A Prospective, Randomized, Double-Blinded, Placebo-Controlled Study of Human Intravenous Immunoglobulin for the Acute Management of Presumptive Primary Immune-Mediated Thrombocytopenia in Dogs

Background Immune-mediated thrombocytopenia (IMT) is a common hematologic disorder in dogs. Human intravenous immunoglobulin (hIVIG) may have a beneficial effect in canine IMT. Hypothesis A single hIVIG infusion (0.5 g/kg) in dogs with presumed primary IMT (pIMT) is a safe adjunctive emergency treatment to accelerate platelet count recovery and shorten hospitalization time without increasing the cost of patient care. Animals Eighteen client-owned dogs with a presumptive diagnosis of pIMT. Methods Prospective, randomized, double-blinded, placebo-controlled clinical trial. Results There were no identifiable immediate or delayed adverse reactions associated with hIVIG administration over a 6-month period. The median platelet count recovery time for the hIVIG group was 3.5 days (mean +/- SD: 3.7 +/- 1.3 days; range, 2-7 days) and 7.5 days (mean +/- SD: 7.8 +/- 3.9 days; range, 3-12 days) for the placebo group. The median duration of hospitalization for hIVIG group was 4 days (mean +/- SD: 4.2 +/- 0.4 days; range, 2-8 days) and 8 days (mean +/- SD: 8.3 +/- 0.6 days; range, 4-12 days) for the placebo group. There was no significant difference between groups with respect to expense of initial patient care, whereas significant reduction in platelet count recovery time (P = .018) and duration of hospitalization (P = .027) were detected in the hIVIG group. Conclusions and Clinical Importance Compared with corticosteroids alone, adjunctive emergency therapy of a single hIVIG infusion was safe and associated with a significant reduction in platelet count recovery time and duration of hospitalization without increasing the expense of medical care in a small group of dogs with presumed pIMT.