Splenectomy in the management of primary immune-mediated hematological diseases

Current reports about the use of splenectomy for the management of immune-mediated hemolytic anemia (IMHA) or immune-mediated thrombocytopenia (ITP), or both, in dogs are limited. 

The authors of this study sought to retrospectively describe the use of splenectomy as part of the management for IMHA, ITP, and concurrent IMHA and severe thrombocytopenia (CIST) in dogs. It was hypothesized that splenectomy would be beneficial in allowing for reduction of dose of immunosuppressive drugs or discontinuation in one or more of these groups. 

Seventeen client-owned dogs (7 with IMHA, 7 with ITP and 3 with CIST) were identified across seven UK-based referral hospitals from a study period of 2005 to 2016. 

Data were collected retrospectively via questionnaires and included information about diagnosis, management, and treatment response before and after splenectomy. Based on clinical outcome, treatment with splenectomy as part of the management protocol was classified as either successful or unsuccessful. 

Six of seven dogs with ITP were managed successfully with splenectomy as part of their management protocol (3 complete and 3 partial responses), although one subsequently developed suspected IMHA. Of the seven dogs with IMHA, splenectomy was part of a successful management protocol in four dogs (2 complete and 2 partial responses). In the CIST group, one case (one of three) responded completely to management with splenectomy as part of the management protocol. 

Splenectomy was considered successful and well tolerated in most cases of isolated ITP. Whether there is a benefit of splenectomy in cases of IMHA and CIST could not be determined in the current study. 

Splenectomy in the management of primary immune-mediated hemolytic anemia and primary immune-mediated thrombocytopenia in dogs.” Jason P Bestwick, et al. J Vet Intern Med. 2022 Jul 7.  doi: 10.1111/jvim.16469. 

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