Immune Globulin,Dose, contraindications and adverse effects.

Human intravenous immune globulin (IVIG), used off label in dogs and cats for severe immune-mediated disease such as immune-mediated hemolytic anemia and… Human intravenous immune globulin (IVIG) has been used in veterinary medicine for immune-mediated hemolytic anemia (IMHA), immune-mediated thrombocytopenia (ITP), Evans syndrome, myasthenia gravis, sudden acquired retinal degeneration syndrome (SARDS),1 and dermatologic autoimmune diseases. However, available studies have demonstrated mixed results.

Immunoglobulins are produced by B lymphocytes as part of the humoral response to foreign antigens. The actions of intravenous immune globulin (IVIG) antibodies in autoimmune disease are poorly understood and likely multifactorial and modulate the immune system by Fc receptor disruption, pathologic autoantibody neutralization, complement inhibition, Fas-Fas ligand (FasL)…

Dogs that have had prior hypersensitivity reactions after receiving human albumin should not receive intravenous immune globulin (IVIG). Trace amounts of human albumin may be found in IVIG. In humans, many adverse reactions are associated with administering IVIG at rates higher than recommended. Follow infusion rate guidelines carefully. At doses used in dogs (0.5 – 1.5 g/kg), IVIG is generally infused over a 6- to 12-hour period.

In dogs, intravenous immune globulin (IVIG) can cause increased blood pressure. Local reactions at or near the injection site are possible. Anecdotal reports of anaphylaxis have been reported in dogs receiving IVIG. IVIG can contain trace amounts of human albumin that has been associated with hypersensitivity reactions in dogs. As IVIG can have colloid-like properties, volume overload is possible.

■ Blood pressure and TPR prior to infusion and frequently during administration ■ Lung auscultation to assess for volume overload ■ Renal function tests and urine output ■ Clinical efficacy and subsequent monitoring depend on the purpose for use.