Page 10 - RVC Clinical Connections - Spring 2025
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RVC RESEARCH STUDY VETERINARY SERVICES RVC.AC.UK
Internal medicine
PROGRESSING IMHA TREATMENT THROUGH
COLLABORATIVE RESEARCH
Barbara Glanemann, Associate Professor in Small Animal Medicine
M ost immune-mediated haemolytic Case study
anaemia
treatments
(IMHA)
Milo, a three-year-old male entire cocker
involve suppressing the immune
system to stop the body from destroying its spaniel, presented to the Queen Mother
Hospital for Animals with a 48hrs history
own red blood cells. Distressing side effects of lethargy, anorexia and icterus. Being
of the medications include increased thirst, only mildly anaemic and thrombocytopenic
appetite and urination, panting, muscle with marked hyperbilirubinaemia on initial
wastage, lethargy and behavioural changes. presentation to his primary care practice, he
There is consequently a major clinical was referred for further management of a
need to understand how dogs can be possible leptospirosis infection.
treated effectively, while minimising the By the time of admission to the QMHA
adverse effects experienced in treatment. though, Milo had marked anaemia with typical Erythrophagocytosis on peripheral blood
smear at time of diagnosis
At the RVC we are attempting to uncover hallmarks of immune-mediated haemolysis
new information on how IMHA develops in (e.g. positive Coombs test, spherocytosis,
dogs and hoping to identify which treatment erythrophagocytosis on peripheral blood
works best for individual dogs. This could smear, hyperbilirubinaemia).
have a major impact on the quality of life for Further investigations were performed to
dogs with this distressing disease. rule out any potential underlying causes,
We have been awarded a grant from the and after initial transfusion of a matched
Morris Animal Foundation鈥檚 Donor Inspired red blood cell unit, Milo was subsequently
Study programme to advance critical started on immunosuppressive therapy,
research into IMHA. The grant will support consisting of prednisolone and azathioprine.
the exploration of mechanisms that cause To minimise the risk of thromboembolic
the disease, using cutting-edge single cell disease, clopidogrel therapy was also In vitro haemolysis assay to assess
RNA sequencing approaches, as well as initiated. phagocytic activity of PBMC after exposure to
dexamethasone, ciclosporine, mycophenolate
evaluating different treatments ex vivo with and leflunomide
the aim of understanding how individual
dogs respond to different medications that Milo鈥檚 owner had kindly agreed for his
are already available in veterinary practice. residual blood samples to be used for
This research is led by myself, in research. From the residual EDTA blood
collaboration with RVC colleagues James sample at time of admission, we were able
Swann (Visiting Associate Professor), to isolate his peripheral blood mononuclear
Balazs Szladovits (Associate Professor in cells (PBMC) and expose those cells ex
Clinical Pathology) and Floryne Buishand vivo to immunosuppressive drugs used
(Lecturer in Soft Tissue Surgery). commonly in veterinary medicine prior
Residual samples will be obtained from to evaluating their capacity to lyse red
dogs presented and diagnosed with IMHA blood cells. Furthermore, we will be able
at the RVC and two collaborating referral to perform single cell RNA sequencing of
centres 鈥� Davis Veterinary Specialists and those PBMC to define the predominant T
Dick White Referrals. The findings will help cell activation state. By comparing this to
improve understanding of which genes are Severe icterus on presentation data from healthy control PBMC, we hope
turned on and off 鈥� therefore shedding light to understand how myeloid cells become
on what is going wrong with the patient鈥檚 hyperactivated to engage in phagocytosis of
immune system. erythroid cells in patients with IMHA.
Comparing results to those from healthy Following seven days of hospitalisation
dogs will help improve knowledge of how Milo鈥檚 PCV had stabilised and he was
and why the immune system attacks red discharged for continued therapy at home.
blood cells and may identify new therapeutic Immunosuppressive therapy will be tapered
targets for drug development. As we will off gradually over the following weeks,
also investigate how those immune cells while careful monitoring for any relapse and
from dogs with IMHA respond to common adverse treatment effects.
medications, we can create prediction
models, which would be available to vets to
help decide which medication will be most For small animal referrals, please call:
01707 666399
effective for their individual patient. Milo鈥檚 mucous membranes at discharge Email:
qmhreception@rvc.ac.uk
10 Spring 2025
