Concurrent immune-mediated hemolytic anemia and severe thrombocytopenia in 21 dogs
Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire.The Veterinary record (Impact Factor: 1.49). 10/2008; 163(11):323-7. DOI: 10.1136/vr.163.11.323
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: Immune-mediated thrombocytopenia (IMT) is a common hematologic disorder in dogs. Human intravenous immunoglobulin (hIVIG) may have a beneficial effect in canine IMT. A single hIVIG infusion (0.5 g/kg) in dogs with presumed primary IMT (pIMT) is a safe adjunctive emergency treatment to accelerate platelet count recovery and shorten hospitalization time without increasing the cost of patient care. Eighteen client-owned dogs with a presumptive diagnosis of pIMT. Prospective, randomized, double-blinded, placebo-controlled clinical trial. There were no identifiable immediate or delayed adverse reactions associated with hIVIG administration over a 6-month period. The median platelet count recovery time for the hIVIG group was 3.5 days (mean + or - SD: 3.7 + or - 1.3 days; range, 2-7 days) and 7.5 days (mean + or - SD: 7.8 + or - 3.9 days; range, 3-12 days) for the placebo group. The median duration of hospitalization for hIVIG group was 4 days (mean + or - SD: 4.2 + or - 0.4 days; range, 2-8 days) and 8 days (mean + or - SD: 8.3 + or - 0.6 days; range, 4-12 days) for the placebo group. There was no significant difference between groups with respect to expense of initial patient care, whereas significant reduction in platelet count recovery time (P= .018) and duration of hospitalization (P= .027) were detected in the hIVIG group. Compared with corticosteroids alone, adjunctive emergency therapy of a single hIVIG infusion was safe and associated with a significant reduction in platelet count recovery time and duration of hospitalization without increasing the expense of medical care in a small group of dogs with presumed pIMT.Journal of Veterinary Internal Medicine 09/2009; 23(5):1071-8. DOI:10.1111/j.1939-1676.2009.0358.x · 1.88 Impact Factor
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ABSTRACT: To identify and characterize the syndrome of immune-mediated hemolytic anemia (IMHA) with concurrent severe thrombocytopenia (<or=15.0 x 10(9) platelets/L; [15.0 x 10(3) platelets/microL]), and to evaluate prognostic factors, clinicopathologic findings, complications, treatment, outcome, and survival of dogs with this hematologic disorder. Retrospective, observational study. Veterinary teaching hospital. Twelve client-owned dogs with IMHA and severe thrombocytopenia (<or=15.0 x 10(9) platelets/L; [15.0 x 10(3) platelets/microL]), without evidence of overt disseminated intravascular coagulation. The following data were recorded and analyzed from the electronic medical record: signalment, history, concurrent diseases, clinical signs at presentation, clinicopathologic data, diagnostic testing, radiographic findings, treatment modalities, length of hospitalization, complications, and clinical outcome. All dogs were treated with immunosuppressive doses of corticosteroids. Twelve dogs were identified with the diagnosis of IMHA and severe thrombocytopenia; of these, 9 (75%) survived, 3 (25%) were euthanized, and none died. Dogs that survived were significantly younger than nonsurvivors (P=0.03). There were no specific clinical signs or therapies associated with survival. Dogs in this study had a mortality rate similar to reported rates for dogs with either disease alone. Overall, younger dogs were more likely to survive. No association between different treatment modalities and overall survival was identified.06/2010; 20(3):338-45. DOI:10.1111/j.1476-4431.2010.00540.x
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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. DOI:10.1111/j.1748-5827.2011.01074.x · 1.09 Impact Factor
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