Mycophenolate treating Immune-mediated hemolytic anemia (IMHA)

Mycophenolate’s immunosuppressant activity has shown to be effective in a variety of autoimmune diseases including IMHA. IMHA is a potentially life-threatening anemia that occurs when antibodies are formed against host red blood cells. Pale and/or yellow mucous membranes at gums and increased respiratory breathing rate are more specific discernable signs to notice IMHA Animals that survive the initial two week period have good long term survival rates.

A retrospective study of medical cases conducted found regimens with mycophenolate to be safe in dogs with IMHA (Wang, 2013). Mycophenolate combined with prednisolone found favorable survival rates (77% discharge rates). It is an emergency but can be managed outside of the hospital once stabilized with products like Mycophenolate and Prednisolone.

Medication duration is variable based off severity and whether therapy can be tapered off. Some animals require lifelong treatment, so discuss with veterinarian. Compounding weight-based products is very beneficial for this product as it only comes commercially in 250mg increment products or oral fruit flavored suspension that will not be helpful for most animals. Flavored suspensions will avoid unnecessary frustration for both the owner and pet alike. Gastrointestinal toxicity can occur from mycophenolate including primarily diarrhea and vomiting. Monitor weight and owner reports to evaluate significance.

Dosing: 12-17mg/kg by mouth once daily or in two divided doses. Normally given with glucocorticoid like prednisolone.

Wang A, Smith JR, Creevy KE. (2013) Treatment of canine idiopathic immune-mediated haemolytic anemia with mycophenolate mofetil and alucocorticoids: 30 cases (2007 to 2011). J Small Anim Pract. 54:399-404.

West,L.D. & Hart, J.R. (2014) Treatment of idiopathic immune-mediated hemolytic anemia with mycophenolate mofetil in five dogs. J Vet Emera Crit Care (San Antonio). 24/21:226-31. doi: 10.1111/vec. 12121 PMID-24251650