Maia Suellen Rodrigues, de Moraes Reiner Silveira, Geraldes Silvano Salgueiro, de Azevedo Maria Gabriela Picelli, Stefaniszen Amanda Garcia, Moreira Márcio Antônio Batistela, Afonso Angélica, García Henry David Mogollón, Okamoto Adriano Sakai, Melchert Alessandra, Lourenço Maria Lúcia Gomes, Takahira Regina Kiomi, de Souza Fabiana Ferreira, Giuffrida Rogério, Okamoto Priscylla Tatiana Chalfun Guimarães
Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
Centro de Diagnóstico e Banco de Sangue Veterinário, Sanimvet, São Paulo, Brazil.
BMC Vet Res. 2025 May 16;21(1):348. doi: 10.1186/s12917-025-04758-0.
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.
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.
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.
治疗性血浆置换（TPE）已用于免疫性疾病、高黏滞血症以及清除蛋白结合药物和毒素。尽管可能会出现并发症，但据报道其应用对犬类具有一定程度的安全性并能改善临床症状。本病例报告旨在描述TPE在犬类中的可行性和安全性。
五只对免疫抑制治疗无反应的免疫介导性溶血性贫血（IMHA）和/或犬内脏利什曼病（CVL）犬接受了离心式TPE。在TPE前后评估了身体、实验室和心血管参数。尽管一只犬在手术过程中出现血管性水肿，另一只犬出现神经症状（眼球震颤），但未观察到其他明显的血流动力学或止血并发症，并且TPE后身体和心血管参数均保持稳定。血管性水肿和眼球震颤在TPE后均得到控制。血清蛋白和离子钙降低的趋势是主要的实验室检查结果。
基于离心的TPE对患有IMHA和CVL的犬是一种安全可行的治疗方法。应注意低钙血症、低蛋白血症倾向以及诸如神经症状发生等继发性并发症。
