Immune-mediated haemolytic anaemia (IMHA) is a life-threatening autoimmune condition in dogs that causes rapid red blood cell destruction, requiring intensive and often harrowing treatment.
IMHA causes severe acute welfare compromise: profound anaemia causes weakness, tachycardia, pallor, and collapse. The intensive treatment phase involves hospitalisation, intravenous therapy, and blood transfusions — all stressful for the patient. Prednisolone at immunosuppressive doses causes significant side effects including polydipsia, polyuria, increased appetite, and behavioural changes (aggression, anxiety) that reduce quality of life during treatment. Long-term immunosuppression increases infection risk. Welfare monitoring during treatment should use validated QoL tools and track side effect burden. Relapses are common — recurrence carries a worse prognosis and owners should be counselled about the realistic probability of repeated treatment cycles. Some owners appropriately choose euthanasia over repeated intensive care episodes.