Immune-mediated diseases—where the immune system attacks the body's own tissues—cause significant welfare compromise and require long-term management. IMHA, IMTP, and other immune-mediated conditions are welfare-critical conditions.
IMHA occurs when antibodies attack red blood cells, causing severe anaemia, weakness, pale or icteric mucous membranes, and fatigue. Acute severe IMHA is life-threatening—affected dogs may require blood transfusions and intensive hospitalisation. Immunosuppressive treatment (prednisolone, azathioprine, mycophenolate, cyclosporine) controls the immune attack. Recovery is prolonged—weeks to months—and relapse requires rapid recognition and treatment intensification. Thromboembolism risk during IMHA adds additional welfare and monitoring complexity.
IMTP causes antibody destruction of platelets, creating severe bleeding tendency from skin petechiae and ecchymoses to internal haemorrhage. Welfare impacts include bruising pain, mucosal bleeding, and in severe cases, life-threatening internal haemorrhage. Immunosuppressive treatment and supportive care manage acute disease; prolonged monitoring addresses relapse risk. Physical activity restriction during active thrombocytopaenia prevents traumatic haemorrhage.
Acquired myasthenia gravis causes neuromuscular junction dysfunction through acetylcholine receptor antibodies, causing progressive muscle weakness, exercise intolerance, regurgitation from megaoesophagus, and aspiration pneumonia risk. Welfare impacts include weakness preventing normal activity and the serious welfare emergency of aspiration pneumonia. Pyridostigmine treatment improves neuromuscular transmission. Feeding management (upright positioning during and after meals) reduces aspiration risk in dogs with megaoesophagus.
Long-term immunosuppressive therapy creates its own welfare implications: increased infection susceptibility; cushingoid effects from prolonged corticosteroid use; bone marrow suppression from certain medications; gastrointestinal side effects; and increased neoplasia risk. Monitoring frequency, dose tapering when disease allows, and switching to steroid-sparing drugs reduces long-term welfare costs of treatment while maintaining disease control. Regular reassessment balances treatment benefits against cumulative treatment welfare costs.