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The use of high-dose immunoglobulin M-enriched human immunoglobulin in dogs with immune-mediated hemolytic anemia.

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cam.issuedOnline2021-11-15
dc.contributor.authorBestwick, Jason P
dc.contributor.authorSharman, Mellora
dc.contributor.authorWhitley, Nat T
dc.contributor.authorKisielewicz, Caroline
dc.contributor.authorSkelly, Barbara J
dc.contributor.authorTappin, Simon
dc.contributor.authorKellett-Gregory, Lindsay
dc.contributor.authorSeth, Mayank
dc.contributor.orcidBestwick, Jason P [0000-0002-0138-0565]
dc.contributor.orcidSharman, Mellora [0000-0002-0327-298X]
dc.contributor.orcidTappin, Simon [0000-0002-8645-178X]
dc.date.accessioned2021-11-22T14:38:12Z
dc.date.available2021-11-22T14:38:12Z
dc.date.issued2022-01
dc.date.submitted2021-04-27
dc.date.updated2021-11-22T14:38:12Z
dc.description.abstractBACKGROUND: The IV use of human immunoglobulin (hIVIG) in dogs with primary immune-mediated hemolytic anemia (IMHA) has been described previously, but herein we describe the use of high-dose IgM-enriched hIVIG (Pentaglobin). HYPOTHESIS/OBJECTIVES: Dogs treated with high-dose Pentaglobin will experience shorter time to remission and hospital discharge and have decreased transfusion requirements compared to dogs receiving standard treatment alone. ANIMALS: Fourteen client-owned dogs diagnosed with primary IMHA at specialist referral hospitals in the United Kingdom. METHODS: All prospectively enrolled dogs received prednisolone, dexamethasone or both along with clopidogrel. Patients were randomized to receive Pentaglobin at 1 g/kg on up to 2 occasions, or to serve as controls. No additional immunosuppressive drugs were allowed within the first 7 days of treatment. Remission was defined as stable PCV for 24 hours followed by an increase in PCV. RESULTS: Ten of 11 dogs from the treatment group and 2 of 3 dogs from the control group achieved remission and survived until hospital discharge. Survival and time to remission were not significantly different between groups. The volume of packed red blood cells transfused, normalized for body weight, was not significantly different between groups. Potential adverse reactions to Pentaglobin occurred in 2 dogs, but their clinical signs may have been related to the underlying disease. CONCLUSIONS AND CLINICAL IMPORTANCE: Treatment with high-dose Pentaglobin was well tolerated by dogs with primary IMHA but no significant advantage was found in this small study. Additional studies examining larger groups and subpopulations of dogs with primary IMHA associated with a poorer prognosis are warranted.
dc.identifier.doi10.17863/CAM.78263
dc.identifier.eissn1939-1676
dc.identifier.issn0891-6640
dc.identifier.otherjvim16315
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330820
dc.languageen
dc.language.isoeng
dc.publisherWiley
dc.publisher.urlhttp://dx.doi.org/10.1111/jvim.16315
dc.subjectIMHA
dc.subjectPentaglobin
dc.subjectautoimmune
dc.subjectdog
dc.subjecthIVIG
dc.subjectAnemia, Hemolytic, Autoimmune
dc.subjectAnimals
dc.subjectDog Diseases
dc.subjectDogs
dc.subjectHumans
dc.subjectImmunoglobulin M
dc.subjectImmunosuppressive Agents
dc.subjectPrednisolone
dc.titleThe use of high-dose immunoglobulin M-enriched human immunoglobulin in dogs with immune-mediated hemolytic anemia.
dc.typeArticle
dcterms.dateAccepted2021-11-03
prism.publicationNameJ Vet Intern Med
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1111/jvim.16315

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