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Vector Borne Infectious Diseases / Hematological Disorders and Diagnostics · Journal article
Veterinary Record Case Reports · August 26, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a single case report describing a dog with precursor-targeted immune-mediated anaemia (PIMA) confirmed by bone marrow cytology, initially complicated by concurrent haemoparasite seroreactivity. The patient achieved haematological recovery following combined immunosuppressive therapy with prednisolone and mycophenolate mofetil, with normalisation of haematocrit by month three. The report illustrates diagnostic challenges in distinguishing PIMA from infectious haemoparasitic disease and underscores the value of bone marrow examination in persistent nonregenerative anaemia.
Single-case report. One dog with severe nonregenerative anaemia, leukopenia and thrombocytopenia, initially seroreactive for Anaplasma spp. and Ehrlichia spp. and positive for Hepatozoon spp. on blood smear.. Intervention: Combined immunosuppressive therapy with prednisolone and mycophenolate mofetil..
Dog presented with severe nonregenerative anaemia, leukopenia and thrombocytopenia, seroreactive for Anaplasma spp. and Ehrlichia spp., with Hepatozoon spp. gamonts on blood smear. Bone marrow cytology revealed marked erythroid hyperplasia, decreased myeloid-to-erythroid ratio, and rubriphagocytosis, confirming PIMA diagnosis. Haematocrit normalised by the third month following combined prednisolone and mycophenolate mofetil therapy.
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This case emphasises the importance of bone marrow evaluation in dogs with persistent nonregenerative anaemia refractory to initial therapy, particularly when haemoparasite seroreactivity complicates diagnosis. Clinicians should consider PIMA as a differential in dogs with pancytopenia and inadequate reticulocyte response despite antimicrobial and corticosteroid treatment.
Single-case report of a rare diagnosis with clinical outcome; documents therapeutic response but lacks comparative evidence or generalizability.
As stated by the source record.
This case emphasises the importance of bone marrow evaluation in dogs with persistent nonregenerative anaemia refractory to initial therapy, particularly when haemoparasite seroreactivity complicates diagnosis. Clinicians should consider PIMA as a differential in dogs with pancytopenia and inadequate reticulocyte response despite antimicrobial and corticosteroid treatment.
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What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Summary Precursor‐targeted immune‐mediated anaemia (PIMA) is an increasingly recognised cause of nonregenerative anaemia in dogs and may be difficult to distinguish from infectious or other immune‐mediated conditions. This report describes a dog presenting severe nonregenerative anaemia, leukopenia and thrombocytopenia, initially testing seroreactive for Anaplasma spp. and Ehrlichia spp., with simultaneous identification of Hepatozoon spp. gamonts on blood smear. Despite antimicrobial therapy and corticosteroid administration, anaemia persisted with inadequate reticulocyte response. Cytological evaluation of the bone marrow revealed marked erythroid hyperplasia, decreased myeloid‐to‐erythroid ratio, and evident rubriphagocytosis, supporting a diagnosis of PIMA. Combined immunosuppressive therapy with prednisolone and mycophenolate mofetil resulted in progressive haematological recovery, with normalisation of haematocrit by the third month of treatment. This case highlights the diagnostic challenges of differentiating PIMA from haemoparasitic diseases and emphasises the importance of bone marrow evaluation in dogs with persistent nonregenerative anaemia.
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