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BACKGROUND: Treatment of dogs with primary immune-mediated hemolytic anemia (IMHA) is difficult and frequently unrewarding. Prognostic factors have been evaluated in a number of previous studies, and identification of such factors would be beneficial to enable selection of appropriate therapeutic regimens and supportive care. OBJECTIVES: The aim of the current study was to undertake a critical appraisal of the risk of bias in evidence relating to prognostic indicators for mortality in dogs with IMHA. ANIMALS: Three hundred and eighty client-owned dogs with spontaneous primary idiopathic IMHA reported in 6 previous studies. METHODS: A systematic review was conducted to evaluate evidence relating to prognostic factors for mortality in dogs with primary IMHA. Search tools were employed to identify articles and a validated appraisal tool was used to assess the quality of individual studies by considering inclusion and exclusion criteria, measurement of prognostic, outcome and confounding variables, and statistical methods. RESULTS: Few studies evaluated prognostic indicators for IMHA in dogs, and all of these suffered from methodologic flaws in at least 1 major area. Fifteen different variables were identified as prognostic indicators, with 2 variables identified by >1 study. CONCLUSIONS AND CLINICAL IMPORTANCE: There are few pieces of high-quality evidence available to enable estimation of prognosis for dogs presenting with primary IMHA.

Original publication




Journal article


J Vet Intern Med

Publication Date





7 - 13


AIHA, IMHA, Prognosis, Systematic review, Anemia, Hemolytic, Autoimmune, Animals, Dog Diseases, Dogs, Risk Factors