Retrospective evaluation of the short-term response of human intravenous immunoglobulin therapy in the management of canine immune-mediated thrombocytopenia (2010-2015): 27 cases.

Abstract

To describe the short-term response, early prognostic markers, and survival after treatment of canine immune-mediated thrombocytopenia (ITP) with human intravenous immunoglobulin (hIVIG) and methylprednisolone. Retrospective cohort study. Private referral veterinary medical center. Twenty-seven client-owned dogs with primary or secondary ITP. All dogs received 2mg/kg IV methylprednisolone once daily and a single infusion of 5% hIVIG administered over 6-12hours. A substantial increase in platelet count within 60±12hours post-hIVIG infusion (T60) was observed in 19 of the 27 (70%) dogs with ITP (responders). Thirty-four variables, including serum immunoglobulin (Ig) G concentration 24±12hours post-hIVIG infusion (T24IgG) and increase in serum IgG concentration 24±12hours post-hIVIG infusion (T24ΔIgG), were compared between responders and nonresponders at 5 different time points. Mortality rates of responders and nonresponders were evaluated 14days post-hIVIG infusion. Serum T24IgG and serum T24ΔIgG were both significantly higher at T60 in responders. All responders were alive 14days post-hIVIG infusion, and their mortality rate was significantly lower compared with nonresponders. Responder dogs had an excellent 14-day survival rate. Serum T24IgG and serum T24ΔIgG concentrations accurately predicted response status at 60hours post-hIVIG infusion.