Dog needs medical intervention for immune-mediated disease

Facing a diagnosis of an autoimmune condition in their pet, the owners of a small dog ask veterinarian John de Jong for advice. Dr. de Jong explains that their dog likely has one of two conditions — immune mediated hemolytic anemia or idiopathic thrombocytopenic purpura/immune thrombocytopenia. He writes that in animals with such conditions, the body targets its own blood tissue, and he suggests following their veterinarian’s recommendations for treatment.

By Dr. John De Jong / Ask the Vet Sunday, November  4, 2012

Dear Dr. John,

My husband and I own an adorable 4A-year-old teacup poodle who suddenly started bleeding from the mouth and later had some bruising. The first vet who saw her thought she might have an oral infection and started her on antibiotics. Once she started to vomit some brown material, I called the emergency clinic and they advised me to bring her in right away in case she had gotten into some mouse poison. This made no sense to us since we do not have any near us. Our two cats do a good enough job of keeping the mice away.

The clinic ran some blood tests and found our little dog to be severely anemic but that she also had a very low platelet count. They told us that she had some kind of an autoimmune disease and started her on Prednisone, and some other medications to stop the vomiting, and Pepcid for her stomach. They also changed the type of antibiotic that we give her.

We just got news today that a second blood test done earlier in the day showed that she was more anemic with even lower platelets and that she needed a transfusion. What should we do? Can she survive all of this since she is such a tiny dog?

We were told that her chances were 50/50 and we want to do what is right if she has a chance. Thanks.       — M.S.

Dear M.S.:

The two conditions that come to mind are either immune mediated hemolytic anemia (IMHA) or idiopathic thrombocytopenic purpura/immune thrombocytopenia (ITP). Both are autoimmune conditions that have no known cause. ITP is more common in small female dogs. In these two conditions, the body attacks its own red blood cells or platelets destroying them and leading to bleeding and bruising conditions as you experienced with your little dog. The treatment of choice for both conditions is to initially give corticosteroids such as Prednisone, and if that does not help, then other immunosuppressants may be given. A transfusion is needed if the anemia becomes too profound and is meant to sustain the patient until the medications kick in. It is hard for me to suggest what you should do since I do not know what the values are in the blood work. However, I do think it is worth a try to proceed with the transfusion to buy some time for the medications to work and see if things can change. I have seen these kinds of cases go both well and badly, which gives credence to the 50/50 outlook that you were given. Size may not necessarily matter regarding outcome even though she is a tiny dog. Either way, I think you will have an outcome one way or another relatively soon. I wish you luck and hope she pulls through!

One Response to “Dog needs medical intervention for immune-mediated disease”

  1. Todd says:

    Well I would suggest going to a homeopathic vet for an opinion also. Our dog had a similar issue maybe 9 years ago. It occurred right after she had her vaccines. She had Hemolytic anemia. Had to have a blood transfusion. Thank you Pet Care pet insurance. We eventually went to a homeopathic vet to have the vaccines eliminated from the body. She is still with us today.
    That was our experience. Not fun but so glad she made it. Needless to say we never vaccinated again for anything.

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