Peer-reviewed veterinary case report
Neurologic signs linked to high bilirubin in dogs with immune anemia
By Chapman, Sasha et al.·Published in Journal of veterinary internal medicine·2026·Animal Referral Hospital Canberra, Australia·View original on PubMed →
PetCaseFinder translated the abstract of this peer-reviewed paper into plain English so pet owners can read it. We do not publish original research — every detail traces back to the citation above. How we work →
Original publication title: Hyperbilirubinemia and neurologic signs in dogs with non-associative immune-mediated hemolytic anemia: 81 cases (2015-2024).
- Species:
- dog
Plain-English summary
A group of 81 dogs with immune-mediated hemolytic anemia (IMHA) and high bilirubin levels were studied to see if there was a link between bilirubin levels and neurological symptoms. About 20% of these dogs showed signs like stupor, weakness, and seizures. The study found that higher bilirubin levels were associated with a greater chance of these neurological issues. While the exact cause of the symptoms wasn't determined, it highlighted the need for careful monitoring of bilirubin levels in dogs with IMHA. Treatment typically involves managing the underlying anemia and monitoring bilirubin levels closely.
People also search for: dog seizures high bilirubin · IMHA in dogs treatment · why is my dog weak and non-responsive
Abstract
BACKGROUND: Bilirubin encephalopathy is a poorly recognized complication in dogs with immune-mediated hemolytic-anemia (IMHA). HYPOTHESIS/OBJECTIVES: Assess serial trends of hyperbilirubinemia and the association between bilirubin concentrations and neurologic signs in dogs with IMHA. ANIMALS: Eighty one dogs with non-associative IMHA and hyperbilirubinemia. METHODS: Multicenter retrospective cohort study. The signalment, clinical signs, clinicopathological data, treatment, and outcome were evaluated. Bilirubin concentrations were recorded at the baseline, peak, initial decrease, and normalization. Univariable logistic regression was used to determine the association between neurologic signs and hyperbilirubinemia. RESULTS: The median bilirubin concentrations at the baseline, peak, and initial decrease were 2.5 (IQR, 1.4-4.8), 3.7 (IQR, 1.8-24.2), and 1.1 mg/dL (IQR, 0.5-4.3; 43, 64, and 19 μmol/L), respectively. Twenty percent (16/81) of dogs developed neurologic signs. Neurologic signs included stupor, non-ambulatory tetraparesis, and generalized seizures. A significant association was found between the presence of neurologic signs and the baseline, peak, and fold-change of bilirubin concentration (P < .001). The odds of having neurologic signs were 12.2 (95% CI, 3.1-48.2) for dogs with baseline bilirubin concentrations ≥3.3 mg/dL (≥57.5 μmol/L), and 93.3 (95% CI, 11.0-795.5) for dogs with peak bilirubin concentrations ≥13.9 mg/dL (≥239.5 μmol/L). CONCLUSIONS AND CLINICAL IMPORTANCE: Although the causation of the neurologic signs cannot be attributed solely to bilirubin based on our study, these findings emphasize the importance of monitoring serum bilirubin concentrations and the development of neurologic signs in dogs with IMHA. The results reflect findings in our study population and may not be directly applicable to all dogs with IMHA.
Find similar cases for your pet
PetCaseFinder finds other peer-reviewed reports of pets with the same symptoms, plus a plain-English summary of what was tried across them.
Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/41742491/