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Ann M.
Ann M., Dog Veterinarian
Category: Dog
Satisfied Customers: 4844
Experience:  ER and general medicine Veterinarian since 2005
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what are the possible reasons for a low red blood cell count

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what are the possible reasons for a low red blood cell count in my dog. He is an 11 yr old Bichon, been perfect until 2 weeks ago, became very sluggish and sad looking, he had blood in his urine and that was taken care of with a prescription of amoxicillin and within 24 hrs saw a major change. His red blood cell count came back low and he was put on prednisone which did help raise his count from 20 to 26 in three days however the prednisone is now making his heart race and his breathing isn't quite right. Vet told me not to give him the pred yesterday and we saw a change for the better, off today to see what his blood count is now and if there is an alternative med other than the prednisone. His dosage was 5 mg a day and his is 14 lbs. Maybe too high of a dosage?? Just very frustrated because I still don't know what's wrong with him. Help! Thank you
I would be concerned about a condition called Immune-Mediated Hemolytic Anemia, or IMHA. This is where the immune system attacks the body's red blood cells and destroys them. You can see blood in the urine, sluggishness, high heart rate, and breathing harder. This typically requires some pretty aggressive steroid therapy as well as other immune suppressive medications. This can come on suddenly in an older dog. If I were you, I would get a second opinion from another vet. I don't necessarily think that this case is being handled as well as I would want it to be handled. I would just see another vet for a second opinion, and have your vet's office fax all records over to the new vet's office for a second opinion and ask the doctor specifically about IMHA. I would not wait, because if the heart rate is high and the breathing is abnormal, the platalets could be low, too, and the red blood cells could be dropping lower. We typically hospitalize these patients for 3-5 days.

Hope this info helps. Best of luck.
Customer: replied 8 years ago.

Hello Dr. Ann,


Thank you for the quick response though I am not surprised to hear it, that is somewhat similar to what my vet told me, but he didn't mention IMHA he mentioned Autoimmune Anemia but as of yesterday the dr. said that the test for Cooms Disease (not sure of the spelling) came back negative so that tells him that the red blood cell count NOT low because of the Autoimmune and now he is not sure why his count is low. So I am going back in today to get another blood test done to see if the count is any higher and the dr. said he may have to do an xray to see if there is a tumor. Funny you should mention a second opinion. My husband and I talked about that yesterday.

Customer: replied 8 years ago.

Dr. Ann,


I just got back from the vet and Bernie's red blood cell count is now at 29. He started at 20 on 1/26, then to 26 on 1/29 and now 29 today. I have to bring him back in for the same test on Monday 2/9 and see where we are. The vet suggested cutting him back to 2.5 mg of Prednisone a day and see if that continues to help his count climb but if I see the same reaction, rapid heart beat, rapid breathing then I have to stop it. His spirits are good and he is much improved from the initial appt. on 1/26 but I still do not know what he has or what is causing this. Depending on what happens on Monday with his count and what the vet tells me I am seriously considering a second opinion. The next step after this is an xray (according to the vet) but as he feels around Bernie's belly and the rest of his body he feels the dog is not bothered by that but still can't tell without an xray. I will bring up the IMHA and see what respone I get. Is IMHA any different from Autoammue?

Okay, it sounds like your vet knows what is going on, so that is good. From your initial question, it sounded like your vet was not understanding the problem. IMHA is an autoimmune disease, so yes, it is the same thing. There are other medications besides steroids that can be used- cyclosporine or azathioprine (immuran). You can talk to your vet about those options. I would definitely go forward with the xray, because there could be a mass in there and it wouldn't necessarily cause pain on palpation of the abdomen. Sounds like your vet has it under control. When you talked about the high heart rate and abnormal breathing initially, those are signs of anemia, so I was concerned it was getting worse. Hope your dog starts to feel better soon!
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Customer: replied 8 years ago.
Dr. Ann,

Thank you again for the response. I will follow through with the xray, I was just getting frustrated with my vet's lack of response and lack of clear answers, I am hoping Monday with bring some sort of clarity to this. I did give Bernie half of the dose of Prednisone this afternoon and while I do not see any anstyness, restlessness, panting or "labored" breathing, I do notice that his heart rate is up and his breathing is a bit off, not as bad as on the 5 mg but still enough to make me uncomfortable so I think I will take the vets other suggestion of giving him 2.5 mg of Prednisone every other day until I bring him back in on Monday, I will talk with him then about an xray. If a mass if found (and I pray there isn't one) does it necessarily have to be the end? or is there a possibility that medication can help him? I have been so upset and worried since this started and I can't bare the thought of losing him. He has always been such a healthy dog and I want to do whatever I can to help keep him that way. He is like my third babySmile. I thank you again so much for your responses.

It does not necessarily have to be the end. You can do surgery, chemotherapy, radiation, etc. These things are much better tolerated in animals than in humans, so it is something to think about if your dog does end up having a mass.


Have to go take care of animal emergencies. Best of luck.