Azathioprine and low dose prednisolone in the therapy of secondary Immune-Mediated Hemolytic Anemia (IMAH) in dogs: case report

Immune-Mediated Hemolytic Anemia (IMHA) is an autoimmune disease characterized by hemolysis of erythrocytes of primary or secondary origin, occurring in dogs and recommended therapy using corticosteroids and immunomodulators. Thus, the objective is to report the association of azathioprine with low-dose prednisolone in the treatment of secondary IMHA pyometra. A female, American Pitbull breed, 8 years old, not castrated, arrived for treatment with anorexia, weight loss and prostration for 7 days; being diagnosed with pyometra after clinical and complementary examinations. Seven days after surgery, the patient returned prostrate with a blood count showing hypochromic normocytic anemia, leukocytosis, reticulocytes with a moderate response and a positive saline agglutination test, confirming AHIM. The therapy adopted was azathioprine (2 mg/kg) and a low dose of prednisolone (0.5 mg/kg), both administered orally every 24 hours. Within twelve days, he was clinically stable with normalization of hematological parameters. It was concluded that the association of azathioprine with low-dose prednisolone was effective in controlling IMHA secondary to pyometra.