Canine immune mediated hemolytic anemia (IMHA) is an autoimmune disease characterized by the increased destruction of red blood cells by autoantibodies. A type two hypersensitivity reaction, it can be primary or secondary in nature. Most cases are primary (idiopathic) but secondary IMHA can occur with concurrent infection, such as with the blood parasites (Ehrlichia and Babesia) or leptospirosis, with inflammation or immune mediated processes such as systemic lupus erythematosus or with lymphoid malignancies. Viral infection can also predispose an animal to IMHA, in particular parvovirus and distemper. Treatment of IMHA centers on finding the causative agent, in the case of secondary disease, and on immunosuppressive therapy with drugs such as corticosteroids, cyclosporine, azathioprine and cyclophosphamide. The short-term prognosis for dogs with IMHA is guarded due to the multiple complications inherent in the acute stages of the disease. If an animal survives acute disease the long term prognosis is fair. Dogs frequently experience relapse and may become refractory to previous therapies with each relapse. This study centers on the case of Scooter, an English bulldog, who was diagnosed at Cornell University's Hospital for Animals with IMHA in June of 2002.