Use of therapeutic plasmapheresis in a case of canine immune-mediated hemolytic anemia
Version of Record online: 22 JUL 2009
© Veterinary Emergency and Critical Care Society 2009
Journal of Veterinary Emergency and Critical Care
Volume 19, Issue 4, pages 375–380, August 2009
How to Cite
Crump, K. L. and Seshadri, R. (2009), Use of therapeutic plasmapheresis in a case of canine immune-mediated hemolytic anemia. Journal of Veterinary Emergency and Critical Care, 19: 375–380. doi: 10.1111/j.1476-4431.2009.00431.x
- Issue online: 12 AUG 2009
- Version of Record online: 22 JUL 2009
- plasma exchange;
- transfusion medicine
Objective – To investigate the clinical application and potential utility of plasmapheresis in canine immune-mediated hemolytic anemia.
Case Summary – A 7-year-old spayed female Maltese diagnosed with immune-mediated hemolytic anemia was initially treated with prednisone, cyclosporine, and received multiple transfusions of packed RBC. Because of the progression of clinical signs despite traditional medical therapy, plasmapheresis was initiated. Plasma immunoglobulin G and immunoglobulin M levels were measured before, during, and after treatment to help determine if there had been a significant decrease in immunoglobulin levels with plasmapheresis. Plasmapheresis was successfully performed over a 2.5-hour period in this dog with minimal complications. Hypocalcemia was identified as a known complication of circuit anticoagulation, and was corrected through calcium supplementation. Post-plasmapheresis there was a decrease in immunoglobulin G and immunoglobulin M levels, and the patient showed clinical improvement. Following discharge the dog had no known complications of therapy, and had complete resolution of the anemia.
New or Unique Information Provided – Plasmapheresis was performed successfully with minimal complications. Because transfusion requirements appeared to be reduced, and the procedure was well tolerated, there may be a place for this modality in severe cases to act as a bridge until medical therapy takes full effect. Because of the cost of performing this therapy, and the potential requirement for multiple treatments, it should be reserved for selected patients.