Use of recombinant human erythropoietin for management of anemia in dogs and cats with renal failure

Larry D. Cowgill From the Department of Medicine and Epidemiology (Cowgill) and the Veterinary Medical Teaching Hospital (James, Levy, Lobingier), School of Veterinary Medicine, University of California, Davis, CA 95616-8734; The Cat Hospital, 163 E Hamilton Ave, Campbell, CA 95008 (James); and AMGEN, 1840 DeHavilland Dr., Amgen Center, Thousand Oaks, CA 91320-1789 (Browne, Miller, Egrie).

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Katherine M. James From the Department of Medicine and Epidemiology (Cowgill) and the Veterinary Medical Teaching Hospital (James, Levy, Lobingier), School of Veterinary Medicine, University of California, Davis, CA 95616-8734; The Cat Hospital, 163 E Hamilton Ave, Campbell, CA 95008 (James); and AMGEN, 1840 DeHavilland Dr., Amgen Center, Thousand Oaks, CA 91320-1789 (Browne, Miller, Egrie).

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Julie K. Levy From the Department of Medicine and Epidemiology (Cowgill) and the Veterinary Medical Teaching Hospital (James, Levy, Lobingier), School of Veterinary Medicine, University of California, Davis, CA 95616-8734; The Cat Hospital, 163 E Hamilton Ave, Campbell, CA 95008 (James); and AMGEN, 1840 DeHavilland Dr., Amgen Center, Thousand Oaks, CA 91320-1789 (Browne, Miller, Egrie).

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Jeff K. Browne From the Department of Medicine and Epidemiology (Cowgill) and the Veterinary Medical Teaching Hospital (James, Levy, Lobingier), School of Veterinary Medicine, University of California, Davis, CA 95616-8734; The Cat Hospital, 163 E Hamilton Ave, Campbell, CA 95008 (James); and AMGEN, 1840 DeHavilland Dr., Amgen Center, Thousand Oaks, CA 91320-1789 (Browne, Miller, Egrie).

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Allan Miller From the Department of Medicine and Epidemiology (Cowgill) and the Veterinary Medical Teaching Hospital (James, Levy, Lobingier), School of Veterinary Medicine, University of California, Davis, CA 95616-8734; The Cat Hospital, 163 E Hamilton Ave, Campbell, CA 95008 (James); and AMGEN, 1840 DeHavilland Dr., Amgen Center, Thousand Oaks, CA 91320-1789 (Browne, Miller, Egrie).

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Robert T. Lobingier From the Department of Medicine and Epidemiology (Cowgill) and the Veterinary Medical Teaching Hospital (James, Levy, Lobingier), School of Veterinary Medicine, University of California, Davis, CA 95616-8734; The Cat Hospital, 163 E Hamilton Ave, Campbell, CA 95008 (James); and AMGEN, 1840 DeHavilland Dr., Amgen Center, Thousand Oaks, CA 91320-1789 (Browne, Miller, Egrie).

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Joan C. Egrie From the Department of Medicine and Epidemiology (Cowgill) and the Veterinary Medical Teaching Hospital (James, Levy, Lobingier), School of Veterinary Medicine, University of California, Davis, CA 95616-8734; The Cat Hospital, 163 E Hamilton Ave, Campbell, CA 95008 (James); and AMGEN, 1840 DeHavilland Dr., Amgen Center, Thousand Oaks, CA 91320-1789 (Browne, Miller, Egrie).

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Objective

To test efficacy and safety of recombinant human erythropoietin (r-HuEPO) administration in dogs and cats with naturally developing chronic renal failure.

Design

Case series.

Animals

6 client-owned dogs and 11 client-owned cats with chronic renal failure.

Procedures

r-HuEPO was administered intravenously or subcutaneously. Erythropoietic effects were monitored by determining CBC, performing cytologic examination of bone marrow aspirates, and measuring serum iron concentration before and during treatment. Development of adverse effects was monitored by performing sequential clinical assessments, CBC, and serum biochemical tests and by measuring indirect blood pressure and anti-r-HuEPO antibody titers.

Results

Administration of r-HuEPO increased RBC and reticulocyte counts, hemoglobin concentration, and Hct comparably in dogs and cats. Assessments of clinical well-being, including appetite, energy, weight gain, alertness, strength, and playfulness, were improved variably. Adverse effects, including anemia, anti-r-HuEPO antibody production, seizures, systemic hypertension, and iron deficiency, were demonstrated inconsistently in dogs and cats.

Clinical Implications

Anemia contributes to clinical manifestations of chronic renal failure in dogs and cats. Administration of r-HuEPO has the potential to resolve anemia and improve clinical well-being. However, its administration poses risks of antibody production and adverse effects associated with correction of RBC mass. Use of r-HuEPO in dogs and cats requires conscientious assessment of risks and benefits until homologous forms of erythropoietin are available. (J Am Vet Med Assoc 1998; 212:521-528)

Objective

To test efficacy and safety of recombinant human erythropoietin (r-HuEPO) administration in dogs and cats with naturally developing chronic renal failure.

Design

Case series.

Animals

6 client-owned dogs and 11 client-owned cats with chronic renal failure.

Procedures

r-HuEPO was administered intravenously or subcutaneously. Erythropoietic effects were monitored by determining CBC, performing cytologic examination of bone marrow aspirates, and measuring serum iron concentration before and during treatment. Development of adverse effects was monitored by performing sequential clinical assessments, CBC, and serum biochemical tests and by measuring indirect blood pressure and anti-r-HuEPO antibody titers.

Results

Administration of r-HuEPO increased RBC and reticulocyte counts, hemoglobin concentration, and Hct comparably in dogs and cats. Assessments of clinical well-being, including appetite, energy, weight gain, alertness, strength, and playfulness, were improved variably. Adverse effects, including anemia, anti-r-HuEPO antibody production, seizures, systemic hypertension, and iron deficiency, were demonstrated inconsistently in dogs and cats.

Clinical Implications

Anemia contributes to clinical manifestations of chronic renal failure in dogs and cats. Administration of r-HuEPO has the potential to resolve anemia and improve clinical well-being. However, its administration poses risks of antibody production and adverse effects associated with correction of RBC mass. Use of r-HuEPO in dogs and cats requires conscientious assessment of risks and benefits until homologous forms of erythropoietin are available. (J Am Vet Med Assoc 1998; 212:521-528)

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