Page 26 - Eclipse - Autumn/Winter 2023

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Page 26 - Eclipse - Autumn/Winter 2023
P. 26

CLINICAL NEWS







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        A decade of extracorporeal therapy





               en years ago the RVC began   had died, despite expert veterinary care.   infection (leptospirosis), causing acute
               delivering extracorporeal    Alba’s condition continued to deteriorate   kidney failure and liver damage.
               therapies for cats and dogs with   in hospital and her urine production
        Tkidney injury, immune-mediated     decreased – a sign the kidneys were   Despite starting antibiotic treatment and
                                                                                supportive therapy, including diuretics, his
        disease and certain toxicities. More   shutting down.                   kidneys completely stopped producing urine
        than 50 patients have since received   Plasmapheresis had never been    and the team was concerned he would
        the advanced treatment, most of which   attempted as a treatment for a dog with   develop life-threatening complications.
        would have died without it.
                                            CRGV, but her owners were keen that all   Dialysis was discussed with Marty’s
        RVC Small Animal Referrals remains the   treatments were considered. Using the   owners and three dialysis sessions were
        only veterinary centre in the UK to offer   evidence-base from human medicine,   performed over the following days. Marty
        extracorporeal therapy. The machine uses   where similar conditions can be helped   started producing urine after the final
        different filters, which allow removal of   by TPE, Alba was treated with this novel   session, which was a fabulous outcome
        different sizes and types of molecules.   therapy. She made a good recovery and   for the team looking after him. His kidney
        These molecules could be undesirable   went on to become an active adult dog.   values gradually returned to normal, and
        substances or specific antibodies, which                                by discharge he had returned to his usual
        can cause various auto-immune diseases.  Marty’s case                   excitable temperament.
        The treatment is called renal replacement   A more recent patient was 10-week-  The extracorporeal therapy equipment
        therapy (a form of dialysis) when treating   old Labrador Marty, who was referred   was funded by the RVC’s registered
        patients with acute kidney failure, and   this year. He presented with a bacterial   charity, the Animal Care Trust.
        plasmapheresis or therapeutic plasma
        exchange (TPE) when treating patients
        with immune-mediated disease. Both
        dialysis and plasmapheresis can be used
        for the removal of toxins and drugs.
        ‘Alabama rot’ and Alba
        In 2014 the team and equipment enabled
        a breakthrough in the treatment of
        cutaneous renal glomerular vasculopathy
        (CRGV), dubbed ‘Alabama rot’ and ‘New
        Forest syndrome’. A Labrador puppy
        called Alba started developing wounds
        over her body and acute kidney injury.
        She was referred to RVC Emergency
        and Critical Care clinicians, who became
        concerned she was suffering from CRGV.
        There were no documented cases of
        dogs with this condition and severe renal   Marty
        failure surviving and dozens of dogs


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