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Immune-Mediated Thrombocytopenia in Dogs
What is Immune-Mediated Thrombocytopenia?
Platelets cannot be replenished quickly enough by the body. It can be difficult to diagnose and many veterinarians will refer you to a specialist in order to properly diagnose and treat immune-mediated thrombocytopenia. The American Cocker Spaniel, Standard Poodle, Miniature Poodle, Toy Poodle, Old English Sheepdog, German Shepherd Dog and Labrador Retriever are predisposed to immune-mediated thrombocytopenia. Middle aged dogs are more likely to be diagnosed with immune-mediated thrombocytopenia.
Immune-mediated thrombocytopenia in dogs attacks the dog’s own blood platelets and is a very serious disease. Antibodies will bind to the surface of platelets causing the affected platelets to prematurely destruct.
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Symptoms of Immune-Mediated Thrombocytopenia in Dogs
Immune-mediated thrombocytopenia is a serious condition and if you see any of these symptoms, contact your veterinarian immediately for a thorough physical exam and testing.
- Abnormally rapid breathing
- Weakness
- Lethargy
- Bruising
- Bleeding from the gums
- Bleeding from the nose
- Tarry stools
- Pale gums
- Difficulty breathing
- Anorexia or lack of appetite
- Sudden death
Types
Immune-mediated thrombocytopenia in dogs can be classified in two categories.
Primary Immune-mediated Thrombocytopenia
Also known as idiopathic thrombocytopenic purpura, primary immune-mediated thrombocytopenia is an autoimmune disorder where the antibodies attack portions of the platelet membrane. There is no underlying disease causing the immune-mediated thrombocytopenia.
Secondary Immune-mediated Thrombocytopenia
The antibodies are being bonded to antigens and then absorbed into the platelet surface. Secondary immune-mediated thrombocytopenia is the result of an underlying disease.
Causes of Immune-Mediated Thrombocytopenia in Dogs
There are numerous causes of immune-mediated thrombocytopenia and your veterinarian will try to determine the exact cause to ensure that the treatment plan put in place will address the cause.
Vaccines
Although rare, there have been some cases where dogs have developed immune-mediated thrombocytopenia after receiving a vaccine.
Neoplasia
Immune-mediated thrombocytopenia is very commonly associated with hematopoietic and solid neoplasms. This includes mammary adenocarcinoma, lymphoma, fibrosarcoma, nasal adenocarcinoma and mast cell tumors.
Infections
Bacterial, viral, parasitic or protozoal infections within the body can cause destruction of blood platelets. The destruction of these platelets can cause immune-mediated thrombocytopenia.
Autoimmune Diseases
Other autoimmune diseases in dogs can trigger immune-mediated thrombocytopenia. Systemic lupus, rheumatoid arthritis and immune-mediated hemolytic anemia are some of the more common autoimmune diseases that can cause immune-mediated thrombocytopenia.
Drug Therapies
It has been found that any drug can cause immune-mediated thrombocytopenia but there are certain drugs that have a higher incidence of causing it. These drugs include cefazedone, auranofin and trimethoprim-sulfonamide combinations.
Diagnosis of Immune-Mediated Thrombocytopenia in Dogs
Diagnosing immune-mediated thrombocytopenia is a process of elimination and determining the cause of the symptoms. Your veterinarian may refer you to a specialist for a definitive diagnosis and specialized treatment plan.
Clinical Symptoms
Your veterinarian will evaluate your dog’s symptoms and try to rule out other diseases. Most of the time, a dog is presented to them with signs other than severe bleeding, therefore, trying to determine the cause of the symptoms can be frustrating.
Physical Exam and Medical History
Your veterinarian will do a thorough physical examination of your dog. An evaluation of your dog’s medical history will help determine if there are any recent changes such as new medications or vaccinations. Try to give your veterinarian as much information as possible, including daily routines, recent traveling and changes in activities.
Diagnostic Testing
A CBC, or complete blood count, will be ordered to determine the amount of blood platelets being produced by the body. Other tests that may be performed include a blood smear, serum chemistry profile, heartworm antigen testing, and coagulation profile. Blood samples will be collected by atraumatic venipuncture to prevent the activation of clotting factors or minimize platelet clumping. Confirmation based on a CBC test and blood smear examination can be done if the immune-mediated thrombocytopenia has progressed to the point of rapid platelet depletion.
Urinalysis
A urinalysis is conducted to rule out fungal disorders or rickettsial. Urine must be collected by free catch.
Imaging
To determine if the underlying cause is a neoplasia a thoracic and abdominal radiograph and an abdominal ultrasonography will be ordered.
Bone marrow aspiration
Bone marrow aspiration is only needed if concurrent leukopenia, with or without anemia, is not present. If performed, it may show an underlying cause that is not apparent through a clinical examination.
Treatment of Immune-Mediated Thrombocytopenia in Dogs
Your veterinarian will create an individualized treatment plan for your dog. These treatment plans are often aggressive and require continual care, therefore, hospitalization is usually required.
Immunosuppressive drugs such as steroids, cyclosporine and azathioprine have been effective in treatments. Immunosuppressive drugs will help control your dog’s immune system response to the depletion of blood platelets.
Supportive care may be necessary depending on how ill your dog has become. Oxygen support and IV fluids will be given. Blood transfusions may be required if your dog has become anemic.
In the case of secondary immune-mediated thrombocytopenia, the underlying cause must be treated as well as the thrombocytopenia. Your dog may need to remain on supportive care while the underlying cause is being addressed.
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Recovery of Immune-Mediated Thrombocytopenia in Dogs
Immunosuppressive drugs may need to be continued for several months. Your dog can be weaned from the medications upon conclusion of the entire treatment plan. Drug therapy may be required for the rest of your dog’s life to ensure that your dog’s blood platelets are not decreasing. Most dogs, when treated aggressively and diagnosed in time, can live normally following treatments.
Any vaccines or medications that were found to be the cause of immune-mediated thrombocytopenia in your dog should be avoided for the rest of his life. All immune system stimulants, such as vaccinations, should be avoided also.
Be sure to listen carefully to your veterinarian and follow all treatments set for your dog to ensure recovery from immune-mediated thrombocytopenia. All medications should always be used as prescribed and any concerns should be directed to your veterinarian.
Immune-Mediated Thrombocytopenia Average Cost
From 250 quotes ranging from $2,000 - $15,000
Average Cost
$7,500
Top
Immune-Mediated Thrombocytopenia Questions and Advice from Veterinary Professionals
Chihuahua
Oso
3 Years
13 found this helpful
13 found this helpful
My pet has the following symptoms:
Lethargy
Severe Lethargy
Low Wbc, Low Platelets, Normal Rbc,
tldr: What's up with the normal RBC, low WBC, low platelets??? Dog is in the hospital being treated, but vets are stumped.
Oso was totally active and (seemingly) healthy a couple days ago. Started being a bit lethargic late Friday, pretty down on Saturday, so I took him to a vet on Sunday (not ours but one that was open on a Sunday - he was way too sick to wait until Monday). 105 fever at the vet and they ran a rapid blood test, which showed normal RBC, low WBC and low platelets. That vet suspected their machine was clumping because of the low platelets, and said they'd rerun it. But based on how sick he was, she recommended taking him to the emergency hospital to get him going on fluids and whatever else (we have a fabulous 24-hr. facility here). At the hospital, they reran the test; also did an x-ray and urinalysis. The WBC and platelets came back low again. Nothing on the x-ray or in the urinalysis. The vet last night diagnosed him with IMT and they started a steroid, an antibiotic and fluids. His fever came down as we waited to be admitted. Overnight, not much improvement in terms of his lethargy and overall state (mind you the ONLY things they can show as being wrong are the WBC and platelets; he has no fever, no pain, virtually no other symptoms besides being severely lethargic, almost to the point that he looks drugged). At 4 p.m. today, they will rerun labs to see where platelets are at to see if the steroid has made a difference. If it has, we continue on with this treatment. If it hasn't, they are recommending an ultrasound on his abdomen and sending the CBC out again to another pathologist. The vet even suggested they may consult with an internal specialist. All of the vets at the hospital are stumped, mainly because of the strange combination of low platelets and low WBC. His RBC is normal and is showing no signs of bleeding or anemia. The last vet I spoke with cannot give me answers and started to describe this "path" we would go on to find out what's wrong... cancer, lukemia (she said was rare in dogs), etc. He was tested for tick and worm-borne things. I cannot think of anything he would have gotten into in terms of poisons or plants (other than what's been in our yard for the past 3 years). I'm sad, of course; he's totally limp. I just spent an hour in the hospital crying room (that's what I named it) holding him and weeping. So sad and frustrating because we just don't know. How does one decide where the "path" ends? Is it financial? It could be when our tab gets to a certain point. If he's dying, I just wish I knew that so we could help him one way or the other. Of course, I want to know how to solve this, but the poor dog. How can you lose your dog so quickly?
Aug. 20, 2018
Answered by Dr. Michele K. DVM
13 Recommendations
I think it is worth seeing if the steroids helped Oso when they recheck his labwork. You have ruled out a number of diseases, and IMT is not an uncommon disease. He may respond to medications. If not, then yes, the path to finding out what is going on does get harder, and more expensive, and decisions sometimes need to be made. It sounds like you have a great veterinarian paying attention to all of the details, and I think waiting to see what the recheck lab results show is the next best step. I hope that all goes well for him.
Aug. 21, 2018
Afternoon results were bad. Platelets are lower and RBC is now starting to drop. They suspect bleeding and will do an X-ray. I’m gutted.
Aug. 21, 2018
Oso's Owner
How is Oso doing. My dog was diagnosed five days ago and it is looking pretty dire. I am trying to not lose hope. Very similar situation to what you are describing. Did Oso recover and how did he progress further. I am devastated, my dog is 3.5 year old.
Sept. 9, 2018
Roxanne M.
How is Oso? My dog is going through the same thing and we are devastated. He is on prednisone and another immunosuppressant but does not seem to be improving. My dog is only 3.5 years old. How did this progress for you sweet boy. What an evil disease.
Sept. 9, 2018
Roxanne M.
Was this question and answer helpful?
Boxer
Toby
4 Years
2 found this helpful
2 found this helpful
My pet has the following symptoms:
Panting
Thirsty
My 4 year old boxer/lab was diagnosed with IMT in April 2018. He responded well to the prednisone treatment and we have almost weaned him off. However, my local vet says the only next course of action is to put him on cyclosporine (atopica) twice a day. I've been doing some research and have found that cyclosporine isn't the only route and may not be used as often as other immunosuppressants in long term treatment of IMT. I'm concerned about what long-term consequences of this drug may have on him, and if other treatments may be better. Can you provide information on what the most common long-term treatments for IMT are. As well as what factors are taken into consideration when determining which is best to use?
July 30, 2018
2 Recommendations
Treatment for immune mediated thrombocytopenia is down to your Veterinarian’s discretion; prednisone is the most common treatment given which may be combined with other medications like azathioprine. Cyclosporine (among others) is normally considered when patients have adverse reactions or side effects to prednisone other other treatments. You need to remember that treatment for condition like immune mediated thrombocytopenia isn’t always straightforward and your Veterinarian may need to change and adjust treatment based on Toby’s response (platelet count). Regards Dr Callum Turner DVM
http://veterinarycalendar.dvm360.com/diagnosis-and-treatment-immune-mediated-thrombocytopenia-proceedings?pageID=2
July 31, 2018
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Immune-Mediated Thrombocytopenia Average Cost
From 250 quotes ranging from $2,000 - $15,000
Average Cost
$7,500
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