21. EMedicine - Hemolytic-Uremic Syndrome : Article By Tamara Biega, MD HUS consists of the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Since 1955, thousands of cases have been reported http://www.emedicine.com/ped/topic960.htm

(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Pediatrics Nephrology Hemolytic-Uremic Syndrome Last Updated: March 2, 2004 Rate this Article Email to a Colleague Synonyms and related keywords: schistocytic hemolytic anemia with severe thrombocytopenia, hemolytic anemia, uremia, thrombocytopenia, acute renal failure, Shiga toxin, Shiga toxin 1, Shiga toxin 2, Stx, Stx1, Stx2, HUS, diarrhea-associated HUS, D HUS AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography Author: Tamara Biega, MD , Staff Physician, Department of Pediatrics, Tripler Army Medical Center Coauthor(s): Ronald Prauner, MD , Assistant Chief of Pediatric Hematology-Oncology, Assistant Professor, Department of Pediatrics, Tripler Army Medical Center Tamara Biega, MD, is a member of the following medical societies: American Academy of Pediatrics , and American Medical Association Editor(s): Richard Neiberger, MD, PhD

22. Autoimmune Hemolytic Anemia Frequently Asked Questions Q What is the morality rate for autoimmune hemolytic anemia ? http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

23. Anemia, Hemolytic anemia, hemolytic, Search. anemia, hemolytic. The hemolytic anemias are those caused by destruction of red cells in the bloodstream by a disease process. http://www.drhull.com/EncyMaster/A/hemolytic_anemia.html

Help for sleepless parents Encyclopedia Index A anemia, hemolytic Search anemia, hemolytic The hemolytic anemias are those caused by destruction of red cells in the bloodstream by a disease process. They include hemolytic disease of the newborn, usually caused by blood group incompatibility between mother and baby ( ABO incompatibility Rh factor incompatibility hemolytic anemias caused by abnormal red cell membranes, chiefly hereditary spherocytosis and hereditary elliptocytosis, and a variety of other, rarer conditions hemolytic anemias caused by abnormal hemoglobin (the oxygen carrying molecule that fills the red cell); for example sickle cell anemia and thallassemia Complications of hemolytic anemias include all the ill effects of sometimes profound anemia as well as (in the newborn) possible problems caused by jaundice

24. AUTOIMMUNE HEMOLYTIC ANEMIA What Every Owner Of An AIHA Dog Needs To Know Provides basic knowledge about autoimmune hemolytic anemia and the different drug treatment options. http://www.geocities.com/aihadogs/

AUTOIMMUNE HEMOLYTIC ANEMIA WHAT EVERY OWNER OF AN AIHA DOG NEEDS  TO KNOW Home FAQ Treatment Options Reference Guide Glossary Links New!!! IMHA/AIHA Registry Submit information to a major veterinary college to research developing trends Autoimmune hemolytic anemia is a serious, life threatening disease. This site was set up to help owners make informed decisions about the care of their pet. It is not intended to take the place of a veterinarian, only to provide information on treatment options available and basic information about the disease. It is important to realize that having an AIHA dog requires a TOTAL commitment. Not only will this disease require a lot of time, but the emotional and financial burden can be great. The medications can be quite expensive and added to the veterinarian bills, can become overwhelming. You will need to adjust your schedule around visits to the vet and administering medications. The financial burden and time limitation are insignificant compared to the emotional roller coaster you will be on. This is a disease that can be controlled, but there is no cure. WHAT YOU NEED TO ASK YOUR VETERINARIAN American College of Veterinary Internal Medicine (ACVIM) THE GOOD THINGS ABOUT AIHA Send Questions / Comments to aihadog@yahoo.com

25. Wing-N-Wave Labradors Canine Autoimmune Hemolytic Anemia Canine Autoimmune hemolytic anemia A disease characterized by increased destruction of red blood cells (erythrocytes) by the dog's own immune http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

26. Haemolytic Anaemia Testing Tests to check for the presence of hemolytic anemia. http://www.uq.edu.au/vdu/HDUHaemolyticAnaemiaTests.htm

Virology The Basics Taxonomy Links ... HOME Headlines DNA Down Under New section on RNA interference as a tool to block virus replication. Haemolytic Anaemia Testing To check for the presence of any haemolytic anaemia the following test may be performed: Haematology Profile (FBC/FBE) Should demonstrate an anaemia Blood Film Schistocytes Products of RBC breakdown Suggests intravascular haemolysis (IVH) Microspherocytes Intra/Extravascular haemolysis (IVH/EVH) A hallmark of haemolytic anaemia (HA) Polychromasia (IVH/EVH) Nucleated Red Blood Cells (IVH/EVH) Erythroid hyperplasia is more pronounced than in HA than in non-HA (Dec. M:E) Noticeable that the lifespan of RBCs from a patient with an intrinsic RBC defect, when infused into a normal patient, are decreased. Normal RBCs infused into a patient with an intrinsic RBC defect do not haemolyse. Osmotic Fragility Test (OFT) A measure of the RBCs resistance to haemolysis by osmotic stress, depending primarily on the volume of the cell, the surface area and the cell's membrane function

27. Dog Owner's Guide Autoimmune Diseases Autoimmune hemolytic anemia. Anemia is a clinical sign, not a disease, and is defined as a decrease in the number of red blood cells (RBCs) or the http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

28. Immune-Mediated Hemolytic Anemia & Immune-Mediated Thrombocytopenia Client Infor ImmuneMediated hemolytic anemia Immune-Mediated Thrombocytopenia client handout information. http://www.cloudnet.com/~jdickson/imhaitphandout.htm

TEXTBOOK OF VETERINARY INTERNAL MEDICINE Client Information Series Immune-Mediated Hemolytic Anemia and Immune-Mediated Thrombocytopenia By Carol Norris, DVM, DACVIM, Clinician, Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis Immune - mediated hemolytic anemia (IMHA) and immune- mediated thrombocytopenia (ITP) are diseases in which the body's own immune system attacks its red blood cells (IMHA) or platelets (ITP). Symptoms that develop are caused by a massive, often sudden, depletion of red blood cells or platelets. One of the major functions of red blood cells is to carry oxygen from the lungs to all other tissues in the body. When there are inadequate numbers of red blood cells (anemia) the body becomes starved for oxygen. As the pet owner, you may notice depression, listlessness, panting, loss of appetite, weakness or reluctance to exercise in your pet. The major function of platelets is to help form blood clots to stop bleeding. Destruction of large number of platelets can result in pinpoint bleeding in the skin or gums or may appear as nosebleeds. Less commonly, blood can be seen in the stool, ( which takes on a black appearance if it is digested or a bright red appearance if it is not) or urine. Severe anemia can result from excessive bleeding. Occasionally, IMHA and ITP occur together. IMHA and ITP are more commonly seen in dogs than cats. It is believed that cocker spaniels, toy and miniature poodles and Old English sheepdogs are breeds predisposed to develop IMHA. The latter two breeds and standard poodle are also at increased risk for developing ITP. Most affected dogs are middle-aged females. No breed or sex predilection is appreciated in cats. You should remember, however, that these conditions can develop in any dog or cat of any age, either sex, neutered or not. There is no scientific evidence that these diseases are caused by anything you feed your pet or where your pet lives.

29. Index Of /aiha Discussion forum and information on idiopathic thrombocytopenia and autoimmune hemolytic anemia provided by VetNet. http://www.vetnet.co.uk/aiha/

Index of /aiha Name Last modified Size Description ... Parent Directory 22-Jul-2005 14:23 - aiha_dog2.html 21-Jan-1999 00:03 5k aiha_quest1.html 22-Jan-1999 23:42 4k

30. Immune Mediated Hemolytic Anemia In hemolytic anemia, a loss of red blood cells (rbcs) occurs due to destruction prognosis in the treatment of immune mediated hemolytic anemia (IMHA). http://www.vetinfo.com/dimhanemia.html

Please note: The information on our site is for everyone to read. Please use it as often as you like. Please use the search engine or one of the indexes to access the information you need on our website. Subscriber Info The income from subscriptions helps defray the cost of maintaining the site and allows us to keep the large amount of information on www.vetinfo.com free to our readers. Immune Mediated Hemolytic Anemia IMHA IMHA - crisis treatments Immune mediated hemolytic anemia in Giant Schnauzer Drug treatment options following IMHA ... Hemolytic anemia also see Thrombocytopenia also see Blood also see IMHA - Looking for Answers also see Immune also see Medication - side effects Immune Mediated Hemolytic Anemia (IMHA) or Autoimmune hemolytic anemia (AIHA) The mechanism by which the immune system mistakes red blood cells for a "foreign invader" varies somewhat according to the cause. It usually involves adherence of the offending agent (parasite, drug, toxin, etc) to the surface of the rbc. The immune system wishes to attack this agent but manages to injure the rbc as well. Dogs with IMHA usually experience a sudden onset of clinical signs, including depression, lethargy, pale gums or conjunctiva, sometimes jaundice or a heart murmur and bruising. Vomiting or abdominal pain may be present. It is unusual for overt blood loss to occur, such as nose bleeds or excessive bleeding from a minor injury. Death can occur rapidly, even with appropriate treatment.

31. I - Immune Mediated Hemolytic Anemia (IMHA) Whenever hemolytic anemia is present it is wise to carefully rule out initiating causes Examples of problems that can lead to hemolytic anemia include http://www.vetinfo.com/dencyclopedia/deimha.html

Vetinfo Canine Encyclopedia Feline Encyclopedia VetInfo Digest ... Your Turn Encyclopedia of Canine Veterinary Medical Information Immune Mediated Hemolytic Anemia (IMHA) or Autoimmune hemolytic anemia (AIHA) The mechanism by which the immune system mistakes red blood cells for a "foreign invader" varies somewhat according to the cause. It usually involves adherence of the offending agent (parasite, drug, toxin, etc) to the surface of the rbc. The immune system wishes to attack this agent but manages to injure the rbc as well. Dogs with IMHA usually experience a sudden onset of clinical signs, including depression, lethargy, pale gums or conjunctiva, sometimes jaundice or a heart murmur and bruising. Vomiting or abdominal pain may be present. It is unusual for overt blood loss to occur, such as nose bleeds or excessive bleeding from a minor injury. Death can occur rapidly, even with appropriate treatment. Whenever hemolytic anemia is present it is wise to carefully rule out initiating causes that might be treatable. Examples of problems that can lead to hemolytic anemia include ehrlichiosis (a blood parasite), reactions to sulfa antiseptics or penicillin antibiotics, zinc toxicosis which can occur due to the ingestion of pennies. If any of these problems can be identified and treated the prognosis is much better. The combination of clinical signs and spherocytes on a blood smear give a strong indication of this condition very rapidly. It can be confirmed using a Coomb's test to check for antibodies adhered to red blood cells. This test is usually done at body temperature and at a colder temperature (4 degrees Celsius). A small percentage of dogs that have IMHA will not test positive on the Coomb's test.

32. Wing-N-Wave Labradors Canine Autoimmune Hemolytic Anemia Severe canine hereditary hemolytic anemia treated by nonmyeloablative Treatment of immunemediated hemolytic anemia in dogs with cyclophosphamide. http://www.labbies.com/aiha.htm

Home What's New About Wing-N-Wave Purchasing a Labrador ... Canine Legislature Pamela A. Davol, 76 Mildred Avenue, Swansea, MA 02777-1620 pdavol@labbies.com AIHA Letters A compilation of selected letters from my archives addressing issues pertaining to AIHA. Canine Autoimmune Hemolytic Anemia A disease characterized by increased destruction of red blood cells (erythrocytes) by the dog's own immune system, canine autoimmune hemolytic anemia (AIHA) is one of the most common blood (hematologic) disorders affecting canines. Though much attention has been given recently to AIHA due to evidence linking the process of vaccinating with the manifestation of this sometimes life-threatening disease, immunization is only one potential cause for this condition. The following article provides a detailed explanation of AIHA in terms of the disease process, diagnosis and treatment, and explores factors that may play a role in the development of this disorder in the canine. The Blood: A Brief Overview The blood is considered an organ having its own complex and diverse development, structure and functions. Its unique form, cellular tissue suspended in fluid plasma, allows it to serve as a main distribution system throughout the body. Cellular tissues composing the blood include: the red blood cells, which provide oxygen to tissues of the body; the white blood cells, which prevent invasion of microorganisms or other foreign substances; the lymphocytes, which carry out immune surveillance; and the platelets, which are involved in keeping the components of the blood in balance. Remarkably, all of these cellular components originate from a common source called stem cells located in the bone marrow. These stem cells give rise to a mature colony of cells which as they continue to divide and mature undergo a series of changes, a process known as differentiation, and eventually develop into the specialized blood cells indicated above.

33. InteliHealth: Hemolytic Anemia InteliHealth Featuring Harvard Medical School s consumer health information. For more than 550 diseases and conditions, learn What Is It?, Symptoms, http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/21246.html

chrome_imgPreload('gifChr_mid_but_home_mo_1','http://img.intelihealth.com/i/C/Chr_mid_but_home-o.gif'); chrome_imgPreload('gifChr_mid_but_comm_mo_2','http://img.intelihealth.com/i/C/Chr_mid_but_comm-o.gif'); chrome_imgPreload('gifChr_mid_but_dental_mo_3','http://img.intelihealth.com/i/C/Chr_mid_but_dental-o.gif'); chrome_imgPreload('gifChr_mid_but_drug_mo_4','http://img.intelihealth.com/i/C/Chr_mid_but_drug-o.gif'); chrome_imgPreload('gifChr_mid_but_askexpert_mo_5','http://img.intelihealth.com/i/C/Chr_mid_but_askexpert-o.gif'); chrome_imgPreload('gifChr_mid_but_medical_mo_6','http://img.intelihealth.com/i/C/Chr_mid_but_medical-o.gif'); chrome_imgPreload('gifChr_mid_but_chats_mo_7','http://img.intelihealth.com/i/C/Chr_mid_but_chats-o.gif'); chrome_imgPreload('gifchr_mid_but_news_mo_8','http://img.intelihealth.com/i/c/chr_mid_but_news-o.gif'); chrome_imgPreload('gifChr_mid_but_privacy_mo_9','http://img.intelihealth.com/i/C/Chr_mid_but_privacy-o.gif'); Advertisement Hemolytic Anemia What Is It? Symptoms Diagnosis Expected Duration ... Additional Info What Is It? Anemia is an abnormally low level of red blood cells. Hemolytic anemia is the general name for any type of anemia that occurs because red blood cells are being destroyed too quickly.

34. Hemolytic Anemia - June 1, 2004 - American Family Physician Common acquired causes of hemolytic anemia are autoimmunity, Microangiopathic hemolytic anemia occurs when the red cell membrane is damaged in http://www.aafp.org/afp/20040601/2599.html

Advanced Search AAFP Home Page Journals Vol. 69/No. 11 (June 1, 2004) Hemolytic Anemia GURPREET DHALIWAL, M.D., PATRICIA A. CORNETT, M.D., and LAWRENCE M. TIERNEY, JR., M.D. San Francisco Veterans Affairs Medical Center/University of California-San Francisco School of Medicine, San Francisco, California A PDF version of this document is available. Download PDF now (8 pages /381 KB). More information on using PDF files. See page 2507 for definitions of strength-of-recommendation labels. H emolysis is the destruction or removal of red blood cells from the circulation before their normal life span of 120 days. While hemolysis can be a lifelong asymptomatic condition, it most often presents as anemia when erythrocytosis cannot match the pace of red cell destruction. Hemolysis also can manif est as jaundice, cholelithiasis, or isolated reticulocytosis. Pathophysiology There are two mechanisms of hemolysis. Intravascular hemolysis is the destruction of red blood cells in the circulation with the release of cell contents into the plasma. Mechanical trauma from a damaged endothelium, complement fixation and activation on the cell surface, and infectious agents may cause direct membrane degradation and cell destruction. The more common extravascular hemolysis is the removal and destruction of red blood cells with membrane alterations by the macrophages of the spleen and liver. Circulating blood is filtered continuously through thin-walled splenic cords into the splenic sinusoids (with fenestrated basement membranes), a spongelike labyrinth of macrophages with long dendritic processes.

35. Online Letters To The Editor - April 1, 2005 - American Family Physician hemolytic anemia Manifesting As Improved A1C Values. to the editor I read with interest the article1 on hemolytic anemia by Dr. Dhaliwal and colleagues. http://www.aafp.org/afp/20050401/lettersonline.html

Advanced Search Online Letters to the Editor Alternative to the Traditional Bilateral Neck Exploration TO THE EDITOR: In the article, American Family Physician, the discussion of surgical options mentions the traditional approach of bilateral neck exploration and the minimally invasive parathyroidectomy (MIP). To contemplate an MIP, preoperative localization studies, usually a Sestamibi scan and ultrasound, are necessary. Dr. Taniegra reports that MIP can be video-assisted, endoscopic, radioguided, or image-guided. While these are indeed all options, the first three approaches have significant drawbacks. The video-assisted approach requires two incisions and usually is performed under general anesthesia. The endoscopic approach requires three incisions and expert endoscopy skills, inflates most of the central neck, and does not allow the surgeon to make a tactile assessment. Finally, a recent study Preoperative localization allows for appropriate planning of the incision and directs the surgeon to the abnormality. Dissection is localized to the specific locale of the abnormality, minimizing pain and preventing extensive scarring. The remainder of the neck is left undisturbed. Image-guided MIP is the most effective alternative to the traditional bilateral approach when preoperative studies localize the adenoma and can be recommended as the most effective alternative to bilateral exploration. RICHARD LOPCHINSKY, M.D.

36. Anemia In a condition known as autoimmune hemolytic anemia, the immune system mistakes Common forms of inherited hemolytic anemia include sickle cell anemia, http://kidshealth.org/parent/medical/heart/anemia.html

KidsHealth Parents Medical Problems Anemia, one of the more common blood disorders, occurs when the number of healthy red blood cells decreases in the body. The disc-shaped red blood cells contain hemoglobin , a unique molecule that carries oxygen to the body's tissues. Anemia occurs for different reasons. These include: increased destruction (break down) of red blood cells (RBCs) increased blood loss from the body inadequate production of red blood cells by the bone marrow In some cases anemia results from an inherited disorder , whereas in other cases the condition is caused by something in a person's environment , such as a nutritional problem, infection, or exposure to a drug or toxin. Types of Anemia and Their Causes Anemia Caused by Destruction of Red Blood Cells Hemolytic ("hemo" means blood, "lytic" means destroying) anemia occurs when red blood cells are being destroyed prematurely and the bone marrow (the soft, spongy tissue inside bones that produces new blood cells) simply can't keep up with the body's demand for new cells. This can happen for a variety of reasons. Sometimes, infections or certain medications - such as antibiotics or antiseizure medicines - are to blame. In a condition known as autoimmune hemolytic anemia , the immune system mistakes red blood cells for foreign invaders and begins destroying them. Other children inherit defects in the red blood cells, which may involve the RBC's structure or the production of hemoglobin or RBC enzymes. Common forms of inherited hemolytic anemia include sickle cell anemia, thalassemia, and glucose-6-phosphate dehydrogenase deficiency.

37. Hemolytic Anemia CHC Wausau Hospital s Medical Library and Patient Education Center provides research services and healthcare information to physicians, http://www.chclibrary.org/micromed/00050650.html

Main Search Index Definition Description Causes ... Resources Hemolytic anemia Definition Description As a group, anemias (conditions in which the number of red blood cells or the amount of hemoglobin in them is below normal) are the most common blood disorders. Hemolytic anemias, which result from the increased destruction of red blood cells, are less common than anemias caused by excessive blood loss or by decreased hemoglobin or red cell production. Inherited hemolytic anemias involve conditions that interfere with normal red blood cell production. Disorders that affect the red blood cell membrane include hereditary spherocytosis, in which the normally disk-shaped red cells become spherical, and hereditary elliptocytosis, in which the cells are oval, rather than disk-shaped. Other hereditary conditions that cause hemolytic anemia include disorders of the hemoglobin, such as sickle cell anemia and thalassemia , and red blood cell enzyme deficiencies, such as G6PD deficiency. hypersplenism , in which a large, overactive spleen rapidly destroys red blood cells. Major symptoms of hemolytic anemias are similar to those for all anemias, including

38. BCOA Basenji Dog - Hemolytic Anemia Pyruvatekinase deficient hemolytic anemia was first diagnosed in Basenjis in the 1960 s, OFA has an open registry for hemolytic anemia DNA status, http://www.basenji.org/healthha.htm

Hemolytic Anemia Pyruvate-kinase deficient hemolytic anemia was first diagnosed in Basenjis in the 1960's, although prior to that date Basenjis had died of a then-unknown form of anemia. Research began in the 1960's, with a carrier test available in 1972. The gene is a simple recessive. Affected dogs may faint, typically have very white gums and mucous membranes, are likely to have low energy levels, and have light, "golden" colored stools. Affecteds typically die by age 2, with age 4 being the outside limit of survival. Most Basenjis are now descended from tested clear stock. A few carriers still exist in the gene pool, so it is a good idea to use only dogs descended from tested clear stock or dogs that have themselves been tested clear. A DNA test, available by cheek swab, is available from VetGen, Genesearch, or the University of Pennsylvania. Costs for the DNA test vary from $40-145. A blood-based test is available from Dr. Johnson at the University of Missouri. OFA has an open registry for hemolytic anemia DNA status, at a cost of $15 to list your dog. The BCOA also has an open registry for dogs tested by Dr. Johnson. DNA testing gives an actual reading of the dog's status as a clear, carrier, or affected, so the testing does not have to be repeated.

39. Hemolytic Anemia - Lucile Packard Children's Hospital hemolytic anemia is a disorder in which the red blood cells are destroyed faster The following lists some of the causes of extrinsic hemolytic anemia, http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hematology/hemoanem.html

Bone Marrow Transplantation Hematology Hematopoietic Stem Cell Transplantation Oncology ... Effects of Pediatric Brain Tumors and Their Treatment Haunt Survivors for Years, Stanford/Packard Study Finds Hematology and Blood Disorders Hemolytic Anemia What is hemolytic anemia? Hemolytic anemia is a disorder in which the red blood cells are destroyed faster than the bone marrow can produce them. The term for destruction of red blood cells is "hemolysis." There are two types of hemolytic anemia: intrinsic - the destruction of the red blood cells due to a defect within the red blood cells themselves. Intrinsic hemolytic anemias are often inherited, such as sickle cell anemia and thalassemia. These conditions produce red blood cells that do not live as long as normal red blood cells. extrinsic - red blood cells are produced healthy but are later destroyed by getting trapped in the spleen, destroyed by infection, or destroyed from drugs that can affect red blood cells. The following lists some of the causes of extrinsic hemolytic anemia, also called autoimmune hemolytic anemia: infections: hepatitis, cytomegalovirus (CMV), Epstein-Barr virus (EBV), typhoid fever, E. coli, or streptococcus

40. Immune-mediated Hemolytic Anemia In autoimmune hemolytic anemia, the immune system destroys red blood cells prematurely, What breeds are affected by autoimmune hemolytic anemia? http://www.upei.ca/~cidd/Diseases/immune disorders/autoimmune hemolytic anemia.h

related term: immune-mediated hemolytic anemia What is autoimmune hemolytic anemia (AIHA)? Normally red blood cells live about 4 months in dogs. As the cells age, they are removed and destroyed by other cells that are part of the immune system. New red blood cells are produced in the bone marrow at a rate that matches the destruction of older cells. In autoimmune hemolytic anemia, the immune system destroys red blood cells prematurely, faster than the rate at which new ones can be produced. The name says it all - anemia (reduced red blood cells) caused by hemolysis (destruction) by the body's own immune system (autoimmune). How is autoimmune hemolytic anemia inherited? Inheritance is unknown, but the condition is more common in certain breeds. What breeds are affected by autoimmune hemolytic anemia The old English sheep dog, cocker spaniel, and poodle have an increased susceptibility to this disorder, although it occurs in all breeds. It is more common in females than males. For many breeds and many disorders, the studies to determine the mode of inheritance or the frequency in the breed have not been carried out, or are inconclusive. We have listed breeds for which there is a consensus among those investigating in this field and among veterinary practitioners, that the condition is significant in this breed.

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