Optimizing Immunosuppressive Therapy for Autoimmune Diseases in Cats and Dogs: Efficacy, Safety, and Long-Term Outcomes

Abstract

Autoimmune diseases in companion animals present significant therapeutic challenges, often requiring long-term immunosuppressive regimens to control disease progression and achieve remission. This study employed a mixed-methods approach to evaluate the efficacy, safety, and long-term outcomes of various immunosuppressive therapies in 685 clinical cases of autoimmune diseases in cats and dogs.A review of medical data indicated that doctors most frequently used prednisolone, by itself or with azathioprine.  Using only corticosteroids for treatment reduced the patients’ chances of surviving after two years to 62% and led to more relapses, affecting 35% of the group.  Cyclosporine and mycophenolate mofetil had better results; in particular, mycophenolate played a big role by giving the highest rate of complete remission (72%), the lowest percentage of patients who experienced a relapse (18%) and the best 1-year survival rate (88%) as well as 2-year survival rate (84%).  Laboratory examinations showed there were important improvements in hemoglobin, platelet count and markers for kidney and liver function (p < 0.01).  Every regime was linked to side effects and in most cases, it was corticosteroids that caused polyuria/polydipsia and azathioprine was responsible for myelosuppression.  After a thematic analysis of expert interviews, it appeared that including mycophenolate in daily care is encouraged, tacrolimus presents a reflection of variable results and there is a push for the same standards and increased supervision.  It seems that using individualized treatment with second-line drugs instead of first-line ones helps treat the disease better, reduces complications and improves patients’ chances of surviving.  The study points to the importance of using clinical experience, continuous monitoring and scientifically based choices to control viral diseases.