Extracorporeal Therapies
Extracorporeal therapies.
Since November 2023, the Pet Emergency and Intensive Care Department at ULiège's Clinique Vétérinaire Universitaire (CVU) has been offering the possibility of treating its patients with extracorporeal therapies such as dialysis and plasmapheresis.
These therapies enable us to provide better care for patients suffering from intoxication, acute kidney disease or immune-mediated diseases (hemolytic anemia, thrombocytopenia, polyradiculoneuritis or myasthenia gravis).
What are extracorporeal therapies?
These involve the use of machines specifically developed to purify blood by eliminating undesirable components or those present in abnormal
quantities. Depending on the technique used (hemodialysis, hemofiltration, hemoperfusion, plasmapheresis, etc.), it is possible to target the type of component (metabolites, toxins, antibodies, proteins, cells, etc.) to be eliminated.
What techniques are available and what are the indications?
Hemodialysis:
Like mechanical ventilation, used as a supportive treatment for severe respiratory failure, hemodialysis is an extracorporeal technique developed to provide support for patients with severe renal failure, by substituting renal function with an "artificial kidney". In the same way that a ventilator does not treat the underlying cause, hemodialysis offers support, and therefore time for the patient suffering from acute renal failure to recover. What's more, hemodialysis ensures a better quality of life for the patient, as excess nitrogenous substances are eliminated, and electrolyte, water and acid-base disorders are corrected thanks to this treatment.
The duration of treatment and the number of sessions required for a patient in acute renal failure are not predictable, but the average number of sessions in veterinary facilities that perform hemodialysis is around 3 to 5. The patient's daily clinical evolution and biological constants will be predictive of the possibility of weaning.
A number of toxic molecules are also dialyzable, making hemodialysis the treatment of choice in cases of severe intoxication, with extremely favorable results when the patient is treated rapidly after ingestion.
Some dialyzable toxic substances: barbiturates (phenobarbital, pentobarbital), theophylline, methanol, ethylene glycol, digoxin, paracetamol, lithium, theobromine, etc
Hemoperfusion:
This is a treatment modality in which the blood circulates through an adsorbent filter, making it possible to extract toxic substances or overdosed drugs. However, other indications are being studied in human medicine, notably as adjuvant treatment of sepsis or severe acute inflammation.
Plasmapheresis:
Unlike hemodialysis, where only small blood components are filtered out, plasmapheresis removes all plasma components, including large molecules such as proteins and lipids.
Information :
If you are interested in this study or have any questions about it, please do not hesitate to contact Dr Etienne ESCANDE, DMV or Dr Kris GOMMEREN, DMV, DECVIM-CA, DECVECC.
