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.		[[ |Link to Article]]