Clark's IMHA Journey is featured in the current issue of MAF Animal News: https://769b073a.flowpaper.com/AnimalNEWS234/#page=10.
Clark's IMHA Journey
Created by Allen and Barbara Dearry
Despite recognition as a disease of dogs in 1957, canine IMHA continues to be associated with high morbidity and mortality. We are therefore sharing the story of our journey through diagnosis and treatment of IMHA in our amazing whippet, Clark. And we are collaborating with Morris Animal Foundation to support IMHA research with the hope of preventing and reducing the incidence and harmful outcomes of canine IMHA.
Clark is approaching his 5th birthday, but near the beginning of 2022 we thought it very likely he would not reach age four. Within a few weeks of a leptospirosis vaccination, he became more lethargic and lost some appetite. While we didn’t think much of this initially, when he tried to run like a normal whippet, he suddenly came to an abrupt halt, and stood there gasping for air. Then we knew something was not right, so we made a vet appointment. A complete blood count (CBC) revealed his hematocrit (HCT; percentage of red blood cells in the blood) was 24%. Previously, his HCT had been 56%. After additional testing to rule out other possible causes, Clark was diagnosed with IMHA. We had never heard of IMHA and didn’t know anything about this complicated condition in which the body attacks its own red blood cells.
IMHA is a common immune-mediated disease in dogs and an important cause of severe anemia. IMHA occurs when autoantibodies are formed against red blood cells, leading to their destruction by phagocytic cells in the liver and spleen or by complement proteins within blood vessels. This results in a rapid onset of potentially life-threatening hemolytic anemia. IMHA is treated with immunosuppressive medications, anti-thrombotic medications, and supportive therapy including blood transfusions. Steroids are the mainstay treatment for IMHA and Clark started on prednisone immediately. This drug can cause serious side effects and can be tough on the body. Our boy was a real trooper and cooperated beautifully with his dosing regimens. Lucky for him, and us, he has a very treat-driven personality so the sound of “pill" also meant “treat to follow.” Nevertheless, Clark was on prednisone for twelve months and was unfortunately visited by a host of side effects, including increased hunger and thirst, panting, psychological changes ranging from skittishness to depression, muscle wasting, alopecia, pyoderma, a cancer scare requiring general anesthesia and surgery, and multiple infections and accompanying antibiotics. He has now been off prednisone for one month, is still on a secondary immunosuppressive drug, and seems to be recovering well. His HCT is now 49%. We are extremely hopeful that, after a year of medication and regular blood sampling, Clark will be one of the lucky dogs that recover fully and that he can live the life of a lively whippet for many years to come.
We are fortunate that we have been able to afford the ongoing veterinary care and treatments that have brought our boy back to a happier and more active life. We are also aware that the prognosis for patients with IMHA is guarded, with mortality rates of 50-75% and relapse rates of 6-15% commonly reported. In reality, little is known about the genetic and environmental contributions to the disease process; little consensus exists on the criteria required for definitive diagnosis; and treatment relies on nonspecific immune suppression, which is associated with numerous adverse effects that contribute to patient morbidity. This is why we are seeking to raise funds to study IMHA in order to develop better means of early detection, diagnosis, and treatment. We hope that you, if you are able, will join us in this effort to turn Clark’s journey--and that of all IMHA pups--into positive action for the benefit of all our canine friends.
RFP update. IMHA proposals were received November 15 and will undergo peer review in February 2024.
Morris Animal Foundation has opened its Request for Proposals (RFP) aimed at further understanding canine immune-mediated hemolytic anemia (IMHA). This is the RFP that will result in awards that are aided via this fundraiser. Proposals are due November 15, 2023. Please see the press release (https://www.morrisanimalfoundation.org/article/morris-animal-foundation-opens-call-canine-imha-focused-research) and proposal guidelines (https://www.morrisanimalfoundation.org/sites/default/files/filesync/FY24-Canine-IMHA-Proposal-Guidelines.pdf) and help us promote the RFP to the broad scientific community so that we can support the best research into IMHA. Thank you.
Clark recently wrote a letter (with a little help) to his friend Woody, who writes a column in the local weekly newspaper The State Port Pilot. It's posted below. In his letter, Clark talks about his IMHA and the fundraiser here. He also mentions MAF investment in hemangiosarcoma research in Golden Retrievers like Woody. Unfortunately, Woody passed away from his cancer. We are hopeful that further research will help to lower mortality and morbidity due to both IMHA and cancer in our canine friends and family.