Immune Mediated Thrombocytopenia

[peacefrog]

Does anyone have any experience with this terrible condition??

My gorgeous little 6yo maltese x shih tzu has been diagnosed with Immune mediated thrombocytopenia, she is currently at a pet hospital receiving the very best of care.

We first noticed she wasn't herself on Sunday night, she wouldn't eat and was very quiet and lethargic, by Monday she couldn't walk properly in her back legs. Her usual vet immediately referred her to a specialist.

She was in terrible condition when she went in, they did tests and her platelet count was zero and her red cells were dropping. She was given a shot of cortisone and we were told we just need to wait, it may take up to 4 days to see any improvement. The next morning they called and said she still wasn't responding but this wasn't unusual or critical jsut yet. We went to visit her yesterday and she looked so much better, alert and lively, and scoffed her dinner. The vet said she is in very good condition and they have held off on giving her any further pain meds but her red blood count was still dropping and this was a concern. He also told us this condition has a 50% mortality rate!! Anyway her red cells dropped from about 26 when she was admited to 20 yesterday and if it went to 18 they would give her a blood transfusion during the night. We rang at midnight to see if she needed it or if she had perked up and it was down to 16 so they gave her the transfusion!!

Needless to say I was a wreck all night and was expecting the worst this morning. However the vet has called and said she is a very chirpy little girl this morning and she is very pleased with her. We are going to see her again this afternoon and hopefully we will see some positive progress by then.

But I am just wondering if the blood transfusion has just helped her temporarily . The vet said it may take up to 4 days for the platelets to come back and if they don't start picking up they will try a stronger course of treatment. Do they keep giving her blood transfusions and we wait? The immediate concern is a sudden bleed, but how long can she hang on if her platelets and red cells don't start responding??

[Di*]

Sorry, no experience but there's quite a bit of info online. Must be very worrying for you. From what I've read sounds like it's a bit of a wait and see scenario.

Best wishes to you. Hope your girl makes a full recovery.

Di

[peacefrog]

Thanks Di that means alot. It definitely is the "wait and see" that is worrying me, from all the things I have read online on it it is a very touch and go process and dogs have declined after making some progress seemingly without reason and very quickly.

I am off to see my girl very soon, I just pray there is some positive news today!

[moosepup]

Our Chihuahua X Maltese, Zoe had this about 6 years ago. If I recall correctly she was on steroids for quite some time until her white cell count was back to normal levels and then gradually weaned off. Luckily she didn't need a transfusion and she was able to stay at home with us through her treatment. She had to be handled very very gently (I think we drove home doing about 20km/h!) and was on strict bed rest, no running around etc as she was at high risk of internal bleeding. She made a full recovery. She did develop some dark spots on her belly while she was ill that have never gone away.

Think good thoughts peacefrog, hopefully she will be fine. Also, dogs that recover from this illness don't tend to ever relapse. Sending your girl some strong healing vibes.

ETA - She is SUPER cute! Love her name too (it's one of my nicknames. )

Edited February 3, 2010 by moosepup

[peacefrog]

Thanks so much Moose, do you remember how long it took for her to start responding to the treatment?

Esmay's red cells dropped off again overnight after her transfusion on Tuesday night so she has had another one. And now we just wait again for her body to start responding. It's agonising

[SueM]

Everything crossed for little Esmay

[Di*]

Thanks so much Moose, do you remember how long it took for her to start responding to the treatment?

Esmay's red cells dropped off again overnight after her transfusion on Tuesday night so she has had another one. And now we just wait again for her body to start responding. It's agonising

Can't think of anything inspiring to say, I'm sure her recovery is the only thing that will make you feel better. Hopefully, some good news soon.

best wishes

Di

[Bundyburger]

Poor Esmay, she's a gorgeous little girl..

Long time no see M

[peacefrog]

Thanks vari, di and teg.

Has been ages Tegz!

I am trying to remain positive but it's becoming so hard when she isn't progressing as hoped.

[Starkehre]

Hi Peacefrog. I am very very sorry to hear that Esmay has contracted IMT. I really hope she starts to respond to the cortisone soon. I also hope she is with vets that are experienced with IMT as there other drugs etc that she can be on to give her the best chance.

I do have a reasonable amout of experience with this dreadful disease, and I am very happy for you to PM me with questions and you can even call me if you want to. I have lost one dog to IMT and have had one survive.

There are quite a few of us here on DOL that have experience IMT and other Immune Mediated diseases, so keep asking if you want some more anecdotal stories.

If you wish to check out this link, I am sore Bokezu will not mind you reading what her boy Jordy went through late last year. There is also stories in this thread about other peoples' dogs. I think you will find a lot of info there that will help inform you more.

http://www.dolforums.com.au/index.php?showtopic=182287

Bokezu may even pop in, as well as others.

I wish you all the best of luck. Esmay may need several blood transfusions over several days before the drugs kick in and her platelets lift. It becomes a fight against the clock.

I have PMd you also.

Edited February 4, 2010 by dyzney

[peacefrog]

Thanks Dyzney, I just sent you a pm, can you let me know if you don't receive it as the page did something funny as it sent!

She is at a vet hospital receiving 24-hour care, they seem to be extremely good and thorough. I know they did mention that if she didn't pick up soon that they will try some stronger drugs. I will find out what these are tonight. She has had a few shots of cortizone in the last 2 or so years for back issues and has always responded quickly to them but may need something a bit stronger now.

Thanks for the link to that thread, I tried to search on dol for people who have gone through the same thing but nothing came up in my search! One thing I find that does help is immersing myself in as much information as possible.

[Starkehre]

You are welcome pf. I just finished sending you my great long winded PM reply.

Sounds like Esmay is in good hands.

Something the vets will want to try to ascertain fairly quickly, once they have Esmay blood loss and platelets under control, is whether her IMT is primary or secondary. So, they will want to be running tests when they get her well enough.

I am no vet, but if there is anything you want to know that I could possibly help with, please just ask.

Get well Esmay

[moosepup]

Thanks so much Moose, do you remember how long it took for her to start responding to the treatment?

Esmay's red cells dropped off again overnight after her transfusion on Tuesday night so she has had another one. And now we just wait again for her body to start responding. It's agonising

Hmmm I have a pretty poor memory but I don't think it took too long for her platelet levels to start to rise. I'm sure she was on pill form steroids and we had to take her in every morning to have bloods taken. I think she was on the steroids for several weeks, gradually lowering the dose until she stopped taking them. She didn't have any external bleeding, just some 'bruising' like marks on her belly that are still there.

The only symptoms she was showing were lethargy and just looking 'off' if you know what I mean. We took her in and they took bloods which is what confirmed it. She has had us on tenderhooks quite a few times this girl! She has had cruciate ligament surgery, IMT, anal gland abcess, mysterious inflamed spleen (several ultrasounds and tests later and we never did found out what that was about) and a few other things.

Sorry I can't provide more info, Zoe is our family dog so it was mostly dad taking her to the vet at the time. I'm thinking good thoughts for Esmay, it sounds like she is in fantastic care and we have all fingers and paws crossed for a quick recovery.

[dogbesotted]

my dear boy Morris had thrombocytopneia.. had 4 blood transfusions before he stabilised....he had several massive bleeds -- including one two days after he first came home. i awoke to find him lying on the spare bed.. soaked in blood. However ITP has quiute a good prognosis unlike IMHA which is much more hit and miss.

he was given his wings 18 months later.. lymphoma. there is some evidence that seems to link ITP with increased liklihood of lymphoma.

Good luck

H

[moosepup]

Gosh, reading some of these stories, it seems like we got really lucky with Zoe. No external bleeding and no need for a transfusion. I didn't realise it could be so terrible.

[Lemonlime]

Thinking of you and your little girl. As you know I just lot my boy to a rare form of IMHA. He didnt make any improvement at his time in hospital but its good to hear that Zoe is fighting as hard as she can.

Which state are you in?

[Starkehre]

How is Esmay this morning pf.

Any improvement as yet? I am hanging out for some good news.

[peacefrog]

I am back at work today, so didn't really want to know anything until I got home but just couldn't help myself!!

Her red cells have dropped a little bit again so she will probably have her third transfusion today. Her platelets are still 0 I think but they are going to try her on a different course of drugs very soon and that should help.

She is able to walk around, is reasonably perky when we first go to see her but gets tired very quickly. She isn't bleeding in her wees or poos, not vomiting blood etc. Just has the bruising over her body (Am I right in my information that this is caused by internal bleeding and isn't abnormal?) and bloody eyes which I think they said was bruising.

Each time she has received a blood transfusion because her red cells have dropped I have thought it's the worst thing in the world......but I am so relieved to hear that others have had numerous transfusions until being stablised. This is day 5, WHEN will there be some positive news?

groupfive, I am in QLD. Esmay is in 24 hour care at an animal hospital. Some of these specialists sound pretty amazing so I think she is receiving the very best of care there is, now it's just up to here. Thank-you so much for your well wishes in your own time of grief and my sincerest apologies to you again for the loss of your boy yesterday. I am hating on these diseases with a passion!!!

[dogbesotted]

hang in there!!!!!!!!

will keep esmay tucked into myheart all day and sending prayers for a really stunning improvement

hugs

h

[peacefrog]

Moosepup & dogbestotted - that is so reassuring to hear about your babies. Do you know what levels their platelets were at? Were they experiencing the same sort of dramas, nil platlets and decreasing red cell count? I cannot find any similiar cases online where the dogs had absolutely 0 platelets and went on to make it.

dogbestotted, I am sorry to hear your baby passed after all you went through, I have read about that link and I know that and possible organ degeneration due to the drugs will be the next worries. But I just want the chance to have her home for now and I will be monitoring her closely for the rest of her life and we will fight the new battles as they come.

I may not have the chance to reply again until tonight but please keep the stories coming, it is so nice to hear from others who have been through this.