Stem Cell Therapy

[Michala]

Petal has just relapsed with her second platelet issue. She has also had IMHA twice. We have followed the protocol and had success, (if you dont count relapses) but obviously with the detrimental issues that come with the treatment. The most recent ultrasound showed nodules on her liver and possibly something small in her spleen. The question i wanted to ask was do i consider stem cell therapy? Spleen removal? Liver Biopsy? Or just treat with drugs as per the protocol. She is 11.5 and i dont really want her to suffer, the initial IMHA was triggered by a spay op, hence the relunctance to operate, along with the clotting issue.

[Jo CIMDA]

Hi

I am sorry Petal is unwell again.  Can you think what might of 'triggered' this attack so you might be able to avoid the trigger in future?

The nodules on her liver may be nothing. They may just be benign cysts.  The most immediate problem is bringing  the AI disease into remission in order to stop the destruction of the platelets or red blood cells.  I presume she is on the correct dogs of immunosuppressive drugs and a good regimen.    If Petal were my dog I would avoid a liver biopsy, especially as she has a platelet problem, because the liver is an organ that can bleed profusely. 

I honestly don't know if there is currently stem cell therapy available for this sort of problem in dogs.  Some years ago I looked into it and emails someone who was doing stem cell therapy in humans and they said it wasn't available for animals - but perhaps thing have moved on since then.

As she has been successfully treated before then I don't see why this round of treatment won't be successful.  Make sure she is on something to protect her stomach from the drugs.  A very good drug, used  in the early stages of IMTP and if the platelets aren't responding to immunosuppressive treatment is Vincristine.  This is given  as a one off injection to boost platelet production.

I have known several dogs who continually relapsed with regenerative anaemia to have spleen removal and it usually works very well.  So if there is evidence that the destruction is going on in the spleen then this might be an option.  I hope the current treatment will do the trick and further 'invasive' treatment won't be necessary.

Jo