Topic:Azathioprine
Azathioprine is an immunosuppressive medication used in veterinary medicine, including equine practice, to manage autoimmune conditions and reduce inflammatory responses in horses. It acts by inhibiting the proliferation of lymphocytes, thereby modulating the immune system. Azathioprine is often administered in cases where corticosteroids alone are insufficient or when a steroid-sparing effect is desired. The use of azathioprine in horses requires careful monitoring due to potential side effects, such as bone marrow suppression and liver toxicity. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacokinetics, therapeutic applications, and safety profile of azathioprine in equine medicine.
[Therapy of bullous pemphigoid in a Warmblood gelding]. A 15-year-old Warmblood gelding was presented with multiple large, ulcerative, and crusty dermal lesions that had been existing for 4 years. Histopathology of a skin biopsy revealed cleft formation at the dermal-epidermal junction beneath the basal cells and above the basement membrane leading to the diagnosis of bullous pemphigoid. Immunosuppressive therapy with dexamethasone and azathioprine was initiated and after 14 weeks full remission of the ulcers was achieved. Scar tissue formation was evident in the areas of the formerly affected lesions. Following medication tapering over a perio...
Corticosteroids and Immune Suppressive Therapies in Horses. Immune suppressive therapies target exaggerated and deleterious responses of the immune system. Triggered by exogenous or endogenous factors, these improper responses can lead to immune or inflammatory manifestations, such as urticaria, equine asthma, or autoimmune and immune-mediated diseases. Glucocorticoids are the most commonly used immune suppressive drugs and the only ones supported by robust evidence of clinical efficacy in equine medicine. In some conditions, combining glucocorticoids with other pharmacologic and nonpharmacologic treatments, such as azathioprine, antihistamine, broncho...
Hemorrhage and blood loss-induced anemia associated with an acquired coagulation factor VIII inhibitor in a Thoroughbred mare. A 23-year-old Thoroughbred mare was evaluated because of a coagulopathy causing hemoperitoneum, hematomas, and signs of blood loss-induced anemia. Results: The mare had tachycardia, pallor, hypoperfusion, and a large mass in the right flank. The mass was further characterized ultrasonographically as an extensive hematoma in the body wall with associated hemoabdomen. Coagulation testing revealed persistent, specific prolongation of the activated partial thromboplastin time (> 100 seconds; reference interval, 24 to 44 seconds) attributable to severe factor VIII deficiency (12%; reference inte...
Idiopathic immune-mediated polysynovitis in three horses. This paper describes the clinical, laboratory and histological findings in three horses with immune-mediated polysynovitis; they had lost weight, suffered intermittent fever, were lethargic and stiff, and had effusions in several joints. Laboratory abnormalities included anaemia, leucocytosis, hyperfibrinogenaemia and hyperglobulinaemia. The diagnosis was based on the presence of a suppurative, non-septic inflammation in at least two different joints in each of the horses and the presence of immunoglobulins in the synovial membrane of one of them. The horses were treated with a combination of ...
Pharmacokinetics of azathioprine following single-dose intravenous and oral administration and effects of azathioprine following chronic oral administration in horses. To determine pharmacokinetics of azathioprine (AZA) and clinical, hematologic, and serologic effects of i.v. and oral administration of AZA in horses. Methods: 6 horses. Methods: In study phase 1, a single dose of AZA was administered i.v. (1.5 mg/kg) or orally (3.0 mg/kg) to 6 horses, with at least 1 week between treatments. Blood samples were collected for AZA and 6-mercaptopurine (6-MP) analysis 1 hour before and at predetermined time points up to 4 hours after AZA administration. In study phase 2, AZA was administered orally (3 mg/kg) every 24 hours for 30 days and then every 48 hours for ...
Flow cytometric detection of platelet-bound antibody in three horses with immune-mediated thrombocytopenia. Immune-mediated thrombocytopenia (IMT) is a sporadic cause of thrombocytopenia in horses for which it is difficult to establish a definitive diagnosis. In this report, we describe 3 horses with severe thrombocytopenia in which flow cytometric analysis of platelets for surface-bound IgG was used in an attempt to substantiate a provisional diagnosis of IMT. A distinct proportion (4.28%, 5.04%, and 7.95%) of platelets with surface-bound IgG was detected in the 3 thrombocytopenic horses, but not in 6 healthy horses (0.03% to 0.15%) or 6 horses with colic (0.00% to 1.21%). These results, in conjunc...
Thiopurine methyltransferase in red blood cells of dogs, cats, and horses. Our objective was to determine if thiopurine methyltransferase (TPMT), the enzyme important in the metabolism of azathioprine in human beings, is detectable in red blood cell lysates (RBCL) of healthy dogs, cats, and horses. Values for TPMT activity were determined from blood collected from 20 healthy dogs, cats, and horses. The TPMT activity in each animal's RBCL was determined using a radioenzymatic end point involving TPMT-facilitated metabolism of 6-mercaptopurine to 6-methylmercaptopurine (6-MMP). One unit of TPMT activity represents the formation of 1 nmol of 6-MMP per milliliter of pack...
Azathioprine for treatment of immune-mediated thrombocytopenia in two horses. Azathioprine, a thiopurine antimetabolite used in the treatment of immune-mediated thrombocytopenia in human beings and dogs, was used in 2 cases of immune-mediated thrombocytopenia in horses that failed to respond to corticosteroid therapy alone. Platelet counts were increased to acceptable values in both horses. One horse returned to a successful racing career, and the other was euthanatized after developing renal disease and mild laminitis.
Immune-mediated hemolytic anemia in a horse. An 18-year-old Quarter Horse gelding was determined to have immune-mediated hemolytic anemia after detection of autoagglutination of RBC spherocytosis as well as a positive direct Coombs test result. A lack of response to treatment with corticosteroids necessiated the administration of cyclophosphamide and azathioprine. The anemia resolved after treatment with chemotherapeutic drugs.
Recent experience with heart transplantation. The major factors contributing to the recommencement of clinical heart transplantation in the United Kingdom last year were the steadily improving results from Stanford University, the clarification of the diagnosis of brain death, and advances in preserving donor hearts. Twelve men aged 16 to 52 years received heart transplants at Papworth Hospital from January 1979 to July 1980. Six had cardiomyopathies and six ischaemic heart disease. The donors were aged 16 to 35 (mean 21) years. A combination of road and air transport was used to transport the heart to Papworth in seven cases. The total d...
Seven years’ experience with antilymphoblast globulin for renal transplantation from cadaver donors. Antibody of the IgGab type can be isolated from horses immunized with cultured human lymphoblasts plus complete Freund's adjuvant. The essential steps for the production of a safe, potent anti-human lymphoblast globulin (ALG) are: A) the use of early bleedings after immunization to reduce the titer of antibodies which react with red blood cells and platelets; B) careful absorption with human red blood cell stroma and platelets; C) stabilization with non-crystalline silica dioxide; D) chromatography through QAE sephadex to remove pyrogens, microaggregates and possible inhibitors of ALG activity...
Clinical evaluation of equine antithymocyte globulin in recipients of renal allografts: Analysis of survival, renal function, rejection, histocompatibility, and complications. Equine antithymocyte globulin combined with azathioprine and prednisone as immunosuppressive therapy in 50 transplant recipients prolonged allograft survival and seemed to modify the severity of rejection episodes. Although nine patients died from a variety of causes, only three kidneys were lost to rejection, one of which was hyperacute. There were no serious untoward hematologic or systemic effects caused by the ATG, and all patients completed the course of therapy. Infection, a serious and frequent complication of transplant patients, was encountered no more often than in other transplant s...