Article Text

Download PDFPDF
Randomised controlled trial of fractionated and unfractionated prednisolone regimens for dogs with immune-mediated haemolytic anaemia
  1. James W Swann1,
  2. Balazs Szladovits2,
  3. Anna J Threlfall3,
  4. Oliver A Garden4,
  5. Yu-Mei Chang5,
  6. David B Church6 and
  7. Barbara Glanemann6
  1. 1 Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
  2. 2 Pathology and Pathogen Biology, Royal Veterinary College, Hatfield, UK
  3. 3 Small Animal Internal Medicine, Davies Veterinary Specialists, Higham Gobion, UK
  4. 4 School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  5. 5 Research Support Office, Royal Veterinary College, London, UK
  6. 6 Queen Mother Hospital for Animals, Royal Veterinary College, Hatfield, UK
  1. E-mail for correspondence; james.swann{at}


Methods A randomised non-blinded non-inferiority trial was conducted to determine whether treatment with an unfractionated regimen of oral prednisolone was inferior to a fractionated regimen for dogs with primary immune-mediated haemolytic anaemia. Dogs received the same total daily dose of prednisolone as unfractionated (group 1, starting at 4 mg/kg orally once daily) or fractionated (group 2, starting at 2 mg/kg orally twice daily) doses. Questionnaires were administered to owners to assess adverse effects and quality of life (QoL). End points included survival to eight weeks, and changes in QoL and clinicopathological parameters over time.

Results Thirty-nine dogs were enrolled in the study, of which 5 were withdrawn and 17 were assigned to each group. The number of cases recruited was insufficient to determine whether unfractionated treatment was inferior to fractionated. Total serum bilirubin decreased more rapidly in dogs in group 2, whereas polydipsia improved more rapidly in group 1. Blood pressure and score for polyuria were higher in dogs in group 2 over time, whereas lymphocyte concentration was lower.

Conclusion Administration of the same total daily dose of prednisolone as an unfractionated dose resulted in fewer adverse effects but the effect on survival could not be assessed in this study.

  • dogs
  • fractionated
  • IMHA
  • prednisolone
View Full Text

Statistics from


  • Funding This study was funded by PetSavers (grant number: CRP 05.13).

  • Competing interests None declared.

  • Ethics approval The trial was approved by the Clinical Research Ethical Review Board at the Royal Veterinary College, University of London (reference number 2011_1134).

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.