Human intravenous immunoglobulin use for hematological immune-mediated disease in dogs

Abstract

OBJECTIVE To report on survival rates and risk factors in dogs with immune-mediated hemolytic anemia (IMHA) and immune-mediated thrombocytopenia (ITP) treated with human IV immunoglobulin (hIVIG; Privigen). We hypothesized that hIVIG could be used as a salvage treatment to improve survival and reduce the requirement for ongoing blood transfusion therapy in IMHA and ITP patients. ANIMALS 52 client-owned dogs with IMHA or ITP were included, comprising 31 females (28 spayed and 3 entire) and 21 males (19 castrated and 2 entire). Miniature Schnauzers were the most common breed (5), with a further 24 different breeds identified. PROCEDURES A retrospective cohort study was conducted between January 2006 and January 2022 that assessed the survival rates, risk factors, and need for ongoing transfusion in dogs with IMHA and ITP treated with hIVIG compared with those not receiving hIVIG. RESULTS Of 36 dogs that did not receive hIVIG, 29 (80%) survived and 7 (24%) died, and of 16 dogs administered hIVIG, 11 (69%) survived and 5 (31%) died (P = .56). No effect of PCV at admission or age on the risk of death was detected (OR, 1.00; 95% CI, 0.94 to 1.08; P = .89; and OR, 1.10; 95% CI, 0.85 to 1.47; P = .47, respectively). CLINICAL RELEVANCE This was the largest study to date of dogs with hematological immune-mediated disease treated with hIVIG. There was no difference in survival rates for dogs that received hIVIG versus those treated with standard immunosuppression. The benefit of hIVIG as a salvage treatment appears limited.

Use of human intravenous immunoglobulin for the treatment of 12 dogs with newly diagnosed malignant disease and presumed secondary immune‐mediated thrombocytopenia

“…Blockade of Fc receptors on mononuclear phagocytic cells has been described as a mechanism of action for the observed response to hIVIg infusion in dogs (Reagan et al ., 1998). Reports of safe use of hIVIg in dogs with IMT have been surfacing in the veterinary literature for the past two to three decades (Kane & Greer, 2023; Spurlock & Prittie, 2011). Evidence of rapid platelet count recovery after hIVIg infusion as an adjunctive therapy for the acute management of dogs with presumptive primary IMT is well described (Back et al ., 2013; Balog et al ., 2013; Bianco et al ., 2007; Bianco et al ., 2009; Bianco & Hardy, 2009; Fathi & Jamshidi, 2014; Huang et al ., 2012; Scott‐Moncrieff & Reagan, 1997).…”

Do platelets prematurely age in canine immune thrombocytopenia (ITP)? Development of a novel flow cytometric assay to assess the role of platelet desialylation in ITP pathogenesis

“…[84][85][86] IVIG use has rarely been reported in dogs, and like splenectomy, autoantibodies have not been measured. 3,26,87 If our assay can demonstrate differences in desialylation between dogs with ITP and healthy dogs, our assay could potentially help guide which therapies are most likely to be successful in certain subpopulations of ITP dogs.…”