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Agnoli C, Tumbarello M, Vasylyeva K, Selva Coddè CS, Monari E, Gruarin M, Troìa R, Dondi F. Methylprednisolone alone or combined with cyclosporine or mycophenolate mofetil for the treatment of immune-mediated hemolytic anemia in dogs, a prospective study. J Vet Intern Med 2024. [PMID: 38961558 DOI: 10.1111/jvim.17122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/14/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Benefit of adding a second-line immunosuppressive drug to glucocorticoids for the treatment of non-associative immune-mediated hemolytic anemia (naIMHA) in dogs has not been defined prospectively. HYPOTHESIS/OBJECTIVES Evaluate the effectiveness of different immunosuppressive protocols in naIMHA dogs. ANIMALS Forty-three client-owned dogs. METHODS Open label, randomized, clinical trial. Dogs were treated with methylprednisolone (M-group), methylprednisolone plus cyclosporine (MC-group) or methylprednisolone plus mycophenolate mofetil (MM-group). Dogs were defined as responders by disappearance of signs of immune-mediated destruction and hematocrit stabilization. Frequency of responders was compared between M-group and combined protocols (MC and MM-group evaluated together), and among the 3 different therapeutic groups at 14 (T14), 30 (T30), 60 (T60) days after admission. Frequency of complications, length of hospitalization and relapse were also compared. Death rate was evaluated at discharge, T60 and 365 (T365) days. RESULTS Proportion of responders was not significantly different between M-group and combined protocols (MC and MM-groups), nor among the 3 therapeutic groups at T14, T30, and T60 (P > .17). Frequency of relapse, complications, and length of hospitalization were not significantly different between M-group and dogs treated with combined protocols, nor among the 3 treatment groups (P > .22). Death was significantly more common only for MM-group compared with MC-group at T60 (+42.8%; 95% CI: 11.5-67.4; P = .009), and at T365 (+50%; 95% CI: 17.5-73.2; P = .003). CONCLUSIONS AND CLINICAL IMPORTANCE Combined immunosuppressive therapy did not improve hematological response in naIMHA.
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Affiliation(s)
- Chiara Agnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Michele Tumbarello
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Kateryna Vasylyeva
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Carola S Selva Coddè
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Erika Monari
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | | | - Roberta Troìa
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
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Ravicini S, Kent A, Dunning M, Baines S, Clarke S, Allerton F. Description and outcome of dogs with primary immune-mediated polyarthritis: 73 cases (2012-2017). J Small Anim Pract 2023; 64:142-148. [PMID: 36321528 DOI: 10.1111/jsap.13565] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 06/18/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To provide a description of primary idiopathic immune-mediated polyarthritis, including long-term outcome and relapse rates, for dogs starting treatment with corticosteroids alone or corticosteroids with a second immunosuppressant. MATERIALS AND METHODS Medical records were reviewed between January 2012 and December 2017 to identify dogs diagnosed with primary immune-mediated polyarthritis. Data including signalment, clinicopathological findings, type and duration of treatment, relapse and outcome were recorded. RESULTS Seventy-three dogs were included. Fifty-four dogs were started on corticosteroid monotherapy (an additional immunosuppressant was introduced later in 27/54 dogs) and 19 dogs were treated with multi-modal immunosuppression from the outset. Ninety-five percent (69/73) of dogs responded favourably to therapy although death was attributed to immune-mediated polyarthritis in 19% (14/73) of dogs. Relapse of clinical signs was reported in 53% (39/73) dogs (31/39 while on treatment), with multiple relapses observed in 17 dogs. Complete cure (permanent withdrawal of immunosuppressive medication) was achieved in 46 dogs (63%). Overall, 81% of dogs had a well-managed disease for an extended timeframe (≥1131 days). Fourteen of 19 (74%) dogs that started treatment with multi-modal immunosuppression and 32 of 54 (59%) started on corticosteroids alone achieved a complete cure. CLINICAL SIGNIFICANCE This study provides extended follow-up information for a large cohort of dogs with primary immune-mediated polyarthritis. Immunosuppressive therapy was discontinued in the majority of dogs but disease-associated mortality remains high.
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Affiliation(s)
- S Ravicini
- Washington State University, College of Veterinary Medicine, Pullman, WA, USA
| | - A Kent
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - M Dunning
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK.,School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
| | - S Baines
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - S Clarke
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, Solihull, West Midlands, UK
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Tayler S, Hazuchova K, Riddle A, Swann JW, Glanemann B. Investigation of single-nucleotide polymorphisms in the NR3C1a glucocorticoid receptor gene in Cocker Spaniels with primary immune thrombocytopenia. J Vet Intern Med 2022; 36:1281-1286. [PMID: 35689373 PMCID: PMC9308442 DOI: 10.1111/jvim.16468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/27/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In dogs, 6 single-nucleotide polymorphisms (SNPs) have been described in the glucocorticoid receptor gene NR3C1a, 2 of which were nonsynonymous SNPs in exons 2 and 8. The clinical importance of these SNPs is unknown. OBJECTIVES To investigate whether SNPs in NR3C1a are associated with clinical outcome in Cocker Spaniels with primary immune thrombocytopenia (pITP). ANIMALS Twenty-four Cocker Spaniels with pITP presented to a referral center. Dogs were classified as slow (n = 11) or fast responders (n = 12) based on time required after initiating glucocorticoid treatment to achieve a platelet count >70 000/μL. METHODS Deoxyribonucleic acid was extracted from stored blood samples before amplification by PCR and sequencing of exons 2 and 8 of NR3C1a. Associations between genotype and clinical response variables were investigated. RESULTS Neither previously identified nonsynonymous SNPs were identified. The synonymous SNP NR3C1a:c.798C>T in exon 2 was found at an increased prevalence compared to a previous report. No difference was found in prevalence of any genotype at NR3C1a:c.798C>T between fast and slow responders (P = .70). CONCLUSIONS AND CLINICAL IMPORTANCE None of the previously reported nonsynonymous SNPs in exons 2 and 8 of the NR3C1a gene were detected in our cohort of Cocker Spaniels with pITP. The synonymous SNP NR3C1a:c.798C>T in exon 2 was reported at a higher frequency than previously, but was not associated with outcome measures that estimated responsiveness to glucocorticoids.
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Affiliation(s)
- Sarah Tayler
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Katarina Hazuchova
- Small Animal Clinic, Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Anna Riddle
- Clinical Investigation Centre, Royal Veterinary College, Hatfield, United Kingdom
| | - James W Swann
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom.,Columbia Stem Cell Initiative, Columbia University, New York, New York, USA
| | - Barbara Glanemann
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
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Barker L, McManus S, Adamantos S, Black V. Point prevalence and clinical course of proteinuria in dogs with idiopathic non-erosive immune-mediated polyarthritis. J Small Anim Pract 2022; 63:619-623. [PMID: 35508589 PMCID: PMC9542946 DOI: 10.1111/jsap.13503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 02/13/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022]
Abstract
Objectives To describe the point prevalence and clinical course of proteinuria in dogs diagnosed with idiopathic non‐erosive immune‐mediated polyarthritis. Materials and Methods Cases presenting to a single referral centre with a diagnosis of idiopathic non‐erosive immune‐mediated polyarthritis were retrospectively recruited from January 2009 to August 2018. Data including signalment, urinalysis, clinicopathological results, cytology from arthrocentesis, treatment and long‐term follow‐up were analysed. Dogs were defined as: non‐proteinuric (UPC <0.2), borderline proteinuric (UPC 0.2‐0.5) or overtly proteinuric (UPC >0.5). Results Fifty‐eight dogs met the inclusion criteria. Twenty‐two dogs were overtly proteinuric (38%), eight dogs were borderline proteinuric (14%) and 28 dogs were non‐proteinuric (48%). Repeated urinalysis was performed in nine of 12 dogs with UPC greater than 2.0. The UPC decreased in all nine dogs, with the UPC decreasing to less than 0.5 in 44% of dogs. A greater than 50% decrease in UPC was noted in 44% of dogs, despite seven of nine (77%) receiving prednisolone as either monotherapy or in conjunction with an adjunctive immunosuppressive medication. Clinical Significance Proteinuria was common in this cohort of dogs diagnosed with primary idiopathic non‐erosive immune‐mediated polyarthritis. The use of prednisolone does not appear to be contraindicated in proteinuric dogs with idiopathic non‐erosive immune‐mediated polyarthritis.
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Affiliation(s)
- L Barker
- Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK
| | - S McManus
- Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK
| | - S Adamantos
- Paragon Veterinary Referrals, Wakefield, WF1 2DF, UK
| | - V Black
- Bristol Veterinary School, University of Bristol, Bristol, BS40 5DU, UK
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Glucocorticoids, Cyclosporine, Azathioprine, Chlorambucil, and Mycophenolate in Dogs and Cats. Vet Clin North Am Small Anim Pract 2022; 52:797-817. [DOI: 10.1016/j.cvsm.2022.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Swann JW, Tayler S, Hall H, Sparrow R, Skelly BJ, Glanemann B. Cross-sectional study of approaches to diagnosis and management of dogs with immune-mediated haemolytic anaemia in primary care and referral veterinary practices in the United Kingdom. PLoS One 2021; 16:e0257700. [PMID: 34543364 PMCID: PMC8452064 DOI: 10.1371/journal.pone.0257700] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To determine whether veterinarians in primary care practices (PCPs) and board-certified clinicians (BCCs) approach treatment of dogs with immune-mediated haemolytic anaemia (IMHA) similarly, and whether practitioners with more experience treat similarly to those with less experience. We hypothesised those in PCPs would show more variation in their approach to similar cases than BCCs. METHODS A cross-sectional study was conducted by distributing a questionnaire to BCCs and veterinarians in PCPs. The questionnaire included direct questions and a number of clinical scenarios intended to capture approaches to common treatment problems. RESULTS Questionnaire responses were received from 241 veterinarians, including 216 in PCPs and 25 BCCs. Veterinarians in both settings used similar tests for diagnosis of IMHA, but BCCs performed more tests to exclude underlying causes of 'associative' disease. All veterinarians reported use of similar initial dosages of glucocorticoids (median 2 mg/kg per day in both groups, p = 0.92) but those used by more experienced practitioners were higher than those with less experience. Most veterinarians made allowances for the weight of dogs, using lower prednisolone dosages in a clinical scenario involving a 40 kg dog compared to a 9 kg dog (p = 0.025 for PCP, p = 0.002 for BCC). BCCs reported greater use of combinations of immunosuppressive drugs (p<0.0001) and of antithrombotic drugs (p<0.0001); use of antithrombotic drugs was also less common among more experienced practitioners compared to less experienced. CONCLUSIONS Approaches to treatment of dogs with IMHA differ between BCCs and those in PCP. These differences may affect design and implementation of future research studies and clinical guidelines.
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Affiliation(s)
- James W. Swann
- Columbia Stem Cell Initiative, Columbia University, New York, NY, United States of America
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Sarah Tayler
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Harriet Hall
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Richard Sparrow
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
| | - Barbara J. Skelly
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Barbara Glanemann
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom
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Sato M, Veir JK, Shropshire SB, Lappin MR. Ehrlichia canis in dogs experimentally infected, treated, and then immune suppressed during the acute or subclinical phases. J Vet Intern Med 2020; 34:1214-1221. [PMID: 32267035 PMCID: PMC7255653 DOI: 10.1111/jvim.15750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/19/2020] [Indexed: 11/30/2022] Open
Abstract
Background Concerns for recrudescence of Ehrlichia canis infection arise when immunosuppressive drugs are used to treat immune‐mediated diseases in dogs previously infected with E. canis. Objectives Determine whether administration of prednisolone and cyclosporine would reactivate E. canis infection in dogs previously treated with doxycycline during the acute or subclinical phases. Animals Seven beagles previously experimentally infected with E. canis and administered doxycycline for 4 weeks were included. Three of the 7 dogs were incidentally concurrently infected with Anaplasma platys and Babesia vogeli and were administered 2 doses of imidocarb 2 weeks apart before enrollment in the current study. Methods Experimental study. Each dog was administered prednisolone and cyclosporine for 6 weeks. Clinical signs, complete blood cell count (CBC), polymerase chain reaction (PCR) assays for E. canis, A. platys, and B. vogeli DNA in blood, E. canis indirect fluorescent antibodies (IFA) titers, and flow cytometry for antiplatelet antibodies were monitored. Results All dogs completed the immunosuppressive protocol. No evidence for recrudescence of E. canis, A. platys, or B. vogeli were detected based on clinical signs or results of CBC, PCR, IFA, and flow cytometry for antiplatelet antibodies. E. canis IFA titers were negative in 5/7 dogs at the end of immunosuppressive protocol and were negative 6 months after the protocol in 5/5 dogs available for testing. Conclusions and Clinical Importance Dogs administered with a 4‐week course of doxycycline with or without imidocarb failed to show evidence of activation of E. canis infection after administration of a commonly used immune suppressive protocol.
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Affiliation(s)
- Masahiko Sato
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Julia K Veir
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Sarah B Shropshire
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Michael R Lappin
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Narayanan L, Mulligan C, Durso L, Thames B, Thomason J, Fellman C, Mackin A, Wills R, Archer T. Recovery of T-cell function in healthy dogs following cessation of oral cyclosporine administration. Vet Med Sci 2020; 6:277-282. [PMID: 31914237 PMCID: PMC7397919 DOI: 10.1002/vms3.230] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/30/2019] [Accepted: 12/08/2019] [Indexed: 11/30/2022] Open
Abstract
Cyclosporine is a potent immunosuppressive agent used to treat immune‐mediated disorders in dogs. Secondary infections sometimes necessitate withdrawal of cyclosporine, but it is not known how long it takes for the immune system to recover after cessation of cyclosporine. Our goal was to utilize a validated RT‐qPCR assay in dogs to assess recovery time of the T‐cell cytokines IL‐2 and IFN‐γ after discontinuation of cyclosporine. Six healthy dogs were given oral cyclosporine (10 mg/kg every 12 hr) for 1 week, with samples collected for measurement of cytokine gene expression prior to treatment, and on the last day of therapy. Cyclosporine was then discontinued, and samples were collected daily for an additional 7 days. Results revealed that there was a significant difference in cytokine expression when comparing pre‐treatment and immediate post‐treatment values, corresponding to marked suppression of T‐cell function. There was no significant difference between pre‐treatment values for either cytokine when compared with any day during the recovery period. Cytokine expression, evaluated as a percentage of pre‐treatment baseline samples, demonstrated progressing return of T‐cell function after drug cessation, with full recovery seen in all dogs by Day 4 of the recovery period.
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Affiliation(s)
- Lakshmi Narayanan
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Charlee Mulligan
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Lisa Durso
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Brittany Thames
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Claire Fellman
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Andrew Mackin
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Robert Wills
- Department of Pathobiology and Population Medicine, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
| | - Todd Archer
- Department of Clinical Sciences, Mississippi State University College of Veterinary Medicine, Mississippi State, MS, USA
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Ullal T, Ambrosini Y, Rao S, Webster CRL, Twedt D. Retrospective evaluation of cyclosporine in the treatment of presumed idiopathic chronic hepatitis in dogs. J Vet Intern Med 2019; 33:2046-2056. [PMID: 31393054 PMCID: PMC6766481 DOI: 10.1111/jvim.15591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 07/23/2019] [Indexed: 12/16/2022] Open
Abstract
Background The etiology of idiopathic chronic hepatitis (ICH) in dogs is poorly understood, but evidence supports an immune‐mediated pathogenesis in some dogs. Objectives To describe a case series of dogs with presumed ICH treated with cyclosporine (CsA) with or without concurrent medications and to document the incidence of biochemical remission and factors associated with failure to attain remission. Animals Forty‐eight client‐owned dogs diagnosed with presumed ICH, treatment of which included CsA. Methods Two‐institution, retrospective case series of dogs between 2010 and 2017. All dogs were treated with CsA with or without concurrent medications for ≥2 weeks. Data were collected from medical records. Results Biochemical remission (<1.1 times the upper limit of normal for alanine aminotransferase activity) was attained in 79% of dogs (38/48). Median dose of CsA at remission was 7.9 mg/kg/d (range, 2.5‐12.7 mg/kg/d) and median time to remission was 2.5 months (range, 0.75‐18 months). Concurrent hepatoprotectant treatment was not associated with likelihood of remission. Clinical score, ascites, hypoalbuminemia, hyperbilirubinemia, prolonged coagulation times, dose, and duration of treatment were not associated with the probability of remission or time to remission. Common adverse effects of CsA were gastrointestinal signs in 38% (18/48) and gingival hyperplasia in 25% (12/48) of treated dogs. Conclusion and Clinical Importance A treatment regimen including CsA and frequent hepatoprotectant use resulted in biochemical remission of ICH in most dogs. None of the evaluated factors, including hepatoprotectant use, were significantly associated with likelihood of remission. Future prospective studies are indicated to evaluate CsA monotherapy in ICH dogs.
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Affiliation(s)
- Tarini Ullal
- Colorado State University, Fort Collins, Colorado
| | - Yoko Ambrosini
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts
| | - Sangeeta Rao
- Colorado State University, Fort Collins, Colorado
| | - Cynthia R L Webster
- Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts
| | - David Twedt
- Colorado State University, Fort Collins, Colorado
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Swann JW, Garden OA, Fellman CL, Glanemann B, Goggs R, LeVine DN, Mackin AJ, Whitley NT. ACVIM consensus statement on the treatment of immune-mediated hemolytic anemia in dogs. J Vet Intern Med 2019; 33:1141-1172. [PMID: 30847984 PMCID: PMC6524099 DOI: 10.1111/jvim.15463] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/06/2019] [Indexed: 01/07/2023] Open
Abstract
Immune‐mediated hemolytic anemia (IMHA) causes severe anemia in dogs and is associated with considerable morbidity and mortality. Treatment with various immunosuppressive and antithrombotic drugs has been described anecdotally and in previous studies, but little consensus exists among veterinarians as to the optimal regimen to employ and maintain after diagnosis of the disease. To address this inconsistency and provide evidence‐based guidelines for treatment of IMHA in dogs, we identified and extracted data from studies published in the veterinary literature. We developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria, explanation of treatment regimens, and validity of statistical methods. In combination with our clinical experience and comparable guidelines for humans afflicted with autoimmune hemolytic anemia, we used the conclusions of this process to make a set of clinical recommendations regarding treatment of IMHA in dogs, which we refined subsequently by conducting several iterations of Delphi review. Additionally, we considered emerging treatments for IMHA in dogs and highlighted areas deserving of future research. Comments were solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted for publication. The resulting document is intended to provide clinical guidelines for management of IMHA in dogs. These guidelines should be implemented pragmatically, with consideration of animal, owner, and veterinary factors that may vary among cases.
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Affiliation(s)
- James W Swann
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Oliver A Garden
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Claire L Fellman
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Barbara Glanemann
- Royal Veterinary College, University of London, London, United Kingdom
| | - Robert Goggs
- College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Dana N LeVine
- College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - Andrew J Mackin
- College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi
| | - Nathaniel T Whitley
- Davies Veterinary Specialists, Manor Farm Business Park, Huntingdon, United Kingdom
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Cole SD, Palermo SM, Rankin SC. Salmonella enterica serovar Typhimurium isolated from the urine of a dog undergoing treatment for immune-mediated polyarthritis. JMM Case Rep 2018; 5:e005153. [PMID: 30425836 PMCID: PMC6230761 DOI: 10.1099/jmmcr.0.005153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/27/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION In people, Salmonella is a common agent of gastroenteritis, but it can also cause extraintestinal disease such as urinary tract infections. In addition, Salmonella is often linked to the post-infection development of reactive arthritis. In canines, cases that document extraintestinal Salmonella infections or diseases similar to reactive arthritis have not been thoroughly described. CASE PRESENTATION A case of a 5-year-old German shepherd dog with Salmonella bacteriuria during treatment for immune-mediated polyarthritis (IMPA) is described. The patient first suffered from a 3 month period of diarrhoea and presented for evaluation of a 2 month history of shifting-leg lameness. A diagnosis of IMPA was made based on cytological examination and negative synovial fluid culture. Treatment with immunosuppressive doses of prednisone lead to clinical resolution of lameness, but on a recheck abnormal urine was noted. Salmonella enterica serovar Typhimurium was isolated using standard culture methods. The patient was treated with enrofloxacin to control the bacteriuria. CONCLUSION This case report is, to the best of our knowledge, the first to describe Salmonella bacteriuria in a dog and suggests that Salmonella infection may be a potential inciting factor for IMPA.
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Affiliation(s)
- Stephen D. Cole
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shannon M. Palermo
- Department of Clinical Studies - Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shelley C. Rankin
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Ohta H, Morita T, Yokoyama N, Osuga T, Sasaki N, Morishita K, Nakamura K, Takiguchi M. Serial measurement of pancreatic lipase immunoreactivity concentration in dogs with immune-mediated disease treated with prednisolone. J Small Anim Pract 2017; 58:342-347. [DOI: 10.1111/jsap.12652] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/28/2016] [Accepted: 01/02/2017] [Indexed: 12/21/2022]
Affiliation(s)
- H. Ohta
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - T. Morita
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - N. Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - T. Osuga
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - N. Sasaki
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - K. Morishita
- Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - K. Nakamura
- Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - M. Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
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Letters to the Editor. J Am Vet Med Assoc 2016; 248:875. [DOI: 10.2460/javma.248.8.875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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