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Keywords:

  • canine;
  • Evans;
  • hemolysis;
  • immune-mediated;
  • thrombocytopenia;
  • thromboembolism

Abstract

Objective – To identify and characterize the syndrome of immune-mediated hemolytic anemia (IMHA) with concurrent severe thrombocytopenia (≤15.0 × 109 platelets/L; [15.0 × 103 platelets/μL]), and to evaluate prognostic factors, clinicopathologic findings, complications, treatment, outcome, and survival of dogs with this hematologic disorder.

Design – Retrospective, observational study.

Setting – Veterinary teaching hospital.

Animals – Twelve client-owned dogs with IMHA and severe thrombocytopenia (≤15.0 × 109 platelets/L; [15.0 × 103 platelets/μL]), without evidence of overt disseminated intravascular coagulation.

Interventions – The following data were recorded and analyzed from the electronic medical record: signalment, history, concurrent diseases, clinical signs at presentation, clinicopathologic data, diagnostic testing, radiographic findings, treatment modalities, length of hospitalization, complications, and clinical outcome. All dogs were treated with immunosuppressive doses of corticosteroids.

Measurements and Main Results – Twelve dogs were identified with the diagnosis of IMHA and severe thrombocytopenia; of these, 9 (75%) survived, 3 (25%) were euthanized, and none died. Dogs that survived were significantly younger than nonsurvivors (P=0.03). There were no specific clinical signs or therapies associated with survival.

Conclusions – Dogs in this study had a mortality rate similar to reported rates for dogs with either disease alone. Overall, younger dogs were more likely to survive. No association between different treatment modalities and overall survival was identified.