Effects of centrifugation-based therapeutic plasma exchange on coagulation parameters in dogs with canine visceral leishmaniasis

As in humans, therapeutic plasma exchange (TPE) has been investigated in veterinary medicine for managing immune-mediated diseases such as canine visceral leishmaniasis (CVL). TPE may improve clinical outcomes by removing circulating immune complexes and excess antibodies; however, its physiological effects must be understood to ensure safety. Given the scarcity of studies in animals, this study evaluated the effects of centrifugation-based TPE in dogs with CVL receiving fresh frozen plasma (FFP) as replacement fluid. Thirty-one dogs with CVL that failed to respond to conventional therapy were allocated to two groups: clinical treatment alone (n = 18) and clinical treatment plus TPE (n = 13). The TPE group underwent one daily session for three consecutive days. Coagulation profiles were assessed before and after each session. A progressive decrease in platelet counts occurred across sessions, but without significant thrombocytopenia or critical alterations in activated partial thromboplastin time (aPTT) or prothrombin time (PT), which remained within reference ranges. Transient hypocalcemia occurred after the first session and was promptly corrected with calcium gluconate supplementation. Fibrinogen levels decreased mildly without clinical evidence of bleeding. Clinical complications were minimal and effectively managed. In conclusion, TPE was well tolerated, producing predominantly transient and controllable effects on hemostasis and overall clinical homeostasis under the conditions of this study.