View source for Small Animal Emergency and Critical Care Medicine Q&A 20

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'''This blood is from a seven-year-old, intact female Labrador Retriever presented for evaluation of weakness. PCV – 9%; TS – 8.0 g/dl.'''

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<FlashCard questions="4">
|q1=What test has been performed, and what is the abnormality pictured?
|a1=
Slide test for autoagglutination. Autoagglutination.
|l1=Immune Mediated Haemolytic Anaemia#Other Tests
|q2=What does this abnormality suggest about the etiology of this dog’s anemia?
|a2=
The presence of autoagglutination, when differentiated from rouleaux formation, suggests that this patient’s anemia is immune-mediated in origin.
|l2=Immune Mediated Haemolytic Anaemia
|q3=Is a Coombs’ test necessary to confirm the diagnosis?
|a3=
A positive result in saline slide agglutination negates the need to perform a Coombs’ test.
|l3=Immune Mediated Haemolytic Anaemia#Other Tests
|q4=How would you treat this patient?
|a4=
Treatment of IMHA depends on non-specific suppression of the immune system, with glucocorticoids being the mainstay of therapy. 

In dogs with autoagglutination, aggressive treatment with prednisone (2–4 mg/kg p/o bid) and a cytotoxic drug is warranted from the
beginning. 

Cyclophosphamide (50 mg/m2 p/o 4 days per week) or azathioprine (2 mg/kg p/o daily for 4 days, then every other day) may be used. 

Cyclosporin A (10 mg/kg p/o bid for 10 days) may be used in patients with intravascular hemolysis.
|l4=Immune Mediated Haemolytic Anaemia#Treatment
</FlashCard>

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