Hemolytic crisis remains one of our most serious acute conditions. The sight of icteric mucous membranes and the alarming hue of hemoglobinuria still serve as reminders of a time when our treatment options were limited. In this issue’s “Hemolytic Crisis in Small Animals,” Dr. Linklater offers a comprehensive overview of this condition in companion animal patients, including current diagnostic and treatment strategies.
The significance of blood has been acknowledged for thousands of years. Galen, in 150 CE, noted that not all jaundice cases stemmed from liver issues, and his description of a person bitten by a viper—whose “skin turned the color of a ripe leek”—likely marks the earliest account of an acquired hemolytic anemia.
Harvey’s discovery of blood circulation in the early 1600s was followed by the identification of red blood cells around 1650 with the advent of the microscope. The clinical syndrome of acquired hemolytic anemia was first documented in 1898. However, understanding its immune basis had to wait until the development of the antiglobulin test by Coombs and colleagues.
For decades, immune-mediated hemolytic anemia was associated with a poor prognosis in both humans and animals. Our management strategies have evolved from reactive measures to proactive, with a greater understanding of complex triggers such as neoplasia and drug reactions. The current approach, as detailed in this article, demonstrates significant progress through the use of immunosuppressive therapies and the recognition of the importance of diagnosing and managing related clinical conditions.
What’s New in Research Wrapped
Our Research Wrapped newsletter is a monthly roundup of the research that is most relevant to small animal veterinary practitioners. In a recent issue, Dr. Sally Christopher spoke with an author of a study published in JAVMA that explored whether patient-handling methods in small animal veterinary hospitals and training/certification in stress-reducing care affected the injury rates of veterinary staff.
Practical Takeaways
- The study found a significant relationship between certification in one of the stress-reducing care programs and injury rates; injuries were far less frequent in hospitals where 100% of the staff were certified in stress-reducing care.
- The data did not reveal a significant relationship between the use of previsit anxiolytic medications or in-clinic injectable sedation and injury rates.
- The data highlight variability in postinjury protocols.
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