Intravenous administration of human immune globulin in dogs with immune-mediated hemolytic anemia.
OBJECTIVE
To evaluate the efficacy and safety of intravenous administration of human immune globulin in the treatment of dogs with immune-mediated hemolytic anemia (IMHA).


METHODS
Prospective clinical trial.


METHODS
10 dogs with confirmed primary IMHA that had failed to respond to conventional immunosuppressive treatment (administration of prednisone and cyclophosphamide or azathioprine).


METHODS
Diagnosis of IMHA was confirmed by detecting spherocytosis or autoagglutination in blood smears and by excluding secondary causes of IMHA. Dogs were treated with human immune globulin (1 g/kg [0.45 g/lb] of body weight, i.v.) during a 6- to 12-hour period. Prednisone treatment was continued in all dogs, and cyclophosphamide treatment was continued in 4.


RESULTS
Median duration of prior immunosuppressive treatment was 12.5 days. Short-term response could not be evaluated in 2 dogs, because they were given blood transfusions within 7 days after immune globulin treatment. However, there was a significant increase in mean Hct and hemoglobin concentration in 8 other dogs from day 0 to 28 after treatment. Five dogs had clinically meaningful responses to treatment. Three dogs were alive 12 months after treatment. There were not any adverse effects that could be definitively attributed to immune globulin treatment; however, thrombocytopenia was observed in 6 dogs after treatment, and evidence of thromboembolism was detected at necropsy in 5 of the 7 dogs that died.


CONCLUSIONS
Human immune globulin may be useful for short-term stabilization of some dogs with IMHA; however, it did not appear to improve long-term survival.
Scott-Moncrieff
J C
JC
Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA.
Reagan
W J
WJ
Snyder
P W
PW
Glickman
L T
LT
D000744:Anemia, Hemolytic, Autoimmune / Q000628:therapy / Q000662:veterinary*; D000818:Animals; D004283:Dog Diseases / Q000628:therapy*; D004285:Dogs; D004906:Erythrocyte Count / Q000662:veterinary; D005260:Female; D006400:Hematocrit / Q000662:veterinary; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D010976:Platelet Count / Q000662:veterinary; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000209:etiology / Q000662:veterinary; D012156:Reticulocytes / Q000187:drug effects; D013921:Thrombocytopenia / Q000209:etiology / Q000662:veterinary; D016896:Treatment Outcome
D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents