IMHA in Dogs: Vet’s 2025 Guide to Immune‑Mediated Hemolytic Anemia 🩸🐶 

By Dr. Duncan Houston BVSc

Hello—I’m Dr Duncan Houston BVSc, veterinarian and Ask A Vet founder. IMHA occurs when a dog’s immune system mistakenly destroys its own red blood cells, leading to sudden, severe anemia. This vet‑approved guide covers:

• What IMHA is and how it happens
• Who’s at risk—breeds, triggers, types
• Clinical signs and emergency red flags
• Diagnosing IMHA and differentiating types
• Initial stabilization and treatments
• Prognosis, relapse, and long‑term care
• How Ask A Vet tools support monitoring and recovery

1. What Is IMHA?

IMHA is an autoimmune condition where antibodies—often IgG or IgM—attach to red blood cells, causing destruction by the spleen (extravascular) or within blood vessels (intravascular).

2. Primary vs. Secondary

• Primary (idiopathic): ~60–75% of cases with no identifiable trigger.
• Secondary: linked to drugs, vaccines, infections, cancer, or toxins.

3. Who Is at Risk?

• Any age/breed, but predisposed: Cocker Spaniels, Poodles, Dobermans, Mini Schnauzers & Spaniels.
• Slight female predominance and middle‑aged dogs most commonly affected.

4. Clinical Signs & Red Flags

• Pale or yellow gums (pallor, jaundice), rapid breathing or heart rate.
• Collapse, weakness, lethargy, fever, poor appetite, vomiting.
• Dark/red urine (hemoglobinuria) indicating intravascular hemolysis.

5. Diagnosis

• Complete blood count (CBC): severe anemia, reticulocytes, spherocytes, autoagglutination.
• Positive Coombs’ test confirms antibody binding.
• Biochemistry: bilirubin, liver/kidney function; imaging and infectious disease panel to rule out secondary causes.

6. Emergency Stabilization

• Hospitalization with IV fluids and blood transfusions to stabilize red cell volume.
• Supportive medications: anti-nausea (e.g. maropitant), fever control, management of complications.

7. Long‑Term Treatment

• High-dose steroids (prednisone) often combined with azathioprine, cyclosporine, or mycophenolate.
• Antithrombotic therapy (clopidogrel, aspirin) reduces risk of deadly blood clots (pulmonary thromboembolism).
• Ongoing monitoring: CBC every 1–2 weeks initially until stable, then taper medications over months.

8. Prognosis & Relapse

• Initial survival ~50–75%; higher if dogs survive first 2 weeks.
• Long-term remission is achievable, but relapse occurs in ~12–20%.
• Complications: clotting, organ dysfunction, and medication side effects.

9. Home Care & Ask A Vet Support

• Log symptoms—gum color, energy, appetite, urine color—using Ask A Vet diary tools
• Medication reminders to ensure consistent dosing and tapering schedules
• Track lab results and appointments within the app
• Glow alert if relapse signs appear (weakness, pale gums, dark urine)

📌 Final Vet Thoughts

IMHA is a life-threatening condition requiring prompt, aggressive care. With early intervention, immunosuppression, transfusions, and careful monitoring, many dogs go into long-term remission. Relapses and complications are possible, so ongoing veterinary care and owner engagement are essential. Ask A Vet’s tools can make this complex journey more manageable—supporting medication tracking, symptom logging, and communication with your veterinary team. You’re not alone—together, we can pursue a healthier future for your dog. 🐾❤️