IMTP in our English Springer

[crazylegs2012]

We're almost a year on now since first diagnosis so I feel like I can tell our story with a little bit of knowledge and confidence.  Polo is our eight year old ESS bitch, full of beans and the most amazing family pet, especially with our two very young daughters.

Polo was diagnosed with possible immune-mediated thrombocytopenia (IMTP) having been taken to the vets with a cut to her gum after an over indulgent half hour chewing a bone.  She was immediately tested for a whole suite of possible conditions and causes.  Her packed cell volume (PCV) was very low and within 12 hours of being admitted to the vets she had to receive her first blood transfusion.  That night I went to see her and found myself saying 'goodbye' to her as the vets didn't hold out much hope for her seeing the night through.

Never the less, in the morning she was still with us although she could barely get off her bed and was not eating a great deal.  Day two saw her needing a further blood transfusion when her PCV dropped towards 10.  By this time my wife and I had Googled IMTP so were fully aware that the prognosis was not good and we took the decision that the only way to get Polo (and us) through it was to take it one day at a time.  We'd also been made aware that the treatment wasn't cheap but by that point we'd told the vet that money should not be an obstacle.!

Day two passed and at 11pm that night we received a call from the vet to say her PCV was critically low and that she would need another transfusion to make it through the night.  Not much sleep was had that night as we waited for the call to tell us she had not rejected the transfused blood.  She made it through but it didn't take a genius to see that she was very unwell.

Day three was D-day.  Our vets referred Polo to the specialists at Vale Vets in Dursley as they explained there was nothing more they could do for her and that afternoon we drove her to their facility south of Gloucester.  We spent an hour with the vet at Vale discussing Polo's clinical history and talking about the options ahead.  Thankfully when we left, Polo's PCV was stable and the next morning we received the call to say she was okay but that her PCV had dropped again.  By now she was on every regular drug they could give her and still there was no change in her condition.

It was at this point that the vet advised us that they would not be able to give her another transfusion as it would clearly only be a temporary fix and would not resolve or reverse the trend.  The only way forward they could offer was a dose of vincristine, a chemotherapy drug.  We were told that when administered in this situation it can trigger the bone marrow to release immature platelets thus stopping the internal bleeding.  We were also told that if they couldn't find a vein to inject the vincristine, because they kept collapsing, then we would have to let her go.  The discussion was even had with the vet about how they would put her down and could we be with her.

To give you an idea of what Polo was like by this point, she was being hand fed her food because she didn't have the energy to eat herself, her eyes were severely blood shot, her skin was covered with blotches and she had blood pooling in her stomach.  I don't recall the figure the vet gave us but I think it was something like only 40% of dogs in Polo's state react positively to vincristine and make a recovery.  Never the less we went for it.  That night, after she had received the treatment, I sat with her on her bed in her kennel at the vets and, having cried far too much for a grown man, told her that she had to be strong and it was down to her to make it through. 48 hours later they let us bring her home...!!

It's been a very very long road to recovery but right now, 11 months on she is free from all medication and as fit and active as she was when she was 18 months old.!!  For weeks she was on a whole raft of tablets and only a few months ago did she finally come off Prednisone.

I'm not entirely sure why I chose to share our story, other than I guess to let people know that there is hope and that it's not always an unhappy ending. 

I don't know if I have posted this in the right section but I hope it helps.  It's certainly helped me, quite cathartic in fact.

Thanks

JP

[Penel CIMDA moderator]

Hi JP,
It's wonderful that you've posted, really really helpful for other folk whose dogs may just have been diagnosed with IMTP.  It's surely a very tough journey and those of us who have been through similar critical times with our dogs know how upsetting and emotional it is. 
I am so pleased that Polo is getting on well, and I am keeping my fingers crossed that she never relapses.  Obviously now that you know her history you'd be on it like a shot.
Thanks again for sharing.

[Jo CIMDA]

Hi JP

I'm so glad you shared Polo's story and of course it did you good too.  It is a wonderful success story and it clearly illustrates how desperate situations can be overcome and this is the message we want to get over to people who are dealing with these terrible times.  I can't stress enough how much good veterinary care is essential to the outcome.

Thank you for sharing, and I hope this posting is in the right section so it can be there for all to see  - perhaps Penel can check this.

Best wishes to Polo.

Jo

[debsy]

What a great story, something that will help people along, so glad all is OK x

[Barb]

Hi JP

I just read your story and it was so similar to ours. I have never cried as I cried for my dog in the week she was in ICU with IMTP. Thanks for sharing your happy ending.

Barbara

[DW]

I Too have only just come across this story and wow, what a lucky dog.....lucky that he has such persistent Owners, as I know that so many would have called it a day and this just proves a point.
In a strange way, it has helped me a little as well at the moment, as my spirits are rock bottom at the moment and even as I am typing this, I am in tears......frustration, worry, disappointment......
Our is different.  Harley also has IMTP and we were lucky, because at the start he responded immediately to the I.S. dose of steroids he was put on.  His platelets went from 30 to 300 odd almost immediately and that first treatment cycle did continue to go well but then he started to relapse again and was once again returned to a higher dose of Preds, which again, he responded to - only for the same thing to happen when we tried to lower.
I don't want to go over the whole story (it's all on file anyway) but we were referred to a brilliant Vet who restored confidence, along with Jo and others on this Group.   However, we ere not meant to have an easy ride and four plus years on, we are still fighting.    We thought we had hit the jackpot at the start of the year, as the new drug we were using seemed to hold his platelets better than we had seen before, allowing us eventually to wean him off the Preds completely.   Sadly, in December he relapsed again.  It was clear that this 'new' drug couldn't hold him on it's own.  We are now on the 3rd attempt and he has had to go back on steroids and we are currently trying to lower them as soon as is safely possible, as this time he seems not to be tolerating the side effects as well as he has in the past.
This time, it has been especially scary, as the Vet is worried about the feel of his tummy and wants to do a scan to rule out masses. I have had to decide whether to let the scan be done but after some really hard thoughts, I have decided to postpone it at the moment, as I feel the more pressing ad immediate issue is trying to regulate the platelets again.   Also, it is widely thought that the Preds may be the cause of these worries, and that it is his Liver that is swollen (due to the drugs).     I have never felt so unconfident and am constantly struggling with my motives for putting him through all this and all the drugs.   He is a lot quieter than he was but then, when it is time to go for a walk - he's there, ready.  He eats really well and apart from the fact that he rests a lot more, he seems fine in himself.  This, and this alone, makes me feel once again, that he is the one having to fight this hateful disease and as long as he has fight in him, then so must I.
I wish I could take this horrid disease away from him.....I'd give anything to see him well again.
None-the-less, I feel so thrilled when I read about all these success stories....it really is wonderful news.