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.

Question	Answer		Article
What test has been performed, and what is the abnormality pictured?	Slide test for autoagglutination. Autoagglutination.		Link to Article
What does this abnormality suggest about the etiology of this dog’s anemia?	The presence of autoagglutination, when differentiated from rouleaux formation, suggests that this patient’s anemia is immune-mediated in origin.		Link to Article
Is a Coombs’ test necessary to confirm the diagnosis?	A positive result in saline slide agglutination negates the need to perform a Coombs’ test.		Link to Article
How would you treat this patient?	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.		[[Immune Mediated Haemolytic Anaemia#Treatment |Link to Article]]