Treating the ITP patient with vincristine versus human IVIG | VETgirl Veterinary Continuing Education Podcasts

Summary: In today's VETgirl online veterinary continuing education podcast, we discuss treatment for immune-mediated thrombocytopenia (ITP) in dogs. Have you treated a patient with primary ITP? Did you use steroids alone, or did you try combination therapy with vincristine or human intravenous immunoglobulin (hIVIG)? Well, while treatment with immunosuppressive doses of glucocorticoids is the initial treatment of choice, and most patients will have platelet recovery within 1-15 days of starting treatment, adding treatment with vincristine or hIVIG has been shown to shorten platelet recovery time. In some peer-reviewed, scientific veterinary prospective studies, dogs with severe ITP treated with prednisone alone versus prednisone and vincristine, or prednisone alone versus prednisone and hIVIG, both combination therapies resulted in faster increases in platelet numbers and shorter durations of hospitalization. To date, though, there haven't been any studies looking at the efficacy of vincristine versus hIVIG as adjunctive treatments. This is important because hIVIG is much more expensive, and giving it to your patient is more time consuming and challenging that giving vincristine.