When a large percentage of cells are affected, and they are removed faster then they can be replaced, AIHA results and the animal shows external signs of the disease. The clinical signs of AIHA are usually gradual and progressive, but occasionally an apparently healthy pet suddenly collapses in an acute hemolytic crisis. This is due to a buildup of bilirubin, one of the breakdown products of hemoglobin. The diagnosis is usually made on these clinical signs as well as a CBC documenting anemia, often with misshapen or abnormally-clumped RBCs. A Coomb's test may be done to confirm the diagnosis.
Corticosteroids are the primary drugs used to treat any autoimmune disease.
Very high immunosuppressive doses are used initially to induce a remission, and then the dose is very slowly tapered over many weeks or months to a low maintenance dose. Most affected dogs must be kept on steroids the rest of their lives and are susceptible to relapses. These chemotherapeutics are very effective, but the dog must be monitored closely for side effects, including a decreased white blood count. Splenectomy, the surgical removal of the spleen, has also been recommended for nonresponsive cases. An animal can live quite normally without a spleen.