Colorado Animal Specialty & Emergency (CASE) treats patients requiring extracorporeal therapies (ECTs - hemodialysis, hemoperfusion, and apheresis) for acute and chronic kidney disease, intoxications, immune-mediated diseases, and certain types of neoplasia.
Hemodialysis is a therapy that removes blood from the body, which is pumped through a dialyzer (acting like the kidney) to purify the blood. This therapy is extremely effective at eliminating toxic metabolites, balancing electrolytes, and removing excess total body water. Hemodialysis in veterinary medicine is typically performed in patients with acute kidney injury, but can also be performed in patients with chronic kidney disease to prolong quality of life. We recommended to start with two weeks of treatments, then assess if there is improvement in kidney function over that time period and determine if additional treatments are necessary. It is not uncommon for patients to need additional treatments for 2-4 more weeks depending on the underlying cause and prior stage of kidney disease.
CASE also offers these procedures in dogs and cats with witnessed or suspected toxin exposure. Hemodialysis, hemoperfusion, and plasmapheresis are performed to accelerate the elimination of the toxin, which can have negative effects on the body. These therapies have been used to treat a variety of toxins such as (but not limited to) NSAIDs, ethylene glycol (antifreeze), 5-FU, phenobarbital, baclofen, and chemotherapeutic overdoses. Patients typically receive one treatment to expedite the elimination of the toxin within the body, then may require additional hospitalization (2-3 days in some cases) to monitor clinical signs.
Therapeutic Plasma Exchange (TPE)
CASE also offers plasmapheresis, more commonly known as therapeutic plasma exchange (TPE) for immune-mediated conditions that are refractory to conventional medical therapy. With TPE, pathologic antibodies and immune complexes are removed along with the patient’s plasma. The machine separates and discards the patient’s plasma from the red blood cells, then the plasma is replaced with healthy donor plasma. This therapy rapidly eliminates the antibodies to allow time for the immunosuppressive medications to take effect. Common immune-mediated diseases treated with plasmapheresis include IMHA, ITP, myasthenia gravis, glomerulonephritis, polyradiculoneuritis, and others. These therapies are performed in humans with similar diseases and have shown to be beneficial. Plasmapheresis does improve prognosis in veterinary patients that are severely affected by these conditions.
Cytapheresis is a distinct form of plasmapheresis where specific cell types (white blood cells, red blood cells, platelets) are removed from the blood. This procedure is gaining interest in veterinary medicine for alternative options to treat cancer with immunotherapy. We are happy to provide this therapy for cancer patients and clients who wish to explore alternative or additional options to chemotherapy. Please do not hesitate to reach out for consultation.
The Nephrology & Extracorporeal Therapies Service is excited to provide these treatment options to help improve the lives of pets with severe disease. Please do not hesitate to contact our team at (303) 545-2273. We are readily available for consultation on prospective cases.