Tierarztl Prax Ausg K Kleintiere Heimtiere 2018; 46(02): 105-118
DOI: 10.15654/TPK-180274
Übersichtsartikel – Review Articles
Schattauer GmbH

Immunsuppressive Therapie bei Hunden und Katzen. Eigenschaften von Wirkstoffen und ihre Anwendung bei verschiedenen immunvermittelten Erkrankungen

Immunosuppressive therapy in dogs and cats. Properties of drugs and their use in various immune-mediated diseases
Johanna Rieder
1   Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover, Hannover
,
Reinhard Mischke
1   Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover, Hannover
› Author Affiliations
Further Information

Publication History

Eingegangen: 25 February 2018

Akzeptiert nach Revision: 19 March 2018

Publication Date:
04 May 2018 (online)

Zusammenfassung

Tierärzte werden regelmäßig mit der Diagnose und Therapie immunvermittelter Erkrankungen konfrontiert. Zu den häufigeren Erkrankungen gehören die immunvermittelte hämolytische Anämie, die immunvermittelte Thrombozytopenie und Polyarthritis. Aufgrund ihrer Verfügbarkeit, Effizienz und schnellen Wirkung sind Glukokortikoide Mittel der ersten Wahl. Einige Patienten mit immunvermittelten Erkrankungen sprechen jedoch nicht auf eine alleinige Therapie mit Glukokortikoiden an. Bei anderen Patienten muss infolge schwerwiegender Nebenwirkungen zeitnah eine Dosisreduktion der Glukokortikoide erfolgen. In solchen Fällen ist die Anwendung ergänzender Medikamente indiziert. Für Ciclosporin gibt es zugelassene Präparate in der Veterinärmedizin. In der Literatur ist auch der Einsatz von Azathioprin, Mycophenolat-Mofetil und humanen Immunglobulinen beschrieben. Der Artikel gibt einen Überblick über die Wirkmechanismen einzelner immunmodulierender Substanzen sowie deren in der aktuellen Literatur beschriebenen Einsatz bei ausgewählten Erkrankungen.

Summary

Veterinarians are regularly faced with the diagnosis and therapy of immune-mediated diseases. More frequently occurring immune-mediated diseases are immune-mediated hemolytic anemia, immunemediated thrombocytopenia and polyarthritis. Glucocorticoids are commonly used as first-line treatment because of their availability, efficacy and rapid action. Nevertheless, some patients do not respond to glucocorticoid therapy alone. Others require a rapid dose reduction because of severe side effects from glucocorticoid treatment. These patients benefit from adjuvant therapies. Ciclosporin preparations are licensed for use in veterinary medicine. The use of azathioprine, mycophenolate mofetil and human immunoglobulin therapy has also been documented. This article describes the mode of action of certain immunosuppressive agents and their use in selected diseases from recent literature.

 
  • Literatur

  • 1 Abelson AL, Shelton GD, Whelan MF, Cornejo L, Shaw S, O’Toole TE. Use of mycophenolate mofetil as a rescue agent in the treatment of severe generalized myasthenia gravis in three dogs. J Vet Emerg Crit Care 2009; 19 (04) 369-374.
  • 2 Ackermann AL, May ER, Frank LA. Use of mycophenolate mofetil to treat immune-mediated skin disease in 14 dogs – a retrospective evaluation. Vet Dermatol 2017; 28 (02) 195-e44.
  • 3 Allenspach K, Rüfenacht S, Sauter S, Gröne A, Steffan J, Strehlau G, Gaschen F. Pharmacokinetics and clinical efficacy of cyclosporine treatment of dogs with steroid-refractory inflammatory bowel disease. J Vet Intern Med 2006; 20 (02) 239-244.
  • 4 Archer TM, Boothe DM, Langston VC, Fellman CL, Lunsford KV, Mackin AJ. Oral cyclosporine treatment in dogs: a review of the literature. J Vet Intern Med 2014; 28 (01) 1-20.
  • 5 Archer TM, Stokes JV, Kummari E, Fellman C, Thomason J, Haraschak J, Wills R, Pinchuk L, Mackin A. In vivo effects of aspirin and cyclosporine on regulatory T cells and T-cell cytokine production in healthy dogs. Vet Immunol Immunopathol 2018; 197: 63-68.
  • 6 Atopica. Fachinformation in Form der Zusammenfassung der Merkmale des Tierarzneimittels Atopica® 50mg, Ciclosporin, Weichkapseln für Hunde. 2008
  • 7 Atopica. Fachinformation in Form der Zusammenfassung der Merkmale des Tierarzneimittels Atopica® 100mg/ml Lösung zum Eingeben für Katzen. 2011
  • 8 Bacek LM, Macintire DK. Treatment of primary immune-mediated hemolytic anemia with mycophenolate mofetil in two cats. J Vet Emerg Crit Care 2011; 21 (01) 45-49.
  • 9 Balog K, Huang AA, Sum SO, Moore GE, Thompson C, Scott-Moncrieff JC. A prospective randomized clinical trial of vincristine versus human intravenous immunoglobulin for acute adjunctive management of presumptive primary immune-mediated thrombocytopenia in dogs. J Vet Intern Med 2013; 27 (03) 536-541.
  • 10 Barnoon I, Shamir MH, Aroch I, Bdolah-Abram T, Srugo I, Konstantin L, Chai O. Retrospective evaluation of combined mycophenolate mofetil and prednisone treatment for meningoencephalomyelitis of unknown etiology in dogs: 25 cases (2005–2011). J Vet Emerg Crit Care 2016; 26 (01) 116-124.
  • 11 Barrs VR, Martin P, Beatty JA. Antemortem diagnosis and treatment of toxoplasmosis in two cats on cyclosporin therapy. Aust Vet J 2006; 84 (1–2): 30-35.
  • 12 Barth T, Mischke R, Nolte I. Cyclosporin A in aplastic anemia in dogs: first results. Berl Munch Tierarztl Wochenschr 1997; 110 (02) 60-67.
  • 13 Beatty J, Barrs V. Acute toxoplasmosis in two cats on cyclosporin therapy. Aust Vet J 2003; 81 (06) 339.
  • 14 Beccati M, Martini V, Comazzi S, Fanton N, Cornegliani L. Lymphocyte subpopulations and Treg cells in dogs with atopic dermatitis receiving ciclosporin therapy: a prospective study. Vet Dermatol 2016; 27 (01) 17-25.
  • 15 Bianco D, Armstrong PJ, Washabau RJ. Treatment of severe immune-mediated thrombocytopenia with human IV immunoglobulin in 5 dogs. J Vet Intern Med 2007; 21 (04) 694-699.
  • 16 Bianco D, Armstrong PJ, Washabau RJ. Presumed primary immune-mediated thrombocytopenia in four cats. J Feline Med Surg 2008; 10 (05) 495-500.
  • 17 Bianco D, Armstrong PJ, Washabau RJ. A prospective, randomized, doubleblinded, placebo-controlled study of human intravenous immunoglobulin for the acute management of presumptive primary immune-mediated thrombocytopenia in dogs. J Vet Intern Med 2009; 23 (05) 1071-1078.
  • 18 Black V, Adamantos S, Barfield D, Tasker S. Feline non-regenerative immune-mediated anaemia: features and outcome in 15 cases. J Feline Med Surg 2016; 18 (08) 597-602.
  • 19 Blackwood L, German AJ, Stell AJ, O’Neill T. Multicentric lymphoma in a dog after cyclosporine therapy. J Small Anim Pract 2004; 45 (05) 259-262.
  • 20 Bullingham R, Monroe S, Nicholls A, Hale M. Pharmacokinetics and bioavailability of mycophenolate mofetil in healthy subjects after single-dose oral and intravenous administration. J Clin Pharmacol 1996; 36 (04) 315-324.
  • 21 Canonne AM, Bolen G, Peeters D, Billen F, Clercx C. Long-term follow-up in dogs with idiopathic eosinophilic bronchopneumopathy treated with inhaled steroid therapy. J Small Anim Pract 2016; 57 (10) 537-542.
  • 22 Carr AP, Panciera DL, Kidd L. Prognostic factors for mortality and thromboembolism in canine immune-mediated hemolytic anemia: a retrospective study of 72 dogs. J Vet Intern Med 2002; 16 (05) 504-549.
  • 23 Chirek A, Silaghi C, Pfister K, Kohn B. Granulocytic anaplasmosis in 63 dogs: clinical signs, laboratory results, therapy and course of disease. J Small Anim Pract 2018; 59 (02) 112-120.
  • 24 Clements DN, Gear RN, Tattersall J, Carmichael S, Bennett D. Type I immune-mediated polyarthritis in dogs: 39 cases (1997–2002). J Am Vet Med Assoc 2004; 15; 224 (08) 1323-1327.
  • 25 Colopy SA, Baker TA, Muir P. Efficacy of leflunomide for treatment of immune-mediated polyarthritis in dogs: 14 cases (2006–2008). J Am Vet Med Assoc 2010; 236 (03) 312-318.
  • 26 Cooper SA, Huang AA, Raskin RE, Weng HY, Scott-Moncrieff JC. Clinical data, clinicopathologic findings and outcome in dogs with amegakaryocytic thrombocytopenia and primary immune-mediated thrombocytopenia. J Small Anim Pract 2016; 57 (03) 142-147.
  • 27 Cummings FO, Rizzo SA. Treatment of presumptive primary immune-mediated thrombocytopenia with mycophenolate mofetil versus cyclosporine in dogs. J Small Anim Pract 2017; 58 (02) 96-102.
  • 28 Cyclavance. Fachinformation in Form der Zusammenfassung der Merkmale des Tierarzneimittels Cyclavance® 100 mg/ml Lösung zum Eingeben für Hunde, Ciclosporin. 2014
  • 29 Dandrieux JR, Noble PJ, Scase TJ, Cripps PJ, German AJ. Comparison of a chlorambucil-prednisolone combination with an azathioprine-prednisolone combination for treatment of chronic enteropathy with concurrent protein-losing enteropathy in dogs: 27 cases (2007–2010). J Am Vet Med Assoc 2013; 242 (12) 1705-1714.
  • 30 Dewey CW, Cerda-Gonzalez S, Fletcher DJ, Harb-Hauser MF, Levine JM, Badgley BL, Olby NJ, Shelton GD. Mycophenolate mofetil treatment in dogs with serologically diagnosed acquired myasthenia gravis: 27 cases (1999–2008). J Am Vet Med Assoc 2010; 236 (06) 664-668.
  • 31 Dye TL, Diehl KJ, Wheeler SL, Westfall DS. Randomized, controlled trial of budesonide and prednisone for the treatment of idiopathic inflammatory bowel disease in dogs. J Vet Intern Med 2013; 27 (06) 1385-1391.
  • 32 Evans NA, Walker JM, Manchester AC, Bach JF. Acute respiratory distress syndrome and septic shock in a cat with disseminated toxoplasmosis. J Vet Emerg Crit Care (San Antonio) 2017; 27 (04) 472-478.
  • 33 Favrot C, Reichmuth P, Olivry T. Treatment of canine atopic dermatitis with azathioprine: a pilot study. Vet Rec 2007; 160 (15) 520-521.
  • 34 Fenty RK, Delaforcade AM, Shaw SE, O’Toole TE. Identification of hypercoagulability in dogs with primary immune-mediated hemolytic anemia by means of thromboelastography. J Am Vet Med Assoc 2011; 238 (04) 463-467.
  • 35 Fukushima K, Eguchi N, Ohno K, Kanemoto H, Takahashi M, Igarashi H, Ohmi A, Nakashima K, Tsujimoto H. Efficacy of leflunomide for treatment of refractory inflammatory colorectal polyps in 15 Miniature Dachshunds. J Vet Med Sci 2016; 78 (02) 265-269.
  • 36 Galler A, Shibly S, Bilek A, Hirt RA. Inhaled budesonide therapy in cats with naturally occurring chronic bronchial disease (feline asthma and chronic bronchitis). J Small Anim Pract 2013; 54 (10) 531-536.
  • 37 Gerber B, Steger A, Hässig M, Glaus TM. Use of human intravenous immunoglobulin in dogs with primary immune mediated hemolytic anemia. Schweiz Arch Tierheilkd 2002; 144 (04) 180-185.
  • 38 Gershwin LJ. Current and newly emerging autoimmune diseases. Vet Clin North Am Small Anim Pract 2018; 48 (02) 323-338.
  • 39 Giudice E, Giannetto C, Gianesella M. Effect of desmopressin on immunemediated haemorrhagic disorders due to canine monocytic ehrlichiosis: a preliminary study. J Vet Pharmacol Ther 2010; 33 (06) 610-614.
  • 40 Goggs R, Dennis SG, Di Bella A, Humm KR, McLauchlan G, Mooney C, Ridyard A, Tappin S, Walker D, Warman S, Whitley NT, Brodbelt DC, Chan DL. Predicting Outcome in dogs with Primary Immune-Mediated 1. Hemolytic Anemia: Results of a Multicenter Case Registry. J Vet Intern Med 2015; 29 (06) 1603-1610.
  • 41 Goggs R, Wiinberg B, Kjelgaard-Hansen M, Chan DL. Serial assessment of the coagulation status of dogs with immune-mediated haemolytic anaemia using thromboelastography. Vet J 2012; 191 (03) 347-353.
  • 42 Goldstein RE, Lappin MR. Infectious causes of Polyarthritis in Dogs. In: Kirk’s Current Veterinary Therapy XV. Bonagura JD, Twedt DC. eds. Philadelphia: Saunders; 2014: 1224-1228.
  • 43 Graham-Mize C, Rosser E. Bioavailability and activity of prednisone and prednisolone in the feline patient. Vet Dermatol 2004; 15 (Suppl. 1): 9-10.
  • 44 Gregory CR. Immunosuppressive Agents. In: Kirk’s Current Veterinary Therapy XV. Bonagura JD, Twedt DC. eds. Philadelphia: Saunders; 2014: 268-274.
  • 45 Hamzianpour N, Chan DL. Thromboelastographic assessment of the contribution of platelets and clotting proteases to the hypercoagulable state of dogs with immune-mediated hemolytic anemia. J Vet Emerg Crit Care (San Antonio) 2016; 26 (02) 295-299.
  • 46 Hann L, Brown DC, King LG, Callan MB. Effect of duration of packed red blood cell storage on morbidity and mortality in dogs after transfusion: 3,095 cases (2001–2010). J Vet Intern Med 2014; 28 (06) 1830-1837.
  • 47 Hardie RJ, Gregory SP, Tomlin J, Sturgeon C, Lipscomb V, Ladlow J. Cyclosporine treatment of anal furunculosis in 26 dogs. J Small Anim Pract 2005; 46 (01) 3-9.
  • 48 Harkin KR, Phillips D, Wilkerson M. Evaluation of azathioprine on lesion severity and lymphocyte blastogenesis in dogs with perianal fistulas. J Am Anim Hosp Assoc 2007; 43 (01) 21-26.
  • 49 Hauck V, Hügli P, Meli ML, Rostaher A, Fischer N, Hofmann-Lehmann R, Favrot C. Increased numbers of FoxP3-expressing CD4+ CD25+ regulatory T cells in peripheral blood from dogs with atopic dermatitis and its correlation with disease severity. Vet Dermatol 2016; 27 (01) 26-e9.
  • 50 IRIS Canine GN Study Group Established Pathology Subgroup. Segev G, Cowgill LD, Heiene R, Labato MA, Polzin DJ. Consensus recommendations for immunosuppressive treatment of dogs with glomerular disease based on established pathology. J Vet Intern Med 2013; 27 (S1): S55-S59.
  • 51 Jans HE, Armstrong PJ, Price GS. Therapy of immune mediated thrombocytopenia. A retrospective study of 15 dogs.J Vet Intern Med 1990; 04 (01) 4-7.
  • 52 Johnson V, Dow S. Management of immune-mediated hemolytic anemia in dogs. In: Kirk’s Current Veterinary Therapy XV. Bonagura JD, Twedt DC. eds. Philadelphia: Saunders; 2014: 275-279.
  • 53 Jordan HL, Grindem CB, Breitschwerdt EB. Thrombocytopenia in cats: a retrospective study of 41 cases. J Vet Intern Med 1993; 07 (05) 261-265.
  • 54 Keppel KE, Campbell KL, Zuckermann FA, Greeley EA, Schaeffer DJ, Husmann RJ. Quantitation of canine regulatory T cell populations, serum interleukin-10 and allergen-specific IgE concentrations in healthy control dogs and canine atopic dermatitis patients receiving allergen-specific immunotherapy. Vet Immunol Immunopathol 2008; 123 (3–4): 337-344.
  • 55 Kohn B, Linden T, Leibold W. Platelet-bound antibodies detected by a flow cytometric assay in cats with thrombocytopenia. J Feline Med Surg 2006; 08 (04) 254-260.
  • 56 Kohn B, Weingart C, Eckmann V, Ottenjann M, Leibold W. Primary immune-mediated hemolytic anemia in 19 cats: diagnosis, therapy, and outcome (1998–2004). J Vet Intern Med 2006; 20 (01) 159-166.
  • 57 Lappin MR, VanLare KA, Seewald W, Roycroft LM, Scorza AV, King S, Roberts ES. Effect of oral administration of cyclosporine on Toxoplasma gondii infection status of cats. Am J Vet Res 2015; 76 (04) 351-357.
  • 58 Last RD, Suzuki Y, Manning T, Lindsay D, Galipeau L, Whitbread TJ. A case of fatal systemic toxoplasmosis in a cat being treated with cyclosporin A for feline atopy. Vet Dermatol 2004; 15 (03) 194-198.
  • 59 Leemans J, Kirschvink N, Clercx C, Snaps F, Gustin P. Effect of short-term oral and inhaled corticosteroids on airway inflammation and responsiveness in a feline acute asthma model. Vet J 2012; 192 (01) 41-48.
  • 60 Legnani S, Pantchev N, Forlani A, Zini E, Schares G, Balzer J, Roccabianca P, Ferri F, Zanna G. Emergence of cutaneous neosporosis in a dog receiving immunosuppressive therapy: molecular identification and management. Vet Dermatol 2016; 27 (01) 49-e14.
  • 61 Lockwood SL, Schick AE, Lewis TP, Newton H. Investigation of subclinical bacteriuria in cats with dermatological disease receiving long-term glucocorticoids and/or ciclosporin. Vet Dermatol 2018; 29 (01) 25-e12.
  • 62 Magaña A, Sánchez F, Villa K, Rivera L, Morales E. Systemic neosporosis in a dog treated for immune-mediated thrombocytopenia and hemolytic anemia. Vet Clin Pathol 2015; 44 (04) 592-596.
  • 63 Mangels C. Unerwünschte Arzneimittelwirkung bei der Anwendung von Cyclosporin A (Atopica®) bei Hund und Katze. Dissertation, Tierärztliche Fakultät der Ludwig-Maximilians-Universität München. 2012
  • 64 Mason N, Duval D, Shofer FS, Giger U. Cyclophosphamide exerts no beneficial effect over prednisone alone in the initial treatment of acute immune-mediated hemolytic anemia in dogs: a randomized controlled clinical trial. J Vet Intern Med 2003; 17 (02) 206-212.
  • 65 McAtee BB, Cummings KJ, Cook AK, Lidbury JA, Heseltine JC, Willard MD. Opportunistic invasive cutaneous fungal infections associated with administration of cyclosporine to dogs with immune-mediated disease. J Vet Intern Med 2017; 31 (06) 1724-1729.
  • 66 McKeage K, Goa KL. Budesonide (Entocort EC Capsules): a review of its therapeutic use in the management of active Crohn’s disease in adults. Drugs 2002; 62 (15) 2263-2282.
  • 67 Mellett AM, Nakamura RK, Bianco D. A prospective study of clopidogrel therapy in dogs with primary immune-mediated hemolytic anemia. J Vet Intern Med 2011; 25 (01) 71-75.
  • 68 Miller J, Popiel J, Chełmońska-Soyta A. Humoral and Cellular Immune Response in Canine Hypothyroidism. J Comp Pathol 2015; 153 (01) 28-37.
  • 69 Morassi A, Bianco D, Park E, Nakamura RK, White GA. Evaluation of the safety and tolerability of rivaroxaban in dogs with presumed primary immune-mediated hemolytic anemia. J Vet Emerg Crit Care 2016; 26 (04) 488-494.
  • 70 Morris TA, Marsh JJ, Konopka R, Pedersen CA, Chiles PG. Anti-thrombotic efficacies of enoxaparin, dalteparin, and unfractionated heparin in venous thromboembolism. Thromb Res 2000; 100 (03) 185-194.
  • 71 Nam HS, McAnulty JF, Kwak HH, Yoon BI, Hyun C, Kim WH, Woo HM. Gingival overgrowth in dogs associated with clinically relevant cyclosporine blood levels: observations in a canine renal transplantation model. Vet Surg 2008; 37 (03) 247-253.
  • 72 Namikawa K, Maruo T, Honda M, Hirata H, Lynch J, Madarame H. Gingival overgrowth in a dog that received long-term cyclosporine for immunemediated hemolytic anemia. Can Vet J 2012; 53 (01) 67-70.
  • 73 Navarro C, Séguy L, Vila M, Birckel P. Bioequivalence study between two formulations of ciclosporin A (Cyclavance® oral solution and Atopica® soft capsules) following a single oral administration to dogs. BMC Vet Res. 2016 12. 54 doi: 10.1186/s12917–016–0669–9..
  • 74 Neel JA, Birkenheuer AJ, Grindem CB. Thrombocytopenia. In: Kirk’s Current Veterinary Therapy XV. Bonagura JD, Twedt DC. eds. Philadelphia: Saunders; 2014: 280-286.
  • 75 Oggier D, Tomsa K, Mevissen M, Glaus T. Efficacy of the combination of glucocorticoids, mycophenolate-mofetil and human immunoglobulin for the therapy of immune mediated haemolytic anaemia in dogs. Schweiz Arch Tierheilkd 2018; 160 (03) 171-178.
  • 76 Olivry T, Bizikova P. A systematic review of randomized controlled trials for prevention or treatment of atopic dermatitis in dogs: 2008–2011 update. Vet Dermatol 2013; 24 (01) 97-117.
  • 77 O’Marra SK, Delaforcade AM, Shaw SP. Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia. J Am Vet Med Assoc 2011; 238 (03) 346-352.
  • 78 ptimmune. Fachinformation in Form der Zusammenfassung der Merkmale des Tierarzneimittels Optimmune® 2,0mg/g Augensalbe, Ciclosporin. 2016
  • 79 Palmeiro BS. Cyclosporine in veterinary dermatology. Vet Clin North Am Small Anim Pract 2013; 43 (01) 153-171.
  • 80 Panek CM, Nakamura RK, Bianco D. Use of enoxaparin in dogs with primary immune-mediated hemolytic anemia: 21 cases. J Vet Emerg Crit Care 2015; 25 (02) 273-277.
  • 81 Park HJ, Kim JW, Song KH, Seo KW. Application of vincristine-loaded platelet therapy in three dogs with refractory immune-mediated thrombocytopenia. J Vet Sci 2015; 16 (01) 127-130.
  • 82 Piek CJ, Brinkhof B, Teske E, Rothuizen J, Dekker A, Penning LC. High intravascular tissue factor expression in dogs with idiopathic immune-mediated haemolytic anaemia. Vet Immunol Immunopathol 2011; 144 (3–4): 346-354.
  • 83 Piek CJ, Junius G, Dekker A, Schrauwen E, Slappendel RJ, Teske E. Idiopathic immune-mediated hemolytic anemia: treatment outcome and prognostic factors in 149 dogs. J Vet Intern Med 2008; 22 (02) 366-373.
  • 84 Piek CJ, van Spil WE, Junius G, Dekker A. Lack of evidence of a beneficial effect of azathioprine in dogs treated with prednisolone for idiopathic immune-mediated hemolytic anemia: a retrospective cohort study. BMC Vet Res. 2011 07. 15 doi: 10.1186/1746–6148–7–15..
  • 85 Pierce Jr KE, Wilkie DA, Gemensky-Metzler AJ, Curran PG, Townsend WM, Petersen-Jones SM, Bartoe JT. An association between systemic cyclosporine administration and development of acute bullous keratopathy in cats. Vet Ophthalmol 2016; 19 (Supplement 1): 77-85.
  • 86 Pietra M, Fracassi F, Diana A, Gazzotti T, Bettini G, Peli A, Morini M, Pagliuca G, Roncada P. Plasma concentrations and therapeutic effects of budesonide in dogs with inflammatory bowel disease. Am J Vet Res 2013; 74 (01) 78-83.
  • 87 Rhoades AC, Vernau W, Kass PH, Herrera MA, Sykes JE. Comparison of the efficacy of prednisone and cyclosporine for treatment of dogs with primary immune-mediated polyarthritis. J Am Vet Med Assoc 2016; 15; 248 (04) 395-404.
  • 88 Roberts ES, Speranza C, Friberg C, Griffin C, Steffan J, Roycroft L, King S. Confirmatory field study for the evaluation of ciclosporin at a target dose of 7.0 mg/kg (3.2 mg/lb) in the control of feline hypersensitivity dermatitis. J Feline Med Surg 2016; 18 (11) 889-897.
  • 89 Roberts ES, Tapp T, Trimmer A, Roycroft L, King S. Clinical efficacy and safety following dose tapering of ciclosporin in cats with hypersensitivity dermatitis. J Feline Med Surg 2016; 18 (11) 898-905.
  • 90 Rozanski EA, Callan MB, Hughes D, Sanders N, Giger U. Comparison of platelet count recovery with use of vincristine and prednisone or prednisone alone for treatment for severe immune-mediated thrombocytopenia in dogs. J Am Vet Med Assoc 2002; 220 (04) 477-481.
  • 91 Rychlik A, Kołodziejska-Sawerska A, Nowicki M, Szweda M. Clinical, endoscopic and histopathological evaluation of the efficacy of budesonide in the treatment of inflammatory bowel disease in dogs. Pol J Vet Sci 2016; 19 (01) 159-164.
  • 92 Sato M, Veir JK, Legare M, Lappin MR. A retrospective study on the safety and efficacy of leflunomide in dogs. J Vet Intern Med 2017; 31 (05) 1502-1507.
  • 93 Schultze AE. Interpretation of canine leukocyte responses. In: Schalm’s Veterinary Hematology. 6th edn.. Weiss DJ, Wardrop KJ. eds. Ames: WileyBlackwell; 2010: 321-334.
  • 94 Slovak JE, Rivera SM, Hwang JK, Court MH, Villarino NF. Pharmacokinetics of mycophenolic acid after intravenous administration of mycophenolate mofetil to healthy cats. J Vet Intern Med 2017; 31 (06) 1827-1832.
  • 95 Sporimune®. Fachinformation in Form der Zusammenfassung der Merkmale des Tierarzneimittels Sporimune® 50 mg/ml Lösung zum Eingeben für Hunde und Katzen. 2016
  • 96 Spurlock NK, Prittie JE. A review of current indications, adverse effects, and administration recommendations for intravenous immunoglobulin. J Vet Emerg Crit Care 2011; 21 (05) 471-483.
  • 97 Stein TJ, Pellin M, Steinberg H, Chun R. Treatment of feline gastrointestinal small-cell lymphoma with chlorambucil and glucocorticoids. J Am Anim Hosp Assoc 2010; 46 (06) 413-417.
  • 98 Stokol T, Blue JT. Pure red cell aplasia in cats: 9 cases (1989–1997). J Am Vet Med Assoc 1999; 214 (01) 75-79.
  • 99 Swann JW, Garden OA. Novel immunotherapies for immune-mediated haemolytic anaemia in dogs and people. Vet J 2016; 207 (01) 13-19.
  • 100 Swann JW, Skelly BJ. Evaluation of immunosuppressive regimens for immune-mediated haemolytic anaemia: a retrospective study of 42 dogs. J Small Anim Pract 2011; 52 (07) 353-358.
  • 101 Swann JW, Skelly BJ. Systematic review of evidence relating to the treatment of immune-mediated hemolytic anemia in dogs. J Vet Intern Med 2013; 27 (01) 1-9.
  • 102 Swann JW, Skelly BJ. Systematic review of prognostic factors for mortality in dogs with immune-mediated hemolytic anemia. J Vet Intern Med 2015; 29 (01) 7-13.
  • 103 Swann JW, Szladovits B, Glanemann B. Demographic characteristics, survival and prognostic factors for mortality in cats with primary immunemediated hemolytic anemia. J Vet Intern Med 2016; 30 (01) 147-156.
  • 104 Swann JW, Woods K, Wu Y, Glanemann B, Garden OA. Characterisation of the immunophenotype of dogs with primary immune-mediated haemolytic anaemia. PLoS One 2016; 11 (12) e0168296.
  • 105 Thomason J, Archer T, Wills R, Press S, Mackin A. The effects of cyclosporine and aspirin on platelet function in normal dogs. J Vet Intern Med 2016; 30 (04) 1022-1230.
  • 106 Trotman TK, Phillips H, Fordyce H, King LG, Morris DO, Giger U. Treatment of severe adverse cutaneous drug reactions with human intravenous immunoglobulin in two dogs. J Am Anim Hosp Assoc 2006; 42 (04) 312-320.
  • 107 Valenciano AC, Decker LS, Cowell RL. Interpretation of feline leukocyte responses. In: Schalm’s Veterinary Hematology. 6th edn.. Weiss DJ, Wardrop KJ. eds. Ames: Wiley-Blackwell; 2010: 335-344.
  • 108 Viviano KR. Update on immununosuppressive therapies for dogs and cats. Vet Clin North Am Small Anim Pract 2013; 43 (05) 1149-1170.
  • 109 Viviano KR, Webb JL. Clinical use of cyclosporine as an adjunctive therapy in the management of feline idiopathic pure red cell aplasia. J Feline Med Surg 2011; 13 (12) 885-895.
  • 110 Volkmann M, Hepworth MR, Ebner F, Rausch S, Kohn B, Hartmann S. Frequencies of regulatory T cells in the peripheral blood of dogs with primary immune-mediated thrombocytopenia and chronic enteropathy: a pilot study. Vet J 2014; 202 (03) 630-633.
  • 111 Wallisch K, Trepanier LA. Incidence, timing, and risk factors of azathioprine hepatotoxicosis in dogs. J Vet Intern Med 2015; 29: 513-518.
  • 112 Wang A, Smith JR, Creevy KE. Treatment of canine idiopathic immunemediated haemolytic anaemia with mycophenolate mofetil and glucocorticoids: 30 cases (2007 to 2011). J Small Anim Pract 2013; 54 (08) 399-404.
  • 113 Webb JA, Keller SL, Southorn EP, Armstrong J, Allen DG, Peregrine AS, Dubey JP. Cutaneous manifestations of disseminated toxoplasmosis in an immunosuppressed dog. J Am Anim Hosp Assoc 2005; 41 (03) 198-202.
  • 114 Weinkle TK, Center SA, Randolph JF, Warner KL, Barr SC, Erb HN. Evaluation of prognostic factors, survival rates, and treatment protocols for immune-mediated hemolytic anemia in dogs: 151 cases (1993–2002). J Am Vet Med Assoc 2005; 226 (11) 1869-1880.
  • 115 West LD, Hart JR. Treatment of idiopathic immune-mediated hemolytic anemia with mycophenolate mofetil in five dogs. J Vet Emerg Crit Care 2014; 24 (02) 226-231.
  • 116 Whelan MF, O’Toole TE, Chan DL, Rozanski EA, DeLaforcade AM, Crawford SL, Cotter SM. Use of human immunoglobulin in addition to glucocorticoids for the initial treatment of dogs with immune-mediated hemolytic anemia. J Vet Emerg Crit Care 2009; 19 (02) 158-164.
  • 117 Whitley NT, Day MJ. Immunomodulatory drugs and their application to the management of canine immune-mediated disease. J Small Anim Pract 2011; 52 (02) 70-85.
  • 118 Wong MA, Hopkins AL, Meeks JC, Clarke JD. Evaluation of treatment with a combination of azathioprine and prednisone in dogs with meningoencephalomyelitis of undetermined etiology: 40 cases (2000–2007). J Am Vet Med Assoc 2010; 237 (08) 929-935.
  • 119 Woolcock AD, Keenan A, Cheung C, Christian JA, Moore GE. Thrombocytosis in 715 dogs (2011–2015). J Vet Intern Med 2017; 31 (06) 1691-1699.
  • 120 Woolcock AD, Wang A, Haley A, Kent M, Creevy KE, Platt SR. Treatment of canine meningoencephalomyelitis of unknown aetiology with mycophenolate mofetil and corticosteroids: 25 cases (2007–2012). Vet Med Sci 2016; 02 (02) 125-135.
  • 121 Yau VK, Bianco D. Treatment of five haemodynamically stable dogs with immune-mediated thrombocytopenia using mycophenolate mofetil as single agent. J Small Anim Pract 2014; 55 (06) 330-333.
  • 122 Zini E, Hauser B, Meli ML, Glaus TM. Immune-mediated erythroid and megakaryocytic aplasia in a cat. J Am Vet Med Assoc 2007; 230 (07) 1024-1027.
  • 123 Zoia A, Drigo M. Association between pancreatitis and immune-mediated haemolytic anaemia in cats: a cross-sectional study. J Comp Pathol 2017; 156 (04) 384-388.