Internal Medicine Department, Red Bank Veterinary Hospital, NJ, USA.
J Vet Intern Med. 2011 Jan-Feb;25(1):71-5. doi: 10.1111/j.1939-1676.2010.0656.x. Epub 2010 Dec 13.
A major cause of death in dogs with primary immune-mediated hemolytic anemia (pIMHA) is thrombotic disease. Ultralow-dose aspirin (ULDA) is commonly used to prevent thrombosis in dogs with pIMHA; however, the efficacy of antiplatelet agents in dogs with pIMHA is unknown.
The use of clopidogrel (CL), alone or in combination with ULDA, would improve survival to discharge and at 90 days without important adverse effects compared with ULDA alone in dogs with pIMHA treated with standard immunosuppressive therapy.
Twenty-four client-owned dogs with pIMHA.
Prospective, positive-controlled, unmasked clinical trial with dogs randomized in 3 treatment groups to receive PO ULDA or CL or both.
There was no identifiable adverse reaction, evidence of hemorrhage, or increase in transfusion requirements associated with CL therapy, either alone or combined with ULDA, compared with ULDA alone. There was no significant difference between treatment groups with respect to survival to discharge and at 90 days.
This study suggests that CL therapy, alone or in combination with ULDA, was safe and had similar short-term survival compared with ULDA alone in a small group of dogs with pIMHA able to tolerate oral medications and treated with standard immunosuppressive treatment.
原发性免疫介导性溶血性贫血（pIMHA）犬死亡的一个主要原因是血栓性疾病。超低剂量阿司匹林（ULDA）常用于预防 pIMHA 犬的血栓形成；然而，抗血小板药物在 pIMHA 犬中的疗效尚不清楚。
与单独使用 ULDA 相比，在接受标准免疫抑制治疗的 pIMHA 犬中，单独使用氯吡格雷（CL）或与 ULDA 联合使用 CL 会改善存活至出院和 90 天，且不会产生重要的不良反应。
24 只患有 pIMHA 的患犬。
采用前瞻性、阳性对照、非盲临床试验，将犬随机分为 3 个治疗组，分别接受 PO ULDA 或 CL 或两者联合治疗。
与单独使用 ULDA 相比，CL 单独或联合 ULDA 治疗均未发现与 CL 治疗相关的不良反应、出血证据或增加输血需求。
本研究表明，CL 单独或联合 ULDA 治疗在能够耐受口服药物并接受标准免疫抑制治疗的一小部分 pIMHA 犬中是安全的，与单独使用 ULDA 相比，短期存活率相似。
