SARDs/IMR — Awareness Central

We occasionally search for other sites that contain information about SARDs/IMR.  We do this to reach out to other website administrators to let them know that SARDSAwareness.org now exists and that they may want to consider linking to the site.

Most of the information out there is a few years old, and usually there’s a brief explanation of SARDs/IMR and some links to press releases regarding the break-throughs at ISU.

However, one of the sponsored Google ads that we saw pointed us to a website called JustAnswer.com.

At JustAnswer.com, you can ask any veterinary question you want, and a qualified veterinarian will attempt to answer your question.

If you make a $13 deposit into an account, JustAnswer.com will allow you to read the responses from the veterinarian before you decide to “Accept” their answer.  ”Accept”ing the answer forwards your $13 answer deposit to the expert who answers your question.

We decided to give this service a try.  Our intent was to determine what level of awareness this particular service had regarding SARDs/IMR.  After all, it is plausible that many of you may have seen the sponsored ads and have pondered utilizing their services.

Anyway, we thought we’d take the plunge and share our findings with you.

My conversation with Dr. Dave, the expert on staff at the time, was in the form of an email utilizing the JustAnswer.com website interface.  Our conversation started with this one question and what you see here is unedited:

Jay:   What are the treatment options for SARDS/IMR?

There is some new research into using Intravenous immunoglobulin (IV-Ig) to try and treat SARD in dogs.

The benefit is theoretical (a proposed common mechanism with Immune Mediated Retinopathy in people), and IV Ig is dangerous in dogs (high rate of anaphylactic reactions).

As far as I know no benefit to the treatment has been shown. Have you consulted a veterinary ophthalmologist? They are up on this stuff.

Realistically, there are no treatment options. I am so sorry.

Jay:  Can you please provide more information about IV-Ig treatment?  And what is the percentage of anaphylactic reactions?  If there is such a percentage, I’m assuming there is treatment that has been performed?  Can you point me in this direction please?  Does SARDS cause any other issues for dogs other than blindness?

Here is a link to an info page on the treatment out of Iowa State University. I think the first case reports were back in 2007. http://www.techtransfer.iastate.edu/documents/7e3741203712316812.pdf

I don’t know the rate of anaphylactic reactions to IVIg, but it doesn’t preclude its use. We use it in treating life-threatening blood diseases. There is a correlation between SARDS and hyperadrenocorticism or “Cushing’s disease.” Cushing’s disease is relatively easily diagnosed or ruled out by your veterinarian.

Here is a link to an info page on the treatment out of Iowa State University. I think the first case reports were back in 2007. http://www.techtransfer.iastate.edu/documents/7e3741203712316812.pdf

There is a correlation between SARDS and hyperadrenocorticism or “Cushing’s disease.” Cushing’s disease is relatively easily diagnosed or ruled out by your veterinarian.

I don’t know the rate of anaphylactic reactions to IVIg, but it doesn’t preclude its use. We use it in treating life-threatening blood diseases.

Jay:  Thank you for the reply and additional information about Cushing’s disease.   In your original email you specifically mention “high rate of anaphylactic reactions” yet your last reply states that you “don’t know the rate of anaphylactic reactions to IVIg”.   I’m a bit puzzled.  If I wish to seek this treatment, which information should I consider regarding its risk for anaphylactic reaction? Is it in your own personal use of IVIg treatment for blood diseases where you have seen a high rate of anaphylactic reaction?

Sorry I wasn’t more clear. I don’t know the exact rate of anaphylactic reactions to IVIG. I suspect nobody does because it would be a hard study to perform.

For other treatments, we sometimes have published exact complication rates, listed as percentages. I don’t know of any published complication rates for IVIG. That’s what I thought you were asking for.

Our Critical Care Service uses IVIG occasionally (it is rather expensive) for immune mediated hemolytic anemia, and we have not had any anaphylactic reactions that I know of.

This may be because the patients we use it on are very sick and may die before their second dose (theoretically, anaphylaxis happens after a second dose).

I estimate we have used it twice in 3 years in our hospital.  I say the rate is high, but I mean relative to the severity of the disease, because anaphylaxis is life threatening, whereas SARDS is not.

While there are no hard-set rules in veterinary medicine, many people would not attempt a potentially life threatening treatment to cure a non-life-threatening disease.   Then again, I don’t really know the details of the IVIG treatment for SARDS.   For all I know, they may have a very low indicidence of complications from the IVIG treatment.

You should get that info from the people who do the treatment.

I must say, I was quite impressed with Dr. Dave’s attentiveness and his quickness to respond.  At the very least, Dr. Dave was able to provide us with two (2) alternate locations local to us that could provide IVIg treatment.

We have put in queries to those clicnics to ask if they would be willing to treat SARDs/IMR with IVIg and are awaiting their response.  Pending their positive response, we will be updating our SARDs/IMR treatment provider map.

If these clinics are willing to provide treatment adhering to ISU’s protocol, and assuming that your dog is a candidate for IVIg, and does not need intra-ocular IVIg, then local residents of Southern California have local options for treatment.

I believe $13 dollars would have been well spent if the above became true.

For those of you in other states, perhaps JustAnswer.com could be a resource for you to find local treatment providers.

On a separate note, Dr. Dave provides some other topics to consider:

While there are no hard-set rules in veterinary medicine, many people would not attempt a potentially life threatening treatment to cure a non-life-threatening disease.

Dr. Dave also points out:

Our Critical Care Service uses IVIG occasionally (it is rather expensive) for immune mediated hemolytic anemia, and we have not had any anaphylactic reactions that I know of.

This may be because the patients we use it on are very sick and may die before their second dose (theoretically, anaphylaxis happens after a second dose).

On the ISU website for SARDs, it states that a secondary treatment for SARDs is not possible due to the risk of anaphylactic shock.  However, because anaphylactic shock is now mitigated by dexamesathone and diphendydramine, ISU has been able to provide multiple IVIg treatments to dogs.  This has been confirmed with Dr. Grozdanic.

It is true that SARDs is not an immediately life-threatening condition.  However, we should not rule out that other complications may arise causing SARDs/IMR to be life-threatening later.

In recent days, we have had some conversations with others regarding ISU’s IVIg treatment.  As we have stated in our conversations, we are personally biased toward the treatment, only because of the perceived benefit that we believe that we have gained.  There are some other non-tangible reasons as well, but they are rather personal and cannot be quantified in any meaningful way to others.

It is not necessary to chase the latest and greatest experimental treatment.  But it is up to you, the individual, to become educated, and to make reasonably intelligent decisions that benefit your dog, your financial state, and your peace of mind.

We hope the site assists you with that endeavor.