What is immune mediated thrombocytopaenia and how do you treat it?

Immune mediated thrombocytopaenia (IMT) is a condition where there is a deficiency of thrombocytes (platelets) because the body’s immune response is attacking and destroying them. The disease can either be primary (have no identified cause) or secondary to something else (for example, certain types of infections, medicines, cancer, and even other immune mediated diseases). Platelets regulate bleeding. As such, the disease is suspected when unusual bruising, nosebleeds, or blood in the stool or urine is discovered. Internal bleeding can also occur and the dog is then often tired and may have a fever. The disease is more commonly seen in middle-aged bitches. Some breeds, such as English bulldogs, Toy Poodles and Cocker Spaniels, seem to be at higher risk for developing IMT. In order to treat the disease one must first identify and treat its cause. Diagnosing IMT thus requires a thorough work-up. If IMT is found to be primary, the treatment mainly consists of dampening down the immune system with medicines such as cortisone. The treatment is usually very long (around 6 months) and slowly tapered according to the response. Often daily visits are required to check blood values until the platelet count has gone up. It is not unusual that the dog is hospitalized during the beginning of the treatment. Sometimes anaemia accompanies IMT if it is severe, and in these cases a blood transfusion will be required. The prognosis is usually good. However, sometimes there is a poor response to treatment. Some dogs get a recurrence of IMT and these cases tend to have a poorer prognosis.