CIMDA

Just a follow-up...  it's end of December 2015, and Sadie just had her first relapse.  What is particularly scary is how QUICKLY it happened.  She had just gotten blood work taken about a month ago, and had normal blood platelet levels.  Then this week, when I took her to the groomers, they noticed she had some spotting in her ear and thought it was an allergy.  I then noticed a little on her stomach.  Had she not had previously diagnosed with immune mediated thrombocytopedia, I would have dismissed it.  However, given her history, I immediately took her to the vet and found out her platelets were at 8K (normally should be 200K).  Although they put her on prednisone as a precaution even before bloodwork came back, she started to get bruising the first day on her stomach and legs, despite little physical activity.  Fortunately, she responds quite well to prednisone, so vet and I are hopeful.  However, it's a cautionary tale that you  need to constantly check for bruising on your dog once diagnosed with immune mediated thrombocytopedia, as a relapse can occur quite quickly and can easily be mistaken for other problems. Even bloodwork done every few months might not be up to date.  What is also scary is that at least with my dog, there are no obvious symptoms that anything is wrong until the platelets are extremely low and I see bruising (i.e., she has normal appetite, weight, energy level).  This makes it impossible to catch it early.  I have her blood checked every six months, no longer have her vaccinated, and avoid lawn pesticides, and she still had a relapse.

Wanted to share my story for others who just found out their dog was diagnosed with immune mediated thrombocytopedia.  As you are probably doing, I immediately searched the internet for any information I could find.  I kept reading of worst case scenarios, despite the survival rate being 85-90%.  So I thought it would be helpful to hear of an experience on the other end.

My 8 yr old Havanese, Sadie, was diagnosed about three months ago with this disorder.  I had been noticing some slight bruising on her back a few months prior, but didn't really pay much attention to it as she had been rolling around on her back a lot recently.  The night before I was going to leave on vacation, Sadie started vomiting profusely.  What was particularly unusual about it was that it was several times throughout the night so it didn't seem due to something she ingested (in which case vomiting would have provided some relief).  While giving her a bath the next morning, I noticed very slight marks on her stomach and a pretty significant bruise below her chin.  Otherwise, she seemed in pretty good condition, with normal energy levels.   I went to the vet emergency room the next morning as a precaution.  They took her blood, and her platelet level was at 20K (normal is around 200K).  i believe around 20-30K is when you can start to get internal bleeding.  So they told me to cancel my vacation and they immediately put her on 10 mg of prednisone a day (she is 14 lbs).

As expected, the prednisone caused a lot of side effects - mostly excessive drinking of water/eating, lethargy, and somewhat of a change in personality (less affectionate).  Lots of peeing everywhere and anywhere in the house.  She typically sleeps on my bed, and she started sleeping on the floor, I think, because she didn't want to pee in the bed! 

The vet had me come back every 2 weeks to get her blood platelet count rechecked.  After the first week, her numbers were back to over 200K (i.e., within normal range) but her white blood cell count was elevated and she had developed a skin infection.  So they put her on antibiotics too and reduced the prednisone to 7.5 mb a day.  Apparently the higher white blood cell count is pretty typical of a dog fighting this disorder.  Since then, every 2 weeks they have reduced her prednisone.  She's currently at 2.5 mg every other day and seems back to normal.  Her platelet count is at the high end of normal and she's back to her old self several weeks after this started. 

The vet warned me that sometimes what appears to be canine immune mediated disorder is actually cancer.  However, given her rapid recovery, the vet didn't think that was likely here.

In terms of what triggered it, my guess is it was a combination of vaccines and lawn pesticides that people use.   About two months before the incident, she had been exposed to a bat and the CDC recommended she get a second rabies shot just to be sure.  I also take my dogs on long walks during the summer, and a lot of people use lawn pesticides.  I suspect the combination of both things was the trigger.

There are two other people at my work whose dogs are going through the same thing right now - these other two dogs are also around 8-9 years old but all different breeds.  All three dogs have survived, but some have had a lot worst side effects with both the disorder and reactions to the prednisone and have taken a lot longer to recover.  For instance, one dog went temporarily lame and had significant hair loss on prednisone, in addition to the earlier side effects I mentioned.

The whole incident has made me very cautious now about what shots they get as well as walking on other people's lawns. I intend to minimize her vaccinations from now on and will have to keep an eye out for a relapse. 

Not a fun thing to go through but do realize that many dogs do survive this disease with proper, timely treatment.  And be careful of vaccinations and environmental toxins!