A prospective, randomized, double-blinded, placebo-controlled study of human intravenous immunoglobulin for the acute management of presumptive primary immune-mediated thrombocytopenia in dogs

J Vet Intern Med. 2009 Sep-Oct;23(5):1071-8. doi: 10.1111/j.1939-1676.2009.0358.x. Epub 2009 Aug 5.

Abstract

Background: Immune-mediated thrombocytopenia (IMT) is a common hematologic disorder in dogs. Human intravenous immunoglobulin (hIVIG) may have a beneficial effect in canine IMT.

Hypothesis: A single hIVIG infusion (0.5 g/kg) in dogs with presumed primary IMT (pIMT) is a safe adjunctive emergency treatment to accelerate platelet count recovery and shorten hospitalization time without increasing the cost of patient care.

Animals: Eighteen client-owned dogs with a presumptive diagnosis of pIMT.

Methods: Prospective, randomized, double-blinded, placebo-controlled clinical trial.

Results: There were no identifiable immediate or delayed adverse reactions associated with hIVIG administration over a 6-month period. The median platelet count recovery time for the hIVIG group was 3.5 days (mean + or - SD: 3.7 + or - 1.3 days; range, 2-7 days) and 7.5 days (mean + or - SD: 7.8 + or - 3.9 days; range, 3-12 days) for the placebo group. The median duration of hospitalization for hIVIG group was 4 days (mean + or - SD: 4.2 + or - 0.4 days; range, 2-8 days) and 8 days (mean + or - SD: 8.3 + or - 0.6 days; range, 4-12 days) for the placebo group. There was no significant difference between groups with respect to expense of initial patient care, whereas significant reduction in platelet count recovery time (P= .018) and duration of hospitalization (P= .027) were detected in the hIVIG group.

Conclusions and clinical importance: Compared with corticosteroids alone, adjunctive emergency therapy of a single hIVIG infusion was safe and associated with a significant reduction in platelet count recovery time and duration of hospitalization without increasing the expense of medical care in a small group of dogs with presumed pIMT.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Animals
  • Dog Diseases / blood
  • Dog Diseases / drug therapy*
  • Dog Diseases / immunology
  • Dogs
  • Double-Blind Method
  • Female
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Infusions, Intravenous / veterinary
  • Male
  • Platelet Count / veterinary
  • Prospective Studies
  • Purpura, Thrombocytopenic, Idiopathic / blood
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy
  • Purpura, Thrombocytopenic, Idiopathic / immunology
  • Purpura, Thrombocytopenic, Idiopathic / veterinary*

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulins, Intravenous