Neonatal sepsis in puppies: adjunctive fresh frozen plasma vs antibiotics alone — MAYBE (weak evidence)

In puppies with neonatal sepsis, does adjunctive fresh frozen plasma speed recovery and reduce mortality vs antibiotics alone?

Shelf #134 · gate-verified and approved by the developer

MAYBE (weak evidence): The draft anchor checks out — PMID 41576601 is the right record, and the '31 puppies' figure is real but needs its face-value correction: only 16 of the 31 puppies had sepsis and were treated (7 plasma + antibiotic, 9 antibiotic alone); the other 15 were healthy neonates used as a diagnostic comparison group, not a treatment arm. In Pereira 2026, the plasma group recovered laboratory normality faster (leukograms without alterations at 24 hours in 4/7 plasma puppies, 57%, vs unaltered leukograms in the control group only at 72 hours, in 5/9, 55.5%), with higher IgM at 24 hours and higher blood glucose and leukocyte counts at 24 and 48 hours, and lower lactate at end of treatment (all P < .05 as reported). Mortality was 0/7 (0%) in the plasma group vs 2/9 (22%) in the antibiotic-only group — an absolute difference carried by two deaths in 16 septic puppies, with no significance test for mortality reported in the record. The record does not state that allocation was randomised or that anyone was blinded (its publication type is Journal Article only), so how puppies came to be in the plasma group is unknown, and confounding by severity or litter cannot be excluded. Two events cannot carry a mortality claim: this is MAYBE (weak evidence), and as a mortality claim it is Tier C for John's personal ruling regardless. Drafted Nov 10, 2026 (VetMed build, topic #134); all figures from abstracts fetched and verified at drafting.

Pereira 2026: plasma + antibiotic puppies normalised leukograms by 24 h (4/7) vs 72 h in controls (5/9); mortality 0/7 vs 2/9 — in just 16 septic puppies, allocation method not stated

Controlled study (record's own publication types: Journal Article; randomisation and blinding not stated in the record)

Who: Puppies (dogs, newborn/neonatal): 31 puppies in total in a clinical setting — 16 diagnosed with neonatal sepsis and treated either with fresh frozen plasma + antibiotic (plasma group, n = 7) or antibiotic only (control group, n = 9), plus 15 healthy neonates as a healthy comparison group; evaluated at first appointment (M0), after 24 (M24), 48 (M48) and 72 hours (M72) and at end of treatment (ME).

Result: At M0, septic neonates had reduced heart rate, reflexes, blood glucose, body temperature and leukocytes, with increased lactate and troponin I, compared with healthy puppies (P < .05). During treatment, the plasma group showed higher IgM at M24, and higher blood glucose and leukocyte count at M24 and M48, than controls (P < .05); at ME, lactate was lower in the plasma group (P < .05). There were no differences in serum IgG or IgA among groups. Approximately 57% (4/7) of plasma-group neonates presented leukograms without alterations at M24; in the control group, unaltered leukograms were observed only at M72, in 55.5% (5/9). The mortality rate was 22% (2/9) in the control group; there was no mortality in the plasma group. The authors conclude fresh frozen plasma was an important source of IgM, stimulated prompt (within 24 h) clinical and laboratory improvement, and is a promising strategy for reducing neonatal mortality — described by the authors as the first study of fresh frozen plasma as an adjuvant in neonatal sepsis in dogs.

Watch out: The numbers are tiny where it matters most: the mortality contrast is 0 deaths in 7 puppies vs 2 deaths in 9, and the record reports no significance test for mortality — one death moving groups would erase the gap. The allocation method is not stated in the record, so this is not claimed as randomised, and sicker (or less sick) puppies may have been channelled to plasma. Several reported comparisons are laboratory values at single time points among many measured, and the healthy-neonate group answers a diagnostic question (which biomarkers mark sepsis), not the treatment question — the treatment comparison rests on 16 puppies.

Pereira KHNP, Fuchs KDM, Xavier GM, Mendonça JC, Câmara DR, Dos Santos Correia LEC, Marcusso PF, Souza FF, Ribeiro MG, Lourenço MLG. Efficacy of fresh frozen plasma immunotherapy as an adjuvant treatment of neonatal sepsis in puppies. Res Vet Sci. 2026;202:106085. PMID: 41576601. Registry ID: none in the record. MeSH: Animals · Dogs · Sepsis/veterinary,therapy,immunology · Animals, Newborn · Dog Diseases/therapy,immunology · Plasma/immunology · Female · Anti-Bacterial Agents/therapeutic use · Male · Immunotherapy/veterinary,methods

Synthesis: faster laboratory recovery on plasma, a two-death mortality gap, and no established randomisation — promising, not proven

Synthesis

Who: Synthesis of the card above: Pereira KHNP et al. 2026, a controlled study of 16 puppies with neonatal sepsis (7 fresh frozen plasma + antibiotic, 9 antibiotic only) with 15 healthy neonates as a diagnostic comparison group.

Result: What the record supports: septic puppies on plasma + antibiotic normalised faster on the measured laboratory parameters — unaltered leukograms at 24 hours (4/7, 57%) vs only at 72 hours in controls (5/9, 55.5%), higher IgM, glucose and leukocyte counts at 24–48 hours, and lower lactate at end of treatment. What it does not establish: a mortality benefit (0/7 vs 2/9 deaths, untested in the record, in a study whose allocation method is unstated) or any clinical recovery-time endpoint in days — 'speed of recovery' on this shelf means speed of laboratory normalisation, the only version the record measures.

Watch out: A one-study shelf, and a 2026 first-of-its-kind study (the authors' own description) with no replication in these records. The biomarker findings (leukocytes, troponin I, lactate for diagnosis and monitoring of neonatal sepsis) are a separate, diagnostic claim that this treatment shelf does not grade.

Synthesis of Pereira KHNP et al. PMID: 41576601. Registry IDs as on the individual card.

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