title: A prospective study of clopidogrel therapy in dogs with primary immune-mediated hemolytic anemia.
abstract: BACKGROUND
  A major cause of death in dogs with primary immune-mediated hemolytic anemia (pIMHA) is thrombotic disease. Ultralow-dose aspirin (ULDA) is commonly used to prevent thrombosis in dogs with pIMHA; however, the efficacy of antiplatelet agents in dogs with pIMHA is unknown.
  
  
  OBJECTIVE
  The use of clopidogrel (CL), alone or in combination with ULDA, would improve survival to discharge and at 90 days without important adverse effects compared with ULDA alone in dogs with pIMHA treated with standard immunosuppressive therapy.
  
  
  METHODS
  Twenty-four client-owned dogs with pIMHA.
  
  
  METHODS
  Prospective, positive-controlled, unmasked clinical trial with dogs randomized in 3 treatment groups to receive PO ULDA or CL or both.
  
  
  RESULTS
  There was no identifiable adverse reaction, evidence of hemorrhage, or increase in transfusion requirements associated with CL therapy, either alone or combined with ULDA, compared with ULDA alone. There was no significant difference between treatment groups with respect to survival to discharge and at 90 days.
  
  
  CONCLUSIONS
  This study suggests that CL therapy, alone or in combination with ULDA, was safe and had similar short-term survival compared with ULDA alone in a small group of dogs with pIMHA able to tolerate oral medications and treated with standard immunosuppressive treatment.
authors.affiliation: Internal Medicine Department, Red Bank Veterinary Hospital, NJ, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Mellett
authors.forename: R K
authors.initials: RK
authors.lastname: Nakamura
authors.forename: D
authors.initials: D
authors.lastname: Bianco
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy / Q000662:veterinary*; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D000077144:Clopidogrel; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D004359:Drug Therapy, Combination / Q000662:veterinary; D005260:Female; D053208:Kaplan-Meier Estimate; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin