Last night was a very sad night for my friend Alene... she sent an sms to say that her Labrador Tino had just passed away.... Her faithful friend and family companion for the past 10 years sucummbed to cancer. She had been ferrying Tino to and fro to the vet in Brickfields these past few weeks as he wasn't doing very well; he had earlier been diagnosed as suffering from a type of AID - (A)uto (I)mmune (D)isease called Autoimmune hemolytic anemia.
The information below is taken from the Dog Owner's Guide:
The immune system is a marvelous defense network of white blood cells, antibodies, and other substances used to fight off infections and reject foreign proteins. It is a police force patrolling the body, designed to recognize "self" cells from "non-self" cells by markers found on the surface of every cell in the body. It is this ability that causes the body to reject skin grafts, blood transfusions, and organ transplants. Like anything else, the immune system can fail, either by not doing its job or by doing it too well.
Autoimmune disease, on the other hand, is a different kind of immune system failure. In this situation, the ability of the immune system to recognize the "self" marker is lost, and it begins to attack and reject the body's own tissue as foreign. One specific tissue type such as red blood cells may be affected, or a generalized illness such as systemic lupus may result.
In Tino's case, his anemia condition is defined as a decrease in the number of red blood cells (RBCs) or the amount of hemoglobin, resulting in a decrease in the oxygen-carrying capacity of the blood. Anemia can be caused by blood loss, decreased production of new RBCs, or an increase in the rate of their destruction, known as hemolytic anemia.
In hemolytic anemia, the RBCs become "defective" in the eyes of the immune system by acquiring markers on the cell surface that are recognized as "non-self."These markers can be true auto antibodies, as in primary AIHA, or can be secondary to drugs, infectious disease, cancer, blood parasites, or heavy metals. Levamisole, certain antibiotics, Dilantin (phenytoin), lead, and zinc have all been implicated as potential causes of hemolytic anemia.
When the spleen and the rest of the immune system is working to rid the body of old, diseased, or damaged RBCs, it is doing its job appropriately. When a large percentage of cells are affected, and they are removed faster then they can be replaced, AIHA results and the animal shows external signs of the disease.
The clinical signs of AIHA are usually gradual and progressive, but occasionally an apparently healthy pet suddenly collapses in an acute hemolytic crisis. The signs are usually related to lack of oxygen: weakness, lethargy, anorexia, and an increase in the heart rate and respiration. Heart murmurs and pale mucous membranes (gums, eyelids, etc.) may also be present. More severe cases also have a fever and "icterus" (jaundice), a yellow discoloration of the gums, eyes, and skin. This is due to a buildup of bilirubin, one of the breakdown products of hemoglobin.
The diagnosis is usually made on these clinical signs as well as a CBC documenting anemia, often with misshapen or abnormally-clumped RBCs. A Coomb's test may be done to confirm the diagnosis. Corticosteroids are the primary drugs used to treat any autoimmune disease. Very high immunosuppressive doses are used initially to induce a remission, and then the dose is very slowly tapered over many weeks or months to a low maintenance dose. Most affected dogs must be kept on steroids the rest of their lives and are susceptible to relapses.
If steroids alone are insufficient, more potent immunosuppressive drugs such as Cytoxan (cyclophosphamide) or Imuran (azathioprine) may be added. These chemotherapeutics are very effective, but the dog must be monitored closely for side effects, including a decreased white blood count.
Splenectomy, the surgical removal of the spleen, has also been recommended for non responsive cases. This benefits the dog in two ways: less antibodies are made against the RBCs, and the primary organ responsible for their destruction is removed. An animal can live quite normally without a spleen.
Blood transfusions are rarely used. Adding foreign protein can actually intensify the crisis state, increase the amount of bilirubin and other breakdown products the liver must process, and suppress the bone marrow's natural response to anemia. In a life-threatening anemia, cross-matched blood may be transfused along with immunosuppressive therapy.
Every time I would visit Alene he would be there to growl, bark and make some noise to let her know I'm at the gate together with his son Zorro. Those two are one of a kind and the look they give you will make you think twice of stepping into that compound let alone stand beside the gate. Zorro (the naughty-young-growing lab he is) can jump as high as the gate to intimidate you! Of course I won't come empty-handed bringing small little treats or munchies as I just adore the pair.... Alene says I spoil them too much (hehehehehe)!
Though I didn't have the chance to get to know Tino all that much, I'm going to miss his presence at Alene's for sure. He was a very 'naughty', playful, obedient, greedy for McD's chicken nuggets loving lab!!!!! To Alene and all at home, my heartfelt condolences to you...
(Picture courtesy of seefido.com)
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