Plasmapheresis in Dogs

Dogs experiencing autoimmune disease or toxicity may have components in their blood plasma contributing to the disorder. Dogs with these conditions can undergo plasmapheresis to remove and replace components of their plasma contributing to disease with “healthy” plasma components. Components such as autoantibodies, immune complexes, and proinflammatory agents present in plasma may contribute to disease and disorder. By removing and replacing these components with replacement plasma or an inert substance, inhibition of disease progression may be achieved. 

Plasmapheresis is usually used after initial, less invasive treatments fail. However, other immunosuppressive and anti-toxicity treatments that are available take time to be effective, whereas plasmapheresis is a fast acting treatment and may be appropriate in some acute situations. The buildup of disease contributing plasma components will continue after plasmapheresis if the underlying disease or disorder is not identified and treated, resulting in repeated plasmapheresis treatment being required. This procedure should be performed by a veterinarian with supportive care and management available.

The procedure may be repeated over a course of treatments with several day intervals. Anesthetic is usually provided intravenously. Vital signs including blood volume, blood pressure, and coagulation are carefully monitored during the process. Pre and post treatment blood samples are taken to gauge the components present in blood before and after the procedure. A catheter is placed in a major artery and blood from your dog flow into a plasma separator apparatus. Plasma is separated from blood using a centrifuge or membrane filtration technique. Once separated, plasma is filtered through a plasma filter to remove components. The “cleaned” plasma is then mixed with inert cellular blood components and infused back into your dog through a separate catheter into a separate vessel. Sodium citrate is added to bind with calcium in the blood and prevent clotting during this process.

Plasmapheresis is effective for rapid reduction of toxins or immune complexes in plasma in your dog, thus making it a useful therapy for autoimmune disorders. Veterinary use has been somewhat limited in the past and other, more traditional treatments may be used as a primary method of treatment. However, if results are urgent or other therapy fails, plasmapheresis can be a useful option for treatment in your dog.

During and immediately after plasmapheresis therapy, your dog may experience a drop in blood pressure resulting in dizziness, chills and abdominal cramps. Warm blankets and providing them with comfort will help alleviate these symptoms which are usually of short duration. Allow your dog to rest for several hours after the procedure until they are feeling stable and not likely to fall or injure themselves due to dizziness.

As infection, allergic reaction, and problems with blood clotting can occur, although rarely, you should monitor your dog for signs of these conditions and seek veterinary help immediately if they occur.

Multiple plasmapheresis procedures may be required, which will contribute to variations in cost depending on the number of treatments required. Plasmapheresis treatment ranges from $500 to $3,000 or more depending on the cost of living in your area and the number of treatments required.

Although side effects are minimal and usually well-tolerated, blood clotting issues can occur. Treatment with sodium citrate to bind calcium in the blood and prevent inappropriate clotting mitigates this risk. 

Bleeding from catheter sites and damage to vessels at the catheter site can occur. Careful insertion and removal of catheters is necessary.

Infection from contamination is possible and sterile procedures are necessary to ensure this does not occur.

Regular veterinary care to address disease and parasitic infections at an early stage before your dog's immune system becomes overwhelmed or dysfunctional may reduce the incidence of toxic and immune component buildup in plasma resulting in disorders in your dog. In addition, early intervention when autoimmune disorders manifest may allow for less invasive, traditional therapies to be effective, avoiding plasmapheresis therapy.