Consensus Recommendations for Immunosuppressive Treatment of Dogs with Glomerular Disease Based on Established Pathology

摘要: The purpose of this report was to provide consensus recommendations for the use immunosuppressive therapy in dogs with active glomerular diseases. Recommendations were developed based on comprehensive review relevant literature disease and humans, contemporary expert opinion, anecdotal experience treated immunosuppression. subsequently validated by a formal methodology. Study Group recommends empirical application severe, persistent, or progressive which there is evidence an immune-mediated pathogenesis kidney biopsy no identified contraindication therapy. most compelling supporting mechanisms includes electron-dense deposits transmission electron microscopic examination unequivocal immunofluorescent staining glomeruli. For diseases associated profound proteinuria, attendant hypoalbuminemia, nephrotic syndrome, rapidly azotemia, single drug combination consisting acting drugs recommended. mycophenolate alone prednisolone. To minimize adverse effects, glucocorticoids should not be used as sole treatment, when concurrently mycophenolate, tapered quickly possible. stable slowly diseases, chlorambucil azathioprine alternating days. Therapeutic effectiveness assessed serially changes renal function, serum albumin concentration. In absence overt at least 8 weeks nonsteroidal 8-12 provided before altering abandoning trial.