the presence of spherocytes in the blood indicates red blood cell death.
The doctors also said that Bella’s blood also showed signs of “mild agglutination”, which means some of the red blood cells were sticking together. This can be a sign of IMHA and can become a deadly symptom. The reason the red cells are being killed is because they are inappropriately being “tagged” as old and ready to be destroyed even if they’re not, and these tags on the red blood cells can stick together, forming clots. Many dogs who die of IMHA do so because of blood clots in the lungs, so this agglutination was not good news, even if it was mild.
The doctors also ruled out tick borne disease, which can cause IMHA. If it had been Lyme disease, Bella would have been given antibiotics for 4 weeks and could have gotten out of the hospital a lot quicker!
Once the doctors decided they were dealing with primary IMHA, they started Bella on some medications to try to get the anemia under control. Two corticosteroid medications were prescribed to try to suppress her immune system so that it would quit attacking her red blood cells. Since there aren’t medications that can just stop the immune system from killing the red blood cells, doctors can only give drugs that shut down the whole immune system. This means the body cannot fight off a cold or infection if it needs to.
Bella’s pcv had dropped down to 14%, a 7-point drop in 24 hours. Over the course of a week she was given 7 blood transfusions because she kept dropping so dramatically overnight. Her owners contacted us to inquire about stem cells. Bella’s records were reviewed and her local veterinarian consulted on administering the cells to Bella intravenously when they arrived the next day. Following her 7th blood transfusion Bella was given her first round of stem cells through an I.V. catheter. The next few days her pcv values bounced around between 20% and 28% and a second round of cells was given. Before the second round of stem cells her pcv was down to 24%, and the day after the stem cells it was up to 30%. Over the next few days it climbed to 35% then 47% and on up to 50%. Two months later she was at 48% and now, nearly 2 years later, she remains in the upper 40’s to mid-50’s.
Nowadays Bella has forgotten all about being sick; she’s too busy wrestling and playing with her brother, showing him who’s boss and just enjoying normal dog life with her family.
