The AHT is the UK’s leading veterinary and scientific research charity and we are working with other leading veterinary specialist centres on an exciting new project. With your help, together we can not only save one animal’s life, we can save thousands…
Immune-mediated haemolytic anaemia (IMHA) is a common haematological disease of dogs. The primary disease process involves destruction of a patient’s red blood cells by their own immune system leading to the development of anaemia. Treatment involves immunosuppression of the patient to prevent this process. Until immunosuppression is effective, patients can be supported with a range of therapies including blood transfusion to treat the anaemia. Despite the increasing availability of transfusions, mortality for patients with IMHA remains high - reported to be between 30 and 70%.
Current Treatment and Research
Despite the wide array of immunosuppressive treatment protocols that have been described for the treatment of IMHA, best practice remains highly controversial. It is typically accepted that corticosteroids are a mainstay of therapy, although evidence supporting this is lacking. Many additional immunosuppressive therapies have been used and described, including azathioprine, cyclosporine A and mycophenolate mofetil. Use of these has mainly been described in retrospective or non-randomized trials, making their benefit unclear. Where prospective, randomized trials have previously been conducted, investigating cyclophosphamide or human intravenous immunoglobulin then these either showed no survival benefit or a disadvantage associated with the use of these additional drugs.
Is there a more effective Treatment?
Intravenous immunoglobulins are thought to have many potential immunomodulatory effects, and these include inhibition of phagocytosis and inhibition of complement activation, meaning that this treatment may be relatively unique in its ability to accelerate remission in IMHA.
The Animal Health Trust recently received a generous donation of Pentaglobin, an IgM enriched form of hIVIG from the family of a human patient. A study in new-born humans with haemolytic anaemia (Aqrabawi 2013) found that this drug was effective in rapidly inhibiting further haemolysis in most patients that received it.
To determine if administration of Pentaglobin at the time of initial diagnosis of IMHA in dogs is beneficial for their outcome.
Pentaglobin administration will improve survival in dogs with IMHA when given in addition to conventional therapies, compared to dogs that do not receive pentaglobin. Pentaglobin will be associated with a more rapid remission in dogs with IMHA. Pentaglobin will be associated with a decreased transfusion requirement in dogs with IMHA.
How Can You Help?
As part of a multi-centre study, collaborating with Dick White Referrals, Davies Veterinary Specialists and Cambridge University, we need to test Pentaglobin’s effect on dogs admitted to participating hospitals that have been diagnosed with IMHA. Participation will be voluntary, with informed owner consent at the time of hospital admission, or once sufficient diagnostics are performed to meet the inclusion criteria.
For more information about the study and what to do if you see a case suffering from IMHA, please contact your local study centre:
Animal Health Trust – Lead Investigators
Mellora Sharman and Mayank Seth
Dick White Referrals
Davies Veterinary Specialists
The Queen’s Veterinary School Hospital
University of Cambridge
Barbara Skelly and Mike Herrtage