Concurrent immune-mediated haemolytic anaemia and severe thrombocytopenia in 21 dogs.
ABSTRACT The medical records of 21 dogs with concurrent immune-mediated haemolytic anaemia (imha) and severe thrombocytopenia (defined as an automated platelet count of less than 50x10(9)/l, confirmed by the examination of a blood smear) were reviewed. Their mean (sd) age was 5.8 (2.5) years. When compared with the 24,759 dogs in the hospital population for the same period Airedale terriers and dobermanns appeared to be over-represented with odds ratios of 22.5 (95 per cent confidence interval [ci] 5.2 to 97.9) and 7.6 (95 per cent ci 1.8 to 32.7) respectively. The median duration of the dogs' clinical signs was seven days, with a range from one to 17 days. Eleven of the dogs had a history of a tendency to bleed, and 15 had evidence of bleeding when examined. Twenty of the 21 dogs had been treated with glucocorticoids, nine with vincristine, and seven with azathioprine. Their median stay in hospital was four days, with a range from one to 17 days. The median period for which they survived after admission to hospital was five days, with a range from one to 558 days, and 16 of the 21 dogs had died or been euthanased within 30 days of their admission.
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ABSTRACT: Despite being the most prevalent autoimmune disease of dogs, there is considerable variation between individuals and institutions in the treatment regimens that are employed for the management of immune-mediated hemolytic anemia. The aim of this review was to evaluate evidence relating to the treatment of the disease systematically and to use this evidence to draw conclusions that are applicable in wider veterinary practice. Search tools were employed to identify relevant articles and these were assessed according to stated criteria. The overall quality of published evidence was poor, with many articles failing to provide details of the enrollment, treatment, monitoring, and assessment stages of the study process. In view of this, firm conclusions cannot be drawn regarding the treatment of this disease and further research of a higher quality is required.Journal of Veterinary Internal Medicine 12/2012; · 2.06 Impact Factor
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ABSTRACT: Immune-mediated haemolytic anaemia (IMHA) is a severe disease for which evidence is lacking to make informed choices regarding immunosuppressive regimen. The aims of the current study were to determine the effect of different treatment regimens on outcome in affected animals and to identify parameters that may be used as prognostic factors for the disease. The records of dogs presenting to a veterinary hospital in the period 2002 to 2010 for treatment of IMHA were examined and follow-up data were obtained. Statistical tests were performed to establish whether treatment regimen affected outcome and to identify prognostic factors for outcome. Treatment regimen had a significant effect on the outcome (measured as survival of hospitalisation) but there were insufficient subjects to determine the cause of the difference. Serum bilirubin and urea concentrations were found to be significant negative prognostic factors for the outcome of IMHA cases and the concentrations of these parameters were significantly different between animals that survived or died while hospitalised. This study presents the first report of a significant difference in outcome comparing animals treated with immunosuppressive drugs which are in widespread clinical usage. Although possible confounding factors should be considered, these findings could have major consequences for the treatment of IMHA.Journal of Small Animal Practice 06/2011; 52(7):353-8. · 0.91 Impact Factor
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ABSTRACT: To review the therapeutic options for immune-mediated thrombocytopenia (IMT). Original research publications and review articles using the PubMed search engine for the phrases "immune-mediated thrombocytopenia" or "immune thrombocytopenic purpura" or "immune thormbocytopenia." VETERINARY AND HUMAN DATA SYNTHESIS: There are a number of therapeutic options for adult-onset immune thrombocytopenia in human medicine with demonstrated efficacy in clinical studies although corticosteroids and immunoglobulin therapy remain the first-line medical treatments. Thrombopoietin receptor agonist therapy and, to a lesser extent, rituximab have shown great promise in initial clinical trials and may become standard of care in human medicine for the management of IMT. Therapeutic options in veterinary medicine are less diverse and only vincristine and human intravenous immunoglobulin therapies have been evaluated in controlled clinical studies. There are a number of therapeutic options in the management of IMT veterinary medicine, most of which have not been investigated in clinical studies. Further research is warranted to best identify the optimal treatment strategy for IMT in veterinary patients.Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001). 01/2012; 22(1):59-72.