Splenectomy in the management of primary immune‐mediated hemolytic anemia and primary immune‐mediated thrombocytopenia in dogs

Abstract

Background: Current reports about the use of splenectomy for the management of immune-mediated hemolytic anemia (IMHA) or immune-mediated thrombocytopenia (ITP) or both in dogs are limited.Objectives: To retrospectively describe the use of splenectomy as part of the management for IMHA, ITP, and concurrent IMHA and severe thrombocytopenia (CIST) in dogs. It was hypothesized that splenectomy would be beneficial in allowing for reduction of dose of immunosuppressive drugs or discontinuation in 1 or more of these groups.Animals: Seventeen client-owned dogs (7 with IMHA, 7 with ITP, and 3 with CIST) were identified across 7 UK-based referral hospitals from a study period of 2005 to 2016.

Non‐regenerative immune‐mediated anaemia in a dog managed following splenectomy and ovarian remnant removal

“…In this second case series, several dogs were reportedly to have non‐regenerative anaemia at the point of diagnosis, although it is not clear whether they could be later classified as pre‐regenerative or NRIMA 6 . In the third study, patients with NRIMA were not separated from cases with regenerative IMHA and it was not possible to assess individual outcomes for cases with NRIMA 8 …”

“…6 In the third study, patients with NRIMA were not separated from cases with regenerative IMHA and it was not possible to assess individual outcomes for cases with NRIMA. 8 In some previous reports, cases of NRIMA were not differentiated from cases of IMHA even if there was no evidence of haemolysis. 2,12,13 In our case, signs of haemolysis were absent, including negative saline agglutination and Coomb's test; absence of hyper bilirubinaemia, haemoglobinuria, haemoglobinaemia; and lack of ghost cells.…”

“…The time to achieve a response to treatment can be prolonged, during which time patients require regular monitoring and, in some cases, repeated blood transfusions 2,3 . Splenectomy has been described as a possible salvage procedure in the management of refractory IMHA in dogs, and it is more widely used in humans for the same condition 5–8 …”

“…2,3 Splenectomy has been described as a possible salvage procedure in the management of refractory IMHA in dogs, and it is more widely used in humans for the same condition. [5][6][7][8] Neuter status and gender have been examined in cases of immune-mediated disease to investigate further the role of sex hormones in autoimmunity. 9 In human medicine, females have a higher incidence of autoimmune diseases than males, which may be related to the role of oestrogen in permitting increased production and maturation of autoantibodies.…”

Septic pericarditis in a complicated case of non-associated immune-mediated hemolytic anemia in a Jack Russel terrier

“…In a study by Horgan et al (2009), ten dogs with IMHA that underwent splenectomy, had an increase in hematocrit three days post-surgery and needed less frequent blood transfusions post-surgery. In another study, four out of seven dogs with IMHA had a partial or complete response to treatment after splenectomy (Bestwick et al, 2022). These outcomes could have been influenced by response to the immunosuppressive therapy since most dogs in both studies were treated in the acute phase of IMHA.…”