Diagnosis Confusion in a Dog: Liver Tumor? IMHA? Daphne’s Story

Do you know what would immune-mediated hemolytic anemia look like in your dog?

IMHA symptoms in a dog result from severe anemia and include:

  • pale gums
  • weakness and lethargy
  • loss of appetite
  • shallow or rapid breathing
  • disorientation
  • fainting

Daphne fell quite ill but it took a while for her to get her diagnosis. Thank you, Nicole, for sharing your story.

Diagnosis Confusion in a Dog: Liver Tumor? IMHA? Daphne's Story

Daphne’s story

I’m so thankful to read the stories on this site. I learned a lot from others who have been or are currently battling Immune-Mediated Hemolytic Anemia (IMHA).

My 8.5-year-old golden retriever Daphne was diagnosed with IMHA last week. 

I am so scared that I didn’t catch it early enough. I feel I should have known from Daphne’s behavior to bring her in immediately. My other golden Roxy was just diagnosed with fibrosarcoma in her jaw less than a month ago after surgery. I fear that while I was paying extra attention to her, I missed the early signs in Daphne.

First symptoms

The Monday before Memorial weekend, I noticed Daphne was panting a lot, had a decrease in appetite, and was lethargic. 

It was hot out, and she has never been a super active dog. So we put the air on and didn’t think too much else about it for the evening. She also has thyroid problems that she takes meds for and is overweight due to the thyroid. We’ve tried green beans and other veggies to supplement her food, and up until this disease hit, she was doing really well.

I noticed her stool looked very orange later in the week and brought it in to be tested. The tech called to say everything looked normal.

By Memorial day she has totally stopped eating and I became panicked. 

Emergency vet visit

I brought Daphne to the ER vet, who did full blood work and x-rays. The vet came back into the room after three hours. She informed me that Daphne had a large mass on her liver and was bleeding internally, thus her pale/yellow appearance/anemia.

I was told the tumor could burst at any time, and Daphne would die a horrible, painful death. She recommended I put her down right away. 

I left in complete shock and disbelief. I made an appointment at my regular vet the following day to discuss options. She said ultrasound and exploratory surgery were the only choices and that Daphne would not make it through the surgery.

I left feeling sick and hopeless. I scheduled a vet to come to my home on Thursday to put Daphne to sleep. She seemed SO sick (and she was, but little did I know it was IMHA and not cancer).

Not once the word IMHA was mentioned from either vet.

What did Daphne’s gums look like?

I never thought to look in Daphne’s mouth at her gums. It kills me because I know I would have researched online and found this disease since she had every symptom! But, instead, I was looking up tumors on the liver, etc.

I woke up on Weds. morning and decided that even if the ultrasound only confirmed what the vets told me, I could not go through with euthanasia unless I knew 100% that I was doing the right thing for her. I got a referral from my vet and immediately got her in for the ultrasound.

IMHA diagnosis

2 hours later the specialist came in and said Daphne had no tumors. She was fairly certain Daphne had IMHA. 

I have never been so sad and so happy before in my entire life. I had never heard of this disease before. Why had the other two vets never considered this diagnosis? How did they conclude that Daphne had large tumors that weren’t there?

The specialist said her liver was slightly enlarged but that clearly a thorough evaluation hasn’t been done.

They diagnosed her with the most common killer of Goldens, cancer of the liver. But blood work clearly indicated a possible immune disorder and anemia regardless of the x-rays (enlarged liver?)

Daphne’s treatment

Daphne was immediately started on an IMHA treatment. 

Her level was at 18, so she received a transfusion and is on 30 mg of prednisone twice a day. Unfortunately, they also cultured her urine which indicated she also has a UTI, so she was also put on powerful antibiotics. My poor, poor baby.

After the transfusion, her levels improved. I know she has a long road ahead. But I am hopeful we can get her levels back up and thankful they seem to be maintained for now.

She started showing signs of her old self. Eating well and seems a bit more active.

We are taking it one day at a time. I am just so terrified that this could change at any moment.

Related articles:
Canine IMHA Complications: Daphne Didn’t Make It

Further reading:
The Reality of a Dog With IMHA

Categories: ConditionsDog health advocacyImmune Mediated Hemolytic Anemia (IMHA)MisdiagnosesReal-life StoriesSecond opinions

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Jana Rade

I am a graphic designer, dog health advocate, writer, and author. Jasmine, the Rottweiler of my life, was the largest female from her litter. We thought we were getting a healthy dog. Getting a puppy from a backyard breeder was our first mistake. Countless veterinary visits without a diagnosis or useful treatment later, I realized that I had to take Jasmine's health care in my own hands. I learned the hard way that merely seeing a vet is not always enough. There is more to finding a good vet than finding the closest clinic down the street. And, sadly, there is more to advocating for your dog's health than visiting a veterinarian. It should be enough, but it often is not. With Jasmine, it took five years to get a diagnosis. Unfortunately, other problems had snowballed for that in the meantime. Jasmine's health challenges became a crash course in understanding dog health issues and how to go about getting a proper diagnosis and treatment. I had to learn, and I had to learn fast. Helping others through my challenges and experience has become my mission and Jasmine's legacy. I now try to help people how to recognize and understand signs of illness in their dogs, how to work with their veterinarian, and when to seek a second opinion. My goal is to save others the steep curve of having to learn things the hard way as I did. That is the mission behind my blog and behind my writing. That is why I wrote Symptoms to Watch for in Your Dog, which has turned out being an award-winning guide to dog owners. What I'm trying to share encompasses 20 years of experience.

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