Immune Mediated Thrombocytapenia (IMT)

The sun has risen and the morning coffee poured and now I do my daily check on Honey Bun’s belly to check for bruising. I give her tummy a pet and see the ever so familiar purplish bruising marks on her belly. I think to myself, “I must be seeing things” as I place my glasses on. Sure enough I see bruising on her lower belly. Has her IMT (Immune Mediated Thrombocytapenia) returned? I immediately called her vet and transported her to the animal hospital on an emergency basis. Honey was very scared and shaking. She was examined and blood work was done and if her blood platelet count was low, my suspicion would be correct. Immune Mediated Thrombocytapenia has returned.

IMT is a blood platelet autoimmune disorder where the body’s immune system is attacking and destroying blood platelets. Blood platelets are needed to form blood clots and to prevent bleeding in the body. The normal blood platelet count for a dog is (150,000 – 500,000). Honey’s platelet count was 17,000 and anything less than 30,000 is considered a severe case of IMT. Five and a half years prior Honey had her first bout with IMT and her platelet count was 11,000. Honey had a bad reaction to an antibiotic she had taken weeks prior which may have triggered the IMT. For the remainder of her life she would no longer receive vaccinations including rabies vaccinations, no antibiotics, no grooming at salons, no dog parks, no kennels and no socialization with other dogs. Her immune system was compromised and she was susceptible to future episodes of IMT.

During the second bout the emergency room vet felt a hard mass on her anal gland and it was highly suspicious of being a malignant tumor. This could have triggered the IMT the second time. A biopsy of the tumor would not take place because it may cause bleeding. Honey was placed into intensive care immediately.  IMT is treatable but also life threatening. The symptoms of IMT are:  purpura (red or purple spots on skin that resemble bruising), petechiae (pinpoint red spots on skin), pale gums, dark tarry stool indicative of blood in stool, blood in urine, nose bleed, gum bleed, vomiting blood, lethargy and weakness. IMT can be primary which is from genetics (cocker spaniels and poodles are susceptible) or secondary which can be from anything that triggers the immune system such as drug therapy including antibiotics, vaccinations including rabies vaccinations, infections, tick borne infections, heart worm infections and cancer. The exact cause is not known.

Honey was in critical condition and began receiving IV fluids and steroids. Vincristine (used to release platelets from cell into circulation – it is chemotherapy) was administered and blood transfusions to treat the anemia. IMT often results in anemia. Anemia is low red blood cell count while IMT is low platelet count and Evan’s Syndrome is a combination of low red blood cell and platelet counts.

On the third day of Honey being at the animal hospital, my phone rang after working a 14 hour overnight shift. The vet informed me that Honey began vomiting blood on an hourly basis and her sodium levels became elevated and she was concerned that Honey may cardiac arrest at any time.

On my way to the animal hospital I knew that I could not put this pup through any further suffering  Honey was brought to me all wrapped up in a Dallas Cowboys blanket and greeted me with her final little wiggle.  As she lay across my chest she snuggled her head into my neck and gently sighed. She was right where she should be as she would leave this lifetime and cross the Rainbow Bridge. I felt her heart beat so fast as she lay over my heart.  Our 2 hearts became one as the vet performed euthanasia. I felt her last heart beat and told her how much I loved her.

Editor’s Note: This article is dedicated to Honey Bun and all the other pups who have lost their battle with IMT. Share and raise awareness, please.

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