Immune-Mediated Hemolytic Anemia: Annie’s Lost Battle with IMHA

What makes immune-mediated diseases so horrible is that the immune system, which should protect your dog from disease, turns on them.

Thank you to Alison Kaylor for sharing Annie’s Immune-Mediated Hemolytic Anemia story.

Immune-Mediated Hemolytic Anemia: Annie's Lost Battle with IMHA

Annie’s story

My little Maltipoo of 11 years and 11 months,  Annie (Snanniebug) was my biggest joy. She was a healthy little pup, had a great appetite and was full of spunk … until one morning …

I noticed she had no interest in her breakfast, and a few of her morning antics were not present. 

That made me nervous, knowing that Annie loved to eat! Trying not to be too alarmed, I went off to work and came home at lunch with some El Pollo Loco chicken thinking this will wet her appetite.

Annie’s brain was interested in the chicken but she couldn’t stomach it. She took only a small bite.

Pale gums

Her gums were pale too. I thought she was dehydrated. It was evident that Annie needed to be checked by her vet so I took her in that evening.

Annie's Lost Battle with IMHA

Initial diagnosis

The vet suggested Annie could be dehydrated which can cause a lack of appetite. In my opinion, her behavior was a little odd as well, which I conveyed to the doctor.  He offered to run some blood work and after talking with him further, he made me feel comfortable enough to take her home to see how she does through the night with the fluids he gave Annie as that could be the solution.

The next morning I woke up to see Annie had wet my bed but the wet spot had a tinge of red.  

Emergency visit

I immediately rushed Annie into the vet closest to my home (VCA Saddleback Veterinary Hospital, Lake Forest, CA).  Dr. Heathcock examined her while I went to work and bad news prevailed when I received a call from the doctor in the early afternoon.

The diagnosis

She informed that Annie had IMHA and tried to explain the disease and its complications.  

I still didn’t fully understand the severity of this disease.  She told me she would start Annie on steroids that I would continue to give Annie once I picked her up the same evening.

When I arrived at the vet I was called into the exam room so Dr. Heathcock could talk with me in private.

She brought Annie out and it was so obvious my poor baby was so tired and lethargic!  

Dr. Heathcock was very sincere and advised I euthanize Annie due to the progression of this disease which had taken a toll on her in such a short time.

I was devastated! I couldn’t fathom giving up and was in complete shock. As an alternative, the vet suggested taking Annie into the Southern California Veterinary Specialty Hospital in Irvine, CA.  She called the specialty hospital giving them notice I was on my way there with Annie and updated them on Annie’s condition.

The intake veterinarian made me comfortable giving me a great deal of hope by informing that their specialty center had a very high recovery rate with IMHA patients – 90% by which she then disclosed, however, there are those 10% of their patients that don’t survive.


Annie was admitted on a Wednesday evening.  

The staff advised me to visit Annie as much as possible and bring some food each time in an attempt to persuade her into eating. The SCVSH had started blood transfusions for Annie as well as immunosuppressants.  Her Pack Cell Volume was extremely low  – “12”. Blood transfusion bumped it up to 15.

Annie continued getting blood transfusions.  

Annie’s highest PCV number while hospitalized was “18” I believe on day 3.

Fighting for life

It was so sad to see this sweet little dog fighting for her life. 

Each day Annie seemed to feel and look worse, with jaundice very evident throughout her body. I continued to ask the doctors for their support and advice as to how much time I should give this disease to turn around the chances of that happening.

The lead Critical Care doctor (Dr. Tracey Rossi) informed that it takes a minimum of 3 days to see any results from immunosuppressants before they catch up to Annie’s immune system, thereby suppressing the antibodies attacking Annie’s healthy red blood cells.

Initially, when I visited Annie, she cried when I was leaving.  After the 3rd night during her hospitalization, she didn’t respond.

I feel I should have listened to Dr. Heathcock at VCA Saddleback.

Annie’s 5th night at the specialty hospital was the night Annie was clinging for life and I was literally clinging for hope on a very thin thread. I wanted my Annie’s health back and Annie wanted to live!

The ultimate decision

After seeing Annie that evening,  I told the doctor on duty I will not let my dog continue to suffer. 

She said to go through the night and then make a decision in the morning.

I went home, and at 12:30 a.m. (Tuesday) morning, I received a call from the veterinarian on duty telling me Annie’s condition had declined and she was having difficulty breathing. I told the doctor to immediately euthanize Annie. She then asked if I would like to come down to the hospital to visit Annie for the last time (which was approx. 20 – 25 minutes from my home with no traffic). I didn’t want Annie to suffer a minute longer and explained to her that I already said my goodbyes to my precious little girl earlier that evening.

I had to ask myself if putting Annie through so much misery was the humble thing to do despite the 42% survival rate – a long term more like 20%.

Finding out about Annie’s condition I was so caught off guard.

I had very little time to research the disease. Had I known what Annie was going to have to go through, I would have made a different judgment call prior to Day 5 (1/2 hr into Day 6) of Annie’s ordeal.

I hope more awareness is raised and more published stories are available as well as studies on this horrific disease (IMHA) to educate everyone who owns a fur baby.

Dog’s lives are much shorter than humans; their quality of life needs to be top consideration (even for 1 week).

Related articles:
IMHA Is Not To Be Taken Lightly: Know The Symptoms

Further reading:
Immune-Mediated Hemolytic Anemia (IMHA) in Dogs

Categories: ConditionsImmune Mediated Hemolytic Anemia (IMHA)Real-life Stories

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Jana Rade

I am a graphic designer, dog health advocate, writer, and author. Jasmine, the Rottweiler of my life, was the largest female from her litter. We thought we were getting a healthy dog. Getting a puppy from a backyard breeder was our first mistake. Countless veterinary visits without a diagnosis or useful treatment later, I realized that I had to take Jasmine's health care in my own hands. I learned the hard way that merely seeing a vet is not always enough. There is more to finding a good vet than finding the closest clinic down the street. And, sadly, there is more to advocating for your dog's health than visiting a veterinarian. It should be enough, but it often is not. With Jasmine, it took five years to get a diagnosis. Unfortunately, other problems had snowballed for that in the meantime. Jasmine's health challenges became a crash course in understanding dog health issues and how to go about getting a proper diagnosis and treatment. I had to learn, and I had to learn fast. Helping others through my challenges and experience has become my mission and Jasmine's legacy. I now try to help people how to recognize and understand signs of illness in their dogs, how to work with their veterinarian, and when to seek a second opinion. My goal is to save others the steep curve of having to learn things the hard way as I did. That is the mission behind my blog and behind my writing. That is why I wrote Symptoms to Watch for in Your Dog, which has turned out being an award-winning guide to dog owners. What I'm trying to share encompasses 20 years of experience.

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