Use of human immunoglobulin in addition to glucocorticoids for the initial treatment of dogs with immune-mediated hemolytic anemia.
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.
Whelan
Megan F
MF
Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA 01536, USA.
O'Toole
Therese E
TE
Chan
Daniel L
DL
Rozanski
Elizabeth A
EA
DeLaforcade
Armelle M
AM
Crawford
Sybil L
SL
Cotter
Susan M
SM
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
D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous