A suspected case of a multiple autoimmune syndrome in a poodle dog

Lim, Dahye; Jin, Yunseok; Son, Young-Min; Oh, Tae-Ho; Bae, Seulgi

doi:10.1002/vms3.741

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…16 Multiple studies support the role of leflunomide for managing canine IMPA, immune-mediated hemolytic anemia, immune-mediated thrombocytopenia, cutaneous histiocytosis, and colorectal polyps. 2,8,17 Severe adverse effects were documented when administered at doses higher than 4 mg/kg/d. 10,12 At doses of 3 to 4 mg/kg/d, response rates of 80% to 93% are reported for multiple immune-mediated conditions, but adverse effects were treatment limiting or prompted further dose reduction.…”

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confidence: 99%

Leflunomide with prednisone or nonsteroidal anti-inflammatory drug therapy is safe and tolerated for long-term treatment of immune-mediated polyarthritis in 27 dogs

Chesne,

Doornink,

Sri-Jayantha

et al. 2024

javma

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OBJECTIVE To retrospectively evaluate safety and tolerance of leflunomide for long-term treatment of canine idiopathic immune-mediated polyarthritis (IMPA). ANIMALS 27 dogs with clinical signs and synovial fluid cytology supportive of IMPA with ≥ 6 months’ follow-up after starting leflunomide. METHODS Medical records were reviewed to identify dogs prescribed leflunomide for treatment of IMPA from February 2012 to May 2022. Initial leflunomide doses of 2 to 4 mg/kg once daily were prescribed and were titrated to the lowest effective dose with concurrent anti-inflammatory therapy. Complete blood count, serum chemistry, and clinical signs were monitored throughout the course of treatment. RESULTS Adverse effects potentially attributable to leflunomide noted in 9 of 27 dogs (33%) included vomiting, diarrhea, lethargy, decreased or absent appetite, polyuria and polydipsia, and secondary antibiotic responsive infection and were self-limiting or resolved with outpatient therapy. Alkaline phosphatase (ALP) and alanine aminotransferase (ALT) elevation were documented in all dogs prescribed leflunomide plus prednisone, with persistent liver enzyme elevation in 6 of 9 dogs (67%) and normalization after antibiotic therapy in 3 of 9 dogs (33%). The majority of dogs prescribed leflunomide plus NSAID (11/17 [65%] dogs) did not experience liver enzyme elevation; 2 of 17 (12%) dogs developed transient antibiotic-responsive liver enzyme elevations, and 4 of 17 (23%) dogs had persistent liver enzyme elevation. CLINICAL RELEVANCE Leflunomide was well tolerated for long-term management of IMPA. A significant difference in liver enzyme elevation was identified between dogs prescribed prednisone versus NSAID in combination with leflunomide. Leflunomide with NSAID therapy resulted in less hepatotoxicity compared with leflunomide with prednisone.

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mentioning

confidence: 99%

Leflunomide with prednisone or nonsteroidal anti-inflammatory drug therapy is safe and tolerated for long-term treatment of immune-mediated polyarthritis in 27 dogs

Chesne,

Doornink,

Sri-Jayantha

et al. 2024

javma

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A suspected case of a multiple autoimmune syndrome in a poodle dog

Lim

Jin

Son

et al. 2022

Veterinary Medicine & Sci

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A 9-year-old castrated male poodle dog was presented with icterus, anorexia, and lethargy. The dog was diagnosed with hypothyroidism 1 month before and was treated with levothyroxine. Severe anaemia with spherocytes, positive saline agglutination test, and hyperbilirubinemia indicated immune-mediated haemolytic anaemia (IMHA).Therefore, immunosuppressive therapy with prednisolone, mycophenolate mofetil, and danazol was started. Although the IMHA was well controlled, during tapering of prednisolone, acute multiple joint swelling and oedema suspected immune-mediated polyarthritis occurred twice. First, clinical symptoms improved as the dosage of prednisolone increased. However, the dog showed severe adverse effects to the steroid.Second time, we added leflunomide as another immunosuppressant, and clinical signs of arthritis disappeared. About 3 weeks later, despite the immunosuppressive therapy, skin lesions resembling an autoimmune dermatologic disorder spread throughout the body. Addition of cyclosporine resolved the skin lesions. This is a case report of a dog showing several sporadic clinical signs related to multiple autoimmune syndromes and their management using different immunosuppressant drugs.

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Suspected multiple autoimmune syndrome in a Kelpie with hypoadrenocorticism

Cleary

2024

Vet Record Case Reports

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An 8‐year‐old, female, spayed Kelpie cross presented with hyporexia, pica, vomiting, collapse and seizures. It was diagnosed with eunatraemic, eukalaemic hypoadrenocorticism, immune‐mediated anaemia and immune‐mediated thrombocytopenia, possibly representing an example of multiple autoimmune syndrome type 3. All abnormalities resolved and the patient was alive nearly 3 years later, maintained on physiological doses of prednisolone. This case serves as a reminder of the variable presentations of eunatraemic, eukalaemic hypoadrenocorticism and the potential for concurrent immune‐mediated disease.

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A suspected case of a multiple autoimmune syndrome in a poodle dog

Cited by 4 publications

References 16 publications

Leflunomide with prednisone or nonsteroidal anti-inflammatory drug therapy is safe and tolerated for long-term treatment of immune-mediated polyarthritis in 27 dogs

Leflunomide with prednisone or nonsteroidal anti-inflammatory drug therapy is safe and tolerated for long-term treatment of immune-mediated polyarthritis in 27 dogs

A suspected case of a multiple autoimmune syndrome in a poodle dog

Suspected multiple autoimmune syndrome in a Kelpie with hypoadrenocorticism

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