Predicting outcome in dogs with primary immune-mediated hemolytic anemia: results of a multicenter case registry

Goggs, R. et al. (2015) Predicting outcome in dogs with primary immune-mediated hemolytic anemia: results of a multicenter case registry. Journal of Veterinary Internal Medicine, 29(6), pp. 1603-1610. (doi: 10.1111/jvim.13642) (PMID:26473338) (PMCID:PMC4864895)

Abstract

Background: Outcome prediction in dogs with immune-mediated hemolytic anemia (IMHA) is challenging and few prognostic indicators have been consistently identified. Objectives: An online case registry was initiated to: prospectively survey canine IMHA presentation and management in the British Isles; evaluate 2 previously reported illness severity scores, Canine Hemolytic Anemia Score (CHAOS) and Tokyo and to identify independent prognostic markers. Animals: Data from 276 dogs with primary IMHA across 10 referral centers were collected between 2008 and 2012. Methods: Outcome prediction by previously reported illness-severity scores was tested using univariate logistic regression. Independent predictors of death in hospital or by 30-days after admission were identified using multivariable logistic regression. Results: Purebreds represented 89.1% dogs (n = 246). Immunosuppressive medications were administered to 88.4% dogs (n = 244), 76.1% (n = 210) received antithrombotics and 74.3% (n = 205) received packed red blood cells. Seventy-four per cent of dogs (n = 205) were discharged from hospital and 67.7% (n = 187) were alive 30-days after admission. Two dogs were lost to follow-up at 30-days. In univariate analyses CHAOS was associated with death in hospital and death within 30-days. Tokyo score was not associated with either outcome measure. A model containing SIRS-classification, ASA classification, ALT, bilirubin, urea and creatinine predicting outcome at discharge was accurate in 82% of cases. ASA classification, bilirubin, urea and creatinine were independently associated with death in hospital or by 30-days. Conclusions and clinical importance: Markers of kidney function, bilirubin concentration and ASA classification are independently associated with outcome in dogs with IMHA. Validation of this score in an unrelated population is now warranted.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ridyard, Ms Alison and McLauchlan, Mr Gerard
• Authors: Goggs, R., Dennis, S.G., Di Bella, A., Humm, K.R., McLauchlan, G., Mooney, C., Ridyard, A., Tappin, S., Walker, D., Warman, S., Whitley, N.T., Brodbelt, D.C., and Chan, D.L.
• College/School: College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
• Journal Name: Journal of Veterinary Internal Medicine
• Publisher: American College of Veterinary Internal Medicine.
• ISSN: 0891-6640
• ISSN (Online): 1939-1676
• Published Online: 16 October 2015
• Copyright Holders: Copyright © 2015 The Authors
• First Published: First published in Journal of Veterinary Internal Medicine 29(6):1603-1610
• Publisher Policy: Reproduced under a Creative Commons License