The next day, we were told that Elvis had IMHA, but that the vets did not know if it was primary disease or secondary (i.e., another underlying disease, like cancer, was causing the IMHA).  They had started Elvis on steroids and aspirin (to prevent clotting) and an antibiotic in the event that the IMHA was due to a tic-borne infection.  They wanted to do a spleen biopsy because at this point they had ruled out hemangioscarcoma, but wanted to check for lymphoma, another type of cancer that might have been causing the IMHA and the swelling of the spleen. 

Over the next two days, Elvis had another blood transfusion and a transfusion of Oxyglobin.  When he was admitted to the hospital, his PCV (packed cell volume) had been at 15 (normal for dogs is 37-55) and his gums were very pale. After the first blood transfusion, it went up to 21, but then dropped to 13 and then 11.  By Sunday, his breathing and heart rate were somewhat elevated and he had a strong pulse in the artery in his neck.  We were told that this could be a sign that he had developed a clot.  On Monday, he looked the worst we had seen him, but the vet said that he still needed time to respond to the steroid medications.  His eyes and skin were turning yellow, but the vet said that this is very typical of IMHA.