Optimal Diagnosis & Rescue of Dogs with Imha Practice Tips & Techniques

Differential Diagnosis of Hemolytic Anemia Hemolytic anemia reflects shortened RBC life span due to intravascular, extravascular, or fragmentation hemolysis. Intravascular hemolysis is primarily associated with type 1 hypersensitivity reactions, either idiopathic or secondary to another primary disease. In some cases an infectious intraerythrocytic or epierythrocytic agent or miscellaneous disorders (e.g., severe hypophosphatemia, zinc toxicity, or severe heinz body anemia) are underlying causes. Extravascular hemolysis is usually caused by RBC removal by the mononuclear phagocyte system and often reflects idiopathic primary or secondary immune-mediated mechanisms. In some cases, hemolysis is secondary to heinz bodies, membrane abnormalities, or enzymatic defects, limiting cell energy production (e.g., pyruvate kinase, phosphofructokinase after exercise induced respiratory alkalosis) and deranging membrane flexibility. Fragmentation hemolysis is associated with shearing effects that damage RBC flexibility crucial for navigating microcirculatory pathways (e.g., vasculitis, hemangiosarcoma, other neoplasia, splenic disease, vena caval syndrome [Dirofilariasis], and DIC).