{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:06:18Z","timestamp":1788282378347,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T00:00:00Z","timestamp":1497225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Vet Emergen Crit Care"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the use of a manual method of therapeutic plasma exchange to reduce total serum bilirubin, manage kernicterus, and halt progression of neurological dysfunction in a dog with immune\u2010mediated hemolytic anemia (IMHA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Summary<\/jats:title><jats:p>A 5\u2010year\u2010old male neutered Lhasa Apso diagnosed with IMHA developed acute onset neurologic signs consistent with kernicterus. Manual therapeutic plasma exchange was performed in an attempt to reduce total serum bilirubin. The initial exchange was performed at a lower plasma exchange volume due to the dog's critical status and the dog's clinical signs progressed. More aggressive plasma exchange was performed that resulted in a reduction in total serum bilirubin and no further progression of neurologic signs. The dog was euthanized due to suspicion of permanent neurologic changes and need for further blood transfusions. Histopathology postmortem confirmed a diagnosis of kernicterus.<\/jats:p><\/jats:sec><jats:sec><jats:title>New or Unique Information Provided<\/jats:title><jats:p>Kernicterus secondary to hyperbilirubinemia is well described in people, but has rarely been reported in dogs. Therapeutic plasma exchange has been used for decades in people to rapidly decrease serum bilirubin when hyperbilirubinemia progresses to neurologic signs, but to the authors\u2019 knowledge this has not been described in a dog.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vec.12622","type":"journal-article","created":{"date-parts":[[2017,6,12]],"date-time":"2017-06-12T16:42:36Z","timestamp":1497285756000},"page":"458-464","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The use of therapeutic plasma exchange to reduce serum bilirubin in a dog with kernicterus"],"prefix":"10.1111","volume":"27","author":[{"given":"Tricia","family":"Tovar","sequence":"first","affiliation":[{"name":"Pittsburgh Veterinary Specialty and Emergency Center Department of Critical Care Pittsburgh PA 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