Association of azathioprine and prednisone in the control of immunomediated hemolytic anemia in dogs / Associação de prednisona e azatioprina na terapêutica de cães portadores de anemia hemolítica imunomediada

Rodrigo Prevedello Franco, Ana Flávia Mendonça, Thaís Yuri Nakamura, Thainá Pires dos Santos Sauniti, Beatriz Teixeira Martuchi


Immune-mediated hemolytic anemia (IMHA) is an immunological disease, in which the immune-mediated destruction of erythrocytes occurs, leading to a prominent drop in globular volume (GV). The diagnosis of the disease must be made through the association of clinical manifestations with specific complementary exams, with therapy aimed at inhibiting intravascular hemolysis in the control of GV. The present study aims to report the therapeutic association of prednisone and azathioprine in the control of IMHA in two dogs, demonstrating its evolution and the clinical effects of the pharmacological association. At the Veterinary Hospital of UNIMAR, a canine, female, Blue Heeler breed, seven years old and a canine, male, Border Collie breed, seven months old, both showing apathy, hyporexia, progressive weight loss, regenerative anemia, leukocytosis, and test of positive saline autoagglutination. After IMHA was diagnosed, polytherapy with prednisone (2mg/kg/SID) associated with azathioprine (2/mg/kg/SID) was instituted. Initially, the first animal showed liver damage due to the side effects of the drugs. As for the control of IMHA, the two animals described showed improvement and stabilization of the clinical and hematological condition after the association, making it possible to reduce the dosages of both drugs without worsening the conditions and ceasing the side effects caused by the chronic use of the drugs. Through this report it is possible to conclude that the use of the therapeutic combination of prednisone and azathioprine for the control of IMHA has greater benefits, being possible to use lower doses of both drugs, reducing their side effects and, consequently, resulting in a better survival.



Azathioprine, Immune-mediated hemolytic anemia, Prednisone.

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BALCH, A.; MACKIN, A. Canine Imunne-Mediated Hemolytic Anemia: Pathophysiology, Clinical Signs, and Diagnosis. Compendium on Continuing Education fot the Practising Veterinarian, v. 29, n. 4, p. 217-225, 2007.

BRANDÃO, L. P.; HAGIWARA, M. K.; FRANCHINI, L. M.; Immunomediated Hemolytic Anemia in Dogs – diagnosis and treatment. Magazine Veterinary Clinic, n. 44. p. 46-54, 2003.

BURGESS, K., MOORE, A.; RAND, W.; COTTER, S.M. Treatment of immunemediated hemolytic anemia in dogs with cyclophosphamide. Journal of Veterinary Internal Medicine, v. 14, p. 456-462, 2000.

GARDEN, O. A.; KIDD, L.; MEXAS, A. M.; CHANG, Y.; JEFFERY, U.; BLOIS, S. L.; FOGLE, J. E.; MACNEILL, A. M.; LUBAS, G.; BIRKENHEUER, A. ACVIM consensus statement on the diagnosis of immune-mediated hemolytic anemia in dogs and cats. Journal of Veterinary Internal Medicine, v. 33, n. 2, p 313-334, 2019.

GOGGS, R., BOAG, A.K.; CHAN, D.L. Concurrent immune-mediated haemolytic anaemia and severe thrombocytopenia in 21 dogs. Vet Record, v. 163, p. 323-327, 2008.

MCCULLOUGH, S. Immune-mediated hemolytic anemia: understanding the nemesis. Veterinary Clinics of North America: Small Animal Practice, v. 33, n. 6, p. 1295-1315, 2003.

MILLER, S. A.; HOHENHAUS, A. E.; HALE, A. S.; Case control study of blood type, breed, sex and bacteremia in dogs with imune-mediate hemolytic anemia. Journal of the American Veterinary Medical Association, v. 224, n. 2, p. 232-235, 2004.

MORAILLON, R.; LEGEAY, Y.; BOUSSARIE, D.; SÉNÉCAT, O. Elservier manual of veterinary medicine: diagnosis and treatment of dogs, cats and exotic animals. 7th ed., Rio de Janeiro: Elsevier Masson, p. 183, 2013.

NETO, M. P.; ALVES, A. N. L.; FORTINI, A. S.; BURATTINI, M. N.; SUMITA, N. M.; SROUGI, M.; CHOCAIR, P. R. Therapeutic monitoring of azathioprine: a review. Brazilian Journal of Pathology and Laboratory Medicine, v. 44, n.3, p. 161.167, 2008.

PEREIRA, B. J.; NUNES, L. C.; FILHO, S. M.; COSTA, F. S. Evaluation of the effects of prednisone therapy in dogs using ultrasonographic, cytopathological and histopathological analysis. Ceres Magazine, v. 58, n.5, p.561-566, 2011.

SWANN, J. W.; GARDEN, O. A. FELLMAN, C. L.; GLANEMANN, B.; GOGGS, R.; LEVINE D. N.; MACKIN, A. J.; WHITLEY, N. T. ACVIM consensus statement on the treatment of immune-mediated hemolytic anemia in dogs. Journal of Veterinary Internal Medicine, v. 33, n. 3, p. 1141-1172, 2019.

SWANN, J.W.; SKELLY, B.J. Systematic review of evidence relating to the treatment of immune-mediated hemolytic anemia in dogs. Journal of Veterinary Internal Medicine, v.27, p. 1-9, 2013.



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