Successful treatment of presumptive immune mediated thrombocytopenia and dermatitis with azathioprine in a pregnant mare

Abstract

Summary This report describes the successful treatment of immune‐mediated thrombocytopenia (IMTP) with azathioprine in a pregnant mare that had been refractory to therapy with dexamethasone. The interesting features of this case included the presence of dermatitis, a clinical presentation not previously associated with IMTP in the equine literature and the maintenance of pregnancy and delivery of a healthy normal foal despite immunosuppressive therapy with azathioprine during critical stages of early gestation.

Septic funiculitis caused byStreptococcus equisubspeciesequiinfection with associated immune‐mediated haemolytic anaemia

“…There is limited data on the use of azathioprine for immunosuppressive therapy in the horse; however, this case report adds increasing support for its use to the handful of case reports previously published in the literature. Despite limited oral bioavailabity (White et al 2005), azathioprine has been used successfully to treat IMHA in one horse, immune-mediated thrombocytopenia in 4 horses and immune-mediated polysynovitis in 2 horses (Humber et al 1991;Messer and Arnold 1991;McGuirrin et al 2004;Pusterla et al 2006;Hardefeldt et al 2010). Reasons for its use have been due to failure to respond to corticosteroid treatment or concern over laminitis with corticosteroid treatment, as was the rationale in this case (Messer and Arnold 1991;Hardefeldt et al 2010).…”

“…; Hardefeldt et al . ). Reasons for its use have been due to failure to respond to corticosteroid treatment or concern over laminitis with corticosteroid treatment, as was the rationale in this case (Messer and Arnold ; Hardefeldt et al .…”

“…Reasons for its use have been due to failure to respond to corticosteroid treatment or concern over laminitis with corticosteroid treatment, as was the rationale in this case (Messer and Arnold ; Hardefeldt et al . ). Its immunosuppressive effects are most likely due to signal pathway inhibition of T cells, suppression of antigen‐specific B cell responses and suppression of inflammatory cytokines (Divers ).…”

“…Despite limited oral bioavailabity (White et al 2005), azathioprine has been used successfully to treat IMHA in one horse, immune-mediated thrombocytopenia in 4 horses and immune-mediated polysynovitis in 2 horses (Humber et al 1991;Messer and Arnold 1991;McGuirrin et al 2004;Pusterla et al 2006;Hardefeldt et al 2010). Reasons for its use have been due to failure to respond to corticosteroid treatment or concern over laminitis with corticosteroid treatment, as was the rationale in this case (Messer and Arnold 1991;Hardefeldt et al 2010). Its immunosuppressive effects are most likely due to signal pathway inhibition of T cells, suppression of antigen-specific B cell responses and suppression of inflammatory cytokines (Divers 2010).…”

Intestinal biopsies for investigating and managing inflammatory bowel disease in horses

“…There is a single case report describing its use in IBD, although there is some anecdotal evidence that it is a useful adjunct to corticosteroid therapy in IBD in horses (Divers 2010). The reported dose rate is 3 mg/kg administered orally every 24 hours (Hardefeldt and others 2010), and the dosage is tapered before discontinuation.…”