Immune Mediated Hemolytic Anemia in dogs and cats treatment options, recommended remedies and helpful information has been provided by certified Master Herbalist Philip Reich and certified Canine Nutritionist Maria Reich. Philip and Maria specialize in medical herbalism and nutrition for animals with conditions like IMHA. They approach this situation in a holistic manner with the main priority being the health and safety of your animal.
Anemia is a term used to describe a number of different disease conditions caused by an inability of the blood to carry sufficient oxygen to cells. This can be caused by too few red blod cells or a deficiency of hemoglobin.
Hemolytic anemias are conditions in which red blood cells (RBCs) are destroyed at an accelerated rate and a normal regenerative response is seen in the bone marrow. This means that normal blood cell production is occurring and there is some causative action for the destruction of the red blood cells.
Immune-mediated hemolytic anemia (IMHA) or Autoimmune hemolytic anemia, is a complex disease in which hemolysis, the rupturing of erythrocytes (red blood cells), occurs because of erythrocyte antibody production. This is an autoimmune reaction in which the body's own white blood cells attack its own tissue.
Other anemia conditions can be caused by the destruction of red blood cells or problems with the red pigment called hemoglobin contained within RBCs. These other causes of anemia include zinc or copper toxicity (common in dogs because high zinc concentrations can be found in pennies minted since 1983, board game pieces, zippers, zinc oxide ointment, and various other sources they can easily ingest); Heinz body anemia that can result from ingested onions, too much garlic, certain drugs or vitamin K3; hypophosphatemia which is an electrolyte disturbance in which there is an abnormally low level of phosphate in the blood; hemorrhagic anemia caused by bleeding ulcers; or iron deficiency anemia. Thus, it is imperative to investigate what the underlying cause of your animal's anemia is using the proper diagnostic tests before assuming it is Immune-Mediated Hemolytic Anemia.
Symptoms of anemia include:
There are two forms of IMHA: primary (or idiopathic), and secondary IMHA.
With primary IMHA, your pet's immune system mistakenly produces antibodies that attack its own red blood cells. Any breed can be affected with primary IMHA, but in certain dog breeds such as cocker spaniels, poodles, Irish setters, and old english sheepdogs, it seems to be more common.
With secondary IMHA, the surface of your animal’s red blood cells are modified by an underlying disease process, drug, or toxin. Your dog's immune system identifies the modified red blood cells as something foreign and destroys them. When too many red blood cells are destroyed and not replaced quickly enough by bone marrow, the patient becomes anemic. Secondary IMHA can be triggered by a variety of conditions, exposure to a recent vaccination seems to be a very common association in our experience, but others include:
The first line of treatment in IMHA is immunosuppressive corticosteroids. The addition of secondary and tertiary immunosuppressants, such as cytotoxic drugs, may be indicated when patients present with severe IMHA (very low hematocrits, severe autoagglutination, intravascular hemolysis, or thrombocytopenia), when glucocorticoids do not adequately control the destruction of your animal's red blood cells, or when the side effects of glucocorticoids become unacceptable. The use of multiple cytotoxic drugs in combination requires careful monitoring, however, as there is a risk of severe immunosuppression and danger of infection.
Corticosteroids are glucocorticoids thought to prevent destruction of RBCs by decreasing the clearance of antibody-coated RBCs by macrophages, reducing the amount of antibody binding and complement activation on RBCs, and, in the long-term, minimizing autoantibody production. Side effects include polyuria, polydipsia, polyphagia, increased panting, gastrointestinal ulceration, and increased susceptibility to infection.
Various immunosuppressant drugs that work by decreasing the activity of the body's immune system so it will not attack its own tissue. These have numerous side effects including the possibility of serious infection and may increase your pet's risk of developing certain types of cancer, especially skin cancer and lymphoma. Some can cause severe bone marrow and hepatic toxicosis in cats. Certain of these immunosuppressant drugs have showed no benefit in studies yet are commonly used by the veterinarian community - go figure!
If the above do not work and they too often do not, your dog or cat will be subject to repeated blood transfusions which is an attempt by the veterinarian to increase the concentration of red blood cells. This can be life saving and we are not against this procedure. However, we know of animals that have received six transfusions that did not save their lives.
It is our experience that an animal with IMHA goes to the vet and gets diagnosed because they are very sick. They receive a blood transfusion and begin immunosuppressant therapy. It is our experience that few animals survive this therapy, and those that do survive it live in spite of the therapy not because of it!
We have a client that has a very young dog that survived IMHA using our protocol and weaning off the immunosuppressant drugs. She met a woman very sad at the recent loss of her dog from IMHA after expensive veterinary treatment and six blood transfusions! As they talked she discovered that the two dogs were from the same breeder. Her dog survived on our protocol and the other unfortunately did not by following the standard veterinarian course that seldom works but vets keep doing it over and over and over...
And when treatment with immunosuppressant drugs doesn't seem to be working, increasing the dosage or switching to another dangerous drug is not the answer. The sad thing is that many of these vets truly feel there is nothing more they could have done and that is very sad for all their future clients that come into their office hoping for them to save their beloved family member. Because more times than not, it is just not going to happen and that animal is most likely going to die.
The goal of our Natural IMHA Protocol is to support your entire animal so the body can return balance to the immune system to prevent further damage to red blood cell tissue.* At the same time we provide supplements that promote development of new red blood cells and their oxygen carrying capacity.* In addition, in a holistic fashion, we want to educate you and help you to recognize, and then remove, any contributing factors whether these are in your pet's diet, environment or occur during veterinary visits. We do not necessarily know the root cause(s) of the anemic condition in your particular animal, but we do know from our research and experience the primary culprits.
In the case of IMHA, pharmaceutical drugs, and possibly even a blood transfusion, are often part of a holistic protocol for your animal to maintain their health especially at the beginning. Even though immune suppressing drugs are used immediately at the diagnosis of IMHA, animals that do the best are the ones that are weaned off of the medications as soon as is safe when your dog or cat begin to stabilize and improve. If medications can be reduced when using our protocol this must be done in conjunction with your veterinarian so your animal can be properly monitored.
Core Recommendations Suggested products are included in the Core IMHA Package found below.
Our "Core Recommendations" form the backbone of our Natural IMHA Protocol. They consist of the supplement recommendations we feel are the most important to provide to your animal companion for this condition. They are displayed individually or as a package at the bottom of this page along with other helpful products from which you may make additional selections. Pet foods can be purchased at your finer, local pet stores. If you desire more individualized attention please feel free to use our Consultation Form to provide detailed information about your dog or cat so we can better help you.
Core Recommendation #1 - BioPreparation
This special blend of four unique algae was developed by a Russian Scientist, Dr. Michael Kiriac after decades of research. It is grown in controlled hydroponic conditions so it is the purest microalgae supplement on the planet. Its thousand of nutrients are so bioavailable they do not have to be digested, they easily pass through the digestive tract and feed cells on a cellular level - very important for this condition. BioPreparation can cross the blood brain barrier to feed the brain, support the hypothalamus to help balance the entire endocrine system and even cross the blood retinal barrier to nurture the eyes. We have had outstanding success with this product so it is highly recommended. Select the F3+ Forte for this condition.
Please Note: It has been brought to our attention that there is an IMHA chat-room/group in which some members caution against using BioPreparation. This is because they believe it stimulates the immune system which, of course, is not recommended in the case of autoimmune disorders. Let us make clear that BioPreparation does not stimulate the immune system. It is a blend of microalgae that feeds cells on a cellular level and improves the function of the hypothalamus. This has amazing benefits and acts to strengthen the entire body including the immune system. But this action works as an immunomodulator, which means it helps to bring the body, and immune system, back into balance. People that post to groups may have good intentions but we are the experts and our knowledge and experience lead us to highly recommend this product for those animals with IMHA.
Core Recommendation #2 - Daily Multi PlusOur Daily Multi Plus is formulated with organic, whole foods that are extremely important to an animal's nutritional needs but are often missing from the majority of canine and feline diets. This special formula provides the enzymes, probiotics, prebiotics, glandulars, vitamins, minerals, antioxidants and phytonutrients that are so beneficial to the body's daily maintenance and repair needs for healthy aging. In this formula you will find the vitamins, minerals and antioxidants recommended by the veterinarian community for this condition - only in an organic, whole food form!
Core Recommendation #3 - Immune Balance
This herbal remedy has been formulated by a certified Master Herbalist with organic herbs that have a long history of benefiting those with autoimmune conditions. In addition, a new study has provided yet more hope for those with conditions like IMHA because research indicated that a constituent in hydrangea root, called halofuginone, halted the progression of autoimmune disease. This formula will help to reduce inflammation and modulate the immune system for the benefit of your pet with IMHA.
Core Recommendation #4 - ChlorOxygen
This is a very concentrated source of chlorophyll for the dog suffering with IMHA. Chlorophyll is related to a compound in blood and can help the animal suffering with anemia produce more oxygenated red blood cells. We feel this product can be a life saver and is why we have included it with our core recommendations.
Highly Recommended Products
Whole Food Nutrition
With a autoimmune condition like IMHA in which red blood cells are being destroyed we feel it is beneficial to feed small, nutritious, frequent meals. This is because digestion requires an awful lot of energy from the body, diverting the body's blood flow to the digestive system. This can be counter-productive in cases of anemia for obvious reasons - blood is in short supply! So feed three to five small meals throughout the day. A whole food diet is important always, but especially at this critical time because kibble diets are harder for an animal to digest and this is the last thing your pet needs to expend energy on.
Probably the best food for an animal with anemia is calf liver (approx. 1 oz per 25 lbs). This food is a natural source of iron, B12 and folic acid, all of which are important nutrients for those with anemia. In addition, liquefy and feed a mix of organic, green leafy vegetables (not iceberg lettuce) which are naturally high in soluble chlorophyll. The chlorophyll molecule is similar to the hemoglobin molecule and can greatly benefit those with anemia. You can also mix in some free-range eggs (higher in beneficial nutrients than standard supermarket brands) and other types of meat or whole foods your animal likes.
If you decide to make a homemade diet please research the proper way to do this and make sure to add a calcium source like our Seaweed Calcium. For a quick and easy way to add high-quality protein to your pet's diet take a look at our Whey Protein Isolate. For more information, when your animal is better, read our article How to Feed Your Dog or How to Feed Your Cat that can be found in our Education section.
The proline-rich polypeptides found in colostrum have been shown in studies to regulate immune response by inhibiting the over-production of T-cells, the white blood cells largely responsible for the autoimmune response. Lab tests of PRP's have demonstrated their ability to stop the progress of overly aggressive immune responses associated with autoimmune conditions like IMHA.
Earlier we indicated the benefit of eating liver for those with anemia. Here we have some freeze-dried, New Zealand liver glandular with all the nutrients of liver in an easy to feed capsule.
Vaccinations and Toxins
Vaccinations and/or toxins from topical flea and tick products, household cleaners and lawn chemicals may have caused or contributed to your animal's IMHA. Vaccinations should be avoided for those with IMHA and you should be able to get an exemption for the rabies vaccination with a letter from your vet (read our article: Are You Over Vaccinating Your Dog or Cat). Topical pesticide products would be a big 'no' for your animal and you should eliminate their exposure to household and lawn chemicals for the good of their long term health.
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Hi - I wanted to let you all know of my recent experience with Pet Health & Nutrition Center... I started doing my own research and found the Core IMHA package on the Pet Health & Nutrition site. I ordered my first pack and received it promptly from Maria at Pet Health & Nutrition, along with a hand written note which included instructions for the Biopreparation F3 and well wishes... Two weeks later, Feb 11, Enzo’s PCV was 39%. I truly believe that the supplemental core IMHA regimen alongside Leflunomide stopped the disease progression in its tracks and turned it around quickly. Additionally, the products have protected his liver and his ALT & AST continue to be within normal range... We have truly appreciated the support of Maria and her team while dealing with this traumatic pup situation... Thank you for all of your help thus far! Valerie G.