title: Use of human immunoglobulin in addition to glucocorticoids for the initial treatment of dogs with immune-mediated hemolytic anemia.
abstract: OBJECTIVE
  To determine the utility of human intravenous immunoglobulin (hIVIG) for the initial treatment of canine immune-mediated hemolytic anemia (IMHA).
  
  
  METHODS
  Blinded, randomized, clinical trial.
  
  
  METHODS
  Veterinary teaching hospital.
  
  
  METHODS
  Twenty-eight, client-owned dogs with primary IMHA.
  
  
  METHODS
  At enrollment, after diagnosis of IMHA, dogs were randomly assigned to receive either hIVIG or placebo, in a blinded fashion. For the next 14 days, all dogs received glucocorticoids as the sole immunosuppressant agent. All dogs received low-molecular-weight heparin as an anticoagulant. D-dimer concentrations were evaluated at the beginning and end of the study protocol to monitor for thromboembolic complications.
  
  
  RESULTS
  Twenty-five of 28 dogs (89%) were discharged from the hospital. Thirteen of those received hIVIG and 12 received placebo. Twenty-four dogs (86%) were alive 14 days after enrollment, and of these 13 received hIVIG and 11 received placebo. D-dimer concentrations were elevated in 86% of all dogs at the time of diagnosis.
  
  
  CONCLUSIONS
  For initial treatment of dogs with IMHA, the addition of hIVIG to corticosteroid treatment did not improve initial response, nor did it shorten hospitalization.
authors.affiliation: Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA 01536, USA.
authors.forename: Megan F
authors.initials: MF
authors.lastname: Whelan
authors.forename: Therese E
authors.initials: TE
authors.lastname: O'Toole
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Chan
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Rozanski
authors.forename: Armelle M
authors.initials: AM
authors.lastname: DeLaforcade
authors.forename: Sybil L
authors.initials: SL
authors.lastname: Crawford
authors.forename: Susan M
authors.initials: SM
authors.lastname: Cotter
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy / Q000662:veterinary*; D000818:Animals; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male
chemical_list: D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous