Immune Mediated Hemolytic Anemia (IMHA) is a type II hypersensitivity disorder that is both recurrent and difficult to treat, resulting in almost half of affected animals being deceased within a year of diagnosis despite vigorous use of transfusions and immune suppressive medications. A case report is presented here of a dog refractory to these measures who suffered IMHA twice within a six month timespan. Chinese herbal medicine was effective in both instances, with no recurrences afterwards.