The Patient
Halo, an almost 2 year old intact female Welsh Corgi, came to see me after she had been vomiting and lethargic for a few days. Her owner said she had stopped eating and he had to carry her around since she was so tired.
The Case
On examination, Halo was depressed, unable to stand, and was showing some signs of labored breathing. When I examined her mouth, I was alarmed to see that her gums were bright yellow!
She also had a yellow tinge to her skin, sclera (whites of her eyes), and her urine was very dark, almost brown in color.
I immediately recommended that we run some labwork and take some xrays to determine the cause of her illness. Her labwork showed severe anemia (low red blood cell count) and a very high bilirubin level which both indicated that Halo had a disease known as immune-mediated hemolytic anemia (IMHA). In this disease, the body attacks its own red blood cells causing the cells to rupture and be taken out of circulation. It is an autoimmune disease, meaning the body attacks itself. There are a few causes of this disease but they are all treated similarly. The yellow appearance of her gums, skin, eyes, and urine comes from the overwhelming amount of iron that is released when the red blood cells burst. The iron in the red blood cell is sent to the liver for recycling in the form of a yellow pigment called bilirubin. This is what causes the yellowing of the body in this disease and is known as icterus or jaundice. It also causes bilirubin to be released into the urine which creates the brown color of the urine. Some owners often mistake this as bloody urine since it does appear very dark. Halo's bilirubin level was 19.6! Normal is
The Treatment Plan
Halo needed a blood transfusion urgently and to be started on immunosuppressive medications to stop her immune system from overreacting and to stop the attack. I immediately referred Halo to our nearest 24 hour care emergency facility for hospitalization, IV blood transfusions, and aggressive medical care. Roughtly 80% of dogs with this disease will die if not provided with appropriate care. Halo had a severe case of IMHA and needed 5 transfusions to save her life.
The Outcome
She ultimately recovered and went on to lead a very normal life and has yet to have a relapse of this disease. As far as the cause of the autoimmune attack, we will never really know. It has been linked to recent vaccinations, certain medications, tick related diseases, and can also be a sequela to certain types of cancers. As a precaution we no longer vaccinate Halo and we avoid certain types of antibiotics just in case. If you have a dog (or cat) at home, flip their lip and take a peek at their gum color today.
It should look bubblegum pink just like yours look in the mirror. Some pets do have black pigmentation to the gums and tongue which is normal but in areas where there is no pigment, it should look nice and pink. This is an easy test to make sure your pet is healthy and breathing normally. If you have any concerns with your pet, please don't wait! Call us today!
The Drake Center for Veterinary Care is an AAHA-accredited animal hospital located in Encinitas, CA. The Drake Center loves being a source of information for all pet owners across the country; however, if you have any questions regarding pet care and do not live in Encinitas, CA or surrounding cities, we encourage you to contact your local veterinarian.