Objective—To evaluate prognostic factors, survival,
and treatment protocols for immune-mediated
hemolytic anemia (IMHA) in dogs.
Animals—151 dogs with IMHA not associated with
underlying infectious or neoplastic disease.
Procedure—Information recorded from review of medical
records included signalment at the time of initial
evaluation; vaccination history; 30-, 60-, and 365-day follow-up outcomes; laboratory data; results of imaging
studies; and necropsy findings. Dogs were grouped
according to the presence of spherocytes, autoagglutination,
a regenerative erythrocyte response, and treatments
received (azathioprine, azathioprine plus ultralowdose
aspirin, azathioprine plus mixed–molecular-weight
heparin [mHEP], or azathioprine plus ultralow-dose
aspirin plus mHEP) for comparisons. All dogs received
Results—Cocker Spaniels, Miniature Schnauzers,
neutered dogs, and female dogs were overrepresented.
Alterations in certain clinicopathologic variables were
associated with increased mortality rate. Rates of survival
following treatment with azathioprine, azathioprine
plus ultralow-dose aspirin, azathioprine plus mHEP, and
azathioprine plus ultralow-dose aspirin plus mHEP were
74%, 88%, 23%, and 70%, respectively, at hospital discharge;
57%, 82%, 17%, and 67%, respectively, at 30
days; and 45%, 69%, 17%, and 64%, respectively, at 1
year. In comparison, mean survival rates at discharge
and at 30 days and 1 year after evaluation collated from
7 published reviews of canine IMHA were 57%, 58%,
and 34%, respectively.
Conclusions and Clinical Relevance—Treatment
with a combination of glucocorticoids, azathioprine,
and ultralow-dose aspirin significantly improved short-and
long-term survival in dogs with IMHA. (J Am Vet
Med Assoc 2005;226:1869–1880)
Objective—To evaluate factors associated with response to treatment, remission duration, and survival in cats with low-grade lymphoma affecting various organ systems.
Design—Retrospective case series.
Sample Population—41 cats with histologically confirmed low-grade lymphocytic lymphoma.
Procedures—Medical records and biopsy specimens of cats with histologically confirmed low-grade lymphocytic lymphoma of various organ systems treated with prednisone and chlorambucil between 1995 and 2005 were reviewed. The Kaplan-Meier method was used to estimate remission duration and survival. Factors potentially associated with prognosis were compared.
Results—Common clinical signs were weight loss (83%), vomiting (73%), anorexia (66%), and diarrhea (58%). Seventy-eight percent of cats tested had low serum cobalamin concentrations. Lymphoma was confined to the gastrointestinal tract in 68% of cats. Fifty-six percent of cats achieved a complete response to treatment, and 39% achieved a partial response. Five percent of cats had no response. No association was found between any risk factors (including anatomic site) and response to treatment. Partial response was associated with shorter remission duration, compared with complete response; median remission duration was 428 days for cats achieving a partial response, compared with 897 days for cats achieving a complete response. No other factors were associated with remission duration. Overall median survival time was 704 days. No factors were significantly associated with survival time.
Conclusions and Clinical Relevance—Most cats with lymphocytic lymphoma responded to treatment with prednisone and chlorambucil, and most factors evaluated were not associated with outcome.