ACVIM consensus statement on the treatment of immune‐mediated hemolytic anemia in dogs

Journal of Veterinary Internal Medicine. 2019;33(3):1141-1172 DOI 10.1111/jvim.15463


Journal Homepage

Journal Title: Journal of Veterinary Internal Medicine

ISSN: 0891-6640 (Print); 1939-1676 (Online)

Publisher: Wiley

Society/Institution: American College of Veterinary Internal Medicine

LCC Subject Category: Agriculture: Animal culture: Veterinary medicine

Country of publisher: United States

Language of fulltext: English

Full-text formats available: PDF, HTML



James W. Swann (Kennedy Institute of Rheumatology University of Oxford Oxford United Kingdom)

Oliver A. Garden (School of Veterinary Medicine University of Pennsylvania Philadelphia Pennsylvania)

Claire L. Fellman (Cummings School of Veterinary Medicine Tufts University North Grafton Massachusetts)

Barbara Glanemann (Royal Veterinary College University of London London United Kingdom)

Robert Goggs (College of Veterinary Medicine Cornell University Ithaca New York)

Dana N. LeVine (College of Veterinary Medicine Iowa State University Ames Iowa)

Andrew J. Mackin (College of Veterinary Medicine Mississippi State University Mississippi State Mississippi)

Nathaniel T. Whitley (Davies Veterinary Specialists Manor Farm Business Park Huntingdon United Kingdom)


Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 22 weeks


Abstract | Full Text

Immune‐mediated hemolytic anemia (IMHA) causes severe anemia in dogs and is associated with considerable morbidity and mortality. Treatment with various immunosuppressive and antithrombotic drugs has been described anecdotally and in previous studies, but little consensus exists among veterinarians as to the optimal regimen to employ and maintain after diagnosis of the disease. To address this inconsistency and provide evidence‐based guidelines for treatment of IMHA in dogs, we identified and extracted data from studies published in the veterinary literature. We developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria, explanation of treatment regimens, and validity of statistical methods. In combination with our clinical experience and comparable guidelines for humans afflicted with autoimmune hemolytic anemia, we used the conclusions of this process to make a set of clinical recommendations regarding treatment of IMHA in dogs, which we refined subsequently by conducting several iterations of Delphi review. Additionally, we considered emerging treatments for IMHA in dogs and highlighted areas deserving of future research. Comments were solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted for publication. The resulting document is intended to provide clinical guidelines for management of IMHA in dogs. These guidelines should be implemented pragmatically, with consideration of animal, owner, and veterinary factors that may vary among cases.