Serum Acute Phase Protein Concentrations in Dogs with Autoimmune Hemolytic Anemia

Serial monitoring of acute phase protein (APP) concentrations in canine autoimmune hemolytic anemia (AIHA) has not been reported. Acute canine AIHA is accompanied by an acute phase response (APR) characterized by increased C-reactive protein (CRP) and alpha 1-acid glycoprotein (AAG) concentrations and decreased albumin concentrations. Twenty-seven dogs with AIHA and 11 control dogs. Prospective, cohort study. CRP, AAG, and albumin concentrations, white blood cell (WBC) count, and packed cell volume (PCV) were determined at admission (day 1), every 48 hours until death or discharge, and on days 30, 90, 180, and 365. Compared with controls, CRP and AAG concentrations were increased and albumin concentration was decreased in dogs with AIHA (days 1-7; P < .002) and normalized with disease stabilization (days 9-365; P > .05). APP concentrations on day 1 were not predictive of survival, duration of hospitalization, or number of blood transfusions (P = .153-.940). PCV correlated with APP concentrations over time (CRP r = -.600, AAG r = -.665, albumin r = .533; P < .0001) as did WBC count (CRP r = .253, AAG r = .486, albumin r = -.246; P < .006). Day 1 CRP concentration was lower for dogs that received corticosteroids before referral (115.3 mu g/mL) compared with dogs that did not (191.2 mu g/mL; P = .02). An APR occurs in canine AIHA. Initial APP concentrations are not predictive of acute survival, correlate with hematologic markers of remission, and normalize rapidly with disease stabilization.