INTRAVENOUS ADMINISTRATION OF HUMAN IMMUNE GLOBULIN IN DOGS WITH IMMUNE-MEDIATED HEMOLYTIC-ANEMIA

Objective--To evaluate the efficacy and safety of intravenous administ ration of human immune globulin in the treatment of dogs with immune-m ediated hemolytic anemia (IMHA). Design--Prospective clinical trial. A nimals--10 dogs with confirmed primary IMHA that had failed to respond to conventional immunosuppressive treatment (administration of predni sone and cyclophosphamide or azathioprine). Procedure--Diagnosis of IM HA was confirmed by detecting spherocytosis or autoagglutination in bl ood smears and by excluding secondary causes of IMHA. Dogs were treate d with human immune globulin (1 g/kg [0.45 g/lb] of body weight, IV) d uring a 6- to 12-hour period. Prednisone treatment was continued in al l dogs, and cyciophosphamide treatment was continued in 4. Results--Me dian duration of prior immunosuppressive treatment was 12.5 days. Shor t-term response could not be evaluated in 2 dogs, because they were gi ven blood transfusions within 7 days after immune globulin treatment. However, there was a significant increase in mean Hct and hemoglobin c oncentration in 8 other dogs from day 0 to 28 after treatment. Five do gs had clinically meaningful responses to treatment. Three dogs were a live 12 months after treatment. There were not any adverse effects tha t could be definitively attributed to immune globulin treatment; howev er, thrombocytopenia was observed in 6 dogs after treatment, and evide nce of thromboembolism was detected at necropsy in 5 of the 7 dogs tha t died. Clinical Implications--Human immune globulin may be useful for short-term stabilization of some dogs with IMHA; however, it did not appear to improve long-term survival.