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What is Hemophilia?

Hemophilia can often be seen in puppies, who can exhibit prolonged bleeding and even die within weeks after birth. Dogs that are less severely affected can survive into adulthood, but will have intermittent episodes of bleeding. The severity of the condition depends on the degree of the coagulation deficiency. Hemophilia is more commonly seen in purebred dogs, and occurs more often in the males.

Hemophilia is an inherited disorder involving a deficiency of the clotting activity in the blood. Hemophiliac dogs suffer from spontaneous and prolonged bleeding from various areas, such as trauma sites, umbilical cords after birth, and the nose, mouth and eyes. Internal bleeding in body cavities such as the chest or abdomen can cause swelling that can lead to death.

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Symptoms of Hemophilia in Dogs

Dogs affected with hemophilia can suffer spontaneous episodes of bleeding that are often quite prolonged. They can also exhibit prolonged bleeding after surgery. Spontaneous bleeding into joints and muscles can lead to swelling and lameness, while the acute blood loss can result in hypovolaemic shock. Symptoms you may see in your dog include:

  • Sudden death within the first few weeks of life
  • Prolonged bleeding from umbilical vessels
  • Spontaneous bleeding 
  • Bleeding from mouth, particularly during the growth of adult teeth in puppies
  • Skin hematomas, or a swelling composed of clotted blood
  • Excessive and prolonged bleeding at any trauma or surgery site
  • Bleeding into joints or body cavities
  • Swelling in joints or muscles
  • Lameness
  • Red, round, pinpoint spots appearing on skin
  • Discolored skin
  • Nose bleeds
  • Blood collecting inside the eye, covering the iris and pupil
  • Partial or complete loss of vision
  • Dark and sticky feces containing blood
  • Anemia 
  • Weakness
  • Shock
  • Death 

Types

There are two types of hemophilia seen in dogs.

  • Hemophilia A is a deficiency of coagulation factor VIII, and is the most common inherited clotting disorder in dogs. It can affect most dog breeds
  • Hemophilia B is a deficiency of coagulation factor IX. This type is rarer than hemophilia A, and has been known to affect over 25 breeds of dogs

Causes of Hemophilia in Dogs

Hemophilia results from a deficiency of the coagulation Factors VIII and IX. These genes are responsible for the normal blood clotting activity that stops the body from bleeding out. When a mutation or abnormality occurs in these genes, it can disrupt the coagulation process, preventing blood clotting and resulting in uncontrolled bleeding.  

This deficiency comes about from a spontaneous gene mutation that can be transmitted through generations. This sex-linked recessive gene is carried on the X chromosome, which means that it is transmitted by the females, who are often asymptomatic carriers. Male puppies born to an affected dam have a 50% chance of developing hemophilia, while the female puppies carry a 50% chance of becoming carriers.

Diagnosis of Hemophilia in Dogs

Hemophilia is often noticed in dogs after routine surgery if post-operative bleeding becomes excessive or prolonged. A diagnosis will depend on the specific symptoms, the results of testing, and possibly, a pedigree analysis.

Testing includes performing coagulation assays on blood samples. Tests such as an APTT, or activated partial thromboplastin time, can detect a clotting disorder, but cannot diagnose the particular type of hemophilia present.  Measuring a different blood protein or the activity of Factor VIII can help to determine the type of hemophilia your dog may have. The levels of Factor IX can also be measured in the blood.

Treatment of Hemophilia in Dogs

There is no cure for hemophilia. The main method of treatment for bleeding episodes in dogs involves repeated substitution therapy. This means intravenous whole blood or plasma transfusions until the bleeding can be controlled. Whole blood transfusions are generally given to more severe cases involving life-threatening anemia. Your dog may also be given blood products containing clotting factors. Gene therapy that uses adeno-associated viral vectors may also be a possible treatment.

Recovery of Hemophilia in Dogs

Recovery for puppies who show signs of hemophilia can be poor, as many experience internal bleeding early on that can be lethal. In older dogs, the bleeding can be excessive, and if left untreated, can also be fatal. If your dog has a less severe case, he may experience intermittent bleeding episodes throughout his lifetime that need to be promptly treated before too much blood loss has occurred. 

Prevention of this inherited gene dysfunction is through selective breeding by excluding affected dogs. Once hemophilia is diagnosed in a puppy, it can alert you to the presence of the gene in the mother. Whether she is an asymptomatic carrier or shows signs of the condition, she should not be bred further, nor should any females born of male carriers. Keeping updated pedigree records can help stop the further spread of this mutation.

Hemophilia Questions and Advice from Veterinary Professionals

Thunder
Bearded Collie
18 Months
Serious condition
0 found helpful
Serious condition

Has Symptoms

Hematomas

Hi. I have an eighteen month old Bearded Collie. After two hematomas, one after castration and then another after a grass see was removed, he has been diagnosed with Hemophila B. If he bleeds inside, how can I tell? What can I do? Will there be behavioral changes? Also, should I tell the breeder. Is it from the Dam? Thanks in advance.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2985 Recommendations
If Thunder has or develops internal bleeding, you will notice subtle initial symptoms like lethargy, increased respiration rate, pale gums etc… Normally internal bleeding would occur after a traumatic injury so any time he has a trip, fall or anything else you should visit a Veterinarian immediately. Haemophilia B is a deficiency of clotting factor IX and is an X-linked genetic disease meaning that it is coming from the dam, you should notify the breeder. Regards Dr Callum Turner DVM

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Flann
Yorkshire Terrier
14 1/2 years
Serious condition
0 found helpful
Serious condition

Has Symptoms

gum disease, arthritis

Medication Used

Delvosteron

I have a 14 1/2 year old hemophiliac female Yorkshire Terrier due another Delvosteron injection for birth control. She has had small non-growing ovarian cysts for the past 4 years. Given her age, she no longer wants to socialize with other dogs, has arthritis, now sleeps most of the day, but good appetite, would it be safe to now discontinue these injections?

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2985 Recommendations
If you are sure that Flann will not have any contact with intact males and will not get pregnant, you may consider stopping the Delvosteron (proligestone) after a discussion with your Veterinarian; heat should commence again after six or seven months. However, you should consider the bleeding from the uterus during a heat cycle, I would continue with the injections but would recommend that again you discuss with your Veterinarian. Regards Dr Callum Turner DVM www.noahcompendium.co.uk/?id=-454534

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fidel
French Bulldog
3 Months
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Blood In Stool

Hi my French bulldog puppy had a hematoma removed, near his penis when he was eight weeks old, ever since he is being passing blood on the stool, took him back to same vet office twice after the surgery, explained to the vet. She give him antibiotics and ask for stool sample which she send to lab the lab results war normal could this be hemofilia?

Dr. Michele King, DVM
Dr. Michele King, DVM
1402 Recommendations
Thank you for your email. I'm not sure how a hematoma and passign bloody stool might be related. Without examining Fidel, I'm not sure why he may be having bloody stools, but parasites are very common in 3 month old dogs. If he hasn't been dewormed, that would be a good idea. Hemophilia is very unlikely in his age group, with the signs that you are describing. It would be best to follow up with your veterinarian to determine what the cause of his signs might be.

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Zippy
Yorkie terrier
13 Months
Fair condition
0 found helpful
Fair condition

Has Symptoms

week back legs,

We just adopted a 13 month-old Yorkie terrier with hemophilia B.
He's been fine and very 'normal' so far, but today he had a very short episode (less than a minute?) where he was dragging his back legs, as if he couldn't walk on them.
Is this a symptom of hemophilia, and should we be worried?
He's back to his normal self, very hyper again.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2985 Recommendations
Some lameness may present after physical exercise if there is some bleeding in the joints, but nothing too concerning; you should keep an eye on Zippy for the time being as the issue may be related to another cause like patellar luxation or similar. If you have concerns or it occurs again you should pop into visit a Veterinarian for a thorough examination. Regards Dr Callum Turner DVM

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Buddy
Chihuahua
3 Years
Fair condition
0 found helpful
Fair condition

Medication Used

N/A

Are there any medications for hemophilia? If so, are they costly? I'm considering adopting a chihuahua with this disease but need to know more about the possible occurrence of fatal bleeding and what I can do about it? Are there any factors that bring on a reaction/bleeding? Is there a good diet for dogs with this genetic disorder? When can a bleeding strike and how quickly would I need to act to save his life? Is it possible that he won't ever have an attack again, since he hasn't had one in a very long time? Thank you so much for answering my one million questions!

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2985 Recommendations
There is no real advice I can give you apart from ensuring that Buddy stays out of trouble; there is no real day to day management for this condition but I would be proactive by getting some frozen plasma set aside at your practice for Buddy and try to identify suitable whole blood donors in your area. All this can be discussed with your Veterinarian to ensure that if Buddy has an accident or needs surgery they are prepared. Regards Dr Callum Turner DVM

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Milo
Terrier mix
6 Months
Serious condition
0 found helpful
Serious condition

Has Symptoms

Hemophilia

My 6 month old dog, Milo, has Hemophilia A. We are still waiting for the antibody screening. He has a Factor VIII of less than 1%. At three months old he had severe pain in his spine and was hospitalized for a week(at this time we were unaware of the Hemophilia). He has had lumps on his spine and front right leg which are now gone. He also spent another few days being lethargic and in pain in his neck area. Other than those episodes he is a normal active dog. I only knew to get him tested because other puppies from the litter were diagnosed. I have two other dogs. They all get along well, but recently Milo is becoming aggressive at times and is always “on” them. Is neutering him the anwer or is this much too dangerous with his condition. Struggling with this decision.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
2985 Recommendations
Normally a dog will be diagnosed with haemophilia after castration due to the presence of a haematoma; there are management options available during surgery but you will need to discuss with your Veterinarian if castration is worth the hassle (couldn’t think of a better word). You should discuss the aggression issues and decide whether or not you want to castrate him or not. Regards Dr Callum Turner DVM

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