Evaluation of the safety and feasibility of extracorporeal therapy: therapeutic plasma exchange in dogs - report of five cases.

Abstract

BACKGROUND: Therapeutic plasma exchange (TPE) has been used in immunological diseases, conditions of hyperviscosity, and the removal of protein-bound drugs and toxins. Although complications may be encountered, its use has been reported to offer some degree of safety and clinical improvement for dogs. This case report aimed to describe the feasibility and safety of TPE in dogs. CASE PRESENTATION: Five dogs with immune-mediated hemolytic anemia (IMHA) and/or canine visceral leishmaniasis (CVL) not responsive to immunosuppressive treatment underwent TPE by centrifugation. Physical, laboratory, and cardiovascular parameters were assessed pre- and post-TPE. Although one dog presented with angioedema and another dog presented with neurological signs (nystagmus) during the procedure, no other significant hemodynamic or hemostatic complications were observed, and both the physical and cardiovascular parameters remained stable post-TPE. Both angioedema and nystagmus were controlled at post-TPE. A tendency for a decrease in serum protein and ionic calcium was the main laboratory finding. CONCLUSIONS: Centrifugation-based TPE is a safe and feasible therapy in dogs with IMHA and CVL. Attention should be given to hypocalcemia, the tendency toward hypoproteinemia, and secondary complications such as the occurrence of neurological signs.