Immune-mediated Thrombocytopenia in Dogs (ITP)

Hey guys, this is Dr. Lara here today. I'm here with Maddie. Maddie is a five year old golden doodle. And Maddie came in to me on Tuesday because, not that it really matters to you guys, but she came in to me about two days ago, two or three days ago, because when she was at the groomer, the groomer noticed that she had some bruises on the inside of her belly. And so, Abraham, if you come over here, you'll be able to see bruising right here. Here. These are all bruises. And this, this is bruises over here as well. You can see. And so this is something that's very abnormal for Maddie. Sometimes dogs will have markings like that. But that's something that makes us really suspicious for something called immune mediated thrombocytopenia. I'm going to call it ITP because that's a mouthful. But and what that is is the body. A lot of times there's a short circuit in the immune system where the body all of a sudden starts attacking, starts attacking the platelets. Now the platelets are a part of the system that helps to form clots. So when you hit yourself and you form a bruise, that's because you broke some blood vessels and the blood started oozing out. But then the body goes ahead and creates clots. Maddie, she created these bruises because just. Because. Because there was nothing to stop. Even just slight pressure where it caused damage to blood vessels, caused her to start bruising and the blood starting to ooze out. Now this is something that can be very, very dangerous because the dogs could eventually just start bleeding spontaneously and they could die from this. And so what we normally do with patients like this is we did blood work to see where her platelet count was at. Her platelet count, which normally should be around 125 to 150,000, was at a whopping zero, according to our machine. So it was very, very low. And the other thing that we did was we went ahead and we did some X rays on her to see if we were able to identify any sort of tumor or cancer in her chest or her abdomen. And also any pieces of metal or anything like that that could potentially be causing this. Now we went ahead, we started her on some steroids, and the purpose of that is to go ahead and suppress the immune system so that way she's less likely to have an overreaction. Now, this can take time and it can take days. So we went ahead and rechecked her values today and everything is still pretty low. Now she's registering 8,000. We're going to go ahead and send out her blood to the laboratory and they're going to do what's called a manual count where somebody's going to look under the microscope and actually count every single platelet to get an idea of how many she actually has circulating through her bloodstream. The other thing that we did today was we did an ultrasound that went ahead and confirmed for the most part that there isn't any evidence of cancer and that we are most likely dealing with a short circuit in the immune system. The other thing that could potentially cause this would be some sort of what we call a tick borne disease. Tick borne diseases are infections that are transmitted by the ticks whenever they bite. So it's kind of like if you guys think of something called West Nile virus or what's the name of that virus, Abraham? That was Zika virus. How mosquitoes transmit Zika virus? Well, ticks can transmit certain viruses just like that. And we went ahead and we sent a test out for that. And so the other thing that we started her on, the same day that we started her on the steroids was on doxycycline. Doxycycline is the antibiotic that treats the majority of the tick borne diseases. And so we treat as if we want to cover all our bases and then once we start seeing response, we go ahead and we start peeling treatments off. Now if we don't start seeing the response in her blood as quickly as we would like, there is a possibility that we may have to add on a secondary immunosuppressive drug. And there's a list of those. Whether it's atopica, whether it's zithromycin, whether it's mycophenolate. These are just some different drugs that we use to go ahead and help suppress the immune system to a degree where it no longer endangers matter. If you got most of these dogs actually have a very good prognosis of surviving, some of them will have to stay on the medication for life. Some of them will come off the medication and only need to be on it for a few months. So it's not something that we're going to stop the medication immediately. It's something that we will go ahead and slowly but surely discontinue the medication because we want to make sure that as we drop the dosages that we will go ahead and test her blood to see if the values are starting to drop again. And that's absolutely what we don't want. If you guys found this video helpful, give us a thumbs up. Subscribe Share and if you guys have any comments about this, I know that this is something that, you know, there's a lot of questions. This is one of our longer videos. Leave it in the comment box. I'm more than happy to help. And please just have a little bit of patience with us. You know, the business is getting busier, we're getting more people engaged on the YouTube channel, so we're starting to get a lot more parts questions and it's taking us a little bit longer now to respond. So don't think that we're ignoring you guys. We're just trying to go ahead and try and take care of everyone as quickly as possible. Please be safe and take care of yourself. Thanks so much for watching and have a great day.