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Extracorporeal therapy

Extracorporeal therapy represents a treatment modality promoting removal of endogenous or exogenous poisons (drugs or toxins) and supporting or temporarily replacing a vital organ (e.g. kidney). 

Acute kidney injury can lead to the kidney's inability to remove toxins, thus its accumulation in the blood. Hemodialysis is done to filtrate the blood while giving time for the kidneys to heal. This can add some valuable time to the patient.

Hemodialysis, hemoperfusion, and plasma exchange can be used to remove certain toxins that could have been ingested by the pet. Certain medication overdoses can also be removed by these techniques. This can be a life-saving treatment if the pet ingested a lethal dose of a medication or toxin. 

Pets with acute kidney injury that are not producing urine may become over hydrated, especially if they are treated with intravenous fluids as an attempt to stimulate urine production by the kidney. Overhydration can be detrimental and may lead to serious consequences. Ultrafiltration can be performed to remove the excess fluid that has been retained by the pet. 

Therapeutic plasma exchange (TPE) is a novel treatment option for certain immune-mediated diseases like immune-mediated hemolytic anemia (IMHA). The idea of performing TPE is to remove and exchange the patient's plasma that is filled with anti-red blood cell antibodies for plasma that does not have antibodies against the red blood cells. This may help buy time until immunosuppressives kick in to prevent further antibody formation and subsequent red blood cell destruction.  

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