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Canine immune-mediated thrombocytopenia

02 June 2019
11 mins read
Volume 10 · Issue 5


Immune-mediated thrombocytopenia (IMT) is a common disease in dogs. Primary IMT is idiopathic, while secondary IMT can result from a variety of infectious agents or some treatments. Symptoms may include lethargy, anorexia and mild pyrexia, together with a low platelet count and associated bleeding disorders. Prognosis is generally positive, but reduced with presence of melena or raised blood urea nitrogen. Treatment will include some form of immunosuppressive therapy, such as prednisolone, which can have multiple side effects. Nursing the IMT patient will aim at monitoring and reducing spontaneous haemorrhage and managing treatment side effects. To ensure owner understanding and compliance, it is vital to discuss these side effects and any appropriate home adjustments so an achievable plan can be developed for home care.

The aim of this article is to provide an up to date overview of this disease and highlight key aspects of nursing care and owner support. Immune-mediated thrombocytopenia (IMT) is the most common cause of a low platelet count seen in dogs. Destruction of the platelets occurs when immunoglobulins attach to the platelet surface, causing macrophages to respond and initiate phagocytosis (Harvey, 2011). Primary IMT is idiopathic and only diagnosed after the exclusion of the causes of secondary IMT and other causes of thrombocytopenia, such as bone marrow disorders. Secondary IMT can result from an infectious agent, such as viral, bacterial or parasitic organisms, neoplasia or a drug-induced aetiology, such as the use of sulpha-based antibiotics (Cummings and Rizzo, 2017). Blood transfusion may also induce IMT (Day and Kohn, 2012).

This is a common disease and occurs more frequently in dogs than cats. Signalment is strongly associated with Primary IMT (Day and Kohn, 2012). Documented breed pre-dispositions include; Cocker Spaniels (Figure 1), Miniature and Toy Poodles, Golden Retrievers, German Shepherds and Old English Sheep Dogs. Females are twice more likely to be affected than males (O'Marra et al, 2011). Age of onset reported in the literature ranges from <1–14 years, however, the majority of cases are reported with a median age between 4–8.1 years (Lewis and Meyers, 1996; O'Marra et al, 2011; Day and Kohn, 2012).

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