Erythropoietin Retrospective Study

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ErythropoietinRetrospective Study

• Recombinant Human ErythropoietinDogs and Cats
  with Naturally Occurring Renal Failure

Dr. Dianne E. Kittrell, DVMDr. Cathy Langston,
ACVIMThe Animal Medical CenterJanuary 30, 2003
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Retrospective Overview

• Background Information
• Population Signalment
• Results and Discussion
• Case Study Examples

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Background Information

• The Problem Anemia of renal failure
• Both Human recognition and animal incidence
• anemia of human CRF, recognized 1836
• Anemia present 35 feline CRF, reported1992
• Main Causes Pathogenesis of anemia
• Inadequate erythropoietin
• Limits red blood cell production
• shortened red cell survival, recognized 1953
• platelet dysfunction, recognized 1956
• Iron deficiency and uremic bleeding

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Background Information

• The Solution r-HuEPO
• Structurally conserved among species
• R-HuEPO suitable replacement, 1985
• Efficacy established in animals, 1998
• The Objective
• Evaluate resolution of anemia and resultant
  complications of erythropoietin treatment

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Population Signalment
Canine (17)
Feline (83)
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Adverse Effects of Treatment

• Antibody formation
• Hypertension
• Seizure activity
• Polycythemia
• Pain on injection site

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Population Response to Therapy
Indeterminate (27)
Responsive (57)
Unresponsive (16)
Conclusion Population sample demonstrates strong
response to therapy with limited complications
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Median Survival from EPO Start
plt0.0001
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Canine Median Survival from EPO
plt0.0001
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Feline Median Survival from EPO
plt0.0001
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Case Study Comparisons
Case 715009Alex Steinbuch, Feline Siamese MC
Case 714687Sylvester McGee, Feline DSH MC
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Case 01 Optimal Response
Case 715009Alex Steinbuch, Feline Siamese MC
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Case 02 Antibody Complications
Case 714687Sylvester McGee, Feline DSH MC
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Concluding Remarks

• Evidence suggests that erythropoietin treatment
  positively impacts animals quality of life

• Final comments
• Further research
• Research Citations

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References

• Cowgill LD, James KM, Levy JK, Browne JK, Miller
  A, Lobinger RT, Egrie JC. Use of recombinant
  human erythropoietin for management of anemia in
  dogs and cats with renal failure. JAVMA, Vol
  212, No 4, Feb 15, 1998.
• Osborne CA, Lulich p, OBrien TD, Polzin DJ.
  Feline renal failure Questions, answers,
  questions. The Compendium, Vol 14, No 2, Feb
  1992.
• Eschbach JW, Egriem JC, Michael RD, Browne JK,
  Adamson JW. Correction of the anemia of
  end-stage renal disease with recombinant human
  erythropoietin. The New England Journal of
  Medicine, Jan 8, 1987. pp.73-78
• Eschbach JW, Haley NR, Adamson JW. The anemia of
  chronic renal failure Pathophysiology and
  effects of recombinant erythropoietin.
  Complications in chronic renal failure. Contrib
  Nephrology. Vol 78, 1990. pp.24-37
• Rrslev AJ. Erythropoietin. The New England
  Journal of Medicine, May 9, 1991, Vol 324, No 19.
  pp. 1339-1344