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Influence of drug treatment on survival of dogs with immune-mediated hemolytic anemia: 88 cases (1989–1999)

Sophie A. Grundy BVSc1,2 and Claudia Barton DVM, DACVIM3
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  • 1 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX, 77843–4474.
  • | 2 Present address is the Department of Medicine and Epidemiology, Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616.
  • | 3 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX, 77843–4474.

Abstract

Objective—To evaluate association of various treatments for immune-mediated hemolytic anemia with survival to discharge in dogs.

Design—Retrospective cross-sectional analysis.

Animals—88 dogs with idiopathic immune-mediated hemolytic anemia.

Procedure—Medical records of dogs with immunemediated hemolytic anemia treated between August 1989 and August 1999 were examined. Survival to discharge, PCV at referral, autoagglutination, and drug treatment and dosage were recorded.

Results—Treatments included administration of prednisone, dexamethasone, azathioprine, danazol, cyclosporine, cyclophosphamide, bovine hemoglobin solution, and human immunoglobulin. Overall mortality rate was 50.5%. Significant associations with death were not detected for use of azathioprine, cyclosporine, danazol, or human immunoglobulin. A significant difference in mortality rate was not detected between use of multiple immunosuppressive drug treatments and use of single immunosuppressive drugs. Use of cyclophosphamide and bovine hemoglobin solution were associated with significant increases in relative risk of death.

Conclusions and Clinical Relevance—Results suggest that use of cyclophosphamide and bovine hemoglobin solution in treatment of idiopathic immunemediated hemolytic anemia may be associated with increased risk of death. (J Am Vet Med Assoc 2001;218:543–546)

Abstract

Objective—To evaluate association of various treatments for immune-mediated hemolytic anemia with survival to discharge in dogs.

Design—Retrospective cross-sectional analysis.

Animals—88 dogs with idiopathic immune-mediated hemolytic anemia.

Procedure—Medical records of dogs with immunemediated hemolytic anemia treated between August 1989 and August 1999 were examined. Survival to discharge, PCV at referral, autoagglutination, and drug treatment and dosage were recorded.

Results—Treatments included administration of prednisone, dexamethasone, azathioprine, danazol, cyclosporine, cyclophosphamide, bovine hemoglobin solution, and human immunoglobulin. Overall mortality rate was 50.5%. Significant associations with death were not detected for use of azathioprine, cyclosporine, danazol, or human immunoglobulin. A significant difference in mortality rate was not detected between use of multiple immunosuppressive drug treatments and use of single immunosuppressive drugs. Use of cyclophosphamide and bovine hemoglobin solution were associated with significant increases in relative risk of death.

Conclusions and Clinical Relevance—Results suggest that use of cyclophosphamide and bovine hemoglobin solution in treatment of idiopathic immunemediated hemolytic anemia may be associated with increased risk of death. (J Am Vet Med Assoc 2001;218:543–546)