ITP in dogs can be a scary diagnosis but it doesn’t have to keep your dog from living a great life. Take it from Dr. Laura Garlow, veterinarian and mom to Fletcher, a Goldendoodle who lived with ITP for nine years. On the invitation of integrative veterinarian Dr. Julie Buzby, Dr. Garlow takes a comprehensive look at ITP in dogs and shares her experience walking this path with Fletcher.
I think that everyone’s first dog as a “grown-up” holds an extra special place in their heart. That was the case for me and Fletcher. I like to affectionately call Fletcher the “best bad dog” in the world. No other dog will ever be able to fill the Goldendoodle-sized hole he left in my heart when he passed away a little over a year ago at the respectable age of 11. He had a long happy life, nine years of which he lived with immune-mediated thrombocytopenia, but it still never feels like long enough.
My now-husband (who was my fiancée at the time) and I picked Fletcher up as a rambunctious ball of fluff the summer before I started veterinary school. I wanted to make sure I did everything right. So I spent that summer reading all the puppy training manuals I could and hiding everything chewable in our little apartment.
Fast forward a couple of years and Fletcher had turned into a pretty great dog. Maybe the puppy training manuals I poured over so carefully had worked. Or maybe he was just destined to have a wonderful temperament. Regardless, he was a good boy and he brought us so much joy.
Tiny signs of an issue with blood clotting
My husband and I got married during the summer between my second and third year of veterinary school. While on our honeymoon, we boarded Fletcher at a doggy daycare that he loved. He had a blast playing with his doggy friends but had gotten a little scruffy. So when we got home, I gave him a bath, dried him off, and brushed him out. He was his normal self at that point. But just a couple of hours later, I noticed that the insides of both of his ears were covered with tiny pin-prick red dots where I had brushed him.
While I was only halfway through my veterinary education, I knew enough to know that this was not normal. With a bad feeling in the pit of my stomach, I quickly texted a picture to a close friend and mentor. He confirmed my fear that the tiny pin pricks looked like petechia, or very small bruises. Then he gently reminded me that petechia are evidence of an issue with blood clotting. This meant we needed to have some lab work performed ASAP to try to pinpoint the problem.
Since Fletcher was otherwise feeling well with no other evidence of bleeding or bruising, we decided that it was okay for me to wait to take him into the clinic until first thing the following morning. I didn’t sleep a wink that night.
A diagnosis of ITP, immune mediated thrombocytopenia
We went into the clinic the next day. A couple of blood tests later and just like that, Fletcher had been diagnosed with immune mediated thrombocytopenia, or ITP.
This diagnosis had a profound impact on our family, and on my career. I developed a special interest in internal medicine and immune-mediated diseases. This interest led me to complete an intensive one-year internship at a specialty and emergency veterinary hospital after graduation. I found that I enjoyed the challenge of complicated medical cases, and I especially enjoyed helping pet parents understand and navigate the challenging situation of having a hospitalized pet.
After my internship, I spent many years at the same specialty hospital caring for sick hospitalized patients. In that time, I treated many wonderful dogs with immune-mediated thrombocytopenia. Through the years, I have learned so much about this condition, both from our experience with Fletcher, and from my experience caring for my patients. I want to share some of my knowledge with you.
If your beloved dog has been diagnosed with ITP, I hope you finish this article feeling empowered with the knowledge you need to face this challenge head-on.
What is ITP in dogs?
Immune mediated thrombocytopenia (ITP) is one of several autoimmune diseases in dogs. In ITP, the dog’s own immune system attacks and destroys his or her platelets. As a result, the dog has thrombocytopenia, which is the fancy medical term for a low platelet count.
Platelets 101
Platelets are tiny cell fragments within the blood. They are made in the bone marrow and are vital to blood clotting. You may think about platelets helping stop bleeding from a large cut or wound, but platelets aren’t just there for the primetime trauma. They also prevent life-threatening bleeding from normal daily microscopic wear and tear to blood vessels. When these tiny tears occur, platelets clump together at the site of the damage to form a blood clot. This stops any bleeding before you would even be able to notice there was an issue.
Normal platelet counts vary depending on the laboratory equipment being used to measure their levels. Generally speaking, a normal platelet count is anywhere from about 180,000 to 500,000 platelets per microliter of blood. Most of the time, there are no signs of ITP until the platelet count dips below about 40,000 platelets per microliter of blood. At that point, the risk of spontaneous bleeding sets in.
Occasionally, dogs are diagnosed with ITP due to a moderately low platelet count found by accident on routine yearly bloodwork. However, it is much more common for dog parents to have no idea there is a problem until the platelet count is less than 10,000 platelets per microliter and their beloved companion starts showing obvious signs of bleeding.
What are the symptoms of ITP?
The clinical signs of ITP can be broken into three main categories:
1. Direct signs of bleeding or bruising
- Small pinpoint bruises on the skin or mucous membranes (i.e. petechia)
- Larger bruises on the skin or mucous membranes (i.e. ecchymosis)
- Blood in the urine (i.e. hematuria)
- Dark, black, or tarry stool (i.e. melena)
- Fresh red blood in the stool (i.e. hematochezia)
- Blood in vomit that can appear like coffee grounds ( i.e. hematemesis)
- Nose bleeds in dogs (i.e. epistaxis)
- Bleeding into the whites of the eyes (i.e. scleral hemorrhage)
2. Signs related to anemia in dogs (i.e. low red blood cell count) from losing too much blood
- Pale or white gums
- A lethargic dog
- Decreased appetite
- Exercise intolerance
- Rapid heart rate
- A dog who is breathing fast
- Collapse
3. Signs related to the body system where bleeding has occurred
- Blindness from bleeding into the back of the eye (retinal hemorrhage)
- Dog seizures or other neurologic signs from bleeding in the brain
- Difficulty breathing from bleeding into the lungs
If you notice any of these signs, please make an appointment with your vet immediately. In some cases, severely affected dogs may need an emergency vet visit .
How does the vet reach an ITP diagnosis in dogs?
At the appointment, your veterinarian can check your dog’s number of platelets on the in-house laboratory equipment as part of a complete blood count (CBC). Since low platelets are the primary characteristic of ITP, a platelet count is the diagnostic tool of choice.
The CBC will also allow your veterinarian to check your dog’s red cell count. This is important as anemia can be present due to bleeding from ITP. Or sometimes ITP is combined with immune-mediated hemolytic anemia (IMHA in dogs). Evan’s Syndrome is the name for ITP and IMHA in dogs.
Occasionally platelets can clump together and read as falsely low with in-house machines. This means that in most cases, your veterinarian will want to confirm the low platelet count by looking at a blood smear underneath a microscope.
The vet will also take into consideration your dog’s age, gender, and breed when diagnosing ITP. Any dog can have immune-mediated thrombocytopenia, but like most conditions there are some dogs who might be more predisposed. Many auto-immune conditions are more common in females, and ITP follows that trend too. Middle-aged dogs are the age group most likely to have ITP. Some breeds have a higher risk as well. These include Poodles, Cocker Spaniels, and Old English Sheepdogs.
Once the vet has determined your dog has ITP, he or she will start looking for the underlying cause, if there is one.
What causes ITP in dogs?
When veterinarians think about ITP, they break it into two classifications—primary and secondary. Primary ITP (i.e. idiopathic ITP) is a diagnosis of exclusion. This means the vet will use additional diagnostic testing to rule out the presence of a trigger. If the vet doesn’t find a clear cause, he or she will categorize it as primary ITP.
Secondary ITP occurs when another medical condition triggers the immune system to run amok within the body, attacking its own cells. Common triggers of secondary ITP include:
Infections
Almost any infection can over-stimulate the immune system and trigger autoimmune disease. However, there are some infections where this is a much more common occurrence than others. Fleas and ticks spread many, but not all, of these infections.
Some of the more common infectious triggers of ITP include:
- Tick-borne disease in dogs such as Ehrlichia, Rocky Mountain Spotted Fever, or Babesia
- Bartonella
- Mycoplasma
- Leishmania
- Leptospirosis
- Heartworm disease in dogs
- Systemic fungal infections
Drugs or vaccines
- Sulfa drugs
- Cephalosporins
Note: While vaccines were once thought to be a common trigger for immune-mediated diseases like ITP, more recent studies have not supported this link. In general, vaccines are safe and do a great job of protecting your pet from preventable illness. If you are wondering which dog vaccines are absolutely necessary, I recommend having an open conversation about your concerns with your veterinarian.
Cancers
- Lymphoma in dogs
- Leukemia
- Multiple Myeloma
- Histiocytic Sarcoma
- Hemangiosarcoma in dogs
How do you find the underlying cause?
To look for these triggers, your veterinarian will study your pup’s medication and vaccine history, ask you questions about preventative medications and lifestyle, and run additional diagnostic tests.
Your vet may perform a more limited in-house test for some common tick-borne infections. Alternatively, more comprehensive tick panels are available through outside veterinary diagnostic laboratories. In some cases the vet may decide to start a course of the antibiotic doxycycline while awaiting these results because doxycycline is effective against many tick-borne diseases.
To look for any underlying evidence of cancer, your veterinarian will likely recommend full lab work. He or she may also recommend chest and abdominal radiographs or even an abdominal ultrasound.
Fletcher’s ITP trigger
In Fletcher’s case, he had not been on any recent medications and we were diligent about giving him his flea, tick, and heartworm preventative medications. His chest radiographs were normal. Since I had access to internal medicine specialists at my veterinary school, we also performed an ultrasound and a more comprehensive infectious disease panel a few days later. Thankfully, Fletcher’s ultrasound did not show any evidence of cancer.
When the infectious disease panel came back, we were surprised to discover that Fletcher was positive for Bartonella, an infection that is spread via fleas and can sometimes trigger ITP. We treated Fletcher’s Bartonella infection with a course of antibiotics and crossed our fingers.
Many times, if you treat the underlying trigger, the ITP can resolve. However, this was unfortunately not the case for Fletcher. His ITP did not go away, but with the help of daily medications, he managed to have a wonderful life.
What is the treatment for ITP?
After reaching a diagnosis of ITP, the veterinarian will propose a treatment plan. It may involve:
Immunosuppressive medications
An out-of-control immune system is the root problem with ITP. So you would be correct if you guessed that medications to suppress the immune system are the mainstay of treatment. Steroids like prednisone for dogs are almost always part of the arsenal. However, the vet may also add on other secondary immunosuppressive medications like cyclosporine, mycophenolate, or azathioprine.
Vincristine
If your furry friend ends up needing to be hospitalized for ITP, your veterinarian may talk to you about a medication called vincristine. This is an injectable chemotherapy medication. Since it is given at a lower dose for dogs with ITP, side effects are rare. Vincristine functions to push any leftover tiny platelet fragments out of the bone marrow and into circulation. Studies have shown that dogs who receive vincristine have slightly shorter hospital stays due to a more rapid increase in their platelet count.
IVIG
Intravenous Immunoglobulin (IVIG) is a more intensive treatment option that veterinarians usually reach for in severe cases or if a patient is not responding to more standard therapy. It is a human product and can be quite expensive, making it cost prohibitive for many pet parents.
IVIG essentially works by neutralizing the immune system cells by clogging up the site where they would bind to the platelets they were planning to inappropriately destroy. It is an injectable medication that must be given in the hospital as an infusion. IVIG can be a good option for some situations, and is generally well-tolerated. However, it is not a common day-to-day medication in the arsenal against ITP.
If you are interested in learning more about vincristine and IVIG, a study published in the Journal of Veterinary Internal Medicine compared these two options in dogs with ITP.
Blood products
Some dogs with ITP experience significant blood loss since they cannot mount an effective clotting response. If dogs lose enough blood that they are experiencing clinical signs from their anemia, they may need a blood transfusion. Packed red blood cell transfusions are the most common type of blood transfusions performed in veterinary medicine. These transfusions don’t provide any platelets or stop the bleeding, but they do stabilize the patient to buy more time for the medications to stop platelet destruction.
In some cases, veterinarians may reach for a whole blood transfusion to help with anemia and ongoing life-threatening bleeding. Whole blood contains both red blood cells and platelets, but unfortunately the platelets in the transfusion last for an incredibly short time inside the body. They may very temporarily help with severe bleeding, but this effect is short-lived. Unfortunately, a whole blood transfusion will not lead to an increase in platelet count.
Since ITP destroys platelets, it would seem like giving the dog more platelets would be a good treatment option. However, while platelet transfusions are relatively common in human medicine, they aren’t that useful in dogs with ITP. Two issues are at play in this situation. The first is that canine platelet products have somewhat limited availability. The second and more significant issue is that the platelets, once transfused, will be destroyed within hours by the same abnormal immune response that is destroying the dog’s own platelets.
Other supportive care
If your beloved pup is diagnosed with ITP, your veterinarian may add in other supportive medications to help treat specific symptoms. These may include:
- Antacids or stomach coating medications if your dog is experiencing gastrointestinal bleeding.
- Antinausea medications if your dog is nauseous.
- Appetite stimulants for dogs if your dog is not eating.
Your veterinarian will work closely with you to tailor the medication and treatment plan to your furry family member’s specific situation.
What is the prognosis and survival rate for dogs with ITP?
Using the treatment options we just discussed, the short-term prognosis for ITP Is good. The overall survival rate is roughly 80 to 85%. Unfortunately, though, this does mean that 15 to 20% of dogs pass away or are euthanized due to ITP.
There are a couple of factors that have been linked to a lower survival rate for some dogs with ITP. These include bleeding from the GI tract and an elevation in a blood marker known as BUN. If your pup falls into one of these categories, instead of losing hope, I recommend specifically talking to your veterinarian about your worries and discussing ways to tailor your dog’s treatment to his or her specific clinical situation.
The ups and downs of ITP treatment
One of the harder things to counsel clients on during treatment for ITP is the very normal, but understandably anxiety-inducing waiting game. It can take anywhere from four to seven days on average for immunosuppressive medications to kick in. During that time, we often check the platelet count and red cell count on a daily basis.
It can be very disheartening for dog parents to see that platelet count go from 8,000 to 5,000 to 5,000 again, especially if their dog is showing signs of bleeding. However, it is important to understand that just because a dog hasn’t responded over the first few days, doesn’t mean they still don’t have a good chance of responding positively to their medications.
Indications of improvement
You can breathe a sigh of relief when your dog’s platelet count increases above about 40,000 platelets per microliter. This is generally when your veterinarian will consider your dog to be out of the woods. At this level, life-threatening spontaneous bleeding is much less likely. Even so, you will want to treat your dog as if he or she is quite fragile until the platelet count increases back into the normal range.
This means no running or jumping or boisterous play. I even tend to recommend soft or canned food to decrease the risk of bleeding from the gums while waiting for the platelet count to normalize.
Happily, once the platelet count begins to rise, it normally continues to do so very quickly. Your veterinarian will likely want to monitor the platelet count every several days until it is normal. Once the platelet count has been in the normal range for three to four weeks, then the first step is to gradually reduce the dose of the steroid medication (often prednisone).
The vet typically decreases the dose by about 25% every three to four weeks while continuing to monitor to ensure the platelet count does not start to drop back down. If a secondary immunosuppressive agent was part of the treatment regimen, the vet will decide whether or not to stop or wean that medication once he or she is able to get the dog off steroids.
Medication side effects
Vets aim to taper the steroid dose first because while steroids are potent and effective medications to suppress the immune system, they do come with a number of side effects. Being able to use lower doses of steroids can be one of the advantages of adding in a secondary immunosuppressive medication.
All dogs are susceptible to experiencing steroid side effects, but large and giant breed dogs tend to be most sensitive. Some of the side effects you might see with chronic, high-dose steroid administration include:
- Increased thirst in dogs and increased urination
- Increased panting
- Lethargy or listlessness
- Weight gain, especially for small to medium-sized dogs
- Weight loss and significant loss of muscle mass, especially for medium to larger breed dogs
- Pot-bellied dog appearance
- Increased appetite
- Increased risk of other infections (skin infections, UTIs in dogs, etc.)
- Thinning of the skin
- A thin or dull haircoat
- Insulin resistance, which may increase the chances of diabetes mellitus or cause issues in an already diabetic dog
- Iatrogenic Cushing’s disease in dogs
If you think your dog’s steroid side effects are becoming problematic, speak to your veterinarian. He or she may be able to adjust your dog’s medications to reduce or eliminate some of the side effects.
What to expect long-term
Because of these side effects, vets always hope that we will be able to wean our ITP patients off all of their medications. That is possible in many cases. However, approximately one-third of dogs will have a relapse of their ITP either during their medication tapering or at a later date.
Sometimes it can be harder to get these dogs back into remission, but often they do still respond well to immunosuppressive medications. In some cases, dogs end up on life-long immunosuppressive medications to keep their ITP at bay. The vet will always try to get them on the lowest doses of medications that both control their disease and minimize their side effects.
Fletcher’s long and happy life with ITP
I can’t end this article without telling you what happened to Fletcher. He responded well to his medications and went into remission quickly. Happily, he never ended up needing a stay in the hospital or any blood transfusions.
A couple of months after weaning off his medications, a routine recheck revealed a significantly decreased platelet count. This indicated a relapse, which of course we felt disappointed about. He responded well again but his platelets dropped once more as we got him on the lowest doses of medications. This meant that he fell into the camp of dogs who need lifelong immunosuppressive medications to keep their disease at bay.
We bought a pill organizer, and we were diligent about giving his medications every day and keeping up with his routine rechecks. He experienced some side effects of the long-term steroid use including having to pee more often and losing a lot of his muscle mass. Luckily, at this point I was working at a specialty hospital. The internal medicine specialists were great about giving me lots of advice on his care.
We switched up his medication cocktail and found the right combination of medications that kept him in remission but also minimized his side effects. He lived a very happy life on those medications for more than six years.
Fletcher’s legacy lives on
Fletcher’s happy-go-lucky nature was both a blessing and a curse because by the time he started to act sick from cancer (unrelated to his ITP), it was already in his liver, spleen, and bones. We kept him as comfortable as we could and fed him lots of tasty, previously off-limits foods. Then we let him go when he told us it was time.
We still miss him very much, but we have so many wonderful memories with him. I am grateful for all the lessons he taught me, both about navigating a diagnosis of ITP and about how to empathize with dog parents when they are dealing with a complicated medical condition in their beloved companions. I hope that if you are facing a diagnosis of immune-mediated thrombocytopenia with your beloved dog, this article and Fletcher’s story give you the knowledge and the hope you need to make it through to the other side.
Has your dog been diagnosed with ITP?
What words of advice do you have for other dog parents who find themselves in a similar situation?
This is a really great piece, thank you. My dog was hospitalized three years ago with ITP and received blood transfusions, chemo, the works. Now at 13 his teeth are rotting and infecting his gums (from a lifetime violent refusal to let me brush his teeth!) and his vet says the teeth need to be removed, but obviously the anesthesia and bleeding from teeth removal are a huge risk for an ITP relapse. I’m trying to weigh whether the high risk procedure is worth it to make him more comfortable, or if letting the teeth rot is a better fate than a serious relapse. Would amping him up on his previous steroid medication better prepare him for a surgery like this? Or should I consider the whole thing too big of a risk?
Dear Stephanie,
I am sorry you are facing this difficult decision for your senior pup. I understand why you are conflicted about how to proceed and wish I had some great advice. Unfortunately, without playing a personal role in your dog’s medical care, it is hard to offer specific recommendations. If the ITP is stable and platelet numbers look good, I would probably try the dental procedure for my own pup. While a relapse is a possibility, dental pain is a real concern, and I would not want to force anyone to live with chronic pain if there was a way to prevent it. Here is an article with more information: Senior Dog Tooth Extraction: What to Expect
I am not sure there is truly a right or wrong way to proceed in this situation. No matter what you decide, your vet should be able to offer pain medications and help with comfort care. Praying for clarity and wishing you both nothing but the best.
Hi Dr Buzby!
i know it has been quite a while since i last wrote on here about Mowgli.I had a lot going on and for some reason typing on here seems to have a bug from my phone.Mowgli is still doing good! I have him checked every 4 weeks and his platelets remain around 550.I am still supplementing him.Last August i had a bit of a scare when they made an ultrasound of him as they found an incidentilome in his left adrenal gland.I had him tested for Cushing and a pheochrocytome but he tested negative for both.Two weeks ago i had another ultrasound made and luckily no growth was detected in the adrenal gland and spleen! By the way,have you seen the new protocol in how to treat ITP? My veterinarian sent it to me and told me that after she discussed Mowgli at the convention they have a new consensus statement on AVCIM where Romiplostime is now mentioned!Meanwhile 3 other people saw my messages on here and reached out to me with questions😃And this all thanks to your great platform!Again,sorry that it took me a while to get back at you but we are still alive and kicking!
Bye for now,Greets,Chomissa
Hi Chomissa,
It is so good to hear from you! I was thinking about you and actually mentioned you in a reply to another reader just the other day! I am glad Mowgli is doing so well. I needed that good news today. ♥ I haven’t seen the updated ITP protocol yet. Do you have a link to it by any chance? I am still amazed at how Mowgli’s case has helped propel veterinary medicine forward in this area. I feel like I know a celebrity. 🙂 Thank you for playing an active role in offering guidance to our readers facing this difficult disease in their own pups. As always, wishing my best to you and your boy. Keep up the good work!
Hi Dr Buzby,
The title is to be found on the veterinary journal of medicine and is called ACVIM consensus statement on the treatment of immune
thrombocytopenia in dogs and cats.
The date of the article is mation on the pathophysiology, diagnosis, and treatment of clinically important animal diseases. The ACVIM Board of Regents oversees selection
of relevant topics, identification of panel members with the expertise to draft the statements, and other aspects of assuring the integrity of the
process. The statements are derived from evidence-based medicine whenever possible and the panel offers interpretive comments when such
evidence is inadequate or contradictory. A draft is prepared by the panel, followed by solicitation of input by the ACVIM membership which may
be incorporated into the statement. It is then submitted to the Journal of Veterinary Internal Medicine, where it is edited prior to publication. The
authors are solely responsible for the content of the statements.
ACVIM consensus statement on the treatment of immune
thrombocytopenia in dogs and cats
Dana N. LeVine1
| Robert Goggs2
| Barbara Kohn 3 | Andrew J. Mackin4
|
Linda Kidd5
| Oliver A. Garden6
| Marjory B. Brooks7
|
Erin R. B. Eldermire8 | Anthony Abrams-Ogg9
| Elizabeth H. Appleman10
|
Todd M. Archer 11
| Domenico Bianco12 | Shauna L. Blois9
|
Benjamin M. Brainard13
| Mary Beth Callan14
| Claire L. Fellman15
|
Jillian M. Haines16
| Anne S. Hale17 | Alice A. Huang18 | John M. Lucy 19
|
Shana K. O’Marra20
| Elizabeth A. Rozanski15
| John M. Thomason 4
|
Jenny E. Walton21 | Helen E. Wilson 22
Correspondence
Robert Goggs, Department of Clinical
Sciences, Cornell University College of
Veterinary Medicine, S1-068 Schurman Hall,
240 Farrier Road, Ithaca, NY 14853, USA.
Email: [email protected]
Abstract
Management of immune thrombocytopenia (ITP) in dogs and cats is evolving, but
there are no evidence-based guidelines to assist clinicians with treatment decisions.
Likewise, the overall goals for treatment of ITP have not been established. Immunosuppressive doses of glucocorticoids are the first line treatment, but optimal treatment regimens beyond glucocorticoids remain uncertain. Additional options include
secondary immunosuppressive drugs such as azathioprine, modified cyclosporine,
Abbreviations: ABCB1, ATP binding cassette subfamily B member 1; CBC, complete blood cell count; CR, complete response; DOGiBAT, daily canine bleeding assessment tool; hIVIg, human IV
immunoglobulin; IMHA, immune-mediated hemolytic anemia; ITP, immune thrombocytopenia; MDR1, multidrug resistance 1; MMF, mycophenolate mofetil; NR, no response; NSAID,
nonsteroidal anti-inflammatory drug; PICO, Population Intervention Comparison Outcome; pITP, primary immune thrombocytopenia; PR, partial response; sITP, secondary immune
thrombocytopenia; TEG, thromboelastography; TPE, therapeutic plasma exchange; TPO, thrombopoietin.
Dana N. LeVine, Linda Kidd, and Oliver A. Garden are co-chairs on the Consensus Statement.
Dana N. LeVine, Robert Goggs, Barbara Kohn, and Andrew J. Mackin share first authorship.
Marjory B. Brooks, Robert Goggs, Barbara Kohn, and Andrew J. Mackin are panel members on the Consensus Statement.
Erin R. B. Eldermire, Anthony Abrams-Ogg, Elizabeth H. Appleman, Todd M. Archer, Domenico Bianco, Shauna L. Blois, Benjamin M. Brainard, Mary Beth Callan, Claire L. Fellman, Jillian M.
Haines, Anne S. Hale, Alice A. Huang, John M. Lucy, Shana K. O’Marra, Elizabeth A. Rozanski, John M. Thomason, Jenny E. Walton, and Helen E. Wilson are advisory task force members on the
Consensus Statement.
For affiliations refer to page 2001
Received: 29 March 2024 Accepted: 4 April 2024.
I have it on pdf file,if you cannot find it feel free to email me so i can send it to you.Today i received the sad news that Luna,the little Maltese from Ivana passed away today😢She had a liver tumor.Her age was 14.My heart goes out to Ivana who did so much for her dog child.May she be blessed for that.
Bye for now,Chomissa
Hi Chomissa,
Thank you for the information! I look forward to reading through it and will pass it along to the blog team as well. I am so heartbroken to hear about Luna. Please pass along my condolences to Ivana. ♥
Hi again,
Sorry i copied more then necessary only saw it now.it is the veterinary journal of internal medicine!
Bye!
Chomissa
The comments reference the drug Romiplostim. My dog still has ITP after a long bout of steroid treatment and a splenectomy so my vet wants to try this drug. However, I can’t find a source for it. Can you tell me where you got it? Thanks
Eileen McDonough
Hi Eileen,
I am sorry your pup is not responding well to the traditional treatment for ITP. I have not personally used Romiplostim in my patients and would not know how to obtain it. This comment came through as a reply to my previous reply. Try to see if you can reply to Chomissa directly as she would have better information. Wishing you all the best of luck and praying your boy can make a full recovery. ♥
How do we get in contact with Dr. Laura Garlow please? We are dealing with this new diagnosis for our dog and would be incredibly grateful for the opportunity to communicate with her directly.
Thank you.
Evelien
Hi Evelien,
I am sorry your pup has received this terrible diagnosis. Unfortunately, Dr.Garlow is no longer in private practice and is working in veterinary medicine in a different capacity. Due to this recent change, there is no clinic to contact in order to speak with her directly and I am not able to give out her personal information. You should be able to speak to an internal medicine specialist in your area to receive similar advice as what Dr.Garlow would be able to offer. There are also great sources of information and guidance at the veterinary teaching hospitals in each state. I am sorry I can’t be of more help. Wishing your pup all the best and praying for a positive outcome.
Hi Dr. Buzby,
My 6.5 yo GSD was recently diagnosed with ITP. It was a scary time (still is) as his first sign was a bloody nose. That has since stopped. He’s been put on a steroid. However, in the rush of everything thrown at me and the worry. I cannot remember all that the vet told me to look out for other than tar poop and additional bleeding. I remember the vet says something about internal bleeding but what are signs to rush him to the er for internal bleeding? I noticed a red spot but also not sure if it was there before as it’s hard to see with his coat.
Thank you.
Hi Ashley,
I am so sorry your boy is dealing with this worrisome condition. What a blessing his bloody nose resolved after starting the steroids. Signs of internal bleeding include pale gums, distended abdomen, labored breathing, restlessness, and weakness. You may also notice a lack of appetite if he starts to relapse. Hoping you will never have to worry about this becoming an issue. Wishing your sweet boy all the best and praying he has many happy years ahead.
Hi Dr. Buzby,
Thank you so much for posting so much information about this terrible disease. My sweet girl was diagnosed in Feb 2020. She’s had a few relapses over the years and is going through one right now. It’s been about three years since her last relapse. This time around she doesn’t seem to be responding to the prednisone the way she has in the past. We will re-check her count in 2 more weeks and go up on her pred dose if her platelet count still hasn’t increased. She’s holding steady at 15K, but in the past she would have at least been out of the spontaneous-bleed zone after the two weeks she’s been on this dose.
I’ve been digging into information again like I did the first time and came across some info that suggested cranberry supplements can be problematic in humans with ITP. I have had my girl on OTC cranberry supplements for dogs for a few years now. She’s a rescue, so her age isn’t certain but she’s at least 15.5 and maybe 17.5 years old. The vet didn’t want to add meds for incontinence due to the ITP so the cranberry pills were to mitigate UTI problems. I didn’t think to ask the vet about the cranberry pills, though. I just read the reviews from people saying they helped their geriatric female dogs, and I got them. Now I wonder if I induced this episode in my sweet girl.
I’ve stopped the cranberry pills in case they also may be problematic for ITP in dogs too. Wondered if you’ve come across this link for dogs in your research? Her last blood check was before I found the cranberry info so I’m hoping against hope that the new check, without the cranberry pills, will finally show her platelets rising again.
Dear Nee,
I am sorry your girl is experiencing a relapse of her ITP. Before reading your comment, I had never heard of cranberry causing any issues with dogs living with ITP. I tried to see if I could find any information on the subject, but all of my research came up empty. While I can’t rule it out completely, I would be surprised if the cranberry had anything to do with this relapse. I understand your concern for your pup, especially since she is not responding to the medications as expected. Hoping her body can stabilize and start to get things back on track. Wishing you both nothing but the best and praying for a full recovery.
Thank you so much for responding Dr. Buzbee! Your care and compassion are appreciated more than you probably know. I’m delighted to share that my sweet girl finally started to respond to the pred. She is very much out of the danger zone she was in (4K!). Last check her platelets were back to 167K. I think in trying to find anything that might be a cause, and therefore might be something to change, I was/am desperately hoping for something in my control to help her.
I know she’s approaching the end of her time here on earth just because of her age, and I’m trying to prepare myself for that, but as we all know – it’s just so hard. I greedily want any extra time I can have with her as long as her quality of life is good too. For now, she’s back to aggravating the cat and enjoying her stuffed ducky.
May we all hope to someday be as good as dogs. Sending you much gratitude!
Nee
Hi Nee,
Yay! I am so glad your girl is feeling better and is showing improvement in her platelet numbers. Thank you for the update and the kind words. Continuing to pray for healing for your sweet girl. Keep up the good work!
We have a 2yr old neutered collie who had a nose bleed on 5th July. We called the vets who said it wasn’t urgent and saw him the following week. On 10th July they told us his platelets were 4000, and he started prednisone on 12th July. After 5 days of prednisone he had repeat bloods and his platelet count has not improved. The vets have suggested one week of higher dose pred plus another immuno-suppressant, and said that’s the final resort. Is it kinder to euthanise if his levels remain at 4000? He is showing no symptoms (other than the one nose bleed which stopped within 30minutes). He is a rescue and is having to be sedated at the vets, so it’s a traumatising experience and the vets want to check his platelet levels frequently.
Dear Alex,
I am sorry you are facing this difficult situation with your young Collie. It is hard to know what would be best without playing a personal role in his medical care. If your boy is not having any symptoms and seems to be feeling well, I am not sure euthanasia is needed at this point. I do realize that if his platelet numbers drop you could end up in a life-threatening situation with little to no warning. Unfortunately, some problems just don’t have a definitive right or wrong way to handle them. I will be praying for clarity and strength as you navigate this unknown path. Wishing you both nothing but the best and holding on to hope for a full recovery for your sweet boy.
Hi Dr. Buzby,
I am so thankful for you and for this article. Elsie, our 8-year-old female toy poodle, is in the hospital with suspected completely primary ITP. Her platelet count was zero with RBC 16% down from 29% admitted yesterday. She was lethargic for a few days (she was diagnosed with pancreatitis a few months ago and since then has good spells and lethargic spells, but always came out of it until now). She has abdominal petechiae, corneal bleeding. She is very alert, and barks when we leave from visiting her. She has had 1 transfusion with vincristine, as well as steroid/antibiotic, and immunosuppressant (mycophenolate) and anti-nausea. She’s eating and drinking. Her gall bladder was enlarged during an ultrasound and they think that is why perhaps pancreatitis blood marker is high right now.
1. Do you feel that this could have been the same issue that we were dealing with in November back at our GP vet (diagnosed with a blood test after I complained of lethargy and upset stomach)? Or did we have two unrelated issues? I didn’t know if you’ve seen that before.
2. I am certain my hospital will recommend to keep her there until her platelet count is around 50,000. The cost is just so incredibly expensive for us- but we love her so (first “adult” dog). I wonder if we could take her home after a few days, even with low platelets, and be extremely careful with her and begin at-home treatment.
I’m so grateful with any response you may have.
Hi Raquel,
I am so sorry you are facing this difficult situation with Elise. I understand your concern for her wellbeing and your finances. It is possible this was contributing to the issues she was facing back in November, but there really is no way to know for sure. Taking her home to continue treatment may be an option. There is no way to predict how she will respond without giving it a try. I encourage you to discuss this with your vet and get their expert opinion. They will let you know when they think she can be released with the least amount of potential negative consequences. Praying for healing and a positive outcome for your sweet girl. Feel free to keep us updated on how things are going.
Dr Buzby,
Thank you for your very informative article. My friend’s dog just died of ITP. He was 3 years old. His groomer was the first to observe discoloration of the gums and some spots on his body, and told my friend that she was concerned because she suspected ITP. This was yesterday and my friend took him immediately to the emergency vet. He was perfectly normal otherwise, but his platelet count was very low. They decided to keep him overnight and administered Vincristine. He also received a transfusion. How common is for things to deteriorate so rapidly? He didn’t have any symptoms at all. We are in such a shock.
Dear Sonia,
I am sorry your friend lost their pup in such a tragic way. They are lucky to have someone like you in their life who is willing to search for answers and offer support. Unfortunately, this disease is very unpredictable, and things can change rapidly. Some dogs just don’t respond to treatment and then pass fairly quickly. Your friend did everything they could for their boy, and I am certain he knew how much he was loved. I hope with time the grief will begin to fade and you can take comfort in the memories of all the good times you shared. Wishing you brighter days ahead. Bless you all. ♥
Hi Dr Buzby,
What a wonderful resource that is available here for Dogs with ITP.
Our almost 14 year old 20kg labradoodle had a platelet count of 2 about three weeks ago. He was very lethargic and not eating. Vet diagnosed him with critical platelet count and started 20mg prednisone and doxy. Also we had full xrays, ultrasound, and blood work. Vet referred us to emergency hospital to treat him and hospitalize him , but we brought him home with the medicines and he responded very well. Back to eating with an astonishing appetite I have never seen in him before. Recheck a week later his platelets were 800. Lowered the dose of prednisone to 15 mg from 20mg and about a week later I noticed a nose bleed and his gums bleeding within a day. Lenny went back to the vet , this time he as at 0. Vet went back up to 20mg prednisone , and added 20 mg of Leflunomide, and also recommended 3mg melatonin. He still has his appetite and seems to be responding ok. Took him for a 2 mile walk today and he seems like his normal self. I also started feeding him raw flank steak.
The vet doesn’t think its cancer but most likely auto immune or another cause. I don’t think even if we put him through the paces looking for the cause of his ITP would the treatment course change? Lenny has always been a health active dog with minimal problems over his life. I know we are in bonus time with him at 14 years old , but I am worried his platelets will drop again. Any info appreciated.
Hi Casey,
I understand your concern for your senior guy and think he is very lucky to have you taking such good care of him. I am not sure the treatment would change if you found out cancer was the culprit, but it could have a big impact on the prognosis or life expectancy. It is possible for relapses to occur, but it sounds like you are doing everything you can to keep this from happening. Your vet is doing a great job of staying on top of things and being proactive with treatment and testing. Wishing you all the best as you navigate this tricky path. Praying for continued success and many happy days ahead for your sweet boy.
Hi Dr Buzby,
Today another update on Mowgli after a while.Mowgli is still doing good,platelets are about 450 and we are only giving him 0.02 of Romiplostime every 21 days.At the end of this month we will make an ultrasound of his spleen just to see if anything has changed since last year out of precaution.I did tell you before that Mowgli was having major food intolerance since he was a puppy and that i had tried all sorts of food just in hopes that there was anything that he would respond to in a positive way.Since a half year i have him on Royal Canin Hypoallergene and freeze dried ducky bites,plus horsemilk and vitamine B 12 ,vitamin B 9 and probiotica.Ever since i have started giving him all of this his food intolerance went away,so nomore vomitting and diarrhea and nomore ear infections and anal gland problems I wished i had done this before! Now i came across an interesting article that gave me an Aha moment and i just wonder that if any of the other dogs owners were or are experiencing the same issues with their dogs that got struck with ITP as the ones i mentioned in here I will insert the article but i am getting more and more convinced that ITP that is immune mediated has a correlation with a microbiome that is our of balance.I think that we have to think very well what we feed our animals with.After all,we are what we eat right and health overall starts in the gut.I am curious to know your view on this 😃Bye for now and i will keep you posted
Greets,Chomissa
https://animalmicrobiome.biomedcentral.com/articles/10.1186/s42523-023-00268-2#:~:text=IMHA%2FITP%20is%20associated%20with,and%20increased%20overall%20microbial%20diversity.
Hi Chomissa,
I am glad to hear Mowgli is doing well and things are maintaining with the romiplostim injections. This is very interesting information! I agree that gut health is very important and affects far more than what most people are aware of. I briefly looked over the study from the link you attached. It was done with a very small population of dogs and is unfortunate that not all were facing the same disease. I am also concerned that some of the dogs in the study received antibiotics while others did not. I wonder how much this affected the results. I know this was just a pilot study and am glad scientists are staring to pay more attention to this topic. I think we have so much to learn and hope they will continue to dig deeper into this subject. Thank you for sharing. As always, I look forward to our next conversation!
I had a border collie diagnosed in September 2023 who unfortunately just didn’t respond to medication and blood transfusions didn’t help. Then 4 months later our pitty/mastiff also got diagnosed with ITP he spent 4 different occasions in the emergency vet and finally we have seen progress. He has been tapering off medication for 5 months now but he has lost a lot of muscle mass, gained a lot of weight, so many UTIs and ear infections. Is it a normal thing to see so many UTIs and blood count fluctuations? He is almost off prednisone and finally playing again.
Hi Toni,
I am sorry you have been through so much over the past year and wish your boy could be spared from this terrible condition. Unfortunately, treating ITP requires suppressing the immune system. With immunosuppression also comes the risk of infections and side effects from the medications. I would suspect the UTIs and ear infections are a consequence of the immune suppression, and loss of muscle mass and weight gain are side effects of prednisone. Blood count fluctuations are very common and can be an ongoing battle with ITP. I am hopeful that your boy can continue to improve and that his symptoms will subside once the prednisone is discontinued. Praying for healing and wishing your sweet boy all the best at making a full recovery.
Thank you for posting this article! I’ve taken some comfort from it and learned more than elsewhere.
Our German Shepherd puppy was diagnosed at 4 months old. Although we’ve gotten his platelets up from then (platelets were at zero, pup is now 10 months old, platelets up and down), our vet wants him off of prednisone, understandably, and the mycophenolate did nothing. The ONLY symptom he ever displayed was slight lethargy. Nothing else. The vets at the clinic and the technicians at the lab were all stunned-prompting several repeat tests. He’s our joy and deserves a normal life. We had to end all vaccinations, which means his “playmates” are very limited. Do you have any advice? Do you know of any other cases so young? I could only find one online, and that case had a host of other comorbidities.
Thanks for your time!
Hi Karen,
I am so sorry you had to deal with this terrible disease in your puppy! I have never seen ITP in a dog that young. If you aren’t already working with an internal medicine specialist, I would recommend you get established as a patient. A specialist could be extremely valuable if your pup ends up having another episode. Hoping your Shepherd will go on to live a normal life and this will all be a thing of the past. Best wishes and take care!
Hi Karen,
I have written a lot of information about my 7 year old Shih Tzu who was diagnosed with immune mediated ITP last year.After finding an article of a German University who had done a trial with 5 dogs in humane medication i convinced my dog’s internist to give it a try and immediately my dog went in remission.If you want more information you can either scroll down the comments and read my messages or you can email me on [email protected] and i can send you information about it.I advise you also to start giving your dog Vitamine B 12 and follic acidB 9 and probiotica supplement to help his microbiome.get into the best shape.
Greets,Chomissa
Hi Dr Buzby
We reached out about Russell a few months ago. He seems to have responded well to Vincristine … his platelet counts have gone up dramatically and hovered between 400-500. Unfortunately throughout all this he’s developed diabetes. We’ve got the prednisone down to 15mg / a day and 100 mg of Cyclosporine. He’s been on insulin for approximately 1 month now but we haven’t seen much improvement there. His levels were originally 27 and now range from 18-25 on a daily basis. We haven’t seemed to be able to regulate the diabetes, even at 11 units every 12 hours (he’s 30 lbs). Do you have any recommendations for this? We’ve heard human insulin can be more effective than canininsulin?
Thank you for your help!
Hi Emma,
I am glad to hear that Russell showed favorable results with the Vincristine. I am sorry he is now dealing with diabetes too. I will attach links to other articles with more information about diabetes and what you can expect moving forward. I am afraid that as long as Russell is on the prednisone, it may be very difficult to get him well regulated. I hope with more time, your boy will be able to come off the prednisone (sometimes an additional immunosuppressive medication has to be added) and this will in turn help to get his blood sugar more stable. For now, I would recommend you focus on diet as this can play a major role in blood sugar levels. Thank you for the update and praying for a positive outcome for you and your sweet boy.
1. Diabetes in Dogs: The Ultimate Guide
2. Can A Diabetic Dog Eat Chicken Breast? Diabetic Dog Feeding FAQs
Thank you so much for sharing all your veterinary knowledge on this wonderful blog. Our sweet golden irish girl, Ellie, was diagnosed with ITP a few weeks ago and this blog post helped tremendously in understanding exactly what ITP is as I was completely overwhelmed and felt a bit lost after the diagnoses from the ER vet.
A few weeks ago, we took Ellie for a hike, which she was acting totally normal on – her usual energetic self. Shortly after, we noticed a ton of bruising on her abdomen and petechiae on her gums. We took her to the ER where they told us she had a platelet count of 0 and was in crisis. She also tested positive for Anaplasma. At the time, her white blood cell counts and liver enzymes were normal. We couldn’t swing the hospitalization cost so opted for the in home treatment of pred, doxy and mycophenolate. Had another blood draw with our vet a few days after, but there wasn’t a change in her platelet count which they said was normal given she had only just started the drugs. Fast forward to the next blood results a weekish later. Platelet count was up to 214, WBCs normal, but liver enzymes were VERY elevated. Vet consulted with internal medicine who instructed us to drop the mycophenolate and start Denamarin for liver support. This week’s results (the latest blood work) showed a drop in platelets, 184 (in range, but right on the cusp of being low), liver enzymes a lot higher than last week and now we have elevated WBCs. Our vet consulted with internal medicine again, who suggested dropping the pred dosage ever so slightly and getting an ultrasound (scheduled for next week) to rule out possible cancer. I’ve done a lot of research, and it seems like the elevated liver enzymes and WBC can be an expected response from prednisone. Is this accurate or am I misunderstanding the side effects? Ellie’s temperament has also completely changed. She’s gone from being her energetic happy self (she had a slight limp) pre diagnosis to very lethargic and overall depressed since we introduced the drugs. She also has very rapid breathing 20-30 mins after we give her the meds (no panting) and randomly noticed her nipples appear bruised with slightly visible blood vessels. She’s eating and drinking still – have noticed she’s eating more than usual. To me, all the changes to her health and temperament seem to align with the introduction of drugs. Worried that they’re doing more damage than good at this point. Could cancer suddenly flare up and cause elevated WBCs and liver enzymes as well as cause some of these other changes to her health? I feel like I’m bothering my vet with all these questions that they don’t seem to have answers to without consulting a third party, so looking for some additional help understanding all of this!
Hi Georgia,
My heart goes out to you as you face this difficult situation with Ellie. I can only imagine how worried you must be and unfortunately this disease can often produce more questions than answers. You are correct that the majority of Ellie’s issues could be attributed to the medications she is taking. But the problem is they are also symptoms of liver cancer or complications of Anaplasmosis. So, I understand why the specialist is recommending an ultrasound and encouraging your vet to pursue more in-depth testing. I would hate to assume it is all drug related and find out later on that there was something else going on the entire time that was completely missed. Also, you can always ask for a referral to a specialist, but with your vet reaching out personally to internal medicine for support they are saving you a ton of money and getting great guidance and advice. Don’t feel bad for asking your questions and discussing difficult topics. That level of care and service is exactly what you are paying for and what your vet strives to provide. You are doing a wonderful job advocating for your girl’s health and well-being. Praying for healing and keep up the good work!
Hi Dr Buzby,
Here is an update on Mowgli.We are still doing fine.Mowgli is now on 0.2 mycophenolate and 0.02 Romiplostime and his platelets have been consistent around 450 to 480 in the last weeks.Last week i had a bit of a scare because the procyte one gave a count of 231 but this was caused by several agregations in the blood so it gave a false low count and his monocytes were showing a rise.So today i went for a visit to Mowgli’s internist just to be sure and everything was normalised.She was actually really satisfied with the results and the way Mowgli looks healthwise so i had a happy day🌞. Ivana and i have been in contact all the time and Luna’s platelets are also still fine.So yea this is my update for now and i will keep you posted ofcourse.Bye for now!
Hi Chomissa,
We are all still cheering for you and Mowgli! Thank you for the update and for your continued willingness to reach out in support of other readers. Bless you and keep up the good work! Tell Ivana that she and Luna are in my thoughts as well. ♥
Hi Dr Buzby,
It has been a while since i gave you an update on Mowgli so today i decided that i should do this 😃.Mowgli is still doing well.His blood charts have been consistent and platelets between 400 and 500.He is no longer on mycophenolate and has only been getting the Romiplostime every 2 weeks o.o2 ml Now,we have decided to give him Romiplostime every 21 days to see what will happen.So yes,i am very happy about his progress.In July i will go see his internist for a thorough check up.About Ivana,she has been struggling with Luna’s health.At some point her platelets did drop beck to zero and Luna had a blood transfusion.Then they decided to give her more of the Romiplostime and her platelets went way up again,platelet count was 1100! This has now normalised again and Luna had a surgery because of a cornea injurie.Ivana has turned now to a naturopath from Italy that was recommended by one of the veteriniarians and they made a special compose with plants for Luna .I have considered to do this as well but i must admit that i am a bit hesitant about doing that since Mowgli is doing well at the moment I did email the naturopath and she gave me a special compose to that i should order, vitis vinifera+prunus spinosa+tamarix gallica+carpinus betulus+juglans regia.This mix is especially for trombocytopenie.It does contain alcohol though to keep the mix potent What are your thoughts on this? Anyways,i was just reading your bloq on heartworm and i have indeed also encountered many claims mentioning natural remedies against worms so i agree with what you said Well,this is my update for now and i will again keep you posted on Mowgli.Have a lovely day out there!
Greets,Chomissa
Hi Chomissa,
It is so good to hear from you! I was just thinking about you and Mowgli today as I was responding to another comment on the ITP article. Goodness my heart just aches for Ivana and Luna. I hope the compose will be exactly what Luna needs and will help keep her stable. I was not familiar with the plant species that you listed but took a minute to look them up. They are very interesting! The alcohol has me a bit concerned but I guess it can be safe depending on the concentration. Thank you so much for the update! I keep you in my thoughts and will continue to pray for Mowgli’s health and happiness. As always, best wishes to you both. ♥
Hi Dr Buzby –
I’m so glad I came across this article. My 6 yr old maltipoo, Henny was diagnosed in February. He responds well to meds but each time he finishes he is off a few weeks at a time and then his platelets drop again. Also his vet has not been weening him off the steroids until this last time and doesn’t have us starting the weening until the end of 30 days and each reduction is only for a few days at a time for maybe 10 days total. I’m worried she doesn’t know what to do however we were told we had to take him to an internist and she wouldn’t prescribe more meds unless they said it was ok. Problem is internist can’t see us til mid July and my Henny will run out of meds in 2 weeks. Any advice you can off will be appreciated!!
Hi La Ren,
I am sorry your pup is having these recurring issues. Getting a dog well-regulated and preventing relapses can be very difficult, and unfortunately some just don’t respond to treatment. I agree it sounds like your boy would benefit from seeing a specialist. I think the issue with running out of medication before your July appointment is just a miscommunication. I am sure your vet would be willing to give you enough medication to make it to the appointment. They just need to know that the appointment has been scheduled. Make sure you keep the lines of communication open and don’t hesitate to speak up and advocate for your pup. Hoping Henny can keep fighting and praying for a full recovery. Best wishes to you both!
Hi Dr. Buzby,
Today is day 5 of my dog (9 year old cockapoo) being in the ICU. Sunday night, Maisy was totally fine, extra cuddly but herself. Monday morning, I woke up to her running downstairs and peeing seemingly pure blood on the floor. I called the emergency vet and they said it was most likely a UTI and to wait for my vet to open for an appointment. That day, Maisy requested to go outside non-stop, and when she wasn’t outside, she used the basement as her toilet. There were bloody puddles and drops everywhere. After a couple of hours at our vet, they transferred us to the hospital for more testing for suspected ITP.
The vet and doctors are absolutely amazing. They have kept me up-to-date and even sent daily pictures to help this momma. Today I get to visit her for the first time and I can’t help but be fearful that this will be my last time. Maisy hasn’t made a ton of progress in the 4 days that she has been there. She has had 2 blood transfusions and her platelet count remains below 5k. I am not totally sure on which immunosuppressants they have given her, but I do know that she received a dose of Vincristine.
I appreciate your blog post and reading everyone else’s stories so much. I can’t imagine life without her so unexpectedly and hope she comes home soon.
Dear Elizabeth,
My heart goes out to you as you face this difficult diagnosis with Maisy. What a blessing the veterinary staff has been so kind and working hard to keep you updated on her condition. How are things today? Hoping Maisy was able to keep fighting and is now on the road to recovery. Praying all is well. Feel free to leave an update if you have a chance.
I spent all night reading this article along with everyone’s comments to find some peace with my pups recent diagnosis of ITP. I took my 6 year old schnauzer for a dental cleaning, like many have mentioned, and received the scariest call to pick up my dog because his platelet levels were at zero. We rushed him to the emergency room where they began all of the tests to rule out secondary ITP; you can’t help but let your mind wonder what YOU did wrong and if there was anything you could have done to prevent it. It seemed so odd that my super active, healthy, loving boy was battling this awful disease. He stayed overnight in the hospital and to say my heart felt shattered is an understatement. I’m now anxiously waiting to get more answers from his doctor and team to find the best solution moving forward. I’m not going to lie, the stories about relapse during the weaning process terrified me. I’m praying he responds well to the medication so we can get our baby back home. I find comfort knowing your dog made it to 11 with this diagnosis. I will do everything I can to give him the best possible life even with this diagnosis. So far, his labs and diagnostic work has come back negative. No bleeding other then from his tooth (which I initially thought was because he bit down on a hard toy). Thank you for bringing awareness to this topic and for finding passion in your experience to do more research to help owners like us.
Hi Adee,
My heart goes out to you as you face this difficult diagnosis with your Schnauzer. I understand your worry and concern but what a blessing you were able to act quickly and start treatment right away. Hoping your boy will respond favorably to the medications and be able to return home soon. Praying for healing and wishing you both many happy years ahead.
Thank you so much for this article and all the comments.
My 3 yo cockapoo girl was diagnosed with ITP in October 2023 and has been recovering since. Just like you, I went on a holiday and when I came back I started noticing bleeding from her gums. Naively thinking she chipped her tooth on a yak chew, I took her to the vet and events unfolded quite quickly from there. She was hospitalised for 2 weeks, had 2 blood transfusions, high doses of steroids, immune suppressants, and the chemotherapy meds mentioned above. At points I really thought I’ll lose her, but she made it miraculously. As a result now I’m in crippling debt and anxiety of this happening again.
We are off the steroids now – luckily she hasn’t had a relapse throughout the tapering process. Now on the immune suppressant only for another few weeks until our next big blood test and will take it from there.
Honestly, I am praying to all the gods out there for a long and happy life for my girl, but I’m so fearful that she will relapse at some point. I’m single so alone with her and my family lives in another country, so this has been a lot to take in and manage. I’m scared to go on holidays, or to even leave her for longer than 4 hours.
Bless her, she’s a bundle of joy and such a little fighter I really hope she stays with me for a long time.
I wonder if there are any signs before things get really dramatic to look out for? I know before my girl broke down she’s been getting tired from exercise more easily. I didn’t think much of it at the time, but now I think it might be related.
The vet also told us not to vaccinate, and that some vaccines she got previously might have played a role in this. The timing doesn’t align – the only thing I gave her before she started feeling unwell is her flea treatment. Could that be a trigger?
Also, are there any natural remedies that could help maintaining this on the long run?
I really hope she’ll be healthy for a long time.
Thanks,
Alida
Hi Alida,
I am so sorry you endured this scary situation with your little pup. I understand your stress and worry about a possible relapse in the future. I would not think the flea prevention would have triggered ITP. It needs something to trigger the immune system and that is why your vet is suspicious about previous vaccinations. You are absolutely correct that lethargy or lack of energy could be an early warning sign. I am not sure there are good natural remedies to prevent a relapse, but some have talked about using melatonin to help increase platelet numbers. I encourage you to discuss melatonin with your vet and also make sure you have a plan for ongoing monitoring and lab work rechecks. Try to take things one day at a time and make the most of the time you are gifted. Wishing you and your sweet girl all the best for many happy years ahead. Bless you. ♥
Hi Dr Buzby,
Thank you so much for responding to my comment, it definitely gave me comfort in this difficult battle with ITP.
We’re now 9 months after the traumatic events and my girl has been fine. She’s been off all the meds for 3 months and seems to be ok. However, there are two concerning signs that I’d love your input on as I feel like my vets are not very helpful with them.
One is that she’s developed incontinence throughout all of this, but it started before the ITP diagnosis, although it was only occasional back then. Now it’s something constant that we need to live with. I requested Ada’s medical records from the vet and it seems that the incontinence got triggered every time we got a Nobivac vaccine. The last one she got was for kennel cough about 6 months before being hospitalised with ITP.
Another thing that I can see in her medical history is that even though we’re not in the danger zone, her platelets are lower each time we go back for a blood test / check up. They also mentioned that this can be because her platelets are clumping, but didn’t give me any further explanation. Just said it’s kind of okay now and will treat her if she gets into a critical condition again.
I really hope that we don’t have a relapse, I just started relaxing that my dog has miraculously recovered from this with only a minor inconvenience of having incontinence.
Do you know if the platelets decreasing / clumping could be a warning sign? Is there anything we can do to prevent another dramatic and expensive round of hospitalisation?
Thanks so so much.
Hi Alida,
Thank you for the update! I am glad your pup is still doing well and has been able to maintain without medications. The urinary incontinence has me puzzled. Have you mentioned this issue to your vet? If she has not been tested for a UTI or other urinary problems (stones, crystals, etc.), it may be time to do some investigating. As far as the platelets go, clumping is not something to worry about except that it can make getting an accurate count very difficult. If the true platelet numbers are steadily decreasing, I would be concerned. Don’t forget you can always ask for a consultation with an internal medicine specialist if needed. Hoping for continued success and wishing you both nothing but the best.
Thank you again!
Yes, I mentioned the incontinence and we tested for UTI, but it’s not that. The vet was puzzled too but they’re part of Medivet and I feel like most of the time they are more about treating symptoms rather than root causes.
They don’t know if it’s incontinence for sure – they said the only way is to give her the medication and see if it works. Yet another medication with a list of adverse side effects – one of them being ITP I think.
I’m getting a second, third, fourth opinion now to see if we have other options.
With the clamping – how is it possible to tell if there’s a downward trend?
Thanks again for your kindness and dedication to this awful condition. Hope it gets more researched and also cross checked with some vaccinations and meds, because now that I started checking it’s mentioned on way too many leaflets.
Sending you blessings.
Hi Alida,
I can only imagine how frustrating it must be to still have more questions than answers when it comes to this urinary issue with your girl. I think a second opinion is a great idea. Not necessarily because I think your vet is doing anything wrong, but it never hurts to get more than one brain working to find a solution. Your girl is so lucky to have you taking such an active role in advocating for her health and well-being. If the platelet clumping is making obtaining accurate results a challenge, there is a way for your vet to ask for a manual count when submitting the lab work. With a manual count, the lab technician will count the platelets themselves instead of relying on the machine for results. The technician’s result will usually say something like “platelet clumping present but overall count seems adequate”. Please keep me updated on how things are going. I hope you will be very happy with one of the new veterinarians you will be visiting. You deserve to feel confident in the medical care your pup receives and should be able to partner together to ensure she is on the right track. Continuing to pray for answers and healing. Keep up the good work!
Thanks again for your care and dedication to all of us struggling with ITP out here.
This is just an update that I was right about feeling off about the downward trend of Ada’s platelet numbers. She just had a relapse and in the hospital now. Thankfully I caught it early and her vitals are all good, no signs of internal bleeding but we don’t know yet if she will respond to steroids.
I’m worried about the journey ahead, the vet said possibly life long medication. Is this something that’s ok for them, or am I just lengthening her pain and suffering?
Can dogs who have a relapse after a year still recover and have a good quality life?
Thank you again,
Alida & Ada
Hi Alida,
Oh no! I am so sorry your girl has had a relapse and is in the hospital. This just breaks my heart for you and her. Don’t lose hope yet. There are MANY dogs that have a relapse and then go on to live full and happy lives. Lifelong medication may be needed, but I think it is too early to make that conclusion. If your girl does have to stay on something long term, we usually strive to wean off the prednisone and replace it with a different immunosuppressive medication. If you have not read through all the other reader comments, I encourage you to do so and specifically look for the ones written by Chomissa. She is not in the U.S., but her vet was able to try an experimental drug with great success! Praying for healing and a full recovery for your sweet girl. Wishing you strength and comfort as you face this difficult situation.
Hey! I just wanted to say thank you for this article. About this time last year my dog was diagnosed with primary ITP. It was a very tough time. My friend shared this article with me and it was a lifeline. I am so grateful for this information.
If I could provide insight, I’d say take everything one step at a time. My dog is one of the ITP survivors that has to be on meds for life. Her platelet rechecks can be anxiety inducing and a sad reminder of her chronic illness. I ask my friends and family for prayer each time we have a vet appt so that I can be covered in peace and trust. I love my dog one day at a time because that’s what we have. 💙 ITP is a good reminder of how precious life and love is. I’ve gotten used to giving her the daily meds and found a vet I trust for my dog’s treatment. Build your support system and take it one day at a time. I pray the best for everyone on here walking through this!
Hi Meagan,
I love your words of encouragement and think this is great advice. What a blessing your girl was able to stabilize and continues to respond favorably to the medications. Thank you for sharing your experience and insight with us. Keeping you and your sweet girl in my thoughts and praying for many happy days ahead.
My little dog Rosie, a chihuahua, was recently diagnosed with ITP—three days ago. I noticed two dots when rubbing her stomach and thought at first it was a rash. The next day her ribs and abdomen were covered in bruises. We rushed her to the vet who sent us to the emergency medical clinic. She had tested positive for lyme, but I had only ever noticed one tick on her back in May from a hike, and she had been on Simpatica. They didn’t see any of the common tickborne diseases that would trigger her platelets to be at zero. All of her other counts, including her red blood cell count were normal. She showed no signs of illness. She was active and playful and her sassy, sweet little self. They gave her vincristine, antibiotics to be safe, and steroids. She’s only 4.
We came home two days ago and we go back to the vet again in two days for a blood work-up. She is showing signs of improvement, but I am still terrified. I want to keep her improving and from relapse.
Thank you for your post. It’s the only post that I have found details that a dog’s positive personal story like yours.
Hi Sonya,
I am so sorry Rosie is dealing with this terrible disease. What a blessing you were able to get a diagnosis quickly and start treatment right away. I am glad to hear that your girl seems to be improving. Praying for continued healing and hoping things go smoothly when the medications are eventually discontinued. Thank you for sharing your experience with us. Best wishes and bless you and your little pup.
Hi Sonya,
I read your story and i urge you to read as far as you can in my comments below about my experience with my Shi Tzu so far.For him the rescue came in giving him Romiplostime,a humane medication that blocks the antibodies destroying the platelets.If you want to know more you can reach out to me at [email protected].I can then send you information that you can show to your vet.I hope that you read this.
Greets,chomissa
Hi Dr Buzby. (We tried to send this from my partners phone/email but doesnt seem that it was received) Thank you for making this information accessible for everyone. Our 9 year old Labradoodle, Russell, who has many similarities to Fletcher, was recently diagnosed with ITP in November of 2023. It came after he was playing with his ball and started limping. The following day his entire right leg was swollen and purple. After a negative X-ray and no improvement, we started noticing bruising in his ears, gums and belly which is when we found ourselves at the ER. We did a tick test, chest x ray and abdominal ultrasound which were clear and thus we believe it may be primary ITP. Russ has been on 25mg of Prednisone and 150mg of Cyclosporine a day. Throughout this process Russ’ platelets have been a rollercoaster of a response … essentially they’ve gone something like this —> 0-35-55-75-26-15-0-25-36-36 and as of last week we’re at 16. It doesn’t seem like he’s responding to the medication like he should. Of significance, the bruising seems to be going leg to leg … a few weeks after our first ER visits, his other front leg became completely black and blue, and then one of his rear legs after that. Have you ever seen the disease present like this in the legs specifically? We’re 8 weeks in and he still shows sign of pain in that front leg, so I think he may have bleed into the joint? Are their any other diagnostic tests you would recommend at this time? As of yesterday we increased the dose to 30mg of prednisone and 200mg of cyclosporine a day. He is still happy to eat and wants to play with his ball most days, so his spirits do seem to be okay, much different from the first week of the diagnosis. Any guidance is appreciated.
Hi Emma,
I am sorry you didn’t see my reply from the other day! I saw the comment posted under Autumn’s name and wrote back on the 16th. I will paste my reply here just in case you cannot find the original thread:
Hi Autumn,
I am sorry Russell is having so many issues with his platelets and is still experiencing these strange symptoms. Without playing a personal role in his medical care, it is hard to make specific conclusions and recommendations. If you are not already working with an internal medicine specialist, then this could be a good next step to take. Dogs respond to medications differently, and what works for some may not work for others. It is possible Russell would respond better to a different immunosuppressive medication other than cyclosporine. I am hopeful you can keep searching and will find the best treatment for your sweet boy. Feel free to leave an update as things progress. Praying for a positive outcome.
Hi Dr Buzby. Thank you for making this information accessible for everyone. Our 9 year old Labradoodle, Russell, who has many similarities to Fletcher, was recently diagnosed with ITP in November of 2023. It came after he was playing with his ball and started limping. The following day his entire right leg was swollen and purple. After a negative X-ray and no improvement, we started noticing bruising in his ears, gums and belly which is when we found ourselves at the ER. We did a tick test, chest x ray and abdominal ultrasound which were clear and thus we believe it may be primary ITP. Russ has been on 25mg of Prednisone and 150mg of Cyclosporine a day. Throughout this process Russ’ platelets have been a rollercoaster of a response … essentially they’ve gone something like this —> 0-35-55-75-26-15-0-25-36-36 and as of last week we’re at 16. It doesn’t seem like he’s responding to the medication like he should. Of significance, the bruising seems to be going leg to leg … a few weeks after our first ER visits, his other front leg became completely black and blue, and then one of his rear legs after that. Have you ever seen the disease present like this in the legs specifically? We’re 8 weeks in and he still shows sign of pain in that front leg, so I think he may have bleed into the joint? Are their any other diagnostic tests you would recommend at this time? As of yesterday we increased the dose to 30mg of prednisone and 200mg of cyclosporine a day. He is still happy to eat and wants to play with his ball most days, so his spirits do seem to be okay, much different from the first week of the diagnosis. Any guidance is appreciated.
Hi Autumn,
I am sorry Russell is having so many issues with his platelets and is still experiencing these strange symptoms. Without playing a personal role in his medical care, it is hard to make specific conclusions and recommendations. If you are not already working with an internal medicine specialist, then this could be a good next step to take. Dogs respond to medications differently, and what works for some may not work for others. It is possible Russell would respond better to a different immunosuppressive medication other than cyclosporine. I am hopeful you can keep searching and will find the best treatment for your sweet boy. Feel free to leave an update as things progress. Praying for a positive outcome.
only Romiplastim injections, my dog is alive and the blood is great 😁
Hi Ivana,
This is so interesting to me! You are the second person who has reported great success with this treatment. I truly believe this will start to gain more attention and become a big thing in veterinary medicine.
Hi Dr Buzby,
Here a little update on mowgli,his platelets will be checked again tomorrow.Two weeks ago they were 600 and a month ago the same.He has been on 0.03 ml for the last month.If the platelets are still good tomorrow he will be getting 0.02 ml.I will keep you posted!
Greets,Chomissa
Hi Chomissa,
Thank you for the update! Glad to hear things are continuing to remain stable as hoped. Also, I appreciate you reaching out to other readers and offering to share your experience. I wish there was a way to keep your story toward the top of the comments, so it was more visible. Take care and I look forward to hearing from you again!
Hi dr Buzby,
So nice to hear from you again!I
This is Mowgli’s pro cyte one from yesterday and he is doing really well..
RBC
6,62 x10^12/L
5.65 – 8.87
6,88 x10^12/L
HCT
46,0 %
37.3 – 61.7
46,4 %
HGB
15,9 g/dL
13.1 – 20.5
16,8 g/dL
MCV
69,6 fL
61.6 – 73.5
67,4 fL
MCH
24,0 pg
21.2 – 25.9
24,4 pg
MCHC
34,5 g/dL
32.0 – 37.9
36,2 g/dL
RDW
18,4 %
13.6 – 21.7
19,2 %
%RETIC
0,8 %
0,9 %
RETIC
54,3 K/μL
10.0 – 110.0
61,8 K/μL
WBC
10,53 x10^9/L
5.05 – 16.76
9,05 x10^9/L
%NEU
68,9 %
68,5 %
%LYM
16,7 %
19,2 %
%MONO
9,7 %
8,1 %
%EOS
4,7 %
4,3 %
%BASO
0,0 %
0,0 %
NEU
7,26 x10^9/L
2.95 – 11.64
6,20 x10^9/L
LYM
1,76 x10^9/L
1.05 – 5.10
1,73 x10^9/L
MONO
1,02 x10^9/L
0.16 – 1.12
0,73 x10^9/L
EOS
0,49 x10^9/L
0.06 – 1.23
0,39 x10^9/L
BASO
0,00 x10^9/L
0.00 – 0.10
0,00 x10^9/L
PLT
594 K/μL
148 – 484
598 K/μL
HOOG
MPV
11,1 fL
8.7 – 13.2
11,1 fL
PDW
10,6 fL
9.1 – 19.4
12,3 fL
PCT
0,66 %
0.14 – 0.4
I thought it would be nice for you to see his current chart.Next month we will be discussing tapering down with the mycophenolate.i did change Mowgli’s diet to Royal Canin hypoallergenic,the wet food version and nibbles.He had an inflames ear and we treated that with osurnia antibiotic potion and it is healed now.I am glad that he likes the Royal Canin food.I will keep you posted!
Hi Chomissa,
So glad Mowgli is doing well. Keep up the good work!
Hi Dr Buzby,
Mowgli’s last bloodcheck was last week and his platelet count was 466.Lower then the last times but still above average.We have tapered down the mycophenolate from 0.4 to 0.3 ml.I came across an article from a Dutch hematologist who was discussing the options in treating itp in humans and he thinks that a combination therapy works best.He mentioned that romiplostime fights the symptoms of the itp but doesnt cure the disease by itself but if used long enough it might cause immuno modulation and at first they assumed it could cause bone marrow reticulin but they found out that this is not a permanent situation and in humans it can be used for 10 years of necessary and in 30 to 40% of the patients it could cause a permanent remission so i discussed this with my vet.We agreed on continuing with the romiplostime in a lower dose, 0.02 ml in hopes it could cause a similar effect in Mowgli.February 23 he will have another check but if his platelet s will drop significant we adjust the dosage of his medication.I will keep you posted!
Greets,Chomissa
Hi Chomissa,
This is all such interesting information. I hope Mowgli’s recheck will show favorable results and allow you to continue to decrease his dosage. Thank you for the update! Keep up the good work!
My English is a little bad, but I hope you can understand me.. 3 years ago my Maltese Luna (11 years old) came for a teeth cleaning and the platelet count was 0.
She was given vincristine and prednisone. All findings of infectious diseases were excluded and autoimmune thrombocytopenia was diagnosed. They suggested removing my spleen, I went for a second opinion, they said the same and we operated.
She continued to take the medication, the platelets started to rise and everything was fine. We cleaned her teeth and the disease went away, we gradually took her off prednisone and she was in remission for 2 years.
In September 2023, we came to draw blood and also wanted to clean the teeth again PLT 0.. the same treatment procedure plus they introduced Cellcept and Vincristine in parallel. The drugs prednisone and Cellcept did not help, except Vincristine, but only in the short term. I found this blog and started researching, after Chomiss Said and Mowgli’s treatment journey I showed my vet if I could try Romiplastim and they said yes. N Plate Romiplastim started receiving in January 2024.
The medicine was bought in the city pharmacy, 250 mcg, 580 euros, and they said that my 5 kg Maltese has about 10 applications, and he keeps them in the refrigerator at the clinic.
(1st week) 1st dose of Romiplastim, platelets from 0 came to 38 after 7 days.
Cellcept 80mg in the morning and 80mg in the evening, prednisone (5mg) 1/2 in the morning and 1/2 in the evening.
(2nd week) 2nd dose of Romiplastim, platelet count 38 to 718 after 7 days.
Cellcept 80mg in the morning and 80mg in the evening, prednisone (5mg) 1/2 in the morning and 1/4 in the evening.
(3rd week) no Romiplastim, waiting for platelets to go down and now up to 280.
Cellcept 80mg in the morning and 80mg in the evening, prednisone (5mg) 1/4 in the morning and 1/4 in the evening.
(4th week) platelets dropped to 59, and she received Romiplastim, so today 05.02.2024.
Cellcept 80mg in the morning and 80mg in the evening, prednisone (5mg) only 1/4 in the morning.
I hope for a positive outcome. In 3 days we take blood again to see if the platelets have increased. With that medicine, he was in an elevated state of platelets for the longest time, and I hope that everything will return to normal soon. We hoped we had arrived, but we haven’t yet.
I am from Croatia.
If you could contact Chomissa Said for information about the dosage of the medicine, and I’m wondering when Mowgli went into remission after how many applications and time? that is wonderful news, I would like mine to get better as well. I was happy too soon, when we saw high platelets after the second week, we were all happy that they had increased.
Hi Ivana,
This makes me so happy!!! This is exactly what this forum is about… sharing information and advice with others and offering encouragement and support. I am thrilled to know that you were able to use the information Chomissa shared, and it has been a blessing to your pup. Feel free to reply directly to one of her posts. She is very good about checking her replies and responds quickly. Wishing you and Luna all the best and praying for a positive outcome. ♥
Hi Dr Buzby,
Here’s an update on Mowgli’s last blood check.His platelets went up to 571 so we gave him a Romiplostime dose of 0.02 ml and the mycophenolate on 0.3 ml twice a day.On March 6 his next check will be and that will determine if we can taper down any further with the mycophenolate.I am curious to see what the small dose of the romiplostime will do with his platelet count and of course i will inform you about it! Meanwhile,have a great week ahead of you and bye for now:)
Greets,Chomissa
Hi Chomissa,
Thank you for the latest update on Mowgli. As always, I keep you in my thoughts and pray for continued success and happiness!
Hi Dr Buzby,
Such nice things have happened,Me and Ivana have reached out to one another and i was able to connect Luna’s vet with Mowgli’s internist and she gave him valuable advise regarding Luna’s health. Mowgli went in for another platelet count check today and they were 447,lower then the last time but like i told you we have been tapering down the dose of mycophenolate ,0.3 ml and Romiplostime 0.02 also and 447 is still above average and his overall procyte one chart looks positive.Our plan is to taper down with the mycophenolate in small steps just to see how Mowgl will respond to it and ofcourse i will keep you posted on this.
Greets,Chomissa
Hi Chomissa,
I LOVE THIS!!! It just makes me so incredibly happy to know that this community is actively helping each other and working together for the benefit of our senior dogs. Thank you for the update and, as always, I continue to pray for Mowgli. ♥
So are the dogs getting transfusions also? And then starting the medication…I believe this is the diagnosis my dog has just received and after reading comments I have found the red marks on her stomach..the vet was talking to me like there are limited options almost as if wanted me to say put her down. She was doing fine just last week and now she is laid up and also got a hematoma at her neck from them getting blood yesterday.
Dear Hazel,
My heart goes out to you as you face this difficult diagnosis in your pup. Yes, some dogs do get transfusions. It all depends on how low the platelet numbers are and what the bleeding risk is for each dog. Don’t hesitate to ask for a referral to a specialist is needed. They have tons of experience dealing with complicated cases and may have ideas about treatments that are not readily available in general practice. Praying your girl can keep fighting and make a full recovery. Wishing you both strength and comfort as you navigate this tricky road ahead. ♥
Hi Ivana,i would like to get in direct contact with you.You can reach me on Instagram Chmicha37 in direct message and i will give you my email address in there.Mowgli started off with 0.4 ml mycophenolate every 12 hours and with 0.07 ml of Romiplostime one time a week.His platelets went up after one and a half week and for a while we gave him 0.07 ml and then tapered down the dose to 0.06 and 0.05 every 2 weeks.His platelets are still above average as normal count is 300 to 400.I could give you the contact info of my veterinarian clinique so that your vet can contact them.I am so happy that my information was of help to you!!!Feel free to contact me.
Greets,Chomissa
I sent a request to Instagram. thank you. My is ivy_luna1406 (Ivana Luna)
Ivana – where are you getting these Romiplastim injections? What state / country are you located?
Hi Autumn my dog Mowgli has been getting Romiplostim injections since last year and his platelets went up also.He is in remission since last year September. I am situated in The Netherlands.If you scroll back in the comments you can find my journey with my dog so far.
Hi Autumn,
The name for the medicine Romiplostime is N Plate,i don’t know where you are located but you can google on that.Here is an article on it used in dogs.My veterinarian was willing to give it a try after all conventional medication such as prednison and cellcept didn’t give the needed result.My dog inmediatly responded well to N plate and his platelets went up in one week.At the time he was 9 kilo and we started of with 0.07 ml and while his platelets were stable and above normal we tapered the dose down as he is now on 0.02 ml every 2 weeks.His platelet count now is 594 K/μL.
https://pubmed.ncbi.nlm.nih.gov/27283401/
Greets,Chomissa
Hi Autumni did write you a reply but can’t find it back.Romiplostim also named N plate is a humane medication for ITP patients and it worked wonders on my 6.5 year old shi tzu.If you scroll down you can find my messages where i tell about how it works for my dog and i am sure that Ivana took the same road for her dog.if your dog has immune mediated ITP Romiplostime works the best and fast.
Croatia/ Europe
Hi Ivana my dog Mowgli has been getting Romiplostim injections since last year and his platelets went up also.He is in remission since last year September.
Greetings,
First and foremost, Charlie and all of us say THANK YOU for all the prayers and love; the power of prayer is like no other!
When I woke up on Thursday, January 4, 2024, I found blood all over one side of my bed from no known obvious location; it was like a murder scene. Shortly after waking I was sitting with Zeke who then had a seizure randomly in my lap and I was absolute it was him, but he was cleared after a hospital and doctor visit. It was only in the late afternoon after taking Charlie to work with me that I found random dry blood on my hand from his mouth and on a blanket from his chin, at this point he stomach started having blisters of blood/bruising that kept growing quickly.
The local hospital in Saint Petersburg immediate got him back and discovered he was deadly low on his platelets. Here was a dog/my son that was perfectly healthy the night before and then expressed this immune disorder in a deadly way the following day with no prior signs. This is called immune mediated thrombocytopenia, or ITP.
Beacon Hospital saved my dogs life by their fast acts and allowed me to grieve and spend as much time with him while I cried every tear I had left in me and hyperventilated for days until I couldn’t expand my diaphragm much anymore. This was me starting to mourn the kid I picked up 4-years ago that immediately became the BEST part of my life and saved me from day 1 back in 2019; a love I never knew existed fully until this moment.
ITP I have learned is such a very long journey and an expensive one. Over $11k so far and counting in less than a week, but this is what we do for our children – right?! On Monday, January 8, 2024, Charlie was transferred to the ICU unit at Blue Pearl Hospital in Clearwater. Here it was now time to decide how long he may live and how to make him comfortable in the meantime, it was the worst news any parent could level with.
This round I said my goodbyes and kissed my son for what I had feared would be my last time as I saw him deteriorate before me. However I did put a lot of pressure on him by telling him he had a LOT of work to do if he wanted to make this turn to come back home and start the journey of healing. ❤️🩹 So many of you kept praying and clients were so very understanding, to all of you I again say – THANK YOU! 🙏
Today I know even more the power of prayers as I have my son next to me snoring in deep sleep without having to be poke and prodded for a week as long as his body can continue to keep up along with all his medicine. 💊 Charlie is resilient but I know none of this would be possible without your prayers & support.
This moment, hug your little ones and bigger ones and remember these moments are to be captured and treasured and know that tomorrow may not come.
Your site and the comments of so very many with their own stories helped keep me hopeful through this ordeal thus far.
Massive love and blessings from Charlie and all of us as we continue this very long journey ahead and he gets to be in my arms…
God bless,
Jon & Charlie
Hi Jon,
Thank you for sharing Charlie’s story with us! What a blessing he is still fighting, and you have gained this extra time with him. We will continue to pray for you both. Charlie is lucky to have you taking such good care of him and advocating for his health and well-being. Keep up the good work and I look forward to your next update. ♥
Good Morning, I am at the infancy of an ITP diagnosis and trying to quickly learn as much as possible to make the best decisions. During a routine blood work exam for a dental procedure it was determined our 9 year old Chi had gone from a somewhat lowered count at the end of Nov 2023 to a more significant decrease. Blood was tested for tickborn disease which came back negative. The next step advised was a bone marrow sample for analysis. The practitioner who I believe to be an excellent vet is clearly not schooled to your level in this condition. It appears by all I have read a drastic next step. While not looking for a diagnosis or treatment, merely inquiring as to whether that is a best next course after initial diagnosis based on a blood test? Second question as a person who always leans toward natural approaches is diet and supplementing a reasonable initial approach.
Hi Brian,
I understand your concern for your senior pup and think it is great you are searching for answers. Without playing a personal role in your dog’s medical care it is hard for me to make specific recommendations. I agree it would be good to talk to your vet about all the testing options and find out why they are wanting to move forward with a biopsy. There could be some important details of this case that would lead to this recommendation and maybe things were just lost in communication. If you still have lingering concerns, it is ok to get a second opinion. I like to offer my patients the opportunity to speak with a specialist when dealing with complicated diseases such as ITP. You may want to consider a consultation for your boy. I like to use natural approaches when possible, but if your dog’s platelets are continuing to drop you may need to start treatment (usually a steroid) sooner rather than later. Hoping you can get things turned around quickly and praying for a positive outcome!
Hi, my 4 year old female Rottweiler recently started bleeding from her nose the other night (2 nights ago). I took her to emergency vet where she was transferred to a bigger hospital that can do all of the testing. the vet gave her a chemo therapy treatment last night and it didn’t seem to produce new blood platelets. they are starting her on blood transfusions tonight to boost her red blood cell count so she doesn’t go anemic. I am terrified for her. it is her 3rd day in the hospital. they are sure it is ITP primary but still ruling out with tests. when does it get better
Hi Anthony,
My heart goes out to you as you face this difficult situation with your young Rottweiler. I wish I could give you a specific timeframe for recovery, but the hard truth is no one really knows. Some dogs just take longer than others to stabilize. There is also a risk that your girl may not win this fight, but for now we will hold onto hope that the veterinary team can work their magic to keep her going. Feel free to leave an update if you have a chance. Praying for a positive outcome.
Hi Dr. Buzby,
My love bug Hestia was diagnosed with ITP on Oct 7, 2023. I am so heartbroken and scared. Her first bout was treated in the hospital (4 days) with antibiotics and prednisone. She responded well, but relapsed after steroids were reduced and antibiotics were stopped. The internist put her steroid dosage back to 40mg per day, and started her on cyclosporine. Her count went up to 64,000, then dropped to 6000 while on these meds. Sher started mycophenolate. She developed a bruise out of nowhere before she started. If an antibiotic/steroid combination worked so well, why isn’t the vet using an antibiotic again? I have so much anxiety!
Hi Sheryl,
I am sorry Hestia is battling this difficult condition. Antibiotics are not generally part of ITP treatment, so I am not sure why they were initially used or discontinued. The only thing that comes to mind is maybe your vet was suspicious of a tick-borne disease causing the ITP and most tick diseases are treated with doxycycline which also happens to be an antibiotic. I encourage you to talk to your vet and ask these lingering questions. They can give you more details and explain the factors that influenced their decision making. Hoping your sweet girl was able to keep fighting and make a full recovery. Best wishes to you and yours. ♥
Our 3 yr old chihuahua mix was just diagnosed after we took in for what we thought was a rash on her stomach. It turned out to be bruising and the vet took a simpler blood test and saw her platelets were low 13,000 when they prefer upwards to 50,000. Then they asked me to rush her to vet ER where she stayed another two days receiving other tests to rule out the tick infections and cancers. She started prednisone and was watched around the clock for 2 days. Then they called me and said she was stable, eating well, taking medication, but the result was slow in building those platelets back up. Now they are asking us to take her home over the weekend and make the necessary changes. It sounds very overwhelming, but I read this article over and over again!! It was very helpful. Thanks for being so thorough and the style of writing was very personable and easy to ready. I am really glad you shared Fletcher’s story. It’s hard to find other advice like this on the internet and your story was so positive too!
Hi Mandi,
I am sorry your little pup received this difficult diagnosis. What a blessing your vet was able to get answers so quickly and transfer her to the ER for more intensive care. I hope she was able to stabilize and is still comfortable at home. Praying she makes a full recovery and wishing you all the best for a long and happy future.
Hi fellow dog lovers
Our boy Ollie was diagnosed with ITP back in August 2022. I actually came to this site for help.
Good news is he responded well to treatment and still returns strong blood results on just a few meds a week now.
We have been experiencing a new issue though and I wonder if it’s related. Ollie has these episodes of blood noses. It always happens at night during sleeping, always his right nostril. It does clot and resolves itself but it’s also very concerning. Has anyone experienced this with their dog and ITP?
We’ve had a CT scan done which was clear, and his blood pressure is normal. Can anyone Recommend anything or provide advise? Our poor boy looks so defeated.
Thank you x
Ben
Hi Ben,
I am glad Ollie has done so well since his diagnosis over a year ago. I too am puzzled as to why he is experiencing these nose bleeds at night. It could be related to the ITP but I would think his blood work would show some evidence of an issue if this were the case. Here is a link to another article that may offer some new information or helpful tips: Dog Nose Bleed: 13 Causes (And How To Stop the Bleeding)
I hope you can find some answers and ensure Ollie is happy and feeling his best. Thank you for sharing your experience. Best wishes!
Thank you for this wonderful article. Our 8 year old Goldendoodle was just diagnosed last week with Immune-Mediated Thrombocytopenia. I think that is the same as ITP. We were fortunate to have a good groomer as she mentioned a couple of bruises and a minor rash on her belly. Our fur baby started prednisone 3 days ago. I appreciated reading about having patience, which is not something I practice well. Especially when I heard that I might want to consider treating with Vincristine (chemo medication) which would require my fur baby to stay in the hospital. It feels like so much as been thrown at us over the past week as we are truly overwhelmed. Our girl is clinically well and there has been no bleeding. Her Red and White cells all normal and platelets are at 7000. Thank you again for the really helpful information.
Hi Cynthia,
I am so glad you were able to catch this issue quickly and start treatment. What a blessing your groomer has been to you and your pup! It seems like things are headed in the right direction and your girl has responded well to the medication. Thank you for sharing your experience with our readers. Wishing you both the best of luck for a bright and happy future!
I have a 6 yo male newfie (98#). He had blood work done (CBC and chem) at a lower cost vet clinic this week which showed his platelet count to be 82. Everything else was normal. I sent the results of blood test to my current vet. He does have an appt. on 10./24 for his physical exam and fecal. My vet said to have a CBC and differential test done in 30 days at their clinic and go from there. He does not show any symptoms of ITP other than the lower platelet reading. This is the first blood test he’s had. I’ve had him 3 years. I’ve read where a vet can do a blood smear to tell if the platelet count is low. Why would another blood test need to be done? I will ask that at appt. Your suggestions?
Hi Pamela,
I understand your concern for your big guy and think it is great you are searching for more information. Of course, I cannot say for sure why your vet has made specific recommendations. But if I had to guess, they probably want to repeat the lab work to make sure it was not just a transient issue and also to see if the platelet count has increased or decreased. Low platelets do not always have to be due to ITP and your vet may want to do more testing to rule out other possibilities. Here is an article with more information: Low Platelets in Dogs: Thrombocytopenia
I hope you receive good news at the next checkup. Wishing you and your sweet boy the best of luck for many happy years ahead.
We have an 8 year old Miniature Schnauzer who was diagnosed today with ITP. Our Vet called us back saying his platelet count was zero. He did the test again to confirm and it showed zero again. He is starting him on steroids today and other meds to help with side effects. With a zero count is there any hope for our baby? Is there anything we should ask our vet to do or check on?
Dear Brad,
My heart goes out to you as you face this difficult diagnosis in your Schnauzer. There is definitely hope and there are countless stories just like yours that have had a happy ending. It sounds like your vet is starting the necessary medications and for now it may be a waiting game. If the medications cannot get the platelet count up by themselves, you may have to make a decision about trying a blood or plasma transfusion. Don’t forget you can always ask for a consultation or referral to a specialist if needed. Praying your sweet boy can keep fighting and make a full recovery. Don’t lose hope and know we are all here wishing you the best.
Hi Brad,
My shi tzu was diagnosed with itp at the beginning of June this year and none of the conventional therapy medication worked.He had prednisone and mycophenolate wich is a humane medicine to calm down the immune system.My booboo had zero platelets also a few times.I came across a medicine called N plate,a humane medicine to used by people that have itp and his platelets went up within a week from 0 to 648 and he is still doing great.I have written about it in the comment section so if you are interested i advise you to read into it.I wish you all the best with your dog child🙋🏻♀️
Greets,Chomissa
My 7yr old pit mix was diagnosed with primary ITP just over 3 months ago. She has relapsed twice with two taper attempts. She is now also on mycophenolate, which was there during the second taper attempt but I’m assuming it might not have been enough. The internist is recommend 3 other options for a third immunosuppressant. What were your immunosuppressant drugs for Fletcher? We’re desperately trying to get our poor Molly off prednisone, she is now slowly beginning to get the rash-looking skin on her belly which is probably calcinosis cutis.
Hi Max,
I am sorry your girl has not been able to wean off her medications without starting to relapse. This article was written by Dr. Laura Garlow about her own dog. I am not sure what specific medications she used, but it sounds like the internist is doing everything they can to get things under control. How is your girl doing today? Hoping she was able to stabilize and make a full recovery. Bless you and your pup.
Our 15 + year old Boston Terrier was just diagnosed with ITP. She has a mass on her spleen which they suspect may be the cause. We’ve been treating her for a week now and she goes back for follow up this week. Due to her age we’re considering if euthanasia is the most humane choice for her, or if we should continue with treatment. She’s not herself but she’s not in pain. We know it’s just a matter of time and want what’s best for her. Any thoughts? She’s lived a great long life and we will certainly miss her.
Dear Pat,
I am sorry your senior girl has received this difficult diagnosis. I understand your concern for her quality of life and think it would be ok to consider euthanasia to prevent unnecessary suffering in this situation. Sometimes letting go is the most loving option. Of course without examining your girl myself, it is hard to make specific recommendations. I encourage you to trust your instincts as you know your girl better than anyone. Hoping you can find the answers you need to make the best choice for everyone involved. Bless you and your sweet girl.
I have a 12 year old Shih Tzu that was first diagnosed with ITP in December 2020. He started prednisone and after several months, we were able to taper off. A few days ago, after a visit with his vet, his bloodwork showed his platelet count at 0 and the vet saw 4 platelets on the smear. We were sent home with prednisone and cyclosporine. My vet is very concerned, and I may be naive, but Bentley handled treatment so well last time, so I have less worries.
My mom did some research (googling) and suggested I try feeding Bentley small amounts of liver hoping that can help. Besides soft food, do you have any other diet suggestions for dogs with ITP?
Hi Maggie,
I am sorry Bentley experienced a relapse of his ITP. Hoping he is doing better, and things have stabilized. I am not sure I have any specific recommendations for dietary changes to help with this condition. It may be a good idea to reach out to a holistic veterinarian or one that practices Traditional Chinese Medicine for options. Wishing you and your sweet boy the best!
I am so frightened right now. My beloved 9 year Cockapoo had a totally normal yearly physical in April , 2023 with all labs being WNL. On 7/29 I noticed petechiae and bruising on his abdomen. The next day melanotic stools. He was seen the following morning and diagnosed with anaplasmosis (was negative 4/23) and had been on monthly flea and tick preventatives. His PLT count on first appointment was 8,000, 48 hours later dropped to 5,000, HCT 20. He is hospitalized and has received high dose steroids, azathioprine and a whole blood transfusion. He is not improving and today receiving vincristine. PLTs this AM are 1,000. He is not eating. I did say DNR if he arrests as his poor little body could not handle CPR. I don’t know when to say enough is enough and if he can recover from this. Any thoughts would be appreciated.
Hi Carla,
What a scary few days you had with your Cockapoo. It sounds like your veterinary team is doing an amazing job taking care of him and trying all the right treatments to get his platelet counts to come up. Hopefully he starts to respond soon! However, if he continues to decline, it probably does make sense to have that hard conversation with the veterinary team about when it is time to stop. Since I’m not involved in his care, I can’t really speak to when that point would be, but I’m sure that his veterinary team would be able to provide some guidance. Fingers crossed for a good outcome for him!
Hi Dr. Buzby
Thanks for sharing Fletcher’s story. I have a rottweiler who is 12. She was brought to the hospital showing signs of non-stop bleeding from the gum, lethargic and eventually collapse. She has been in care for six days now, having a few blood transfusion as well as given the drug Vincristine and steroids. We are on to day 5 of Vincristine, however, her platelets remain 0. The doctor also suspect gastrointestinal cancer as ulcers are being found in the area and she has bloody diarrhea . However, there seems to be no way to test it because of her ITP (risk of bleeding obtaining biopsy). We seems to be really at a cross road here. Our doctor suggest IVIG next, but we are unsure because of the cost and we were told that it will likely not change the prognosis as well. What is your opinion on IVIG and the chances of it working? This is our family’s first dog, we are really at a loss about how to proceed. We have a good team working on her, but of course they are reluctant to give some straight answers at time. I am hoping to get an insight from a different viewpoint into the situation if possible. Thank you so much.
Dear Melody,
I am so sorry you were faced with this tragic situation. I wish I could tell you what was best, but with these uncertain circumstances, no one really knows what to expect. I am sure your veterinary team is giving you the most straight forward answers available. IVIG does sometimes make the difference for some dogs but not for every case. If you are prepared to do anything and everything (including cost) it is worth a try. It is also never wrong to forgo further procedures and elect to do palliative/hospice care. I am sorry for the delay in responding. Praying your sweet girl was able to turn things around and make a full recovery. Feel free to leave an update if you would like. Bless you.
For a dog with immune-mediated thrombocytopenia (on maintenance prednisone) is there a standard of care with respect to managing heartworm & flea preventative use? I know these things are different from vaccines (& their potential issues), but dogs with IMTP seem “fragile” & I worry about “disordered” reactions to these preventatives that other dogs seem to tolerate well. Vets have said it’s no big deal, but some of the same ones have said vaccinating a dog with (chronic) IMTP isn’t a big deal either. Any thoughts? Thank you.
Hi Karen,
I understand your concern about giving your dog anything that could potentially cause an ITP relapse. Unfortunately, I don’t think there is a standard recommendation when it comes to monthly preventatives. Most of my patients have continued to receive their monthly prevention with no issues but I know we can’t make definite conclusions about what could trigger ITP in different dogs. I think you have to trust your gut and rely on your veterinarian’s experience. I am not sure there is a clear right or wrong answer. Wishing you and your pup the best of luck.
Hi Dr Buzby,
Here a message on the progress of Mowgli,Monday August 7 i went back to the clinique again and unfortunately his platelet count was almost 0 again.So. the vet and i decided to start with the Romiplostime also known as Nplate and i menaged to get my hands on a dose of 125 micrograms and the next day we started with 50.3 microgram and last tuesday i went in again for platelet count and he had a major rise up to 648! We gave another dose of 5.3 and upcoming tuesday he will get his 3th dose and count his platelets..I already purchased a 2nd dose for him and my vet and i are trying to figure out now where to go from here My vet had never heard of Romiplostime used in dogs but since Mowgli was diagnosed with itp i went on a relentless search out on the internet and i found a medical journey that had been done in Germany where it had been tested on 5 dogs and 4 of them went in remission.I am so glad that my vet was open for trying it and i urge any other owner with a dog with itp that doesnt respond on the prednisone and immune supressors to try it out.
https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-016-0718-4
Here is the article and i will keep you posted on how things will go further for my little ewok.
Greetings,Chomissa
Hi Chomissa,
WOW! This is amazing! Thank you for the update and for sharing this valuable information. I hope others can use this and have an informed discussion with their vet to see if this could be an option for their dogs. What great progress you are seeing with Mowgli. This post has made my day. ♥
Hi Dr Buzby,
I wanted to give you an update on Mowgli so yesterday he had his 3th dose of Romiplostime.The veterinarian gave him 40.1 mcg.Three weeks ago his platelets were 648 and she decided to pause with giving him a dose,then one week later his platelets dropped to 110.So last week she gave him a dose of 40.1 mcg and his platelets yesterday were 865! She was thrilled to see again how effective the romiplostime is but she also realises that the trigger causing the ITP isnt addressed so she still thinks that a splenectomy might be necesary in the near future.She is tapering the dose of prednisone now,we went from 15 mg to 5 mg..and the profit of the Romiplostime is that no platelet transfusion will be needed before surgery..In a few months there will be a veterinarian congress in Barcelona and Mowgli’s case will be mentioned there as we are the first ones here in The Netherlands that have used Romiplostime with ITP in dogs..They have also started the Romiplostime now with another dog,this dog is bigger though and needs the whole dose wich is costly.125 mcg is 416 Euro..Did you know that a British and Dutch hospital have created a milt and liver scan in order to predict wich of the two is destroying the platelets for humans? It would be so helpfull if this could work with dogs to!
.https://www.ntvh.nl/journal-article/de-itp-lever-miltscan-een-mogelijke-voorspeller-van-de-kans-op-remissie-na-splenectomie-bij-itp-patienten/
perhaps you can translate this article.
Greets,Chomissa
Hi Chomissa,
WOW! This is amazing! What a blessing for Mowgli and I am so excited you have shared this breakthrough information with us! I know you are still concerned for your boy with such a big surgery coming up. I am praying for him that things will go smoothly, and this will be the turning point in getting him on the road to recovery. Please let me know how things go after his surgery and know we are all wishing you both the best. ♥
Hi Dr Buzby
Here another update on Mowgli,today i went for platelet counting and his count is now 881! The veterinarian gave him a dose of 20 mcg today and the prednison has been tapered to 2.5 mg now and Mowgli is still doing well.Words cannot express how happy i am that he is doing so well on the Romiplostime.I can strongly recommend it to anyone having a dog with itp that is persistent,it’s a life saver! Next week the convention in Barcelona will begin and my vet will be there and tell about Mowgli’s case. i will keep you updated on his progress😃
Greets,Chomissa
Hi Chomissa,
Awesome! So happy for you and Mowgli. He is nothing short of a celebrity and I am honored to follow his journey!
Hi Dr Buzby,
Yesterday i went in for another bloodcheck and Mowgli’s platelets were 763 so still above the norm! Mowgli’s prednisone will be tapered down to 2 days 1.25 mg and then one day no prednisone.He is still on the mycophenolate and the romiplostime he gets is 0.06 now instead of 0.07.. I am so happy that he is still doing well.I will keep you posted!🙋🏻♀️
Greets,Chomissa
Hi Chomissa,
Yay! So happy for you and Mowgli! As always, keeping you both in my thoughts and looking forward to the next update. ♥
Hi Dr Buzby,
Here an update on Mowgli,He is still doing well,2 weeks ago his platelets were 691 after not having Romiplostime for 3.5 weeks.Before that his platelets were 931 so that was quite high so we decided to taper the frequency of the injections.Now he didn’t have Romiplostime for 2 weeks and we have stopped with the prednisone also for 2 weeks now.He started licking his paws,not to bad but i did notice it so i have him on horse milk to now since this works well on itches and allergies.So yeah,tomorrow i will visit the clinique again where they first diagnosed him and they will manually count his platelets and give him a check up and ofcourse i will give you an update on how he is doing!
Greets,Chomissa
Hi Chomissa,
So glad Mowgli is still thriving and feeling well. How was the checkup? Hoping you received good news. Thank you for the update and I look forward to your next post!
Hi dr Buzby,
Last week i went to the clinique and Mowgli’s platelets were 691 so still good! My vet told me that the control values of a dog with ITP should be around 180 so his are way above that.She told me that she had spoken to a few veterinarians from America and Australia and some told her that they had used Romiplostime but usually one dose to get the platelets up and then further treatment with prednison.None of them had never used it as a treatment being used more often so noone had any data on what the Romiplostime will do longterm in dogs but so far so good.Last week he had a dose of 0.05 ml and the plan is depending on his platelets will do to taper of the Romiplostime eventually.Mowgli is still on mycophenolate as well. twice a day every 12 hours he gets 0.04 ml.Next week i wil have his platelets checked at my local vet and at the end of this month back to the clinique.We also discussed to make a thirth echo of his splene,just to see if there is any change in the nodus now that he is off prednisone.I will keep you updated and thank you so much for your interest in Mowgli’s case.
PS, If you would like to have a direct line with my veterinarian for more specific information i could send you her info through email.
Greets,Chomissa
Hi Chomissa,
I am just fascinated by how well Mowgli has done with this experimental treatment. Thank you for allowing me to keep up with how things progress and for the regular updates. The team here tries to keep our articles updated with the latest information and routinely will go through and add new items as more research emerges. We may be reaching out at some point in the future when it comes time to update the ITP article. As always, best wishes to you and your sweet boy!
Hi dr Buzby,
So today i went for another platelet count check and after reducing the dose of Romiplostim to 0.05 his platelets are 591 after 2 weeks so still above average.Today we gave him a dose of 0.04 ml and on November 28 i will go to the clinique again.So far so good so i am really thankfull and happy😀
Greets,Chomissa
Hi Chomissa,
So glad Mowgli is still thriving and responding well to the Romiplostim. Hoping you get a good report at the checkup today!
Hi Doctor Julie,
Here’s another update on Mowgli,i had many distractions going on in my personal life so i didn’t find the time to message you🥴Mowgli is still doing well.On November 28 his platelets were 551 and the dose of N plate was 0.03 mland on December 12 591 we gave him another dose of 0.03 ml.His veterinarian wants to taper the dose with 0.01 with every good blood result and he is still on mycophenolate o.o4 ml every 12 hours.Since we stopped with the prednisone he started to get itchy but nothing really serious.I give him Omega 3 and fatty acids supplements now for that.I have still reason to be optimistic and to be happy about his health progress.My vet went to the convention in Barcelona and also in Sweden and she spoke with collegues from Australia and America.Some of them were familiar with N plate but none of them had given it to a dog for such a long period of time like Mowgli has had it.Some told her that they had given it to a dog to boost the platelets and then to go further with cyclosporine or prednisone There will be a follow up because they are curious to know about Mowgli’s outcome eventually.I must say that he is doing really well though as he is playfull and active again.On January 9 i will go back to the clinique and in 2 weeks i will have a check up at my own local vet.I will keep you informed!
Greets,Chomissa
Hi Chomissa,
I always love your positive updates on Mowgli! Thanks for keeping me in the loop. Give your sweet boy a hug for me and I wish you both a Merry Christmas!
Hi Doctor Buzby,
Today i went for another platelet check to my local veterinarian and Mowgli’s platelet count is 600 so still above average! I could not have wished for anything better then this.We have been tapering the dose of Romiplostim and his platelet count is still going up.My hope is that his condition is slowly going into remission,Only time will tell.The dose next time will be 0.02 of the Romiplostim.His eye lid was a bit inflamed and i’ve treated this with vitamin A potion and it is healed now.His next check will be on January 10.I want to wish you a happy new year and i will message you again in the new year.
Greets,Chomissa
Hi Chomissa,
Happy New Year! Thanks for the update and give Mowgli a hug for me!
We did split the dose of 125 microgram and stored it in the fridge at the clinique. as it is somewhere mentioned that the veterinarians that did the test concluded that this could be done safely allthough it is normally used on humans just one time.Romiplostime is a humane medication used on people with Thrombocytopenia.
Thanks for the article and I saw you mentioned melatonin to one of the commenters. We lost our pup recently to cancer, but I figured to share her experience with ITP in hopes this helps others in her honor.
Similarly to others, my pup was suspected of ITP during her routine checkup. Our vet noticed petechiae around her belly and immediately did bloodwork for CBC. Platelet count was very low… can’t remember the numbers as this was years ago. So we immediately started treatment regimen of suppressing her immune system to allow her body to produce platelets along with anti-nausea and antacids. Perform CBC and monitor, then taper treatment when levels are normal. But every time we taper or remove, platelets drop. We went through multiple cycles of this for more than a year and ending up having to keep her on these meds. My poor pup was miserable, lethargic, and lost muscle mass. Our vet – God bless him – had reached out for options and alternatives and there was some chatter on melatonin in combo with other meds she was already taking. When CBC is up in normal range, then start lowering dose of the meds while keeping her on melatonin. We kept her on melatonin even after the other meds, one by one, were removed. After a year of just melatonin, our vet felt it safe to taper and then eventually stop melatonin treatment. We monitored her CBC, and it remained normal throughout her life. She was ITP-free for 8 years, but sadly cancer took over her last 2 years.
I’m still grieving and I miss her so much. And I hope her story encourages further research and can help others.
If this helps further (and I don’t like to advertise), we were using Nature’s Bounty 5 mg melatonin tablets per our vet’s recommendation.
Hi Jessie,
Thank you so much for sharing your knowledge and experience with us! It seems like melatonin was the miracle your pup needed and offered her a good quality of life. What a blessing to have gained 8 extra years with your sweet girl. I appreciate your willingness to give this valuable information to others and spreading some hope to those in a similar situation. Wishing you the best as you continue life’s journey. Bless you!
Thank you for all the information in this article. Our almost 2 year old female was just recently diagnosed with Evans syndrome. She did end up needing a hospital stay, and we were fortunate enough to be able to bring her home 2 weeks ago. The first day was pretty tough, but she stopped peeing blood within a couple days of her being home. A few days ago her RBC went up by 2, and she appeared to be getting some color back (in her gums and around her nose and belly). Yesterday we were told to give her half the amount of prednisone she was previously taking. I noticed she is starting to have rapid breathing today. Do you happen to know if this is a normal side effect of the decrease in medication or if it could be because her body is attacking her red blood cells again? I am worried about her but also worried I may be over analyzing every minor detail.
Hi Brittany,
You are right to be concerned about this change in your dog’s breathing. Usually panting is a side effect that can be normal for dogs taking prednisone but not usually seen in response to decreasing the dosage. I would be suspicious something may be starting up again. Please make sure your vet is aware of this new symptom and see if they need to examine your pup. Hoping all is well and your young girl is still fighting. Feel free to leave an update if you have a chance.
Dr. Buzby,
Our 8 and half year old miniature Schnauzer was lethargic and eating little of his dinner on a Sunday. I called the vet and took him in first thing Monday morning . They did a IDX – Anemia Real PCR Panel with Lab 4Dx plus test and determined he had IMT and was dehydrated. He was put on fluids and steroids. Later that evening I was told he also had Evans syndrome and she would try other meds. In the morning his platelets were zero and his RBC was down to 12 and his breathing was heavy and labored and told to get to the clinic asap. Seeing how uncomfortable he was we decided it was best to put him down. He was a sweetie and charmer and the vet and all the techs too were teary eye. The vet told us his heart and lungs were strong and goo.d. We have numerous questions but our biggest is how did this move so fast when just a month earlier he had his physical and all was good. Thanks,
Dear Ken,
My heart goes out to you with the recent loss of your Schnauzer. I can only imagine how difficult it must have been to say goodbye with so little time to truly process what was happening. ITP can be triggered at a moment’s notice and progress to a critical level in just hours. There were probably no signs of this at your boy’s physical the month before. I am certain you didn’t miss anything and did all you could to try and save him. I hope with time your heart will heal and release you from the grief you are experiencing. May the memories of the good times you shared be a blessing in your life.
Thank you for writing your experience.
We have a 4-ish-year-old mix breed female (mostly doberman but mixed with others!) who was diagnosed with ITP in May 2022. It was a dangerous situation because she ended up in the emergency with nearly zero platelets, bruising, and dark stool, it was awful. She ended up being there for 5 nights and had 2 blood transfusions, a bunch of steroids, and even a chemo drug to suppress her immune system.
The treatment finally worked. We never found out the real reason for what happened and why she got ITP. From May 2022 to April 2023, she was on prednisone and very slowly decreased from 40mg to 0 through monthly check-ups with our vet and CBC test. Throughout the year, she maintained her red blood cells and platelet levels perfectly and hasn’t relapsed. She is now completely off the medication and though I am happy she is completely off and can start to recover from the awful side effects from the steroids (including loss of muscle and weight gain), I’m nervous this is going to return.
Although she never relapsed during the past year and consistently decreased her steroids every month, I read in your post that dogs who relapse will usually do that during the weaning process of the medication, but with our experience, I am sure she is still at risk of relapsing. Thoughts?
Hi Emma,
I understand your concern about the possibility of a relapse. You are correct that a relapse can happen at any time, but it is much more common during the weaning phase. So, since your girl has been able to maintain and is stable without prednisone, her chances of staying in remission are very good! What a blessing! Thank you for sharing your experience with us. We need to hear more success stories like yours. Praying your sweet pup will have many happy years ahead. Wishing you both the best.
Hello,my 6 year old shi tzu was diagnosed a few weeks ago with idiopathic itp,when i went to an internist with him his platelets were 0 and he had petechiën and echymosis all over his body and blood in his stool,he also did vommit blood. The internist started giving him 10 mg of prednisone and his platelets went up again but last friday i had to wear off to 5 mg and yesterday i discovered echymosis again so that really scared me.Today i will go in again to have his platelets checked.Does anyone have words of advise for me?Thank you in advance and please pray for my little Mowgli.
Dear Chomissa,
My thoughts are with you as you face this difficult journey with your pup. Praying you get good news at the recheck today. Feel free to leave an update if you have a chance. ♥
Hello Julie,
Sorry for my late reply,it has been a journey indeed for the last weeks.Unfortunately ,his platelets didn’t reach the 348 after his relapse and even after increasing the prednisone to 15 mg it still didnt go up that much so the vet decided to prescribe mycophenolate and today i went in for a blood check and his platelets are around 86 now and possibly a bit more since the blood had some clots.He doesnt have any echymoses or petichea at the moment but he has gained some weight.In 2 weeks he went up from 8.4 to 9 kilo..Have you heard about the turkey tail shroom? They say it is good to use against cancer but also auto immune diseases.I would like to hear your thoughts on it.Greets from The Netherlands,
Chomissa
Hi Chomissa,
I am sorry your pup did not respond well to the prednisone alone and is requiring an additional medication to get things under control. I have heard about the turkey tail mushroom. Unfortunately, I don’t have much personal experience with this as a treatment, but several readers have mentioned it and had positive experiences using it for their dogs. I would recommend you talk to your vet about the possibility of adding on this supplement and make sure there are no causes for concern. If you decide to try the mushroom, please let me know what you think! Hoping your sweet boy can make a full recovery and you get some good news. I’ll keep you both in my thoughts. Thank you for the update! ♥
Dear Dr Buzby,
Mowgli is still on mycophenolate and prednisone and he seems ok but i will be sure on next monday where we stand.Our veterinarian is going to order Romiplostim because there has been research on 5 dogs and a few went into remission after giving this medication to them I came across a medical journal where this medication was mentioned and the veterinarian agreed with me that it is worth trying.It is a costly medicine though,393 Euro for 125 microgram and you can only use it once and the dose is 5 microgram per KG but they have another patient who’s owner is willing to try it so the plan is that both our dogs will be treated with it at the same time.I hope that it will work🌈🙏🌟
Greets,Chomissa
Hi Chomissa,
I am so glad Mowgli is hanging in there and seems to be doing ok with both medications. You have me very intrigued by the use of this experimental medication! Please let me know how things go! Praying this will be the miracle we are all hoping for. Wishing you and your sweet boy nothing but the best. Give Mowgli a hug for me. ♥
We lost our Bernedoodle on 3-15-23. ITP was suspected at the ER vet who was treating him for status epilepticus due to his epilepsy. His platelets were 32k. I got him tested 2 days later at our regular vet and they went up to 113k. No treatment for ITP just the epilepsy. The AED’s made him ver lethargic so I didn’t think of it. His neurologist had me pulse dose if he had more than 1 seizure due to clustering. On 3-15-23 he started clustering so I pulse dosed and gave nasal midazolam. He started bleeding from the mouth, rushed to the ER, they tried life saving measures to no avail, he was gone in 1 hour. I’m still traumatized from it. I don’t understand why his neuro and reg vet weren’t concerned and treat the possible ITP. They were focused on the epilepsy.
Hi Jan,
I am sorry you lost your big guy in such a tragic way. I know you are grieving his loss and running all the “what ifs” through your mind. Although the ER vet suspected ITP, it sounds like a definitive diagnosis was never made due to the complicated circumstances. Also, you mentioned your dog’s platelets had improved on recheck without ever initiating treatment. This is probably why your vet was not concerned with a platelet issue and was more focused on the seizure disorder. The fatal bleeding event you witnessed may not have been ITP related. Unfortunately, there is no way to know for sure and there are no good answers. I hope you are able to find comfort in the fact that you did everything you could for your sweet boy. I have no doubt he knew how much he was loved. May his memory be a blessing. Wishing you peace for your heart.
what did you give upurgolden doodle to keep him in remission? our dog goes off steroids and then atopic but itp always rears its head again. my vet says wait until the next time. It is always such a hard recovery for him. I would like to give him something to maintain his health platelet issue.
Hi Char,
This article was written by Dr. Garlow. I don’t know the specifics of what she did for Fletcher, but I assume it was a combination of steroids and possibly cyclosporine. I am not sure what changes were made after they switched his medications up to reduce side effects. This would be a great question for an internal medicine specialist, and you can always request a referral from your vet or ask about a consultation.
My 7 year old pitbull Winchester was diagnosed with itp last year. I noticed some purple circular bruises on his belly and called the vet. His platelet levels were so low they werent even reading. they tested him for tick borne diseases did bloodwork etc and ended up finding nothing. they put him on antibiotics just in case along with high dose steroid. he improved and got back to normal levels and slowly we tapered him off the medicine. For about 6 months he was fine but just recently he relapsed. he had dangerously low levels and had to start back on steroids. He was improving and got to 100k and then within a week had dropped 60k. The vet now has added in cyclosporine along with the prednisone. he is ravenous with hunger and manging that alone is difficult. he was 96 lbs when first diagnosed and is now 107lbs. he definatley gained weight with the steroid treatment. he goes Monday to have his blood taken to see if any increase. the vet said if this doesn’t work next thing would be to do an xray and ultrasound to see if anything else could be causing. all his other bloodwork besides platelets has been good. i am just worried should the xrays and ultrasound be done now and not wait around. he just started the cyclosporine so we will see if this helps. i am hopeful. i love him so much and just want him to feel better.
Hi Kristi,
I am sorry Winchester has had a relapse of his ITP. I am hopeful the new medications will be able to get him stabilized. How is he feeling today? Did you end up having to proceed with the x-rays and ultrasound? Praying all is well and things have calmed down a bit. Feel free to leave an update if you have a chance.
Oh how i feel you here i am going through the same with my shi tzu Mowgli,i’ve been stressing for weeks now since he got diagnosed.All we can do is to take it from day to day.Mowgli is on steroids and mycophenolate now and he has improved a bit but i am fearing the day that he has to taper of the steroids.My vet says that mycophenolate can be used for the rest of his life if necesary.Last resort option would be a splenectomy she says.Wishing you lots of luck with your dog🙏
Greets,Chomissa
My Dr called and she wants to move forward with the injectable antibiotic after speaking with my vet. I believe she once a week and two blood panels a week to check her kidneys. It can be really hard on the kidneys. She feels if this is successful the abcess will be gone in three weeks. She is worried about kidney issues. She also said it could make her lose her hearing. But stated that’s not a fact just a possibility. I feel so bad for Holly. I know everyone days she’s old. She still loves to bark run around outside. bark at me when I’m making her food and follow me everywhere. She’s not even close to ready to go. I do think doing this gives her the best chance of survival. If this is cured, she can go on for however long then.
We found that Holly could take Minocycline. The Dr was just hesitant because it can cause liver issues. She has been on it for two weeks and had her blood work again today. Her ALT went from 360ish to 166 to 164. Her ALKP went from 2760 to 1760 to 1340. Her lypase is back to normal. She has an ultrasound in two weeks to see if she can cone off the antibiotics. She hasn’t had any stomach issues. I’ve been giving her the best prescription probiotic I that is available. Or one of them. She’s doing really good. One thing I didn’t mention because I didn’t want to think about it is that Holly has focal seizures. It only happens in the car or if something is fast moving at her eyes sometimes. It lasts about 2 seconds and she’s back to normal. She typically doesn’t have them unless she is stressed out or anxious. She probably has had one in teo months. She had 6 going 5min on the car. Once she stopped looking outside they stopped. I don’t really want to think about it. I have been charting it and letting the vet and specialist know. They don’t seem to worried given the frequency.
Hi Randy,
I hate that sweet Holly’s seizure activity is triggered by riding in the car, especially with all the vet visits she has endured over the past year. I am glad they seem to be pretty low frequency and think it is great you are keeping a log of when her episodes occur. So happy to hear her blood work is improving since starting the Minocycline. Keeping my fingers crossed that her stomach issues won’t recur, and she can finally get some relief. Thanks for the update. Wishing you a peaceful holiday season ahead.
I made one mistake. It was Doxycycline. Unfortunately I didn’t get the news I was expecting. Her ALT went from 244 to 360 and her ALP went from 1350 to 2300. The ultrasound on her liver looked fine. They did not see any of the ecoli. They don’t know what is causing it now. They said possibly the 4 weeks of Doxycycline. There is a disease somewhere they can’t see. Cushings but unlikely. Pancreas issue as she has chronic pancreatitis but is not showing any clinical signs. She doesn’t drink a lot of water but always wants to eat. it’s insane. They said we are running out of options medically. Last resort would to put her back on shots for ecoli or do exploration surgery. I will not do the last one. I’m very defeated. It was bad timing because I had surgery. I have a drain coming out of my chest. It was supposed to come out but I’m bleeding about 20cc since my blood pressure is so high worrying about Holly.
Dear Randy,
I understand your feeling defeated and my heart aches for you and Holly. I am not sure what the future holds, but I am certain that you have done EVERYTHING you can to give your girl the best chance at life. Holly is dearly loved, and I am sure she knows how much you care about her. She is one lucky pup to have you advocating for her health and well-being, even to the point of putting your own health at risk. When the time comes that there are truly no other options and tough decisions have to be made, we will focus on giving Holly the peaceful goodbye that she deserves. There is no way to know if that will be months down the road or years from now, but sometimes we have to focus on quality of life rather than quantity. All I ask is that you allow yourself some grace and please take care of yourself! Praying for a miracle and still holding on to hope that Holly can make a full recovery. Wishing you comfort and healing. Bless you both. ♥
Sorry. She didn’t have a seizures in the car. She hasn’t had any since.
We lost our 9 year old male con 2/24/33.
He had no appetite, lethargic, fever, white tongue & gums, couldn’t walk. This all happened extremely fast! I was given an initial diagnosis of IMHA . My boy’s prognosis was not good! He had lost 2/3 of his blood. He made it 4 days . In that time he was given both plasma & blood transfusions. He was given Doxycycline as the cause of his IMHA is tick born Erlichea ( probably spelled wrong.)
He was given many steroids & immune suppressive drugs.
I don’t remember everything right now as his loss has been extremely painful!
I have been doing a lot of research on this disease & IMHA as well as Evan’s Disease & I feel that my boy had Evan’s disease because he had symptoms of both diseases. I called and asked my Vet, who is wonderful, but we’re in a fairly small town, and he’s now saying my boy had ITP which is the first time I heard this since his passing.
I am so confused!!!
I know it’s to late to change anything but I have 2 other dogs and would like to be more educated if this ever happens again!!
Hi Kristy,
I am sorry for the recent loss of your pup. I can only imagine how scary it must have been to see it all unfold so quickly. The only real difference between immune mediated hemolytic anemia and immune mediated thrombocytopenia is that with IMHA you have the destruction of red blood cells and with ITP it is the platelets that are being destroyed. It is very common for dogs to have both at the same time. I imagine this could have been the case with your dog and your vet just chose to use one acronym over the other. If you still have some confusion over this tragic situation or need some answers for any lingering questions, don’t hesitate to reach out to your vet. Be honest about your concerns and talk through everything. This is the best way to get some closure and find peace. I hope with time you will be comforted knowing you did everything you could for your sweet boy. Bless you.
my dog was just diagnosed with ITP. I’ve been trying to post but I never see it on here.
Hi Randy,
I just saw this comment left as a reply to Kristy’s comment above. I searched for your name/email address and didn’t find any other comments in my pending section. I am sorry you have been having trouble getting your comment to post. Feel free to reply directly to my response and it should come through!
thanks i tried again. it just says under moderator review and goes away.
Hi Randy,
I FOUND IT! Yes, the comments say they are under review until I have a chance to read them and respond. I am extremely backlogged and had not made it to your original comment left on April 30th. The reason I did not find it on my previous search is because it is under a different email address. I also see the copy you submitted the other day. Responding now…thank you for your patience.♥
I’m really sorry for causing so much confusion. I wasn’t able to find your response. Only the one where you mentioned you found it. I will give an update. Holly is now down to 5mg of Prednisone. every two weeks she has gone down 5mg. her platelets have been stable at around 560k. Her glucose has gone down to almost normal levels. Her alkp or it might be the other is down from unreadable to 4,800 to 3,400. Lowest she has gotten since her gallbladder removal was 900 which was in January. I do have a question. All of a sudden Holly is deaf. Or maybe I didn’t notice it that much. She’s always with me so it’s hard to think I wouldn’t notice. Can IPT itself cause hearing loss? She does currently have a ear infection. I was clapping right behind her head and on the 10th she heard it. it’s really upsetting. She enjoys listening to all the noises outside. She can hear thunder I know that. She runs outside and barks at it. It might be me not accepting that she is 13 1/2. I have two stepkids and my wife can’t have children due to complications. My two dogs are my kids. I’ve had Holly since she was a little girl. I just love her so much.
Hi Randy,
I am glad to hear that Holly’s blood work is improving and you were able to successfully decrease the prednisone! I am not aware of any mention of ITP causing deafness. Since you mentioned she is currently battling an ear infection, I would be more suspicious that the infection has caused this decrease in her hearing. Some ear medications can also cause deafness as a side effect (usually temporary). Please make sure your vet is aware of this change in Holly’s hearing ability. They may want to have it evaluated and/or make changes to her treatment regimen for the ear infection. Thank you for the update and I look forward to keeping up with Holly in the future!
Thank you so much. I let my vet know about the hearing issue yesterday. She didn’t seem concerned but I am. She goes tomorrow for her ear check up. Then Monday is the big day for getting off Prednisone. She will have follow up blood work I’m sure to make sure she didn’t relapse. Her eye is almost blood free. This was a frightening disease. probably because I never heard of it. When they told me what it was I thought it might be over and I balled for 20min in the vet’s office. I want to thank you for your expertise. I don’t want to bother you anymore as others have questions for you. There pets are equally as important to them as mine is to me.
Hi Randy,
Hoping the hearing issue will resolve once the ear infection clears completely. I can only imagine how scary all this has been for you and your girl. I feel like others will gain some insight and comfort from reading your updates and seeing how things can progress over time. Thank you for your kind words. Feel free to keep in touch. Give your girl a hug for me. ♥
just an update. Holly weened off of Prednisone two weekas ago. Two days after her last dose she stopped eating and had very bad diarrhea. She has chronic pancreatitis and no gallbladder. The specalist put her back on 2.5mg once a day. She returned to normal two days oater. We go for blood work tomorrow. I’m hoping she can get off the Prednisone. It’s not a good long term solution. I worry the longer she is on it although at a low dose the more problems she could have. Her blood work has all been good. She will have been on it 2 months in July.
Hi Randy,
I am sorry you are dealing with this setback since discontinuing the prednisone. I agree it would be ideal for Holly to not take steroids long term, but as long as her blood work continues to look good this may be the best course of action. Did her hearing ever return to normal? Hoping you received good news at the recheck last week. I will continue to keep you and Holly in my thoughts!
it’s bizzare with her hearing. Sometimes she can’t hear me and sometimes she seems to hear me. She definitely has trouble hearing but it’s not completely gone. Her blood work was ok. Her platelets were normal. Her liver enzymes slightly increased. By a few points. The specialist said they want her on it a month then to do a recheck and try to ween her off again. It does seem to keep her pancreatitis at bay. She used to have loose stool and stomach gurgling and pass a ton of gas. The only difference is the steroid. Her stool is pretty normal, she doesn’t really pass gas and no gurgling. Not sure if there is a correlation or not. The blood in her eye is completely gone. I’m still hoping she can ween off. I know she is a senior dog, but to me she is my little girl. I love that dog so much. I’ll post updates as I get them. Hopefully she can get some good news. Oh I forgot she did have some kind of pancreatitis attack or something two weeks ago. I was able to shove a cerinia down her mouth which seemed to ease her stomach. She starts crying and digging in the yard. I just walk with her. The episode didn’t last nearly as long as it normally does. It almost gives me a heart attack when it starts. She started eating boiled chicken the next day. I wish I could take on her issues.
all the best,
Randy, Holly and Joey.
Hi Randy,
It’s good to hear from you! It’s interesting Holly’s GI issues have improved since being on the prednisone. Makes me wonder if she had a touch of something like IBD and the prednisone is treating it as well. I agree, her hearing issues are bizarre, but I guess all things considered it isn’t such a big deal. I am glad to hear the blood in her eye has resolved and she is still fighting! I hope the next recheck will bring good news. Thank you for the update. Give your sweet pup a hug for me. ♥
You might be right about the Prednisone and her stomach issues. last time she had a really bad episode was on a weekend so I had to take her to the ER. Her pancreas levels were normal. the only thing they could tell was she had a lot of air in her stomach. I really don’t have an explanation and that’s all they had 2k dollars later.
Yeah….IBD could be a possibility. It might be worth discussing with your vet? Definitely food for thought!
Holly goes for her blood work tomorrow. last time her ALKP was 2800. ALT was 180, GLU 129, TBIL 0.2, GGT 12, ALB 3.4.. Her ALKP will always be high but it’s usually in 1300 range. Wish us luck tomorrow. I doubt I’ll sleep.
Hi Randy,
I am so hoping you will see improvement in Holly’s bloodwork! Come on sweet girl you’ve got this!
Sorry, last question. Do you think the Prednisone is keeping something in check and taking her off is causing her ALT to go up?
Hi Randy,
Of course, I can’t be sure, and anything is possible, but I would assume the opposite. Prednisone is usually a medication that can cause a rise in ALT. Most patients that have an increase in ALT while taking steroids will see a decrease in ALT once the medication has been discontinued. If the ALT is rising without the effects of prednisone playing a role, then I feel like there could be an actual dysfunction issue with the liver or some other diagnosis needs to be investigated. Still praying for your girl. ♥
Holly was on her second day of no Prednisone and she had an episode. Whining, licking her lips, pacing. I don’t know if it’s related to the Prednisone or not. Her last episode was when we tried to get her off and on day 2 she had an episode. She’s calmed down now. I’m extremely upset. She did eat cat feces this morning. I just don’t know anymore. Is the Prednisone keeping inflammation in her gasteo tract down. Her last ultrasound when she was sick only showed air in her stomach. Just really at a loss. Her GI tract will always be an issue with no gallbladder and some bile duct damage..
Hi Randy,
Sorry I didn’t see this comment when I responded to your other one yesterday! I am still very suspicious about Holly having some sort of IBD and thinking the prednisone is keeping it suppressed. Forgive me if we have talked about this before, but is she taking any other immune suppressive medications or just the prednisone? If it is just prednisone, I wonder if trying a different class of drug (non-steroid) for immune suppression would allow her liver some freedom but at the same time help to keep her GI issues under control and treat the ITP. Of course, these are just my random thoughts, but it might be worth discussing with your vet. Poor Holly (and you) just can’t catch a break. Sending hopeful thoughts and wishing you both happier days to come.
Yes, I’m pretty confident she has IBD or some type of stomach disorder. She actually does not need to take Prednisone anymore. Her platelet counts have been fine the past several months. They have been holding in the 480k range. What medication could I speak with my Dr about?
Holly is on:
Denemarian 1x a day
ursidol 1x a day
cernia 1x a day
half a priolsec at night.
Prednisone 1.25mg every 3 days
Hi Randy,
There are too many immunosuppressive medications to list them all, but the most common is cyclosporine. I am not sure if this would be a good fit for Holly or not. But it never hurts to ask questions and see what your vet thinks. Also, here is a link to another article on our site about IBD just in case you haven’t seen it: IBD in Dogs: Symptoms, Diagnosis, and Treatment
You can delete my previous post about her not vomiting. She doesn’t vomit or have diarrhea but what I did notice is when she started the steroid her gas problem completely stopped. 100% everyday to 0%
thank you for all the support. I’ll stop posting as this is for ITP patients. Youvreally helped me get through that part with her. I just hope I have some more time with her.
Holly was doing great on 1.25mg of Prednisone every third day finally. Yesterday she took a turn for the worse. She has become very lethargic, slow, licking her lips and sometimes off balance. She is still eating and using the restroom. I gave her a cerenia which helped a little. She is still following me around like normal.. She wanted to bark and run after a dog but just couldn’t. She seemed very nauseous. I’m taking her to vet at 8am. She was just running and playing a day ago. Very upsetting. Since going to every three days on pred she has had issues. I’m worried about cushings now
Hi Randy,
Goodness…I am so sorry. How is Holly feeling today? Did her platelet numbers take a significant drop again? As always, praying for you both. ♥
Her platelets did go down but are still in range. She either has cancer abscess on her liver or just an abscess. it is not benign. They sent it off and also sent it off to see if it’s an infection. I’m at a loss and can’t even move. How many things can my poor girl go though. They didn’t sound confident that she would make it to end of year
They didn’t say that, but seemed pretty guarded. They did not see cancer cells. I guess at worse it’s an abscess which hopefully can be managed for a month or so
Dear Randy,
My heart aches for you. I am so sorry for all you have endured and all you are still facing with sweet Holly. Let us know what you find out from the lab about the liver abscess. No matter what, we will all fight together to make sure Holly is comfortable and happy. Sometimes we end up having to allow our own hearts to break to give a beloved pup freedom from suffering. I hope it does not come to that….but you know I’ll be here for support along the way.
This is from the specialist:
Holly appears well on exam with normal vitals. Recheck liver ultrasound shows an irregular mass within the right liver
lobe measuring 3.6cm x 2.3cm. This was aspirated and sent out for cytology. In house cytology indicated abundant
neutrophilic inflammation. Bacterial culture was sent out as well. We should have preliminary results Thursday and you
will be contacted once they are available. In the meantime, I would like Holly to start an antibiotic called enrofloxacin.
I don’t fully understand it. I guess she won’t survive. I started to go to a therapist to cope with this. She’s eating and drinking and even ran around today. She wants to live so bad.
Dear Randy,
I am glad the specialist is being thorough and sent the sample to the lab for evaluation. This may not be as bad as you are expecting. Try to stay positive and let’s see what you find out from the preliminary results tomorrow. I think therapy is a good idea, especially when dealing with very emotional situations. Talking with someone else has always been a great outlet for me. I’ll be looking for your update. ♥
thank you for the kind words. I know I’m a little insane when it comes to the dogs. I just love them so much. My specialist was guarded but my vet saw the results and talked to her. They are leaning towards an abscess and not cancer. I don’t really understand it. She said it wasn’t Benign. I took that as either cancer or an abscess that will spread. She’s very guarded with her words so I get confused.
Hi Randy,
That is a bit confusing to me as well. I am sure they just don’t want to jump to conclusions without having all the information. Hopefully the picture will become clear once the pathology report is finalized. Praying for favorable results and a clear path forward!
Holly’s results came back. She was negative for cancer. Her results for bacteria culture came back and she has strain resistant E.Coli. They found only a few antibiotics will cure it. Those antibiotics are very very hard on the liver and or kidney. My specialist needs to think about next steps. She was upset at the finding. She figured E. Coli but not this strain resistant one. The good news is that the Enrofloxacin which showed resistant has shrunk her abcess which has lowered her liver enzymes in a week. The plan is to stay on it and get an ultrasound and blood work done in two weeks to see the results. She said depending on those results will determine if she puts her on one of those antibiotics. She said those cultures are done in controlled lab settings which aren’t always accurate in how it will respond in a dogs body. That’s clearly true as the abcess has shrunk. She still says it’s a high possibility this medication won’t cure it but will keep it at bay. One thing after another for my poor girl. Feel so bad. I’m trying every I can as long as she is happy. She is 100% back to her normal self.
Hi Randy,
I am so glad Holly doesn’t have cancer!!! I saw your other comment about the injectable antibiotic and think this is a good idea. I hope the abscess will resolve over the next few weeks just as the specialist expects. What a blessing your girl is feeling good again! This is the positive outcome we were praying for. Keeping you both in my thoughts and I look forward to the next update.
I’m just really worried about her kidneys on Amikacin injections for two weeks. Since starting the original antibiotic her liver values have gone from:
ALKP: 2891 to 934
ALT: 380 to 203
This was over one week.
I know this antibiotic wont kill the ecoli and will come back after stopping this antibiotic. The Amikacin will kill it but has kidney and hearing side effects. Is it not possible to get the abcess as small as possible so she does not have to be on Amikacin as long? Or is that not how it works? What are your personal thoughts on that antibiotic? Have you seen it cause kidney failure in two weeks? She will be getting two blood tests a week and a urine test. I’m just afraid of her kidneys getting damaged where it can’t be reversed. She is so happy right now. I hope the antibiotic doesn’t make her miserable.
Hi Randy,
That is such a great improvement in those liver enzymes! I know using amikacin is scary, but the alternative is really not great either. I have not personally had a patient go into renal failure after just a couple weeks of using this medication, but I have only utilized this type of antibiotic a handful of times. This is where we have to lean on the expertise of your vet and make the best choices we can with the information provided. We know if Holly doesn’t take the amikacin, then the bacteria will stop responding to her current treatment and the abscess with begin to get out of control. I would rather go ahead and destroy the bacteria before it has time to cause other life-threatening issues. Holly is headed down an unknown path, but I am so hopeful she will make it through to better days ahead. Stay strong. You’ve got this. Holly is lucky to have you advocating for her every step of the way. Continuing to pray for you both!
Thank you. She starts today. Her kidney values were normal. She will be getting two blood tests a week and a urine test once a week for a total of two weeks. They really don’t think she will have kidney issues. If she does they will know quick and get her off before any permanent damage is done. I feel so bad for her. She is so happy now. I emailed you a picture of her
Holly had her first blood test today. Her BUN and Creatine levels were fine. Her ALT also went down even more.
Holly got her first blood test Friday. Her BUN and Creatine levels were normal. Her urine was a little diluted but it was around 4pm when they took it. Her ALT is back to normal!! It was 380 three weeks ago. Friday it was 90.
Hi Randy,
This is amazing news! This is exactly the results we were hoping for! I am so glad things are improving quickly and Holly is headed in the right direction. The team made sure to get Holly’s pictures to me. She is ADORABLE. ♥ I am glad you sent them because now I can picture her cute little face when reading your updates. Take care and give your sweet girl a hug for me.
Holly has her ultrasound tomorrow to see if the mass is still present. Her kidneys have not had any issues thus far with the antibiotic. Her ALT has gone further down to 71. The only abnormal number is her Lipase. I believe it was around 2400 then went down to 2200. They will keep an eye on it.
Hi Randy,
Praying for positive results from Holly’s ultrasound today! Your sweet girl deserves some good news!
Sorry, Lipase was 1400 then 1200.
Hello!
My 14 year old puppy girl was diagnosed with ITP May of last year. And since has weaned completely off prednisone as of this week (still on mycophenolate). She had one relapse at the beginning but fingers crossed she keeps doing good!
She’s had this small cyst on her shoulder that over time has gotten worse and eventually ruptured a couple months ago. And continues to scab then open back up. An aspiration showed no signs of cancer. I was wondering if we decided to have it removed since it’s an ongoing issue I assume she’d need antibiotics to fight infection. Is this dangerous? I’ve read that antibiotics can be a big no no when treating ITP.. Thanks for all your incite!
Hi Eliot,
I understand your concern for your senior girl and the need to prevent a possible ITP relapse. You are correct that some antibiotics can play a role in causing ITP. There are also many choices of medications that should be just fine for your pup. I highly recommend you discuss your concerns with your vet. They can let you know if surgery is needed and what treatments are safe for your dog’s specific situation. I am hopeful you can find the answers you need to make the best choice for your girl. Wishing you both the best of luck and feel free to leave an update if you have a chance.
Our Maltese was diagnosed with this yesterday. She had been breathing heavy all day and not doing anything. We took her in and the did an X-ray. She has a heart murmur and blood in her lungs. She is in the hospital in an oxygen kennel and they are giving her
Vincristine, doxycycline and prednisone. Her platelets are still 0. We are so confused by this and how she got it. Your article was ver helpful and gives us hope. Unfortunately we can’t pay for much more and that’s what worries me. We may have to put her down because of costs. This is just so heartbreaking.
Dear Kim,
My heart aches for you and this difficult situation you are in with your little pup. How are things today? I am hoping your sweet girl was able to keep fighting. Feel free to leave an update if you have a chance. Praying for a miracle. ♥
Hello Buzby,
My dog was diagnosed with ITP last September with only 11 months. She was so bad that she needed blood transfusion and some medicine after. She survived. I have 2 questions. One is, why are the chances of dying after getting the rabies vaccine if she does not get exempted? And the other question is, do all dogs diagnosed with ITP need medicine for the rest of their life? My dog is currently taking no medicine or treatment at all. I wasn’t told to do it.
Hi Ivette,
I am happy to hear your dog was able to make a full recovery from her ITP episode and is doing well without medications! Not all dogs have to stay on immunosuppressants for life after an ITP diagnosis. Many dogs go into remission and do very well without taking medications. There is a good chance a relapse will happen at some point, but I would try not to stress about this too much. There is no way to know if your pup will have a relapse after vaccination. I am not sure there is enough data out there to give specific percentages. Your vet may choose to give your dog some medications to try and prevent a reaction should she not receive an exemption and need to have her Rabies vaccine repeated. Hoping all is well and your sweet girl has a long and happy life ahead.
Hello Dr. Buzby,
thank you for responding. I must read your blog once a day. A lot of times the same article. My best friend and little girl Holly who is a Westie was diagnosed with ITP. I pretty munch had a mental breakdown again. My Holly is 13 and has had some health issues. She had her gallbladder removed a year and a half ago. She got pneumonia while recovering in the hospital. I would sleep in my car outside the hospital where she was staying hoping she knew I was there. Her liver enzymes alkp was unreadable. About two months ago it was down to 900. All of a sudden 4 weeks ago I saw blood in her eye. I took her to the vet and her platelets were just about at 0. They started her on 20mg of Prednisone. I decided to take her the next day to her internist. They ended up hospitalizing her. I completely lost it. They gave her Vincristine. The next day her platelets were at 17,000. The next day she was at 125,000. They let my girl come home. She went in two weeks ago for a blood test and her count was 600,000. They decreased her dosage from 20mg to 15mg. Then two weeks later they were 675,000. She was lowered to 10mg. When she was first diagnosed her ALKP was unreadable and she was close to diabetic. Her Bun levels were fine and x rays and ultra sounds showed no cancer or bleeding. Her glucose on our last visit was about 10 points lower and her liver enzymes were readable but at 4,000. I’m really concerned about her enzymes levels but the interest is not currently. I don’t know if I have a question at this point. I just feel better telling someone. My anxiety goes sky high with her. I love her so much. She’s my shadow. The blood in her eye has gone down from covering half her eye to a speck in the center and best way to describe it is blood flowing down from that speck. How long does it typically take for the eye to go back to normal? Also, I’m really nervous about having her on Prednisone. The possible side effects with her liver and glucose. She does seem almost fully back to herself. She still gets tired and drinks a lot. The one odd thing I have noticed is her fecal has been solid “normal” ever since she started Prednisone. Normally it’s soft as she has digestive issues with no gallbladder and chronic pancreatitis. She’s such a wonder girl. Reading your article about your boy Fletcher gave me hope. I just hope we can keep tapering down and she doesn’t relapse even those it’s fairly common too.
Hi Randy,
First let me say I am sorry for all the trouble you had trying to post your comment. I am glad this finally made it and we can get your story published for others to see. I understand your concern for Holly and these issues she has been dealing with over the last few weeks. She is a lucky pup to have you advocating for her health and well-being. Without examining your girl, myself, I can’t say for sure how things will progress. I know you are worried about the side effects of prednisone, but the benefits definitely outweigh the risks at this point. I wish I had more advice to offer, but if nothing else I hope you know you are not alone. Wishing you and Holly the best for happier days ahead and praying for a full recovery.
Holly has seemed to fully recover and blood work was good. My little boy was playing and enjoying life yesterday. He woke up from his sleep crying and couldn’t get up. He was rolling like a crocodile. His head was tilted upwards and his eyes were all over the place. I immediately thought he had vestibular syndrome. I’m not a Dr. so I rushed him to the ER. I won’t be going back to that ER. They agreed with my assessment and do not think he suffered a stroke. his vitals were good. I asked if they could check for ear infection. They said if I hospitalized him. I told them why does he need to be hospitalized to have his ears checked. They checked his ears and didn’t see anything. There was a lot of fur in one which they took out. They didn’t see his ear drum. But I believe they said that was with all the hair in his ear. I decided I didn’t like how it seemed like a money grab. I’ll pay whatever and anything for my dogs. I just didn’t like how the assistants acted. They seemed annoyed. I’m always very nice and no different this time. I took him home and gave him a Cernia and Bonine for his weight. He was really hungry so I put chicken bone broth for dogs which has low sodium in a syringe and slowly put it in his mouth. He went nuts. I gave him 3 full syringes. I gave him some boiled chicken and he ate it and licked a ice cube. He hasn’t gone the bathroom since yesterday at the ER when he whined and then went. This is so terrifying seeing him like this. I thought at first he had a stroke and was paralyzed. He can move his legs. He moves the front more then the back. He does move the back. I put so many blankets down and made a sqaure with body pillows so he couldn’t hurt himself. I hope he pulls through. It almost seems fatal with the symptoms but I know they can recover and show improvement after 48 to 72 hours. I sleep on the floor with him. I have a torn disk in my back from 26 years of working out. It’s flared up and I can’t move really. But he needs me a d calms down when he can see me. He is 14 1/2. So scary
Dear Randy,
I am glad to hear Holly is doing well and her blood work has stabilized. Goodness I just don’t know what to think about what is happening with your boy! I agree it sounds like vestibular disease but of course there are other more serious possibilities as well. I am sorry your experience at the ER was not favorable. While I can’t say they were acting the way I would hope, I wonder what all the staff had been through since the beginning of their shift to alter their attitudes toward their clients in such a negative way. Did the Cerenia and Bonine seem to make any difference in your boy’s symptoms? Hoping you can reach out to your regular vet tomorrow and get their advice on how to proceed. I know you are familiar with a lot of the articles on the site, but just in case you missed them here are a few about vestibular disease:
1. Vestibular Disease in Dogs: Doggy Vertigo
2. How to Feed A Dog With Vestibular Disease: A Comprehensive Guide
3. 10 Tips and Exercises for Dogs with Vestibular Disease
Hoping you can get some definitive answers about what is causing these worrisome symptoms. As always, I will continue to pray for healing. Keep me updated!
Hi there, my dog is in a similar situation as Fletcher. We have checked for tick borne diseases but that wasn’t it. Idiopathic for our dog and the pred worked at first but is no longer working. We have tried adding in Azathiprine but that hasn’t had any impact either unfortunately. Since we’ve tried upping and tapering prednisone a couple times now our vet recommended an internist. Are you able to share what drug combo worked for your Fletcher? I have been so hopeful but am feeling quite discouraged now and hoping we find a solution for our sweet Pearl.
Hi Meredith,
I am sorry your dog is struggling with ITP. Dr.Garlow did not specifically mention which medications Fletcher was taking other than that he ended up having to stay on prednisone long term. I can try to reach out to her for more information but may not be able to get these details. I definitely think pursuing a referral to a specialist is the best idea. They will have the most experience with cases like your pup and Fletcher and should have some good ideas of how to optimize the treatment plan. Praying Pearl is staying strong and still fighting. Hoping for a positive outcome for your sweet girl!
My 23 month old male black lab was diagnosed with IMTP from Anaplasmosis, however, he is not responding to the Doxycyline or the Prednisone as expected. He has had Xrays of his belly and his chest, both show nothing he has also had an ultrasound on his belly which also showed nothing and now we have been told to add Cyclosporine to the Medications. His red blood count was 32, 22, now it’s at 18, we are heartbroken and we are looking for any advice we can to help get our baby healthy again. Please help…
Hi Lynn,
I am so sorry you are facing such a difficult situation with your young dog. It sounds like your pup’s case is complicated and, in these instances, I like to defer to the experts. You may want to talk to your vet about a referral to an internal medicine specialist. How are things today? Is your sweet boy still hanging in there and fighting? Praying the cyclosporine was able to get things to stabilize. Feel free to leave an update if you have a chance.
Hi, we are in the throes of this ITP nightmare with my grandpup, he is a rottweiler (145 pounds) is and only 1 year, 11 months old. We noticed red blotches on his belly on Wednesday, but he has so many food allergies we didn’t think anything of it. He was eating and playing with no issue. Thursday his gums started to bleed but again he was having his way with a hoof.. so we thought it was that. My son made an appointment for Monday with his vet but that night he was restless, so my son took him to the Emergency Vet, the bloodwork turned out with zero platelets and suspected ITP. They sent us to a hospital more equipped to handle him. We are in day 2 and his platelets are still zero and now his red blood cells are dropping. He has had steroids and vincristine so far. They tested for tick borne diseases but nothing has come back positive yet. A transfusion is on the table and so it Flebogamma which has a cost of over $6,000. His appetite has wanned and he is having a hard time in the cage and this is causing more bruising which is very unsettling. They are considering treating him outpatient for this reason. They called my son in and he got him to eat a hot dog (his favorite) and take his meds. He was playful and happy but the IV came out and it bled an awful lot. For the next 24 hours my son will go there as needed to help them administer meds. I am wondering what to expect from here? Is this the waiting part? Are there any experiences with Flebogamma? I am hearing mixed messages on transfusions as well. Any help and or prayers are appreciated. Will his age help him? He is in “guarded” condition in the ICU right now. Thank you.
Dear Concetta,
I am so sorry your grandpup is fighting for his life with this severe disease. I am not sure his age will play a role in helping his chances of recovery. I understand your concern and wish I had more advice or information to share. Transfusions are a vital part of the treatment for ITP. It may have to be done many times before your vet decides if it is working as hoped. I have heard of Flebogamma but have not had any personal experience with it. I am worried they are considering the Flebogamma as a possible last resort. How are things today? Is your sweet boy still hanging on and fighting? I am praying for a miracle and hoping he is on the road to recovery. Please give us an update if you are able.
hi – my dog has been diagnosed with ITP. Her ITP was likely induced by anaplasmosis, which she tested positive for and has been treated. Her vet said no more vaccinations for the rest of her life! she’s only 7. We live in a rural area with lots of wildlife. She can’t live in a bubble. research on this seems mixed. Help!
Hi Andrea,
I am glad you found the cause for your dog’s ITP! You are right that the opinions on vaccination after an immune mediated disease has been diagnosed are conflicting. There really is no right or wrong answer for this difficult situation. In some states you can get an exemption from the required rabies vaccination if your veterinarian supplies the necessary paperwork/proof. This is not available in all states. Some specialists will go ahead and vaccinate while the dog is taking immunosuppressive medications with the understanding that this does not prevent a relapse, nor does it guarantee the full efficacy of the vaccine. Each case is different. This tricky road will have to be carefully navigated by you and your veterinarian working together as a team. Wishing you all the best of luck! I would love to hear an update with what you decided for your pup.
Hi,
My 2 y/o pup was diagnosed w/ITP this week. He presented w/a 106 fever, vomiting, lethargy, confused, blank stare, clumsy, and unsteady on his feet, are a few of his predominant symptoms. Vet ran labs, X-ray’s, and urinalysis. My little guy was initially treated for an infection w/an unknown origin overnight w/a round of IV fluids, antibiotics, and anti nausea medication. The next day his fever was 103. The next day the vet did another lab work up and his platelets went from 100k-40k. Consequently, ITP Dx. Upon d/c he received an injection of steroids and is now taking them orally. Just over 72 hours in, no improvement. He weighed a healthy 94 lbs when this fiasco started and he has lost 4 lbs. I of course have been doing my own online research and all of the literature that I come across mentions a bleeding/blood issue. My pup has not presented ANY bleeding/blood issues (checked gums, eyes, ears, evidence of bruising, etc). Have you ever encountered/heard of anyone w/a similar experience? My concern is that we may be missing something while trying to treat the ITP. Any recommendations, resources, or direction is sincerely appreciated.
Hi Mel,
I am so sorry your young pup is in this tragic situation. While most dogs with ITP have other signs of bleeding/bruising, this does not have to be the case. It is still very possible ITP is the cause for your dog’s symptoms. With that being said, it is a good idea to still be running tests and investigating this issue. Your vet may try to rule out tick borne diseases or pursue higher imaging like ultrasound. You may want to ask about a referral to an internal medicine specialist. I am hopeful your veterinary team can find the answers needed to keep your sweet boy headed in the right direction. Praying for a full recovery. ♥
I’d love to know more about how you handled vaccination concerns like rabies with your dog while on immune suppressants. My dog is now 10 1/2 yrs old and was diagnosed with ITP in 2020. He responded well to mycophenylate and prednisone and continues on both as well as Prilosec and probiotics. His veterinarian never tried to taper off the meds. I am at the point where I think we should try, carefully. I don’t want to harm him but the medications aren’t benign and the immunization issue is a concern.
Hi Heather,
I apologize for the delay in response. I reached out to Dr.Garlow with your questions. Here was her response: “Personally I still gave rabies vaccines to Fletcher even when he remained on immunosuppressives, knowing that there was a possibility those medications would affect how well the vaccine worked, and vice versa also knowing that there was a chance the rabies vaccine could upset the delicate balance of the control of his ITP.” She also mentioned that for your specific case it would be reasonable to discuss tapering the medications with your vet. She said it would need to be a “very cautious taper” to at least discontinue the steroids. I hope this helps a bit! Best wishes and good luck!
Our 2 year old mixed breed (mostly American Pit Bull and German Shepherd, with a super mutt mix) was diagnosed with ITP on Sunday 1/1/2023. We’ve been a mess. She is a rescue that spent the first year of her life physically abused and starved in a hoarding situation in SC. We were able to adopt her at 11 months and spent the last year building her confidence and gaining her trust. Now to have her hospitalized with strangers and on going tests. It’s so hard to stay positive. They tell me her platelets have been 0 for the last three days, and her skin shows more signs of small bruising. I hope to have a better update, but I’m so broken.
Dear Kaitlin,
I am so sorry you are dealing with such a difficult situation with your young dog. How are things today? It sounds like you and the veterinary team are doing everything possible to give your sweet girl the best chance to make a recovery. I hope your pup was able to keep fighting and respond to the treatment. Feel free to leave an update if you have a chance.
Hi! My 6 year-old male Yorkie was limping, lethargic, and had a fever. The vet diagnosed him with ITP (platelets 47 with a normal range of 148-484) and possible acute Lyme disease. A 4DX test showed he is positive for Lyme (however, he was already found to be positive for Lyme a year ago, but was asymptomatic at the time). He put him on a 30-day course of Doxycycline as well as a month’s worth of Prednisone. I’m to recheck his platelets in 5 days. Information about Lyme disease and thrombocytopenia is scarce, especially how to treat these conditions concurrently. Since there is no definitive test for acute Lyme infection, the doctor wanted to err on the side of caution and therefore put him on the steroids instead of just treating him with the antibiotics. Does treating with Prednisone and Doxycycline simultaneously seem like the right course of action?
Hi Alexandra,
I am sorry your little guy is so sick, and I understand why you are concerned. From what you describe, your dog’s case is complicated. In these instances, it can be tricky to know exactly how to proceed. It sounds like your vet is delivering the standard of care that would be expected and trying hard to turn things around quickly for your pup. How is the treatment going? Is your dog feeling better? If you have any lingering questions or concerns, you can always schedule a consult with a specialist. I hope your sweet boy is on the mend and back to living his best life. Best wishes.
Hi Dr. Buzby, thank you so much for writing back. I just got off the phone with my regular vet. My dog has been on the prednisone and Doxycycline and has been doing well. He is back to his normal self. However, as we’ve been decreasing the prednisone, his platelets have started dropping again. They are still in the normal range, but the doctor suspects that this has not been caused by Lyme disease after all. She suspects that ITP itself is the primary cause. She recommends finishing off the antibiotic anyway, continuing the prednisone for now, but also adding on Mycophenolate while continuing to wean off the prednisone. I am going to have him undergo an ultrasound and x-rays to rule out cancer. I am beside myself with worry that it is not “just” ITP. He’s having those tests done on Monday. I’ll write back when I know more.
Hi Alexandra,
I am glad your vet is not suspecting Lyme Disease anymore, but I know that does not take away your worry for your pup. Hoping this extra testing will produce some answers with a positive outcome. I think it is great you are adding Mycophenolate to the treatment protocol. You should see some good results soon. Praying for your vet visit today. Thank you for the update and I look forward to the next!
Good news! The ultrasound and x-ray came back all clear! I’m so relieved! So now that any underlying condition has been ruled out, the doctor says to keep him on the same dose of Prednisone for now and have another blood test done in a week. When those results come back we’ll decide whether to keep weaning him off the Preds or switch him to Mycophenolate.
Hi Alexandra,
YAY! This is such great news! I am very excited for your little guy and hoping his lab work will show the positive results we are praying for. Thank you for the update and I look forward to the next. ♥
The ultrasound sound came back today. The abcess is gone. They want her off the shots as her urine test is showing a strain on her kidneys. Her blood test for her kidneys is fine. She is also going back to every three days of pred at 1.25mg. They believe where the abcess was, was making her sick. We hope to remove the Prednisone in a week. The only thing I didn’t get an answer on was the Lipase. I kept getting the number wrong. It was 2350 then was 2210. Her platelets were great, white blood cells etc. I’m hoping her kidneys were not damaged beyond repair.
Hi Randy,
This is great news! If the kidney values on lab work look good, then I would not think you would need to worry about kidney damage. It sounds like everything is going the right direction and the abscess has resolved as hoped. The pancreas (responsible for lipase) may have gotten a bit aggravated with everything going on. I am glad your vet is keeping an eye on it and feel like it will calm down now that the abscess is under control. So glad to hear this positive update on Holly. Have a great week!
Hello Dr. Buzby,
Holly had a follow-up ultrasound and the mass is still gone. She is also off prednisone and has not gotten sick. I’m hoping she can catch a break for a little while. gallbladder removal, ITP, Mass on liver. She keeps fighting. She now goes for two walks a day and runs and plays with her friends. She will be 14 in eight days
Hi Randy,
What a great report from the recheck! Maybe things are finally under control and will remain stable for a long time. I am so happy Holly is feeling good and enjoying her daily walks. She definitely doesn’t look 14!!! Thank you for letting me know and allowing me to be a part of Holly’s life. All my best to you both. ♥
Thank you for listening and responding. It was very helpful through these hard times. Holly, Joey and I thank you.
Holly went for a recheck. She has something small on her liver in a different spot and her liver enzymes are up a little. it’s very small they said and can’t tell what it is. They will needle express it. It could be Ecoli again or Inflammation which she has had. She’s been off prednisone for about three weeks with no issues. It’s possible she has to go back on 2.5mg. If it’s the ecoli that’s going to kill her kidneys. I don’t know what she has done to deserve this.
It looks like the ecoli might be back. With her only being on it 10 days because of her kidneys they think it didn’t kill it all. There is another antibiotic that was shown to kill it. It requires two shots a day but is not harmful on the kidneys. I don’t know the name of it. Waiting for the cytology to come back. The biopsy really showed nothing of importance. I’ll have to learn how to give shots. I feel so bad. I don’t want to hurt her. She went on three walks today.
Dear Randy,
I am still praying for Holly and hoping she can overcome all this adversity. Giving injections can be intimidating but I assure you they are easy, and you can do this! A bit of food is a great distraction, and your girl may not even realize she received her treatment. Keep fighting the good fight. I am certain Holly knows how much she is loved and is living a life full of joy because of you and your steadfastness to her care. Bless you and your sweet girl. ♥
Hi Alexandra,
I hope that your Yorkie is responding well to treatment. Your comment caught my attention because of the symptoms that you reported prior to ITP Dx. I have a 2 y/o Doberman who presented w/fever, lethargy, confusion, and literally stumbling/unsteady on his feet. He does not present any bleeding/blood issues. Most of the ITP information that I have found discusses the “blood issues” (bruising, petechiae on eyes, ears, etc). Did your pup have any blood related symptoms? My concern is that I do not want to miss something that could potentially be worse while we are treating the ITP.
Any feedback you can provide is sincerely appreciated. Thank you I’m advance.
Sorry in advance for the super long comment!
This article was do informative and uplifting. Our dog Bentley was diagnosed with primary ITP in July of this year when he was only 1.5 years old, after getting his yearly vaccinations. Fortunately he responded well to Prednisone and his platelets went from basically zero up to normal fairly quickly and have been perfect ever since. We have been very slowly tapering him off over the last few months and everything has stayed stable, and we are hoping to have him completely off of Prednisone and his liver supplement in the next few months, fingers crossed! I’m really hoping after that his platelets will stay up on their own, but we will do whatever we have to do to keep him healthy and happy.
I know in your article you said that there is no real support saying that vaccines can trigger ITP, however this is the only thing that Bentley’s team has been able to find that could have triggered his ITP as it happened so quickly after his shots. We have decided to be very cautious about vaccinating him in the future, but I am worried because I believe by this coming June, he will be out of date on his Parvo and Distemper vaccines, and that worries me. Especially because he loves to be around other dogs and go to public dog events and classes that require these vaccines, and we can’t afford a titer test to prove he’s clear before each of these events. Do you know of any ways to help prevent an immune response when admistering vaccines in a dog with ITP? Thank you for your time, and for writing this article and devoting your career to this!
Hi Becky,
I am so glad Bentley was able to make a full recovery from his scary ITP diagnosis. I understand your concern with the idea of repeating vaccines in the future. I am not aware of any treatments that could lessen the possibility of a relapse. This would be a great question for an internal medicine specialist. Your vet can always consult with a specialist if needed to determine the best course of action. Checking titers is a great option and it is generally done once to twice a year. Most classes and establishments in my area will honor this testing if done yearly (similar to the frequency of vaccination). You can also make sure to get your pup a 3-year Rabies and distemper/parvo vaccine. This way you only have to worry about revaccination every 3 years. Talk to your vet to see which type of vaccine they carry and try and eliminate vaccines that are not completely necessary. I hope this helps a bit and I am wishing you and Bentley the best for a bright future!
Our 2yr old Great Dane is in remission, but has now torn ccl. I am unable to find any info on the internet about a surgery after remission. I am worried the stress and actual surgery will spark imtp again. Your thoughts on this?
Hi Jenn,
I understand your concerns with surgery, and you are right to be cautious. I honestly don’t know if knee surgery would be a potential trigger or not. This would be a great question for a specialist. Your vet should be able to reach out to an internist or schedule you a consultation if needed. I am praying you find the answers you need to make the best choice for your big guy. Please leave an update with what you find out. I am curious to know what the expert recommendation is for your sweet boy’s situation. Wishing you both the best.
Our Boy was diagnosed just today. He is almost 10 years old and on medication for his hip pain. Our choices are either to keep him on his pain meds to keep him comfortable or go with the treatment for this….we chose to keep him comfortable.
He has cancer masses on his body so we guess they can be related.
We know we’re going to have to say our good-byes at some point soon, but we are just trying to keep him comfortable right now.
He still eats well and occasionally wants to play with his brothers, otherwise he sleeps all day.
Dear Danielle,
I am sorry your boy is facing so many difficulties and nearing the end of his days. I am glad you are able to keep him comfortable and enjoy some additional quality time together. My thoughts are with you as you face some tough choices ahead. Praying for strength to face each new day.
Our 4 year old Maggie (4 on Tuesday 11/22) corgi, our first dog….was diagnosed with this last night. She was running agility no problems one night and the next lethargic and not our dog. Her platelet count was near 0 and now at the last lab level she is at 5,000. We opted to bring her home and make her comfortable. We are doing medications with steroids and antibiotics. The next few days are critical, it’s near physically impossible to get in anyplace. Fingers crossed things go in the right direction. She loves dog sports she loves agility and fast cat do you recommend her to no longer do that ever?
Hi Jenny,
I am sorry Maggie is struggling with ITP but glad she was able to come home and be with you while trying to recover. How are things today? I am not sure what the original trigger was for this condition in your pup, but I would not think exercise would have a negative impact once in remission. Of course, it would be a good idea to discuss these concerns with your vet. You may even want to schedule a consult with an internal medicine specialist. I hope Maggie is on the road to a full recovery. Praying all is well and wishing you both the best.
Thank you so much for sharing your experience, and your guidance about this disorder! Our beloved Indy, and 8.5 year old Frenchie, was diagnosed with metastatic adrenal cancer in early October. We began treatment with Palladia and she felt great! They said she was a candidate for stereotactic radiation, so we thought what the heck, let’s do this too! She received SRT from 10/25 to 10/27, and from the moment of her first treatment, she’s been sick. She had hemorrhagic diarrhea and melena, and was hospitalized due to mild anemia. She was released from the hospital but continued to have issues with bleeding until we were able to start her on sulcrafate. But at that point too, they found dangerously low platelets and a raised MPV, along with worse anemia. It wasn’t until yesterday that we learned that the platelets were 100% not a mistake, and Indy’s been put on prednisone. Thank you for sharing, this helped us feel less scared and alone.
Hi El,
I am sorry your little guy has had so many setbacks over the last few weeks. I am glad the platelet issue was found rather quickly and am hopeful the prednisone will help Indy stabilize. How are things going today? Praying you are seeing some improvement and your sweet boy can achieve remission. Wishing you better days ahead.
These are amazing stories.. My Mia 10 Years old was perfect one day and by the evening she was bleeding from her gums and had bruising on her belly. We took her to the ER and she was diagnosed with ITP. Her Platelet count was 24,000 and she was bleeding at a rapid speed. She got meds and we took her home but she kept getting worse. By the forth day she had not eaten or drank water for about 36 hours. I carried her to her bowl and she collapsed. Her gums were white and I knew it was time to let her rest. The meds did not work fast enough to fix the damage. I knew from the beginning it was a race for time.
My heart just wants to explode with the hurt I’m feeling. Should I have waited longer could I have fought harder did I do enough. Its been horrible. Bless those that have pulled through this horrible disease
Dear Liz,
I am sorry for your loss of sweet Mia. It is normal to grieve and ponder all the “what ifs” when you lose a beloved pup, especially under these tragic circumstances. Take comfort in knowing you did everything you could and definitely did not fail your girl. You made the right decision to free her from her suffering and give her peace and rest. I have no doubt she knew how much she was loved. I pray Mia’s memory will stay with you forever and be a blessing. ♥
Hi – our almost 11 month old Frenchie puppy Ruby was just diagnosed with suspected ITP. She stayed overnight at the ER and we just brought her home. Her symptoms were lethargy and fever only. No bleeding. The platelet count was 20,000 upon admission to ER and she had a high fever. She responded quickly to treatment and her ultrasound was clear so she was discharged. We are waiting for the more advanced blood work results to come back. She seems herself and we are being very careful she doesn’t overexert. This has been so shocking as she was fine one day and lethargic and feverish the next with no explanation. The doctors still don’t know the reason. We are praying she recovers – she’s practically a baby. Thank you for your wonderful article and its also very helpful reading thought the comments. Barbara
Hi Barbara,
I am sorry you are dealing with this scary situation in your young pup. What a blessing that Ruby hasn’t had any bleeding issues and seems to be responding well to the treatment. I am hopeful that she can achieve remission and continue to thrive. Praying for good results from the pending lab work. Wishing you both the best!
It’s great to hear positive outcome stories for a dog with ITP. We’ve been treating ours for about 6 months. She had an early relapse but has been in the 450-500 range since that relapse. She now is down to 3 MG a day (mycophenalate and melatonin as well). Her recent blood work came back as 148. Starting to worry it’s the beginning of another relapse. Our vet hasn’t been able to give a clear answer if we slightly increase the dose that it could increase the platelet count or reverse a relapse. We’re just hoping to not have a full relapse and start the process over at 20 mg again.
Hi Eliot,
I am glad your dog has continued to fight and stay strong through so many trials over the past 6 months. I understand your concern with the recent mild changes noted on lab work. I am hopeful that this is just a blip on the radar and not signs of something more serious. Praying your pup can remain stable and continue to thrive. How are things today? Feel free to leave an update if you have a chance.
Thank you for the prayers! She’s been stable since the drop in platelets hovering around 148k which is great. We decided to keep her on the 3 mg of prednisone for a couple more weeks to see if there’s any movement on the platelet count before attempting to drop it anymore. Fingers crossed it stays stable/positive so we can lower the dose!
Hi Eliot,
Thank you for the update! Glad to hear things are stable and you may be able to decrease the prednisone in the near future. I am still praying for your girl and hopeful good things are ahead for both of you. Best wishes!
So she’s currently developed a nasty UTI and did a 7 day course of nitrofurantonin. Unfortunately it didn’t resolve so we’re going to do another round of it (3 weeks). She’s down to 1.5 mg of prednisone a day. How often does Nitrofurantonin tend to interferes with ITP or blood platelets?
Hi Eliot,
I am sorry to hear your girl has developed a UTI. I am not very familiar with the side effects of nitrofurantoin as this is not a medication I use commonly. I did some research and looked through the veterinary drug formularies. There was no mention of this medication affecting platelets or causing ITP to relapse. With that being said, there is always a slight risk of an unexpected complication, but I don’t think there is cause for concern at this point. I am so glad you were able to decrease the prednisone to 1.5mg!!! That is a big win! Hopefully the UTI will respond to this longer course of treatment. How are things today?
Thank you for.such an articulate recount of this disorder. my girl, Channing, was diagnosed August 2022. At this moment, I am sitting in the parking lot of Channing’s ER Veterinary Hospital, Sage Redwood City, south of San Francisco. we have been unable to titrate her off prednisone. coupled with Mycophenolate, and after a severe gastric bleed initially out of ICU early August due to too much pred (she’s a giant Bluetick coonhound at 120 lb), she’s on 10 mg 2 x bid, 500 Mycophenolate bid, omeprazole, and she was diagnosed with idiopathic epilepsy at 1 yr old. After another blood check this past Tues, she was stable only after we had to increase pred again after trying to lower from 10 mg in am and 5 in pm. Twice we’ve reduced pred to this and both times, evidence of bleeding happened. Tonight when I for home from work, I noticed a bleed in her mouth. The right side of what looked like her tongue was bleeding significantly. I tried to pack it with gauze and apply pressure to no avail so I loaded her in the car and drove 45 min again …one of many drives we’ve made over the past 3 months. After sedating her. the ER Dr found a small laceration near her 1st re molar. She packed the area and cauterized as best she could and stopped the bleeding. I asked if … Channing’s platelets are “normal” Tonight, why didn’t the wound stop bleeding. the Dr wasn’t sure and felt Channing would be ok to take home. Channing is a hound and the pred is making her drive for food nearly uncontrollable. I have to watch her constantly on walks as she will dive for anything remotely edible. I’m exhausted. I hope I can get her to at least 10 years in age. she turns 6 this next February. wish me luck. Thank you. Fletcher looks like he would be a heart breaker. Aren’t they all? Cheers
Hi Terri,
I am sorry it’s been such a tough road with Channing these past few months. It sounds like you have a good partnership with the veterinary staff, and they are working hard to make sure your big girl remains stable. I hope with time your girl will be able to wean off of the prednisone without relapsing again. Praying for remission and a bright future for the both of you. Best wishes. ♥
We’re back. Dr Buzby. after a good 6 week run of titrating off pred ( from 10mg am/10 pm to 10mg/am 5/pm), we relapsed Thanksgiving eve when I was in LA with family. I had gained enough courage to leave Channing with my awesome dog walker after detailed instructions on how to watch for any signs of bleeding or lethargy. Chan was doing great. she had a bleed after a morning walk. I keep white sheets on her bed and sofa so we can spot bleeds quickly. since I was in LA and Chan was home in San Francisco, I instructed my dog care giver to raise the pred to 10/10. Chan’s bleeds occur while she’s asleep presenting in blood tinged saliva so it looks alarming on a white sheet. I was super concerned being out of town but managed things while contacting her internist over the holiday. the raised pred has stopped the bleed again and I now am beginning to feel your beloved fletcher and Chan have something in common … maybe a life long pred life. this marks the 3rd attempt to lower her slowly and to no avail. I will never give up on my baby girl so if that is our fate, we will carry on. Thank you for responding. I wasn’t notified but would sure like to know when posts are available to read from you and other dog parents who need support. I really like your pursuit of giving us hope through all you’ve experienced. happy holidays from the city by the bay. Terri. Channing, and Mac
Dear Terri,
I am so sorry the prednisone weaning did not go well again. Poor Channing can’t catch a break! I am glad you have been able to entrust her care to your dog walker and resume some normal activities for the holidays. The white sheet over her bedding is a genius idea. Thank you for the update and I will continue to look forward to any comments you leave in the future! Wishing you all the best. ♥
greetings, Dr.
We’re still in the game. lots has happened. Today, Channing is completely off pred. it took a village but 5 months on pred, and weaning like my life depended on it, she’s finally off. still on Mycophenolate and pregabalin (seizure fix) … we ran into the dreaded calsinosis cutis … Channing can’t catch a break as you said earlier. that has been a 2 month battle. horrific sores on top of her neck, between her front 2 toes, and on her rear end which has been especially challenging to fight bacteria. We’re on the other side of that but now, a new challenge… (fyi I am alone with this fight for her life) … we were walking on the beach as she’s been feeling strong and her rowdy self which has made my heart melt. she chased her ball a couple times as I’ve been conservative with rebuilding her strength (.she’s 125 lb coonhound) … born to run. she suddenly stopped on the beach as we walking lifting her hind leg up. I thought she stepped on something so checked her paw. nothing. kept walking. same behavior. I took her to the suv and by that evening she could barely walk. I was sure she tore a ccl. er visit next morning and it appears she experienced a hyper flex event ( tarsal hyperextension). the surgeon tried lots if leg maneuvers so the trauma seems to be in both hind paws. after 2 days she seemed better. last night I walked her and she was frisky with another dog and after a couple hours she could barely walk again. I couldn’t believe the extent of this injury that literally happened out of the blue. rest is the program. she developed trmors on tramadol so no go. we lost ground from last Sunday after last night’s friskiness so now we pay the price. she’s 6 and giant so m not going the surgical route. Shea been thru so much these past 6 months … I can’t now put her thru major surgery and recovery its just too much to ask of her so I’m going the holistic route of icing as tonight there is swelling on one paw, confinement, tlc and I ordered bracing to support her ankles below ans above the hock. they bear so much weight so I thought it I wouldn’t hurt. her internist said today while doing a recheck on blood for itp to lock in remission confirmation, let’s.give her a break and not put her thru surgery. shes nearing weight on both legs with some visable lameness for sure. at least she can still walk. thoughts?
thank you for hanging with us. Terri and Channing
Hi Terri,
Goodness, what a whirlwind! Bless you for staying strong and continuing to advocate for Channing’s health and wellbeing. I am sorry these new mobility issues have popped up, but so glad to hear the prednisone has been discontinued. That’s a HUGE WIN!!! I agree with your vet, your big girl has been through so much. A holistic approach to her injury/pain seems better than surgery for now. There are several ways to help decrease pain and inflammation without the use of “drugs”. Here is a link to an article with more information: Natural Pain Relief for Dogs: 13 Methods
You may also want to think about discussing Channing’s case with a veterinary rehabilitation professional. They may have additional ideas about therapies or treatments to try. I am still hopeful that your sweet girl can live a long a happy life. I am pulling for her every step of the way. Thank you for this update and please keep in touch!
I found this article very helpful! My 7 yr old terrier mix was diagnosed with primary ITP in June of 2020. He was prescribed Prednisone, and after 6 months of treatment he was in full remission. He has stopped all medication and has not relapsed since. He is going to be due for his updated rabies vaccine soon. Our vet said it was up to us if we decide to get it. What do you recommend? We know the rabies vaccine didn’t trigger it, but will he relapse if he gets it? I’m in CA, and I honestly don’t even know how to excuse him from the vaccine.
Hi Samantha,
I understand your concern with this tricky situation you are facing with your pup. While I am glad he was able to achieve remission, the thought of having to vaccinate him again makes me uneasy. Rabies is required by law, and I am not aware of any instances that an exemption has been made. With that being said, your vet is correct that the decision is ultimately yours. This might be a good topic to discuss with an internal medicine specialist. They probably have experience navigating this exact path with other dogs and could have ideas of ways to help prevent a reaction. I hope you can find the best way to keep your sweet boy safe and living his best life. Praying for a positive outcome!
My Morkie was diagnosed with IMT in May and is slowly being tapered off her meds. She had a very bad case and had to have vincristine and iVIG. Her internal medicine doctor has recommended no vaccines and we have an exemption. So it is possible.
Hi Melissa,
Thank you so much for this reply! I am glad to know that some states are willing to grant exemptions. Hoping your little pup will continue to remain stable and be able to keep living life to its fullest. ♥
hello. Channing’s internist has written an exemption for any vaccines required and we’re in SF, CA. I haven’t researched if it could be contested but I’m sure not allowing any vacs to enter her body again. I feel it is possible with internal medicine recommendation. wishing you the best of luck. we’re still fighting this horrible disease. not giving up. Terri and
Channing
Hi Terri,
I am so glad you were able to get the internist to write Channing a vaccine exemption! I will keep you and your sweet girl in my thoughts and prayers. Please keep in touch from time to time! ♥
Its been a bit, Dr! Channing is still in the fight. We’ve been thru an ITP war and it is not.winning. However the effects of prednisone have literally blown Channing’s hind paws so they are completely flat due to soft tissue/tendons rupturing. Her toes … all of them are completely flat. We’re ok because she’s still alive, happy and even though her running days are over, she is living her best life. After so many trials getting her off prednisone, it is abundantly clear she is a life.long candidate at 20 mg / day. It is simply remarkable that when I begin to wean her off just 5 mg less, within 36 hours, she has a bleed from her gums while sleeping. That is how close I’ve dialed her in on dosage.. I’m sure her platelets are consistently low, ….ranging from 15-30,000 ?? the numbers swing dramatically I’ve noticed …
… after the dozens of blood tests taken, it’s a moving target so I just watch her like a hawk and together we are grateful for each day. she turned 6 February and if I can be lucky enough to get her to 10, that will be my luckiest day ever. She may just make it❤️ thanks for tracking along with our very special life journey, Dr. Hoping all is well on your own journey! Cheers, Terri
Hi Terri,
Thank you for the update on Channing! You are doing a great job at staying on top of her symptoms and finding the right dosage of prednisone. Hoping your sweet girl can keep on fighting and wishing her many happy years ahead. Keep up the good work and stay in touch!
Holly ended up having a minor case of pancreatitis. She’s on boiled chicken, Flaygl. Not sure if that could have caused her liver enzymes to go high
Hi Randy,
It definitely could. We will hope that is the case!
Her numbers went from 360 to 154 ALT. And 2600 to 1100 ALTP.
Hi Randy,
YAY! Will continue to keep you and Holly in my thoughts. Celebrating this small yet wonderful victory!
Hello,
I am in CA with an 11 year old black lab mix. In response to the above question, we have filled out paperwork with our Vet’s help that allows us to get a dog license from CA with no Rabies vaccine. Ask your Vet to provide you with this paperwork. Unfortunately it has to be filled out every year but it is worth it to avoid the vaccine.
This blog is so very helpful for us to see everyone’s stories and various off-label treatments. Buddy was 10 1/2 when he was diagnosed with ITP last November. We were lucky to have found this out after he became lethargic and an x-Ray showed rocks in his stomach (labs do eat anything!). Anyway, the rocks weren’t the issue but his blood tests showed us the ITP. He was in remission briefly and is now on 60 mg pred plus an immunosuppressant. We are lucky to have a great Vet and are hoping for the best. Our Buddy is such a lovely chill guy, he is very pliable and wonderful with all the people who are helping us through this medical challenge.
Hi Teresa,
I am glad Buddy is responding well to treatment and is loving life. I think it is great that the state of California will allow your vet to submit paperwork for Buddy to forgo his annual rabies vaccine. Thank you for sharing your experience. Wishing you and your sweet boy the best. Keep up the good work!
Julie,
Thank you. Unfortunately Buddy has not responded to 2 immunosuppressants and his liver levels are elevated. We are meeting with an internist to see what makes sense at this point. I don’t think we want him on any more immunosuppressants so we plan to ask what would happen if we take him off all medications and just let him enjoy the rest of his time on earth as the happy dog he as before we pumped him full of medication. What is the downside of allowing ITP to run its course, do we have to go straight to euthanasia? My friend is a human doctor and seems to think he would just pass quietly from an internal bleed. He isn’t super physical and doesn’t go to dog parks r really interact with other dogs.
So the risk of a broken bone or being hurt by another dog is slim.
Anyway, I’m glad you are here and would love to know your perspective.
Thank you
Teresa
Dear Teresa,
I am so sorry Buddy’s condition is deteriorating and you are facing some difficult decisions ahead. I am a bit concerned about just allowing the ITP to run its course. While a peaceful passing is a possibility, it is not common. You have to make the choice you are comfortable with, but I just want you to be fully informed. As a dog’s platelet count drops to zero, there are many possible symptoms you could see. These include bruising, bleeding from the nose, gums, eyes, or rectum, struggling to breathe, and seizures. This is not an exhaustive list but just the more common possibilities. It is possible to provide hospice care and still offer a humane euthanasia when the time comes. I always think it is better to say goodbye one day too early rather than one day too late and allow unnecessary suffering. I will attach links to other articles that have great information and good advice from other readers. I hope you can find the answers you need to choose the best path for everyone involved. Wishing you and Buddy comfort and peace. Bless you both. ♥
1. Using a Quality of Life Scale for Dogs
2. Dog Hospice Care Can Bring Peace and Dignity to Your Dog’s Final Days
3. Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
4. Dog Euthanasia: Knowing When to Say Goodbye
Dr Buzby,
I sent a response to this message yesterday but it may be in your box pending approval. Anyway, I will summarize here. Buddy is not doing well and is on a 3rd immunosuppresant. My husband really wants to remove all meds and let Buddy enjoy what few good days he may have left (he is 11 year old Black Lab). We have recently weaned him from 60 to 40 mg of pred and will work with our Vet to keep reducing it appropriately. My question is, what can happen with ITP if it is untreated and does the dog feel pain? We don’t want to put him down any earlier than needed and would like to be realistic about what can happen if he is un-medicated and what we should look for to know it is time. Thank you.
Hi Teresa,
I just finished typing a reply to your comment from Saturday. I hope it will offer some advice and the guidance you are looking for. Praying for you all to have the strength and courage to face this unknown path ahead. Give your sweet pup a hug for me. ♥
Just wanted to say that I found this article and story comforting, and wanted to add my voice to the many commenters. My dog, Ruth, was diagnosed with primary ITP Memorial Day Weekend 2022 (she’s 2 years old, born 4/14/2020). We’ve been on quite a journey and are still working with our vet team to find the right combination of medications for her and dealing with side effects (most notably significant GI issues). I know we have a long road ahead of us, but it’s comforting to know that we’re not alone (sometimes it feels that way), and also that it’s possible to live through this diagnosis. Ruth is my Fletcher, my sweet baby angel, my soul dog, and I hope we get so lucky as to have her as long as you got to have him! I agree with other commenters who have noted the importance of pet insurance. To anyone considering it, just do it, you never know what crazy things might happen and it’s so much better to have it when you need it! My heart goes out to all the pet parents still navigating this and any other medical issues, I empathize with you so deeply <3
Hi Amanda,
Thank you for sharing your experience with us! I am glad Ruth is still fighting and working her way to a better quality of life. I second your advice about pet insurance. It can literally be lifesaving. I hope Ruth can get into full remission and have many happy days ahead. Give your sweet girl a hug for me. ♥
I am located in Abany, NY. Currently in the midst of an ITP relapse in my 9 year old cocker spaniel. She is home and responding to the medications but I would really like to find a vet that specializes in such diseases. We do have a specialty vet in the area but they are more of an emergency practice. Do you happen to know of any vets within a couple hours drive any which way from upstate NY that specialize in pets with autoimmune disorders??
Hi Ashley,
I am not familiar with the Albany, NY area so forgive me if I am recommending options that are further away than what you are asking. I found a practice called Upstate Veterinary Specialties (www.uvsonline.com) located in Latham, NY. If this is too far of a drive, it says they also offer telemedicine consults. They have an internal medicine specialist on staff. Maybe they could be the resource you are looking for to help your senior girl through her current ITP relapse. I hope your Spaniel girl is feeling better and beginning to stabilize. Prayers for a positive outcome and a complete recovery.
Thank you for this article. It’s so enlightening to hear about Fletcher and how you gave him such a great life. My 6 year old Leon (mix breed) was diagnosed with ITP 2 years ago after I noticed his gums bleeding (he’s a fetch fanatic and the tennis balls started to show blood on them). He had a few day stay at a hospital with blood and vincristine treatments. After 2 days he came home. He has been on a couple of different regiments from prednisone (the constant) and a cyclosporine to now prednisone and azathioprine. The prednisone has caused muscle loss hair loss and a belly. He also has cushings. However, he’s happy and spoiled and living his best life. He gets liver and chicken broth made with high iron vegetables, and he takes some supplements. My vet is amazing and always willing to change gears. Hoping others here will read your story and be inspired as well.
Hi Beth,
Thank you for sharing your story with our readers. I am glad Leon has been doing so well since his diagnosis 2 years ago. What a blessing to still have your sweet boy by your side. It sounds like you have a great partnership with your vet. I hope others will find hope in your words and be able to better advocate for their beloved pups. Bless you and give Leon a hug for me!
Our sweet, five-year-old, Australian Shepherd succumbed to ITP one week ago today. The vet did everything possible to save her. We are numb from the loss of our dear Addison.
Dear Brent,
I am so sorry for your recent loss of Addison. My heart goes out to you as you work through your heartache and grief. May her memory be a blessing.
This article was wonderful!!
My husband and I rescued a dog in January of this year that we believe is a pit bull mix (some vets say she’s three some vets say 6, we just meet in the middle and say four or five)! Two days after getting her from the pound we found out she was heartworm positive! We went through treatment and are please to say she is officially heartworm negative! But! As soon as we thought we were out of the woods she should bruising on her stomach in July! We rushed her to an er clinic which then gave us the diagnosis of ITP.
We started with 2 1/2 prednisone then 1 1/2 now just 1 but just got the call that her platelets went from 193,000 to 93,000 this month after reducing dosage. When we first took her in she was at 5,000 platelets, so we aren’t as worried but still very disappointed! When your pup was going through this, what types of tests did you all go through to really ensure and rule out cancers and causes? What did it look like when his platelet count dropped when the dosage lowered? Have you come across many other heartworm survivors who also get ITP. I know you said it can be a trigger but would you consider it to be primary or secondary? Since she really won’t get into remission I just wonder if her system is still recovering from all she went through at the beginning of the year! We just aren’t sure how often to get this blood work done since she is losing platelets again. How often did you guys continue regular blood work since you continued his medication for the duration of his life?
We were so comforted by your story and the story of others here! This is our first dog and Willa’s life and our knowledge of itp is better because of Fletcher’s story 🙂
Hi Emily,
I am sorry your pup has had so many issues arise this year. She is a very luck dog to have found her way into your lives and have you advocating for her health and wellbeing. We reached out to Dr. Laura Garlow (author of this article) and asked her some of the specific questions you had pertaining to Fletcher’s case and disease management. Here is what she shared with me:
“As far as testing that Fletcher had:
– full labs including a path review on his CBC
– comprehensive vector panel including testing for babesia and bartonella
– chest radiographs
– abdominal ultrasound
His relapse looked similar with a platelet dip into the 60-80k range that we caught with preemptive monitoring CBC’s. We monitored his bw (specifically CBC’s) every 3-4 weeks after any medication adjustments and then once his disease was stable on his lifelong meds I still checked bloodwork (CBC/Chem/UA) every 3-4 months for the remainder of his life.”
Dr. Garlow also mentioned that because your dog came out of remission very early in the weaning process of reducing the prednisone, she seems to be “one of the more complicated varieties”. It might be a good idea to schedule a consult with a specialist and discuss the possibility of adding on an additional immunosuppressive medication. I hope your sweet girl can make a full recovery and get back to living her best life. Best wishes to you both and good luck!
I have a 4 year old cocker spaniel that was diagnosed with ITP on Tuesday, Aug. 23. I took him to emergency vet because his nose was bleeding. By Wednesday morning he developed anemia and was given a blood transfusion. Friday his platelets were still near zero and he continued to have anemia and gastrointestinal bleeding. They gave a second blood transfusion Friday evening. By Saturday he is now showing low BUN levels. They gave him a third transfusion and are going to try another with whole blood and platelet transfusion to buy time. He perks up with the blood so my 15 year old son and I are holding out hope for a miracle within the next 24 hours. The internal medicine doctors and the clinic have been very supportive, but I think we will have to say goodbye either Saturday afternoon or Sunday morning. Any advise or encouragement to continue or discontinue treatment would be welcomed. We visit him a couple of times a day and he calms down when we are there..
Dear Cheri,
My heart breaks for you and this tragic situation you are in with your young pup. I agree that if the transfusions can’t get your boy stabilized then saying goodbye may be the most loving option. How did things go over the weekend? It sounds like you have done everything in your power to give your dog the best chance possible to recover. Feel free to leave an update if you feel lead to do so. Praying for a miracle. ♥
Just got off the phone with our Vet. Baxter our 10 yr old TeddyBear was just diagnosed.
. I noticed his stools were black and tar-ish so we took him in. Yesterday his white count was 3,000. After one round of medication, it was zero this morning. They have checked him into the hospital to monitor him and see if a transfusion would help.
I don’t know what to tell our youngest. He is her dog…can we hold out any hope or does it sound too dire. I would appreciate any insight you can provide.
Dear Lori,
My heart goes out to you and this tragic situation you are in with your senior pup. I can only imagine how worried you must be and the emotions your daughter will deal with. Always hold on to hope. There is still a chance. I have seen dogs that shouldn’t have made it find a way to pull through. I hope the transfusion and medications will be able to get Baxter stabilized. Praying for healing for your sweet boy and comfort for your heart. Feel free to leave an update if you have a chance. ♥
Charlie made it. The third blood transfusion bought enough time for the prednisone and other drugs to work. We brought him home on Monday, August 30. He is doing well but has some weakness in his back legs and hips from the internal bleeding. The neurologist thinks it will get better with time. His survival was due to the efforts of the vets and staff at VCA hospital in Norwalk, CT. They didn’t give up.!
Hi Cheri,
YAY!!! This makes me so happy! I am so glad Charlie is still with you and has the possibility of making a full recovery. Thank you for sharing this amazing update and for the positive shoutout to the veterinary team of VCA in Norwalk, CT! Bless you and your sweet boy.
Hi there,
I am so glad Fletcher had a long and happy life despite his diagnosis. I have a 2 year old golden doodle who was diagnosed with IMTP about 6 months ago due to a secondary infection (believe a reaction to a medicine he was put on). We have been continuously going to the vet for CBCs and shifting of his medicines. We have yet to have any luck of truly stabilizing him which is very discouraging. But I am hopeful we will find his perfect medical concoction soon!
Hi Rachel,
I can only imagine how worried you must be for your doodle pup. It sounds like your vet is staying on top of things and you are working well together in hopes of getting your boy stabilized. Thank you for sharing your story with us. I pray you find the right combination of treatments soon and your sweet guy can get back to living his best life. Bless you both. ♥
Thank you for this article! I have a 10 year old female border collie mix who I believe has secondary itp (she ingested 800 mg of Rimadyl… I didn’t realize they were treat flavored and left the closed bottle in a bag she could get to and she chewed through the bottle to get them!) She has been on prednisone for 5 days, As of her blood draw on day 3 there were no improvements, so I’m praying that by her next blood draw we can see an improvement. Your article provided me with some great information to ask my vet about. Please pray for my dog Dallas with me… she is our Fletcher.
Hi Meghan,
I am so sorry you are dealing with this crazy situation with Dallas. I know you must be worried, but there is hope for this to resolve! I am glad you found the article helpful and appreciate you taking the time to share your story with me. Praying for Dallas to make a speedy and complete recovery. Bless you both. ♥
I have a 1 1/2 female Yorkshire terrier who was diagnosed with ITP 9 days ago. She was in the hospital for 3 days, had several transfusions with packed blood. was given vinochristine (sp?) we saw improvement, her platelets at one point were 0. She was discharged on day 4. She was home for 3 days and we noticed her gums were getting pale again, brought her back to the hospital where she has now been for 3 days, they changed out her oral steroid for a IV and given 2 whole blood transfusions. She has not had a increase in platelets. I feel I’m losing hope but I have read that it’s a waiting game and can take time. Only advice I can give to anyone is to get pet insurance, we are over $10,000 and still do not know if she is ever coming home with us. Hopefully we have better news tomorrow!
Dear Shelli,
My heart goes out to you with this difficult situation you are in with your little pup. I am glad she is receiving the best of care and being given every opportunity to turn things around. How is she doing today? I hope things have improved and she is making good progress with her platelets. Praying for a full recovery.
Thank you so much for this article. I have a 10 month old mix who was recently diagnosed with Primary ITP. He is about a month into treatment and doing well. Do you have any dietary recommendations?
He also has Cerebellar Hypoplasia.
Hi Meredith,
I am glad to hear your pup is doing well with the current ITP treatment your vet prescribed. I do not have any specific dietary recommendations as long as your dog is already eating a good quality well balanced diet. I am not sure what medications your dog is currently taking, but in my research, I found many articles with information about a melatonin supplement being extremely helpful for ITP treatment. If this is not part of your pup’s current treatment regimen, it might be a good idea to talk to your vet about possibly adding this to the mix. I hope your sweet boy will continue to respond favorably to his treatment. Praying for a complete recovery and many happy days ahead.
Thank you for the suggestion. My both my internal med vet and regular vet are very hesitant with any supplement so we have not added melatonin – do you have specific canine studies you can share?
I’m also wondering how dogs with ITP are being treated for allergies. My pups team steers clear of meds and supplements but he’s chewing his feet like crazy.
Hi Meredith,
While there is not a lot of information available about using melatonin in dogs with ITP, I do have a resource you can check out. Here is a link to an article we published back in October of last year. Read through the section titled “What conditions is melatonin used for in dogs?”. You will notice there is a number for the reference listed at the bottom of the article. Resource 1 has a link to the article where the info was obtained. I wish I had more advice on allergy treatment. But with all the risks of triggering an ITP relapse, I would defer to your internal medicine specialist.