Investigation of the therapeutic effects, predictors, and complications of long-term immunosuppressive therapy in dogs with precursor-targeted immune-mediated anemia
Dogs with precursor-targeted immune-mediated anemia (PIMA) are commonly treated with immunosuppressive therapy, but information on predictors of treatment response and response time is limited. Therefore, we retrospectively investigated predictive factors that influenced the treatment response and d...
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| Published in | Journal of Veterinary Medical Science Vol. 85; no. 7; pp. 695 - 701 |
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| Format | Journal Article |
| Language | English |
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Japan
JAPANESE SOCIETY OF VETERINARY SCIENCE
01.07.2023
Japan Science and Technology Agency The Japanese Society of Veterinary Science |
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| Abstract | Dogs with precursor-targeted immune-mediated anemia (PIMA) are commonly treated with immunosuppressive therapy, but information on predictors of treatment response and response time is limited. Therefore, we retrospectively investigated predictive factors that influenced the treatment response and duration required to observe a response in dogs with PIMA receiving continuous immunosuppressive therapies for more than 105 days. Of 50 client-owned dogs that developed PIMA, 27 were included in this study, of which 18 were responders and 9 were non-responders to immunosuppressive therapies. Sixteen of the 18 responders responded to treatment within 60 days and the remaining 2 responded at 93 and 126 days, respectively. We found that an erythroid-maturation ratio of <0.17 may be a useful predictor for treatment response. In addition, complications of immunosuppressive therapies were investigated further in 50 dogs. Pancreatitis (n=4) and pneumonia (3) occurred over the entire treatment period, and infections such as abscesses (3) tended to be more common in dogs on an extended period of immunosuppressive therapy. These findings may be helpful when planning for the initial treatment and may provide evidence for informed consent about potential comorbidities throughout the treatment course. |
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| AbstractList | Dogs with precursor-targeted immune-mediated anemia (PIMA) are commonly treated with immunosuppressive therapy, but information on predictors of treatment response and response time is limited. Therefore, we retrospectively investigated predictive factors that influenced the treatment response and duration required to observe a response in dogs with PIMA receiving continuous immunosuppressive therapies for more than 105 days. Of 50 client-owned dogs that developed PIMA, 27 were included in this study, of which 18 were responders and 9 were non-responders to immunosuppressive therapies. Sixteen of the 18 responders responded to treatment within 60 days and the remaining 2 responded at 93 and 126 days, respectively. We found that an erythroid-maturation ratio of <0.17 may be a useful predictor for treatment response. In addition, complications of immunosuppressive therapies were investigated further in 50 dogs. Pancreatitis (n=4) and pneumonia (3) occurred over the entire treatment period, and infections such as abscesses (3) tended to be more common in dogs on an extended period of immunosuppressive therapy. These findings may be helpful when planning for the initial treatment and may provide evidence for informed consent about potential comorbidities throughout the treatment course.Dogs with precursor-targeted immune-mediated anemia (PIMA) are commonly treated with immunosuppressive therapy, but information on predictors of treatment response and response time is limited. Therefore, we retrospectively investigated predictive factors that influenced the treatment response and duration required to observe a response in dogs with PIMA receiving continuous immunosuppressive therapies for more than 105 days. Of 50 client-owned dogs that developed PIMA, 27 were included in this study, of which 18 were responders and 9 were non-responders to immunosuppressive therapies. Sixteen of the 18 responders responded to treatment within 60 days and the remaining 2 responded at 93 and 126 days, respectively. We found that an erythroid-maturation ratio of <0.17 may be a useful predictor for treatment response. In addition, complications of immunosuppressive therapies were investigated further in 50 dogs. Pancreatitis (n=4) and pneumonia (3) occurred over the entire treatment period, and infections such as abscesses (3) tended to be more common in dogs on an extended period of immunosuppressive therapy. These findings may be helpful when planning for the initial treatment and may provide evidence for informed consent about potential comorbidities throughout the treatment course. Dogs with precursor-targeted immune-mediated anemia (PIMA) are commonly treated with immunosuppressive therapy, but information on predictors of treatment response and response time is limited. Therefore, we retrospectively investigated predictive factors that influenced the treatment response and duration required to observe a response in dogs with PIMA receiving continuous immunosuppressive therapies for more than 105 days. Of 50 client-owned dogs that developed PIMA, 27 were included in this study, of which 18 were responders and 9 were non-responders to immunosuppressive therapies. Sixteen of the 18 responders responded to treatment within 60 days and the remaining 2 responded at 93 and 126 days, respectively. We found that an erythroid-maturation ratio of <0.17 may be a useful predictor for treatment response. In addition, complications of immunosuppressive therapies were investigated further in 50 dogs. Pancreatitis (n=4) and pneumonia (3) occurred over the entire treatment period, and infections such as abscesses (3) tended to be more common in dogs on an extended period of immunosuppressive therapy. These findings may be helpful when planning for the initial treatment and may provide evidence for informed consent about potential comorbidities throughout the treatment course. Dogs with precursor-targeted immune-mediated anemia (PIMA) are commonly treated with immunosuppressive therapy, but information on predictors of treatment response and response time is limited. Therefore, we retrospectively investigated predictive factors that influenced the treatment response and duration required to observe a response in dogs with PIMA receiving continuous immunosuppressive therapies for more than 105 days. Of 50 client-owned dogs that developed PIMA, 27 were included in this study, of which 18 were responders and 9 were non-responders to immunosuppressive therapies. Sixteen of the 18 responders responded to treatment within 60 days and the remaining 2 responded at 93 and 126 days, respectively. We found that an erythroid-maturation ratio of <0.17 may be a useful predictor for treatment response. In addition, complications of immunosuppressive therapies were investigated further in 50 dogs. Pancreatitis (n=4) and pneumonia (3) occurred over the entire treatment period, and infections such as abscesses (3) tended to be more common in dogs on an extended period of immunosuppressive therapy. These findings may be helpful when planning for the initial treatment and may provide evidence for informed consent about potential comorbidities throughout the treatment course. |
| ArticleNumber | 23-0010 |
| Author | SASAKI, Noboru TAKIGUCHI, Mitsuyoshi KAGAWA, Yumiko YOKOYAMA, Nozomu SUGAWARA-SUDA, Mei IWANAGA, Yuto NAKAMURA, Kensuke MORISHITA, Keitaro OHTA, Hiroshi YAMAZAKI, Jumpei |
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| Keywords | immunosuppressive therapy non-regenerative immune-mediated anemia erythroid-maturation ratio canine |
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| References | 15. Weiss DJ. 2008. Bone marrow pathology in dogs and cats with non-regenerative immune-mediated haemolytic anaemia and pure red cell aplasia. J Comp Pathol 138: 46–53. 16. Weiss DJ. 2002. Primary pure red cell aplasia in dogs: 13 cases (1996–2000). J Am Vet Med Assoc 221: 93–95. 8. Lucidi CA, de Rezende CLE, Jutkowitz LA, Scott MA. 2017. Histologic and cytologic bone marrow findings in dogs with suspected precursor-targeted immune-mediated anemia and associated phagocytosis of erythroid precursors. Vet Clin Pathol 46: 401–415. 7. Lucidi CA, Gerlach JA, Jutkowitz A, Scott MA. 2021. Immunoglobulin G and phosphatidylserine in regenerative and nonregenerative immune-mediated anemias of dogs. J Vet Intern Med 35: 2713–2721. 11. Scott-Moncrieff JC, Reagan WJ, Glickman LT, DeNicola DB, Harrington D. 1995. Treatment of nonregenerative anemia with human gamma-globulin in dogs. J Am Vet Med Assoc 206: 1895–1900. 1. Assenmacher TD, Jutkowitz LA, Koenigshof AM, de A Lucidi C, Scott MA. 2019. Clinical features of precursor-targeted immune-mediated anemia in dogs: 66 cases (2004–2013). J Am Vet Med Assoc 255: 366–376. 2. Bestwick JP, Skelly BJ, Swann JW, Glanemann B, Bexfield N, Gkoka Z, Walker DJ, Silvestrini P, Adamantos S, Seth M, Warland J. 2022. Splenectomy in the management of primary immune-mediated hemolytic anemia and primary immune-mediated thrombocytopenia in dogs. J Vet Intern Med 36: 1267–1280. 14. Tani A, Tomiyasu H, Ohmi A, Ohno K, Tsujimoto H. 2020. Clinical and clinicopathological features and outcomes of Miniature Dachshunds with bone marrow disorders. J Vet Med Sci 82: 771–778. 3. Cowgill ES, Neel JA, Grindem CB. 2003. Clinical application of reticulocyte counts in dogs and cats. Vet Clin North Am Small Anim Pract 33: 1223–1244, v. 4. Cummings FO, Rizzo SA. 2017. Treatment of presumptive primary immune-mediated thrombocytopenia with mycophenolate mofetil versus cyclosporine in dogs. J Small Anim Pract 58: 96–102. 10. Nakagawa T, Doi A, Ohno K, Yokoyama N, Tsujimoto H. 2019. Clinical features and prognosis of canine megaesophagus in Japan. J Vet Med Sci 81: 348–352. 9. McAtee BB, Cummings KJ, Cook AK, Lidbury JA, Heseltine JC, Willard MD. 2017. Opportunistic invasive cutaneous fungal infections associated with administration of cyclosporine to dogs with immune-mediated disease. J Vet Intern Med 31: 1724–1729. 17. Weiss DJ, Aird B. 2001. Cytologic evaluation of primary and secondary myelodysplastic syndromes in the dog. Vet Clin Pathol 30: 67–75. 12. Stockham SL, Ford RB, Weiss DJ. 1980. Canine autoimmune hemolytic disease with a delayed erythroid regeneration. J Am Anim Hosp Assoc 16: 927–931. 5. Garden OA, Kidd L, Mexas AM, Chang YM, Jeffery U, Blois SL, Fogle JE, MacNeill AL, Lubas G, Birkenheuer A, Buoncompagni S, Dandrieux JRS, Di Loria A, Fellman CL, Glanemann B, Goggs R, Granick JL, LeVine DN, Sharp CR, Smith-Carr S, Swann JW, Szladovits B. 2019. ACVIM consensus statement on the diagnosis of immune-mediated hemolytic anemia in dogs and cats. J Vet Intern Med 33: 313–334. 13. Stokol T, Blue JT, French TW. 2000. Idiopathic pure red cell aplasia and nonregenerative immune-mediated anemia in dogs: 43 cases (1988–1999). J Am Vet Med Assoc 216: 1429–1436. 18. Woolhead VL, Szladovits B, Chan A, Swann JW, Glanemann B. 2021. Breed predispositions, clinical findings, and prognostic factors for death in dogs with nonregenerative immune-mediated anemia. J Vet Intern Med 35: 252–260. 6. Harvey JW. 2011. Veterinary Hematology, Elsevier Health Sciences, Amsterdam. 11 12 13 14 15 16 17 18 1 2 3 4 5 6 7 8 9 10 |
| References_xml | – reference: 10. Nakagawa T, Doi A, Ohno K, Yokoyama N, Tsujimoto H. 2019. Clinical features and prognosis of canine megaesophagus in Japan. J Vet Med Sci 81: 348–352. – reference: 6. Harvey JW. 2011. Veterinary Hematology, Elsevier Health Sciences, Amsterdam. – reference: 8. Lucidi CA, de Rezende CLE, Jutkowitz LA, Scott MA. 2017. Histologic and cytologic bone marrow findings in dogs with suspected precursor-targeted immune-mediated anemia and associated phagocytosis of erythroid precursors. Vet Clin Pathol 46: 401–415. – reference: 2. Bestwick JP, Skelly BJ, Swann JW, Glanemann B, Bexfield N, Gkoka Z, Walker DJ, Silvestrini P, Adamantos S, Seth M, Warland J. 2022. Splenectomy in the management of primary immune-mediated hemolytic anemia and primary immune-mediated thrombocytopenia in dogs. J Vet Intern Med 36: 1267–1280. – reference: 9. McAtee BB, Cummings KJ, Cook AK, Lidbury JA, Heseltine JC, Willard MD. 2017. Opportunistic invasive cutaneous fungal infections associated with administration of cyclosporine to dogs with immune-mediated disease. J Vet Intern Med 31: 1724–1729. – reference: 11. Scott-Moncrieff JC, Reagan WJ, Glickman LT, DeNicola DB, Harrington D. 1995. Treatment of nonregenerative anemia with human gamma-globulin in dogs. J Am Vet Med Assoc 206: 1895–1900. – reference: 12. Stockham SL, Ford RB, Weiss DJ. 1980. Canine autoimmune hemolytic disease with a delayed erythroid regeneration. J Am Anim Hosp Assoc 16: 927–931. – reference: 7. Lucidi CA, Gerlach JA, Jutkowitz A, Scott MA. 2021. Immunoglobulin G and phosphatidylserine in regenerative and nonregenerative immune-mediated anemias of dogs. J Vet Intern Med 35: 2713–2721. – reference: 4. Cummings FO, Rizzo SA. 2017. Treatment of presumptive primary immune-mediated thrombocytopenia with mycophenolate mofetil versus cyclosporine in dogs. J Small Anim Pract 58: 96–102. – reference: 18. Woolhead VL, Szladovits B, Chan A, Swann JW, Glanemann B. 2021. Breed predispositions, clinical findings, and prognostic factors for death in dogs with nonregenerative immune-mediated anemia. J Vet Intern Med 35: 252–260. – reference: 5. Garden OA, Kidd L, Mexas AM, Chang YM, Jeffery U, Blois SL, Fogle JE, MacNeill AL, Lubas G, Birkenheuer A, Buoncompagni S, Dandrieux JRS, Di Loria A, Fellman CL, Glanemann B, Goggs R, Granick JL, LeVine DN, Sharp CR, Smith-Carr S, Swann JW, Szladovits B. 2019. ACVIM consensus statement on the diagnosis of immune-mediated hemolytic anemia in dogs and cats. J Vet Intern Med 33: 313–334. – reference: 1. Assenmacher TD, Jutkowitz LA, Koenigshof AM, de A Lucidi C, Scott MA. 2019. Clinical features of precursor-targeted immune-mediated anemia in dogs: 66 cases (2004–2013). J Am Vet Med Assoc 255: 366–376. – reference: 17. Weiss DJ, Aird B. 2001. Cytologic evaluation of primary and secondary myelodysplastic syndromes in the dog. Vet Clin Pathol 30: 67–75. – reference: 3. Cowgill ES, Neel JA, Grindem CB. 2003. Clinical application of reticulocyte counts in dogs and cats. Vet Clin North Am Small Anim Pract 33: 1223–1244, v. – reference: 15. Weiss DJ. 2008. Bone marrow pathology in dogs and cats with non-regenerative immune-mediated haemolytic anaemia and pure red cell aplasia. J Comp Pathol 138: 46–53. – reference: 13. Stokol T, Blue JT, French TW. 2000. Idiopathic pure red cell aplasia and nonregenerative immune-mediated anemia in dogs: 43 cases (1988–1999). J Am Vet Med Assoc 216: 1429–1436. – reference: 14. Tani A, Tomiyasu H, Ohmi A, Ohno K, Tsujimoto H. 2020. Clinical and clinicopathological features and outcomes of Miniature Dachshunds with bone marrow disorders. J Vet Med Sci 82: 771–778. – reference: 16. Weiss DJ. 2002. Primary pure red cell aplasia in dogs: 13 cases (1996–2000). J Am Vet Med Assoc 221: 93–95. – ident: 9 doi: 10.1111/jvim.14824 – ident: 13 doi: 10.2460/javma.2000.216.1429 – ident: 2 doi: 10.1111/jvim.16469 – ident: 12 – ident: 18 doi: 10.1111/jvim.15986 – ident: 3 doi: 10.1016/S0195-5616(03)00099-8 – ident: 7 doi: 10.1111/jvim.16278 – ident: 10 doi: 10.1292/jvms.18-0493 – ident: 17 doi: 10.1111/j.1939-165X.2001.tb00261.x – ident: 5 doi: 10.1111/jvim.15441 – ident: 15 doi: 10.1016/j.jcpa.2007.10.001 – ident: 6 – ident: 8 doi: 10.1111/vcp.12502 – ident: 4 doi: 10.1111/jsap.12621 – ident: 11 doi: 10.2460/javma.1995.206.12.1895 – ident: 16 doi: 10.2460/javma.2002.221.93 – ident: 1 doi: 10.2460/javma.255.3.366 – ident: 14 doi: 10.1292/jvms.19-0439 |
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| Snippet | Dogs with precursor-targeted immune-mediated anemia (PIMA) are commonly treated with immunosuppressive therapy, but information on predictors of treatment... |
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| SubjectTerms | Abscesses Anemia Anemia - veterinary Animals canine Comorbidity Dog Diseases - drug therapy Dogs erythroid-maturation ratio Immunosuppression Therapy - veterinary Immunosuppressive agents Immunosuppressive Agents - therapeutic use immunosuppressive therapy Internal Medicine Investigations non-regenerative immune-mediated anemia Pancreatitis Potassium Iodide - therapeutic use Retrospective Studies |
| Title | Investigation of the therapeutic effects, predictors, and complications of long-term immunosuppressive therapy in dogs with precursor-targeted immune-mediated anemia |
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