dog with autoimmune disease
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IMT In Dogs: How My Dog Survived An Autoimmune Disease

IMT in dogs is a canine epidemic. My dog survived an autoimmune disease called IMT (immune-mediated thrombocytopenia). I learned as much as I could about IMT, and I decided to journal my dog’s journey with this life-threatening disease. It is my hope that you will find comfort, information, and learn from our experience.

Don’t let anyone tell you IMT in dogs is a death sentence. Many dogs survive IMT, and we are one of the fortunate ones. In fact, some studies report nearly 90 percent of dogs survived IMT to discharge with 31 percent relapsing. My dog survived an autoimmune disorder because we acted fast, and his care was in the hands of a skilled internal medicine veterinarian and his team.

This blog post outlines my Cocker Spaniel’s battle with IMT day by day during hospitalization and on discharge. If you want the TL;DR version: He beat IMT and has not had a relapse in four years’ time. What follows is our dog’s comprehensive journey with IMT.

I’ll share other links to posts I’ve written on the topic. Our story has been documented in Dogster magazine and AKC Family Dog magazine. My first piece of advice: don’t panic. Learn all you can about this disease and help your dog fight it with every fiber of his being.

IMT in Dogs: My Cocker Spaniel’s Battle With Autoimmune Disease

Immune Mediated Thrombocytopenia: Day One

Saturday, October 7th, 2017

My dog is living a natural, more organic, less chemical life. He consumes a healthy diet, gets titer tested for vaccines, and he never gets any sort of chemical put onto his coat or skin.

On Saturday, October 7th, my wife and I packed up the car and headed out of town for a day of fun on the beach with the dog in New Jersey. Dexter p[ayed, ran, displayed tons of energy, ate snacks, and there were no signs of any problems.

Later that night, around 11:30 pm, I performed a flea and tick check on Dexter. I noticed he had some lumpy-looking reddish marks on his inner ear flap. I immediately checked his gums. They were normal in color and capillary refill time was good. However, he had some bleeding along the gum line, and in particular between two teeth on the right side rear portion of his mouth. I noticed splotchy red marks on the inside of his upper lip flaps, too.

My spouse and I rushed our dog to the emergency vet/hospital located about 10 minutes from our house.

He looked like this when we rushed him to the vet:

Sign of IMT in dogs with splotchy gums and bleeding in the mouth.

Panic and Autoimmune Disease Diagnosis

We met with the emergency vet on call and went through the gamut: Discussions, tests, and more. Dexter had a platelet count of zero. Yes, zero. None. His own body’s immune system attacked platelets as if they were a threat and thus, he was starting to bleed. The tentative diagnosis of IMT was made.

They did a chest x-ray and abdominal x-rays. Both normal. They do not do transfusions. We were told he would need to be hospitalized for 3 to 10 days and will be getting steroids and a chemotherapy drug to boost his platelets, among other things.

This came out of nowhere. All his other levels are fine. When I sat down to write this, Dexter was not anemic. When a dog is anemic in this situation, a diagnosis of IMHA (immune-mediated hemolytic anemia) is made. When IMT and IMHA are both present, the diagnosis of Evans Syndrome is made.

Immune Mediated Thrombocytopenia: Day Two: Morning Update

Sunday, October 8. 2017

We are told Dexter cannot be discharged until his platelets stabilize. They generally check platelets when they first see the dog and then not again for 48 to 72 hours.

We are told the reason for this testing pattern is because whether the platelets read zero or 7,000, low is low. A dog’s platelets should be in the 40,000 and up range and eventually over 200,000. Just as a side note, Dexter’s platelets at the end of June of this year were 459,000. They went to zero platelets that fast.

Dexter’s red blood cells are good and so far, with no signs of anemia. They are picking him for a small blood amount for in-house smears. I checked his gums while there and they looked good, but yes, they are bleeding. We are told that is to be expected. We are in the early stages of IMT.

No rectal or urinary blood. We were allowed to visit him twice today.

Dexter ate his food and some treats for me, wagged his tail, peed and pooped for us outside, and then we snuggled together on the exam room floor. I curled up with him and sobbed until my eyes felt like they may fall out, for an hour at least. I couldn’t help it. He had no idea. He fell asleep, and he definitely is feeling the effects of what they are giving him.

The vet explained her concerns and that Dexter requires close monitoring these next three to four days, which she calls critical. We have to be certain that there is no bleed into his brain or heart. He remains hospitalized where he belongs, given his condition.

He is receiving IV fluids, injectable prednisone, got one vincristine injection, doxycycline in case the IMT is tick-related. At this point, they don’t think it is. He receives Baytril for infection, melatonin, and Tresaderm for an ear infection.

The vet did a quick standing-up abdominal ultrasound of him today and that was normal. The more in-depth one will take place Tuesday with the internist. They are checking for internal bleeding. His vitals were normal.

They see at least one diagnosis a day of this dreaded disease. The internist is well versed in this. If we feel good about that, we will keep his care for this disease at that vet and then our regular vet for everything else. (spoiler alert: we are pleased with his care).

At some point, if none of this works, he can be transferred to a vet hospital for immunoglobulin infusions – but we do this first and see what helps.

This will need to be treated aggressively and with frequent blood work, so I prefer this hospital that is within 10 minutes of our home. They do both emergencies and hospital care plus have specialists on staff.

The vet also said she sees dogs come in with this diagnosis and they are so much sicker outwardly, but Dexter is still guarded.

Nothing unusual precipitated this crisis. Dexter had no recent vaccinations, nothing unusual, and chest x-ray and abdominal x-ray are normal. All of his bloodwork is normal except he had zero platelets. No tick-borne diseases based on SNAP 4DX Plus testing in the hospital. He’s been bright, alert, and responsive, has an appetite, and drinks water freely.

IMT Medications as of Day Two

  • Tresaderm for ear infection
  • Dexamethasone injectable steroid once daily
  • Baytril
  • Doxycycline in case tick mediated disease, but everything coming back negative on that end
  • Melatonin: Something to do with helping boost platelets
  • Omeprazole: Gastric care
  • Vincristine: One time shot
Cuddling with my sick dog who is in the hospital with IMT.

Immune Mediated Thrombocytopenia: Day Two: Afternoon Update

Dexter’s vitals are stable. His red cell count is stable. He can’t come home until his platelets are stable. Normal low-end is 200,000. They want him to have at least 40,000 before he is “out of the woods.”

As of this morning, he has a grand total of four (yes, only 4) platelets on his smear. It can take three to seven days before the effects of the medications they are giving him take effect.

There is so much that has happened in the course of 48 hours, that words fail me. Me, of all people: Failed by words. I have decided to arm myself with as much information as humanly possible and stop listening to the negativity and sad/bad stories.

Every dog is different. Every treatment plan is different. This is the one thing I have learned. I am really feeling like millions of shards of broken glass. We got permission to see Dex at noon today and feed him. He will be in the hospital for at least a week, maybe more. Let’s pray he shows improvement sooner and we can bring him home to recover once platelets are stable.

Of note, Dexter’s poop was black. We are told it is not internal bleeding, but rather, the blood he is swallowing from the gums bleeding. He has no internal bleeding and his urinary system is fine. Small victories. I’ll take each one.

Why Isn’t My Dog With IMT Getting a Blood Transfusion?

Our friends and loved ones keep asking the same question: Why is Dexter not receiving platelets? I wondered the same thing: Why isn’t my dog receiving a blood transfusion?!

I found this nugget on a reputable veterinary website called dvm360:

“Most dogs with primary ITP usually present with peripheral platelet counts less than 20,000, and often less than 10,000. Although these dogs are theoretically at risk for spontaneous bleeding, in truth this is rarely noted.

As mentioned above, petechiae or ecchymoses or epistaxis are not uncommon, but bleeding into the lungs, pleural space, or CNS (central nervous system) is very rare without concurrent trauma.

Routine transfusion of ITP dogs with ultralow platelet counts is not recommended for several reasons. First, the amount of blood that would be required to increase a patient’s peripheral platelet count is huge and unrealistic.

Second, transfused platelets are likely destroyed more rapidly than the patient’s own cells because, in addition to being targeted by the anti-platelet antibodies causing the ITP, they are also inherently more antigenic (we do not cross-match for platelet compatibility).

Finally, platelets have a relatively short half-life, and repeated transfusions would be necessary to maintain the peripheral platelet count above 20,000. Despite these limitations, transfusions are definitely indicated in those rare patients with ITP that present with or develop life-threatening hemorrhage. Whole blood or platelet-rich plasma is required in these cases.”

His care will remain local at the veterinary emergency and referral hospital unless he needs to be transferred elsewhere and/or if we feel his care is compromised or they aren’t able to best serve his needs. We have access to Philadelphia, New York, etc but they are several hours from us. I’d really like a local internal medicine vet to provide care, direction, med adjustments, and the frequent blood draws we faced once Dex is discharged. I will know more by Tuesday evening to that end.

Immune Mediated Thrombocytopenia: Day Three

Monday, October 9, 2017

Specialized tick-borne disease testing was sent out (blood) and that will be back in a week. The in-house tick-borne disease testing was negative. More waiting.

Dexter’s platelets have not changed, still a total of 4. His red blood cells are low normal at around 35 (41 on admit) but he is not destroying red blood cells: He is on IV and the red cell slight drop is probably from loss and not destruction. So that’s good news.

The vet called his gums “rosy pink.” The petechiae (splotches) are still there but not as prominent. I did not see heavy bleeding in or on his gums.

They are testing his blood on a smear twice a day, but they may do a full draw tomorrow with the IDEXX machine in-house.

He will see an internal medicine specialist at some point tomorrow, Tuesday, whose protocol for treatment that Dex is on was designed specifically for dogs like Dexter with IMT.

No transfusions yet of anything but time will tell. Again, it takes 3-7 days to see any sort of platelet increase. My mind is racing, my prayers are many, and our friends support us emotionally.

His vitals are good. Dexter’s regular vet said this is a great protocol, stay with it, and he manages a lot of patients with ITP. We plan to go back tonight at 9 PM to visit.

So things are steady, and the one thing the vet said today is she is surprised that he does not have petechiae on his abdomen or on his skin elsewhere. The fact he doesn’t is good.

Our vet said acting fast saved Dexter’s life. The internal medicine vet agrees. Here is a photo from today’s visit and the critical care vet talking to us while Dex just chills. He is disoriented a bit and I know he wants out. He has to get these platelets up.

Immune Mediated Thrombocytopenia: Day Four: Morning Update

Tuesday, October 10, 2017

The hospital called and I talked to a vet tech. The internist wants to see me at 11:30 to go over everything. She says Dex is stable but that the doctor would talk to me in person. She wouldn’t answer any questions and I understand. So yes, my heart is in my throat. In the meantime….

I have a theory. Cockers have long floppy ears and are notorious for ear infections. Dex only had one ear infection in his entire life.

So Dex had this junky stuff for weeks in his ear. I worried about a brewing ear infection. Dexter’s e his right ear canal is super narrow, and the vet told us that and recommended curettage to open the canal more at some point. Dex always gets things on the right side of his body it seems. I digress.

In any case, I was flushing his ears with a veterinarian-prescribed cleansing solution twice a week for weeks.

The vet looked in Dexter’s ear on September 22 and said it was waxy but saw no signs of infection. At that time, he didn’t examine the wax under a microscope to specifically see if there were any bacteria or yeast.

Fast forward to Saturday morning, October 7th. I looked at Dexter’s ear before we left for the beach and it looked disgusting, so I started him on an ear antibiotic. I now believe that was dried blood and wax coming out. It was gross. I was going to call his vet Monday.

I felt comfortable at the time because I had an ear antibiotic to use. I thought the red bumps on I saw on his ear flap that morning were bug bites or infection-related. It was petechiae I have since learned from IMT.

I wrote to the famed veterinarian, Dr. Jean Dodds, and paid $150 for an email consultation. She got back to me today. She gave me some recommendations I will discuss with the internist today but also said that stress or infection can cause IMT in dogs. So I went looking for more on that note. A bell went off. This bell may mean nothing, but it’s the first bell that went off since this nightmare began.

Again, remember one cause of IMT is a bacterial infection. This is what petMD says on that topic, “Otitis media refers to an inflammation of the dog’s middle ear, while otitis interna refers to an inflammation of the inner ear, both of which are commonly caused by BACTERIAL infection.”

Now, are any bells going off? Was this brewing from the ear infection? And yes, Dex is on Tresaderm for ear infection and I think they are doing in both ears, even though one is only affected, and he is on oral antibiotics.

This could be something or nothing, I don’t know. But I know that he had this before the beach now.

Immune Mediated Thrombocytopenia: Day Four: Afternoon Update

Tuesday, October 10, 2017

I met with the internal medicine doctor at the veterinary hospital today. They brought Dexter to be with me, I fed him, walked him, and then we hung out together for a while before the internist came in. Let’s have a drumroll because….

Platelets today are 98,000 and his platelet count is on the way up. They were zero on intake. 98,000!!!!!!!!!!!!! See my jumping up and down?!

This second and complete abdominal ultrasound today was normal. I fed him and he drank a lot of water, a known side effect of steroids. He is on an IV fluids line. He peed and pooped, and this time the poop was a nice brown color. Hallelujah.

The internist had me review what brought Dexter to this point.

The doctor says Dexter responded very quickly. Many dogs don’t, and he said we are very lucky. He has had dogs in the hospital for 2 weeks and 8 blood transfusions in-house, not a Cocker. He treats a lot of dogs for this. He said this could be way worse.

In most cases, dogs present because a groomer or pet parent sees a change. Those changes include bruising, bloody nose or ears, bloody gums, or bloody diarrhea because the dog is bleeding from his intestinal tract. Basically, anywhere the body can bleed from minimal trauma is where they are going to start bruising.

Belly, ears, gums most likely parts to bleed. Dex had bleeding from the ear and gums.

What causes it? Most of the time we never find out.

Anything can do it, including an ear infection.

Anything that stimulates a dog’s immune system can cause this. Even stress. We eventually do find out, so stay tuned.

The typical culprits are tick-borne diseases, so the vet added more things on the blood panel which was sent to an outside lab. He said IMT can be caused by any number of things, including a urinary tract infection, antibiotics such as sulfa drugs, and even vaccines.

Dogs can respond rapidly, which so far Dexter has done. Vincristine is the chemo drug and Dex had one shot of that. Some dogs he has seen have had to get two doses.

Steroids: Doxycycline and other immunosuppressants depending on how the dog responds.

He has responded better than most dogs. That is a direct quote and my favorite quote of the day!

The last dog he saw for this became anemic he bled so much. Would not stop. Another dog required lots of transfusions – he was bleeding into the intestinal tract. Dexter had no outward signs but that.

Dexter’s blood panel: On the 8th all was good, the alk phos was a little high but that was up since he was two years old. Vet says that’s weird but maybe a liver biopsy down the road to know what’s that about if we want. (Spoiler alert: We never had a biopsy and everything remained fine with that level).

He asked me what meds Dex was on at the time, including supplements. He advised me to stop giving Dex all those meds and supplements. They could be a culprit! Unlikely but possible. At this point, my head is spinning but I remain hopeful. He says to try another drug, so another form of glucosamine, for example.

Heartworm preventative – don’t use that one again. Try another one. Don’t give anything. It’s unlikely but it’s possible. No fish oil. Stop anything for now.

Most of the time we will never know what caused this.

We can treat this and it can come back, it can happen again. He teated one dog who had an IMT flare-up every time he got a urinary tract infection. His platelets would go down every time. I will be finding out about things like immune strengtheners and milk thistle. But I can’t add anything in that could make his tender immune system tank again.

He says this is like when we get the flu vaccine…it stimulates the immune system and you may get a fever. The vaccine stimulates the immune system and the immune system does things it is not supposed to do. Other pathways get stimulated and they start doing things like killing the platelets or kill red blood cells.

If cancer were causing this, usually the dog is very sick. Dex is not and has no evidence of cancer on scans and xrays (bone marrow cancer, leukemia); it’s rare he finds cancer.

He looked up Dexter’s blood panels to date: He has responded quickly and he doesn’t see that happening dogs very often. Not that fast. Dexter is a warrior!

His red blood cells are a little low and that is okay. His white cell count is high and that is because his body is responding to the low platelets and saying “hey I have no platelets, the bone marrow needs to be active” so they start shooting out white cells at the same time.

His red cell count is 29.9, and when Dex came in it was 47. It has come down quite a bit. He says when dogs have the immune-mediated disease to one cell line, it can also go to the other.

He says IMHA can happen. I told him I don’t want to hear it. I really did say that.

He says IMHA has a similar treatment and can’t really separate it sometimes. He says Dex has not bled enough through his gums for his red blood cells to have gone so low. So it could be IMHA. He would not be surprised. It will be watched. He is just seeing Dex for the first time today so he said we will monitor this. So now, the platelets need to keep rising and the red blood cells need to stay steady and not drop!

For IMHA, if that is what it ends up as, and with IMT that is called Evans syndrome. We aren’t going there yet. You give vitamins, iron, and a couple of other things. He would handle it. Right now he is adding B12 and folic acid to Dexter’s regimen.

He has to be on steroids and if he becomes too anemic, they have to transfuse him and he is not at that point.

The meds are making him tired and they are watching his red cell count close. He is sending out a blood smear to a lab so they can look under a microscope and he will look to see if evidence of IMHA is there.

In terms of discharge, if his platelets keeping rising and he wants his red cell count to be stable and not dropping. If he gets to 15, they are going to transfuse him with whole blood.

When the critical care doctor saw Dex over the weekend and Monday, she felt the red cell count was dropping from loss and not from destruction, so I am hanging onto that.

The internist will be in the rest of the week every day and will see Dexter. I will go back tonight at around 9 pm to feed him and see him.

Oh and while there, he had a sneezing fit. He sneezed like 20 times. Not sure what that was about.

I firmly believe the power of prayer and love is working. Whatever this is, we have to manage it. He said it will be a roller coaster, he can end up with more episodes and anything can trigger it. We have to be diligent and have blood draws and watch him. We shall.

In all honestly, it is you, the ones who care and are praying and sending love who are watching him. Thank you a million times over.

Oh and on the way out, I stopped at the reception area to tell them I’d be back later. The gal says to me, “I see Sexy Dexy is back.” I started laughing; she loved him and remembered him from the ACL leg surgeries performed at the same hospital years earlier. She shared that this is a roller coaster of a disease but can be handled. I needed that.

And Then This News Comes Crashing Down

I received a note from Dr. Laurie Coger who asked, “Is he autoagglutinating?”

Auto what?

You can see the red cells clumping together, she explained, with the naked eye. Here’s a pic of a slide agglutination test — see how the red cells look grainy and clumped:

IMT in dogs is a canine epidemic. My dog survived an autoimmune disease called IMT (immune-mediated thrombocytopenia).

Dr. Coger says treatment is very similar for both IMHA and IMT. She suspects the drop in Dexter’s red blood count is fluids and some blood loss. Plus, he’s shifted to making platelets and WBC — his body can only churn out so many. The pathologist’s review of the slides will be a good way to see what cells he’s making.

Immune Mediated Thrombocytopenia: Day Four: Afternoon Update

Wednesday, October 11, 2017

Dexter is discharged today.

His platelets at 6 am came in at 197,000! He was at zero on admission. We spoke with the Internist on discharge today. He said that Dexter was doing great. He was sent home with multiple medications.

One of them is melatonin, a nutriceutical, and he will keep him on it for a long time, even after this crisis has passed down the road. It helps platelet production. He is also taking the steroid, prednisolone; doxycycline, an antibiotic; and Baytril, an antibiotic in case he has something called Bartonella, for which the blood test is pending.

He is taking omeprazole, which acts to coat the stomach while Dex is on steroids. He is also sent home on Liqui-Tinic, which is a vitamin and iron supplement for mild anemia. His red cell count is in the low 30s, which is fine.

At some point, he had some blood (melena) in his stool while there. The steroid will make him eat, drink, and pant more. Not all dogs experience the symptoms, but many do. He can be lethargic from it.

Activity-wise, he is not allowed long walks or anything extreme for a while. He expects things to continue to improve. Back to his regular diet. He will be seen again on Friday the 13th (my favorite day and lucky number) with a CBC check, too.

Dexter came in with an ear infection and is going home on Tresaderm, which was used in the hospital.

I can continue teeth brushing. If he bleeds, I need to alert the internist. The diagnosis of IMT is confirmed.

Don't let anyone tell you IMT in dogs is a death sentence. Many dogs survive IMT, and we are one of the fortunate ones.

Immune Mediated Thrombocytopenia: Day Four: Evening Update

Wednesday, October 11, 2017

Dexter is home, where he belongs. He rested, buried his bone, ate a bit, is now having a treat. We have to give him a bunch of meds and my spouse made a chart. Our internist visit is Friday morning for a blood draw.

Dexter was discharged with platelets of around 197,000. Mild anemia but not IMHA. He has IMT. We found out he started bleeding internally on day two but we had him in the hospital so meds caught that. His poop was black. Thank Dog and God we got him to the hospital when we did.

I’m encouraging all of you to know what is normal in your dog, look now. Take photos. Pink gums. Earflaps. Eyes. Then if abnormal happens, you act. Know that any change in urine or bowel movements Should be checked. Don’t wait. Moments matter. Don’t judge someone else’s dog’s illness with your own dog’s issues. Every dog and every treatment plan is different. Trust your gut. Don’t wait. I share to help others and so you feel better prepared as a pet parent and questions to ask, things to watch for.

Log them into a journal like the Dogminder I created. It’s under $10 bucks on Amazon.

On another note, today is the day our first Cocker Spaniel, Brandy Noel, left this earth and crossed over the rainbow bridge on October 11, 2008. I do not think this is a coincidence And I truly feel she watched over her brother.

Immune Mediated Thrombocytopenia: Day Five

Thursday, October 11, 2017

Dexter is holding steady, had a good night, and has a long road ahead, but day by day. He sees the internal medicine specialist tomorrow.

We are waiting for some special blood tests to come back, too. Dex has bad gas and is not too thrilled to eat so I tried to put some plain cooked turkey atop his food. It worked! He ate lunch and then a treat.  His tracheal scarring cough has flared big time. I will talk to the internist about that tomorrow. I was up six times last night – just bolted up out of bed to check him and his gums, etc. He is on nine meds and several things a day.

Results of IMT Consultation: Dr. Jean Dodds

For a fee, Dr. Dodds would do an email consultation. I wrote to ask her a ton of things about IMT. She is the founder of Hemopet and one of the best veterinarians in the world for me and millions of others. I am excerpting a few items of interest in her reply to me:

Question: Any thoughts on reasons for ITP?

Answer:  Does he have bad gingivitis or dental disease? One of the most common causes of ITP is bacterial gingivitis and tartar – as platelets end up being mopped up as so-called “innocent bystanders” in the bacteria + cell-based immune response.   Recent stress?  Any physical, physiological, or emotional stress event can trigger an episode of ITP in genetically susceptible animals or breeds. Is he a parti-color or buff?

Question: What is a typical post-emergency protocol to treat this?

Answer: She gave me an extensive answer, agreed with the protocol, but she insists the vet runs a complete thyroid antibody profile. As a Cocker, she wants to be sure he doesn’t have underlying autoimmune thyroiditis or familial hypothyroidism.

Note: Dexter can’t have this tested right away because he is on steroids and that would affect the test results.

There is much more, but I highly recommend you look up Dr. Dodds for email consultation. She is located in California.

Immune Mediated Thrombocytopenia: Day Six

Friday, October 13, 2017

Dexter saw the Internal Medicine veterinarian today who is handling his case. More blood tests came back and we are waiting on a few more. He also had a blood draw today. Here is where things stand: 

The diagnosis is definitely IMT: Immune-mediated thrombocytopenia with mild anemia. He does NOT have IMHA. YAY! His platelets today are 539,000!!!!! (He was at zero six days ago, friends.)
A blood panel came back from an outside lab, testing for specific tick-borne levels in his blood.

While his in-office SNAP 4Dx Plus Test that screens for six vector-borne diseases came back negative, he had outside lab serology studies. POSITIVE for A. phagocytophilum (E. equi). WHATTTTT?!

“Anaplasmosis in dogs is caused by the bacteria Anaplasma phagocytophilum. It used to be known as Ehrlichia equi and Ehrlichia phagocytophilia. The more complete name for the disease is “canine granulocytic anaplasmosis.” It commonly affects the platelets in the blood, which are small cellular components found in the blood which help clots to form. Anaplasmosis causes thrombocytopenia, which is a lower than a normal number of platelets in the blood.”

Dexter's IMT blood panel sent to a labratory

Dexter has immune-mediated thrombocytopenia which is likely tick-borne. A tick caused ALL of this! Thankfully, Dexter is being treated with doxycycline that was started last week in the hospital on admission. The vet says it can rear its ugly head after sitting in the bone marrow.

Today Dexter also received an injection of Imizol and will get another in two to four weeks to treat this. The only way to know if a tick caused Dexter’s IMT is to re-infect the dog, and no, that is not happening. The internist explained that would be the only way to be absolutely certain of the cause.

Other things could be contributing to this, even his ear infection that he had on admission to the hospital. That is only the second ear infection he ever had in his life.

The Internist tells me that they see IMT rear its ugly head with the change of seasons and have no idea why.

Of all the cases the Internist sees at a very busy veterinary hospital in one week, half of his patients are diagnosed MT or IMHA or both. Paying attention to your dog’s normal so that you can act on abnormal is crucial.

Nothing you can do to prevent it but just be an aware pet parent. Trust me, we are aware.

Dex lost one pound over the past week, which is okay.

I will continue to use what we use on Dexter from a flea and tick perspective, as there is nothing that is 100% preventative. I will screen him more closely with a flea and tick comb. I will not use toxic chemicals, as they harmed our last Cocker Spaniel. Extra due diligence will be our course of action.

Dexter has a cough and that is from tracheal scarring from his previous episode of kennel cough. When he pulls, gets excited, or drinks too fast it flares up. We will address that down the road.

He will be on steroids for months and slowly wean down. Plus a ton of other meds. My credit card is on fire, but he is well. We have vet insurance but I’d work 10 jobs for the dog if I had to. He goes back in a week for a blood draw and recheck, pending any unforeseen circumstances.

How My Dog Beat IMT

On Friday, October 13, I went live on Facebook with Dexter. Here’s what you need to know and how to watch for this and any other diseases in your dog: (click the video to watch and learn more)

My Dog’s Battle With IMT: Years Later Update

It’s been nearly four years since our dog was admitted to the hospital and nearly died from IMT. He is thriving and surviving and has not had a relapse. Here are several articles I’ve written that I highly recommend you read. We made some changes to his lifestyle and more.

One thing I highly recommend is to get your dog to a vet asap if there are any sudden changes like this. While I adore my dog’s veterinarian, I recommend your dog with IMT is seen and treated by a qualified internal medicine veterinarian. An experienced internist sees these cases all the time and knows what to do. He or she can consult with your dog’s regular vet.

If you don’t have a qualified veterinary internist in your area, drive to a veterinary university hospital and seek one out. It’s that important.

Finally, my dog’s littermate, Ricky, was diagnosed with IMHA several years later. He is a survivor and his mom still battles some related issues years later. He is alive. My dog’s nephew, Sonny, battled IMT as well. He was rushed to the same hospital and saw the same internist. He’s alive today as well.

Helpful Links About IMT In Dogs

Help for IMT: Immune-Mediated Thrombocytopenia in Dogs: The best post to read if you need more information about IMT in general.

Journey of a Dog with IMT: Four Years Later: Read to learn what we’ve done, how Dexter fared over the years, and get the most recent update.

IMT in dogs

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98 Comments

  1. Only you could deal with what you are going through with Dexter to inform others. It’s truly selfless. If it happened to me I wouldn’t be able to think of anything else except my dog. That’s why I’m praying (something I really don’t do) so hard for you and Dexter. Not to mention I have a Cocker also that I’ve learned so much from you on how to take care of. Thank you.

    1. Thanks so much. Sandra. I am emotionally drained and so much on the horizon this week. Your kind words mean so much.

      1. Your post is more helpful and encouraging than you can ever imagine! I’m going through the exact same thing. Healthy dog suddenly with 1 platelet. Didn’t respond to Prednisone, vincristine, now on melatonin and mofetil. She’s the joy of my life!! I’m so scared I want to cry! We live in Spain and this happened after a leishmania vaccine and a tick bite, but the exams are clear. (What?) It is so stressful! I just want my chubby girl to be normal again 🙁

        1. Show your vet the protocol my dog’s internal medicine specialist followed. It saved my dog’s life. It was likely from the tick and/or the vaccine and maybe both – a big hit to your dog’s immune system. Please keep us posted, and many hugs.

      2. Thank you so much for this diary. I just found out Saturday when we rushed to the ER about this illness. My dog is currently at platelet count of 0 and this waiting game is heart wrenching. I’m happy to hear Dex is doing well. Gives me hope.

    2. Keeping Dexter in my prayers. If he has living litter mates, have you made contact with the
      owners to see if there is any family history?

  2. While I didn’t comment there, I did see your Facebook posts and we have been thinking of you and your family, and praying for Dexter. I appreciate your writing this post, especially at a time when you must be totally consumed with worry. When reading something shared, I noticed Labrador retrievers were on the list of dogs prone to this, and since we have a Lab mix, I feel it is something I should stay aware of.
    I also read this could be caused by vaccines, but immediately knew that wouldn’t be the case here, since I know and admire the natural lifestyle you live. We try to do the same, and I only wish it could be a guarantee of health!
    It seems like a good sign that Dexter is feeling well outwardly, and we hope and pray that will continue to be the case, and he fights through this.

    1. God will heal Dexter, just keep fighting!

      Most traditional veterinarians believe that IMT is idiopathic meaning we don’t know why it’s going on in the body, however those of us in our veterinary comunity suspect that like most immune-mediated diseases, there is a trigger that prompts the immune system to become confused. What most of our veterinarians agree on is that the exact cause of IMT may not be identified, but we do know that IMT can be triggered or exacerbated by vaccines particularly leptospirosis and line vaccines as well as killed vaccines which contain very strong immune stimulating adjuvant like the rabies vaccine. Sometimes it’s a vaccine alone that trigger the immune system problem in a pet. But more often, it’s vaccines that are coupled with either medications or environmental toxin may be a poor quality diet or other lifestyle stressors. And while sometimes an adverse vaccine reaction is immediate more often times in animal immune systems react to accumulative effect which means vaccinations given over a period of months to years that add up to make the immune system become really confused. That’s why I strongly encourage pet owners to avoid all unnecessary vaccines and certainly revaccination.

      1. Hello Tiffany,

        Would you be interested in helping me with my dog who is being treated for this. Your comments about vaccines and other factors being the trigger hit home.. If you are a vet and would be interested in helping me and my dog. I can share what’s going on with him over the last 15 months.

        1. We are not veterinarians but I am a dedicated health and wellness dog writer/blogger with a wealth of knowledge to share.

  3. Oh Carol & Darlene,
    What an horrific weekend you’ve all had. Thank you for being so alert and acting quickly for Dexter – he is so lucky to have such wonderful & savvy parents. We are hoping that your quick action has minimised any trauma he may have experienced and he will quickly be much improved and home with you again.
    Sending strength & love,
    Annette & WeK, Betty & Finn

  4. We send Dexter tons of purrs and cross our paws for a quick recovery. You’re a Wigglebutt Warrior, Dexter, and so are your moms (except for the wiggle butt part maybe), let’s fight ! Purrs and hugs from Claire

  5. Alice and I are sending Dexter, Darlene and you healing thoughts, prayers, and hugs! Thank you for keeping us up to date and we hope he is able to come home soon!

  6. i am so sorry to hear abt Dexter. i pray that he will be okay. your blogs are so informative. thank you for sharing. please keep us updated. i checked the fb page and did not see anything.

  7. Praying for Decter and thanking you for educating us all. I am sorry you are dealing with this. So hard to have our babies be sick. He is so fortunate to have your love and it sounds like a good medical team

      1. You are more than welcome. I want to help others and everyone is so very much helping me with kindness and prayers. Hugs to you, Nancy.

  8. Sending many good thoughts and prayers your way. Dealing with these things is difficult but Dexter has the perfect advocate in you, and that will be of great help. He is a lucky boy to have such a good dog Mom! Always work from a position of knowledge and hope and remember to take care of yourself while you are caring for Dexter. You all are in my thoughts.

  9. Purring and praying for Dexter. I know this has to be awful for both Dar and you. I appreciate you taking the time to keep us updated on his daily progress. I have a friend who has the human equivalent of this. She gets shots every two weeks and her immune system has a hard time fighting off illnesses.

    I know you are doing everything you can for Dexter. Take care of yourself, too.

  10. We have our paws crossed the meds kick in and those platelets zoom back up to normal within a couple weeks. The worst part of it all is how fast a dog goes from normal to terrible ill. Mom could see Bailie fading away in front of her which is when she said, enough, and took her to the ER. Know your dog! That is the most important thing. A good dog parent knows when something is terrible wrong, just as you all did. Hugs to you guys and Dexter.

  11. Carol and Dar I’m praying for your strength to be there for Dex and for each other. I’ll continue to pray and send positive thoughts.

  12. I’m not sure how I found this blog post. I wasn’t even searching for IMT. My dog went thru something very similar in January 2017 and I thought you might find my documentation helpful or at least hopeful. She too had no strange scans and healthy blood test except for her platelets being very low. The day before all this happened, she was hiking for an hour and a half which is a typical exercise we do weekly. Reading about Dexter really reminded me of what an ordeal this was for my dog and I. If you get a chance, read my documentation.
    She is doing very well and we are 8 months post diagnoses. Such a scary disease. Hang in there. I know things on the internet about IMT is so scary. I remember being so afraid to read it because they were awful stories that often ended in their pet being put down. Have hope.
    http://barkingchef.blogspot.com/

  13. First and foremost, thank you for all the love and dedication . I know from personal experience how hard this must be for you all. It was the scariest thing to hear those words when my first sweet cocker was diagnosed. I was blindsided really, as she was only at the vet for her regularly scheduled check up and out of the clear blue!. The next day we were at the NC State Vet Hospital. She was 7 at the time and we went through almost every step you described, periodically through the rest of her life. Jazmine was a fighter and lived one week shy of her 15th birthday. We learned alot from it all and the two sweet males we have now, we watch like hawks. Jazmine was a parti-color btw. I could go on and on, just know this is do-able. Hold and cherish your sweet boy and bless you for all you do!

  14. Thank you, Carol (and Sexy Dexy) for the diary. I’m going to keep it bookmarked “just in case.” I’m so glad you were able to get him into the vet and diagnosed quickly. I hope things continue to look up for your very handsome boy.

  15. I am so glad Dex is doing better. I had no idea he was sick and thank goodness he has two mommies who are aware of any minor changes in him. Your swift action saved his life! I pray he continues to improve and am so thankful he has the best two dog moms in the world!

  16. I had a client, A Golden Retriever, diagnosed & die with IMT this last week. I missed it when I talked to him, but I get how tehy feel & I knew he felt like crap. I feel for this disease because my Lucie had IMHA. Both can come back at any time. Vets need to get on this and cancer and find out WHY it happens.

    I remember when Lucie was slated to die- the odds werent with her (IMHA) and I talked to an artist friend who’s dog had had IMHA. She said that her dog had completely recovered, and was fine for 5 years. Then it came back out of nowhere. They did a blood transfusion, and her dog died. I remember feeling that I would be SO GRATEFUL for another 5 years with Lucie. I NEVER saw her being as healthy as she is now again. Lucie got Valley Fever AFTER she had IMHA. she didnt use her left leg for a year. I am just SO GRATEFUL that she made it thru, and we have time together.

    Luckily, Luice has the brightest pink ears inside, so I know IMMEDIATELY that she doesnt have IMHA. Once they have an auto immune disease, you can never totally relax or act like everything is normal.

    Good luck Dexter. You have a world of love on both sides, but none of want to lose you yet. Stay strong & help your humans understand.

    1. What I have learned is every dog and every treatment plan is different with immune diseases. Paw prayers for sure and thanks for stopping by, Ann Marie!

    1. I came upon this blog well after Dexter’s emergency scare yet remain immensely grateful for the information and perspective.

      Boba’s second lab test came back with ZERO platelets and now with a side of anemia. I told the rescue group who got him and 18 other dogs out of that hoarding house four year ago so that other fosters/adoptive parents could keep their eyes out. No one REALLY knows who is whose parent/litter mate or what breeds compose any of them. As far as I can tell Boba is a Labrador/Boxer/Things 4(ish) YO MN. He has had a few oddities over the last 4 years: Cellulitis that turned necrotic from a Brown Recluse Spider bite (evidently they reside anywhere, even Cincinnati) and then barfy reaction to the antibiotics, hematomas from playing with his 120 mastiff rescue sister and from using our privacy fence as a platform for parallel-ground parkour…

      I’m hoping that the NSAID we halted full-force will exit his system and that will have been the cause (PLEASE!) since he was already diagnosed with hip dysplasia and gingivitis. Opportunistic indeed.!

      Thank you to Dexter’s very observant moms!

  17. I didn’t know about Dexter until maybe a week ago because I spend little time “live” on Facebook (since the election). I cannot begin to imagine the horror you, Dar and Dex were all experiencing. I am sooooo happy he is back home, thank you for the time you took to journal your experience for all of us. I am praying that Dexter will be ok, I know how deeply, deeply you and Dar love your precious baby boy. Hoping with each day he is better and better! I will be pinning this to help others. (((hugs))) and love to all of you

  18. Thank you SO MUCH for this informative diary. Leelo just got her IMT diagnosis Saturday (Oct 22nd 2017), we were at a specialty veterinary dentistry & oral surgery hospital (2 hours away) for what I thought was needed for her bleeding tooth — endodontic treatment. Nope, a root canal is not gonna fix this problem of very low platelets (uh, what?). Thank goodness that vet was on the ball and familiar with IMT because it’s life-threatening and we caught it in time.

    Leelo is now on a high dose of prednisone, will see our local vet is 3 days for another blood draw, also working with my fave holistic vet doing some TCM supplements to address her low “spleen qi” to boost her immune system.

    I’m very hopeful for a positive result from this IMT episode and expect no others in the future!!

    Doggie hugs and tail thumps to the 3 of you

  19. I’m so happy I have found you. My Shih Poo Lisa Was diagnosed March 2016. Basically the same treatment your Dexter had. Last night, I saw a small red mark on her belly. Looked like a scrape. Being a over-protective mommy, I rushed her to the vet. Her white cell was down to 33,000. They gave her Vincristine & sent her home with Prednisone, Famotidine & Doxycycline. Another CBC tomorrow. Bought plenty of pumpkin to help with her hunger pangs. Keeping you & Dexter in prayer.
    Love and Light,
    Laura

  20. Thank you for all of this information! My dog was rushed to ER this past Friday evening (December 8; it is December 10) as I write hi with similar symptoms (I brought him to the vet for a skin rash, then noticed the mouth bruises and bleeding when at the vet’s. He is still in ICU and has had 1 blood transfusion so far (he’s a Rottweiler, so it was not cheap; hoping we can avoid another). I visited him today and he was definitely worse than yesterday and I am so scared.

    I just adopted him two months ago (a foster failure) and am sure this was triggered by stress (although he’s Mr. Cool, I know he’s internalizing all the changes in his life) and possibly a course of antibiotics he was given for a broken toenail in November. I plan to contact Dr. Dodds as soon as I can (she was a great help with my epileptic Rottweiler years ago) – right now I’m still trying to find equilibrium. Your post is helping. Thank you. I am glad Dexter is doing well – he’s adorable!

    1. I will keep your sweet dog in my prayers. I am very grateful my dog was taken to a facility where they are very familiar with this disease. He is recovering now and off all meds, as later he developed pancreatitis from long-term steroid use. My dog’s platelets were zero. Stress can certainly trigger it and many other things. Be sure they run a complete tick panel for tick borne diseases and send it to an outside lab, as the IDEXX Snap 4 in-house can seem okay and in actually, the test can be wrong. My dog ended up having a tick bite that caused disease and all of this. We never needed a transfusion but they can help many dogs. Please keep us posted, Maureen. Thank you for stopping to share your story.

  21. My Nelson had Immune Mediated Thrombocytopenia as well and beat it. Scary…yes! I am blessed with a great doctor, and Nel was a fighter. He died two yrs ago from oral melanoma. Love and miss my boy.

    1. YAY for Nelson beating IMT, as it is so scary, as you know. I am glad he lived longer for you. I know that pain of missing them all too well. Much hugs.

    2. Would you please tell me how your dog beat the disease? My dog is having it and he might only last another two days at most! My Aussie only 2 years old.! Is there some I could do? Doctors and hospital are running out of options!

      1. Read through the above treatments that my dog was prescribed. Be sure an experienced internal medicine vet is treating your dog. All of the treatments my dog received in the first week are above. Then read this: https://fidoseofreality.com/dog-with-imt/. I send all my positive vibes your dog is okay and survives. Please keep us posted.

  22. I am so happy for you and Dexter that his outcome is positive. We just lost our 11 year old Portuguese Water Dog to this disease on Jan 11/18. Our case presented very much different than yours. We paw parents had the fight but our dear sweet Abby did not. She was my first dog and my one and only. Enjoy your time together and thank you for your post and your honesty about your journey. Snuggle and love them while you can!!! xo

    1. I am so sorry for your loss. That is so devastating. I appreciate you coming in and sharing your story. My heart is with you.

  23. I’d love an update on Dexter as this has been a very helpful post for me.

    My Bella (5 year old schnoodle) was diagnosed with anaplasmosis and thrombocytopenia in May of 2016. We took her in because she appeared to be lethargic and sick, but not obviously bleeding. Last Thursday during our morning tummy rub session, I saw red marks on her belly, even though she had been acting perfectly normal. I took her in to the emergency vet and just sitting in the ER, I could see pitichia and bloody bruises coming up all over her chest, stomach, gums, ears and neck. What a horror show! This time we have a diagnosis of IMT, possibly initiated by her anaplasma infection a year and a half ago. Why the flare up now? No idea.

    After 4 days I took her home last night — her platelets were as low as 2,000 and they will not test until tomorrow because every needle stick causes more bruising. However, minus the needle stick areas, no new bruising or bleeding, no anemia, no blood in stool. Like Dexter, she has had 2 kinds of steroids, famotidine, doxycycline, (even though her anaplasma test was negative) and vincristine. Our internal med vet says no shots ever again, of any kind, including rabies. Tick control is a big challenge because she’s allergic to Advantix (parti colored) and now I’m loathe to give her any kind of feed-through.

    I’d just like to know how other dog parents manage flareups and how many they have experienced. The vets don’t seem to have any answers and as you know, the treatment protocol is expensive (and I do NOT have pet insurance).

    1. Hi Michelle,

      I am sorry to hear Dexter has IMT. This has been a extremely frustrating disease to deal with. My dog George has it and we have been trying to find a medicine that is going to stabilize his platelets. We have been through many trials after the acute phase. He had heart issues too due to this. Those are better for now and is off that medicine.
      He has been on prednisone and doxycycline. Since he cant handle prednisone to well we started Azothioprine and weened him to a lower dose of prednisone. This worked for a while…now he is taking Mycophenalate and Prednisone…this is not working. Now we added Melatonin…this supposedly adds platelets to his system. We still don’t know.

      I asked the Vet and she said she is running out of options since George is not responding. Next I guess is Cyclosporine….and its expensive. That is what the vet says…his Mycophenalate is 110 an month…from a compound pharmacy.

      Anyway this is an extremely expensive disease to manage with all the lab work and pills.

      I can tell you this. I notice that George doesn’t handle stress well and I can witness petichea when he is in stressful situations. I just try to walk him lots, let him get out in the sun, let him rest. He is a 4 year old pit/American bull dog mix.

      We also are giving him Vitamin C to see if it helps with fragility of his vessels. Benadryl as well to help with managing allergies that could be causing his immune system to revolt.

      I hope this helps in anyway.

      1. Thank you for stopping by, Nicole. Dexter is thankfully in remission and we are keeping a close eye on him. Thank you for sharing information about George. If you can let us know how things are going as you are able, we would be most appreciative. Hugs.

  24. Hi!
    I am going through the same disease with my Newfie mix, everything is identical except for the bleeding teeth. Since you have had your pup home has Dexter developed any Diarrhea?

    1. Hi Justin – I am sorry to hear about your Newfie. Did they figure out what caused it? Since being home, Dexter developed pancreatitis from the steroids. Make sure to have Cerenia on hand. Keep us posted. Seek vet care, as we had to twice, for pancreatitis, as it can be fatal.

  25. I just found out yesterday that my dog is going through the same thing,im so scared for him. The vet gave him steroids and antibiotics for now and we have to go back to the hospital on Friday for a checkup. When we got there he was on 3 plt,and i just couldn’t understand whats going on. He’s playing and eating his food and doing everything just fine but im trying to keep him still most of the time and away from things that could injure him. Im 20 years old and i live with my parents they both love him but where i live people dont care for dogs the way you guys do(apart from me of course),and im scared that if things get really expensive my dad would tell me t that i can no longer keep him,i love him to pieces,yesterday he turned 2 and thats when we found out about his situation.pray from guys,i admire how you handled it,i hope for the best for both of my puppy luzs and dax.

  26. Thank you Carol for candidly sharing Dexter’s journey with IMT.
    My beloved Whippet, Ptolemy, endured a horrible bout of Pancreatitis over this last Christmas and New Year 2018. Almost immediately and whilst the Pancreatitis was raging, we noticed those frightening tummy bruises, bleeding gums etc. Our vet took bloods where the Platelets count was only 11 . She immediately put Ptoly onto Steroids and some other antibiotics etc. He reacted positively and the Pancreatitis improved, but the Platelet levels took weeks to increase enough to allow our precious Boykins to begin a reduced steroid level, with a view to stopping them altogether. Sadly, being an incredibly “stressy” dog and never being left alone, following a necessary UltraSound scan where he worked himself into a frenzy of anxiety (only away from us for about half an hour!) this caused a relapse & from 400plus his Platelets dropped to 49 again this last week. Our vet is now having to refer to a Meds Specialist & chemo drugs loom…I dread this. He has an appetite like a wolf and cries almost all through the night for food, or to go out and expel the fibre rich rations he’s on,we try to fill him without too many calories as he’s becoming far too weighty (he’s always had a problem with his weight) I’m going to ask for a referral to a Specialist in Internal Canine Problems. Our vet is doing her utmost, but I cannot leave any option untried. We adore our Blue Boykins soooo much & he loves being with my Husband & myself. He roams through the coast and coutryside with us here in the UK. He’s our first ever doggy pal and only 9 years old. I’m crushed & feel helpless.
    Your blog raised many familiar thoughts and feelings,thank you.
    Lots of love to you all and special Woofs to your gorgeous Dexter.
    Jacqui, York, England

  27. I am so glad that i found this blog. thank you for the info my dog has zero platelets today she is going to receive vincristinethis afternoon. she just started prednisolone, and had one dose of dexamethasone on saturaday. on saturday her platelets were 5, today her platelets are zero!! I am feeling so sad but at the same time am trying to be very hopeful and positive.

  28. My Grady, a Cairn Terrier, was just diagnosed IMT as well. Zero platelets found while doing a pre-dental blood work up. Everything is the same as others. He is my service dog, my therapy dog, my best friend, and my everything. I had him since he was 12 weeks old. He has has Pancreatitis twice in his 8 years, so I am concerned about a relapse of that on top of just tying to get his blood counts somewhere near normal. He has been there for me ever since my stroke. I am going to do whatever he needs to get better. Prayer is the best thing. Your shared experience and wisdom is a great help. I too will be emailing Dr Dodds. Thank you !

  29. My heart goes out to all of you and I’d like to share our story as it might bring hope and peace,. I retired and my little red for lab named Blaze came into my heart and life when she was 3 months old. She was the only one in the litter born from two healthy red fox labs. When she was two I noticed a small white circle in her eye that often older dogs get so to make it short it turns out she had zero platelets. She is perfect,y healthy and happy besides that. Almost lost her so I thought a couple times, from all the drugs, lots of predizone as they could not get her platelets up to even 150,000. She had a blood clot in her spleen and then got pancreatis. So she was on shots of heparin,plus aspirin, plavix,, antiacid, predizone and mycopenolate.. so one med was trying to clot her blood while the other was thinning it . But the blood clot had to be dispersed. Took awhile but it worked., another time I thought I was going to lose her it turned out she ate rabbit poop but the blood was dripping out of her. But after two days on meds she was fine. Well she’s is now 5 years and 3.months old and all her blood tests are great. Can’t ever seem to get her count over 155,000r but she is otherwise happy and healthy. Has had zero a couple times and under 50,000 several times. I used ice and fruit and vegs to fill in when she got hungry. None that had a lot of acid or gas in them but it helped her hunger. She is now down to 7,.5 predizon every other day and 250 mg of mycophenolate daily. If her next test is good for her about 150,000 clumping they will take her down to 5mg predizone every other day. I prayed and I know my prayers were answered many times. So don’t give up hope. Blaze is still happy, healthy and the most fun and kind dog I’ve ever met and shes had it over 3 years! Between God and her amazing vet at PVC in Pittsburgh she’s doing amazing!

  30. Oh my! I am so glad to have found this post. Thank you for sharing your story. I came across it searching for everything I can find about IMT in dogs.
    Sadly my little pup Marley is suffering. She is a 10 year old Rat Terrier.
    It all started 2 weeks ago, but we didn’t realize all these symptoms were connected.
    We saw the red marks on her belly. But there were news stories about Black Gnats (also called Buffalo Gnats) in our area that attack dogs in their yards. Apparently our late snowfalls allowed them extra time to hatch, so they are especially bad this year. Marley’s red spots looked exactly like those on the news and on Facebook.
    Then she was especially lethargic – which I attributed to getting older and the gnat bites.
    Then last week, her gums were bleeding. But the little rascal had just stolen a bag of rawhide chewies out of my shopping bag – and had chewed a hole in the bag and stolen several. We just thought she “overchewed”.
    Then this past weekend, her right eye was all red and bulging. I did my internet research and found “Cherry Eye” – so we thought it was that.
    Then, the worst symptom of all — she started peeing blood. Monday morning she went out, and peed. Then moved 5 feet and peed, Then moved 5 feet and peed. Well, thats not normal at all – so I went to take a look. Definitely blood. Now I’m worried — but its a holiday weekend, and we are far from home.
    We babied her the whole ride home (even an ice cream treat).
    First thing Tuesday morning we had her at the vet.
    And we heard “we can’t be sure”. They did the tick test. But my vet said they are not completely reliable.
    They thought maybe poison? But Marley has no access to that.
    Her platelets are zero. Her red cells are 28.
    She’s on a heavy dose steriod, vitamin K, doxycycline, and a stomach soother.
    She is peeing clumps of blood which terrifies me.
    She has diarrhea — but no blood in her stool. Her eye isn’t bulging and looks a bit better.

    We go back Friday morning for another blood test.
    Please say a prayer for my little girl?

    1. Please keep us posted, Heidi. Is she at a specialist for this? I took my dog right to an internal medicine doc who was familiar with IMT. You can print off the different meds they used for my dog – they worked. The platelets come up slow. Please let us know.

  31. Its been 2 weeks of a roller coaster. She’s been back to the vet 4 times for re-check CBC.
    First visit was great! She had 52,000 platelets! The Steriod was working!
    Another check 4 days later showed 49,000. Not up….but not terrible. BUT, her tummy was bloating. She was up to 23 pounds (normally 20) Doc felt her tummy and wanted an X-ray.
    Her liver is enlarged. ???

    They sent the X-ray to a specialist for reading. His thoughts are the steriod is responsible for the liver being enlarged. He saw pancreatitis…..so now a low fat diet, another antibiotic, and pain meds.
    Back 3 days later. Her tummy is less swollen, and she is down to 21.9 pounds. BUT — zero platelets again.
    She isn’t bleeding anywhere externally. So weird.

    Back to the twice a day steriod — and recheck on Thursday.

    She’s so sleepy. And she’s puffy again — which makes it hard for her to get around.

    I’m researching specialists in my area. It’s all just been a guessing game so far…..

    1. Heidi, My best advice is to see a specialist at a university. Those docs are trained in this and can help.

    2. Marley is continuing to improve in many ways. We have been slowly weaning her off the massive steriod dose she started on. We re-started her steriod at 1 tablet morning, 1 tablet evening. Then check her blood after 10 days…..it was good, so we decreased by a 1/4 tablet in the evening.
      So she was on 1 morning, 3/4 evening for 10 days….recheck blood….good result, so reduced again.
      3/4 morning, 3/4 evening…..recheck 10 days…..and so on and so on all summer.

      She is now down to 1/4 morning and 1/4 evening…and her blood work is great. Consistant.

      But, she has gained 7 (!) pounds from the increased appetite and steriod.
      So, she is lethargic and its hard for her to move.
      Sad seeing my active girl like this.

      Hoping that when the steriod is done her blood will stay level and she can drop some of the weight.

      We had her on a chicken / rice / low fat cottage cheese diet for a while – but she got terrible diarreha from that. So she’s back to her normal food.

      A couple more weeks and we might be in the clear!

      1. Hi Heidi. I am so glad to hear Marley is improving. And that is great news about the decrease in meds and the blood work being where it needs to be.

        We feed a diet called Dr. Harvey’s and it has worked well for us big time. If you want, you can actually call and talk to Dr Harvey. Here is that info. He really helped me and Dexter get on the right food. And Dex lost 4 pounds. https://www.drharveys.com/pages/contact

  32. Thanks for this. Our English Cocker Spaniel Myshkin passed away 2 days ago. He fell sick 2 weeks ago, was on Doxy + Steroids for a week and Mumbai’s best vet did everything. Also had 2 blood transfusions. He perked up for 4 days after 2nd transfusion, started eating, running, did potty. but dropped again. His HB count just was not coming up. In 2 days after relapse he died. We had decided to get him from hospital at home after the first week- places and people he loved. He was just 6 yr old. Tic fever was the trigger- but eventually his pletlets had come to normal. The problem was HB. The crash was so fast. We are relieved that he suffered only for an hour when he couldnt breathe and had trouble staying balanced. I dont know what are we going to do. We are taking it one day a time. He taught us to live in present and look positively at life.

    1. Manasi, Our deepest condolences on the loss of Myshkin. We are truly sorry to hear of this. With the HB, did the vets think it was IMHA versus IMT? Ticks are horrible, the scourge of the earth. My heart is with you. One day at a time.

  33. My dog coco just got diagnosed with imt days ago. Shes got her meds now and received her chemo injection. I’ve been an emotional mess but your blog is so helpful and makes me feel better every time I read it. I’ve read it 3 times already. She hasn’t had to stay over night in the hospital (thank goodness), but her lethargic demeanor is sad to see. I hate not being able to play with her so much, because I’m afraid she’ll get a bruise and the worst will happen. I am hoping by next week at her check up we hear some good news.

    Thanks again

  34. Thank you for this blog. My little boy Chunks was just diagnosed with this. Same thing- marks on his belly and I saw blood on his gums. I rushed him to the doctor and he has been in the hospital for about 24 hours now. I hope i will get him home tomorrow. He’s 7. He’s very active so they have given me encouraging updates- loves his walks, resting, eating, bathroom breaks are all normal. I’m going to see where we are at tomorrow and hopefully the meds start to kick in.

    Curious, what kind of diet do you feed Dexter? How long before his illness went into remission?

    1. Hi Dawn – Thanks for coming here, and I am sorry the reason is IMT. You did the right thing by acting fast. I will keep your Chunks in my thoughts and prayers.

      Dexter eats Dr. Harvey’s veg to bowl now or Dr Harvey’s Canine Health and I add my own protein, cooked organic ground beef. You can add whatever protein you like.

      Dexter steadily showed signs of improvement with each day, but it was scary for a while. He sees the specialist this month for another blood draw.

      Please keep us posted.

  35. I am so glad I found your blog. My 16 month old husky started to bleed from the iris in both his eyes last week. Followed the same day by a small nose bleed. We had been at a dog show all weekend and I thought it was an allergic reaction to grooming products. Especially as I managed to get chalk in his eye. The vet agreed and sent me home with eye drops. I lost his mother to kidney failure due to leishmaniasis 6 weeks before so had learnt to trust my gut instinct and not the vet. I looked online and the only photo I could find of a dog bleeding from the iris was one with ehrlichia. I went back to the vet the next day but the vet said he was fine as he was bouncing about and it must be an allergy as tick fever means he should have a fever. The saline drops stung his eyes and made them swollen, so I contacted an eye specialist. I was worried in case he went blind as it wasn’t possible to see his normal eye colour through the blood. The specialist took one look and said he had never seen an iris before but it must be caused by a blood disorder and sent me back to my vet. The results have come back as Ehrlichia 1/500 and Ana plasma 1/100. The coagulation was normal. He didn’t run a full blood panel though. I live in Spain where vets are cheap but very laid back. He wasn’t there when I went back this morning so I bullied the junior vet into running the blood panel. Normal except for platelets. They are at 20,000. Now I am having a heart attack as they are so low. It is exactly 7 days since the bleed. I have come home with doxy, 250mg a day divided into two for a 24kg dog for 40 days and a red cell vitamin supplement and have to go back in 10 days. No steroids? I have a check up with the eye specialist tomorrow so will check that with him. Thankfully he decided to fall ill four days before his rabies vaccine was due. His mother died 2 weeks after hers. Her only symptoms was a runny nose. I asked the vet if she thought she had leishmaniasis but said she was fine as she had no symptoms. I know now that Husky and Malamutes don’t show symptoms of leishmaniasis. I learnt from your blog to check his gums for bleeding. He has a few marks near the teeth at the back of his mouth so I will monitor that and his eyes for signs of bleeding. My other dog is a cocker so while I am not pleased to read she could bleed for no reason at least I know about it.

  36. I am so relieved your precious boy pulled through. I have just been through it with my Beagle (Dec ’18) and he pulled through as well. He is doing very well. No underlying causes, which I am thankful about but I haven’t stopped trying to figure out what might have triggered it. We live part time in NYC near Central Park and part-time in Nashville. I can only think of the fact that the night before my Robbie started bleeding in the gums, ears, and bruising on the belly, that he ate something off the ground in Central Park and I did not see what it was. Beagles will eat anything, anywhere – it’s a constant struggle and Central Park can be a nightmare. Perhaps whatever he ate was diseased – who knows? This is the frustrating thing – we don’t know what triggers this. But thank you for this record of your journey – it is so helpful for those who haven’t encountered ITP and helpful to those of us who have. I’ve been trying to figure out if I should start Robbie on Immune strengthening supplements or not. He was weaned off the steroids very early after the platelets and other blood counts were normal. His red cell count held steady from the last despite bleeding therefore he never needed a transfusion. He took his last steroid last week and I am relieved to have him off the drug even though I know it saved his life. He was only given prednisone and one dose of vincristine – no other drugs. I’m a great believer, as you are, of no drugs and raw protein diet plus cooked veggies (because dogs can’t digest raw veggies). Therefore, I wanted to refer you to an article that, despite living part time in TN, convinced me to cease all heart worm and tick medication. Please see the articles…
    https://www.dogsnaturallymagazine.com/?s=heartworm
    Another fantastic source of advice and supplements is Dr Peter Dobias https://peterdobias.com He has a terrific tick prevention spray.
    My Robbie has been off heart worm and tick prevention now for three years and I get him blood tested twice yearly according to the instructions in the article. The truth about heartworm will knock your socks off.
    Anyway – thank you for an amazing account of your journey with your little man – I smiled so much because during that time when we were waiting for those platelets I think the entire world was praying for Robbie.
    BTW I received 80% of all costs back from Trupanion which I did not expect. Like you I would have sold my house to fund whatever it took to save my best friend.
    Lynda

  37. Hi there,

    I know you guys went through this in 2017 but my baby Tessa is battling this now. Tessa is a cane corso mix. She will be six in May. I just had to respond to let you and your wife know reading Dexters story gave us hope. I constantly kept re reading your post to have hope Tessa would pull through this since their stories were so similar. Tessa started with bleeding gums and I noticed on Friday night it was coming from between two pre molars. I was going to call the vet in the morning to get her in but Saturday when we woke my husband noticed her right eye was completely red. We panic and took her straight to the Er. I work in dental and was so sure she had an abscessed tooth, but test later showed it would ITP. I cried and cried. How could I miss this? Tessa was reasled later Saturday around four and they told us to take her to a specialist in Akron for the disease. Saturday about an hour after having her home she starting bleeding a lot more so we rest her back and she was hospitalized. At that point she was already started on steroids and all the other meds. Sunday the released her back to us and she was now bleeding from the nose. Sunday night we stayed up making sure she was ok until we could take her Monday to the specialist. Monday came and again she was hospitalized. At this time her red cells were 24 and platelets were at 4,000. The did the chemo drug and we had to take it hour by hour. Jumping to Thursday we get a call her red cells dropped to 22. My husband and I just cried and prayed the platelet test tomorrow would be up. Friday morning we get the call her platelets went up to 35,000 and they released us. Tessa will go back in two weeks for more blood work and hopefully continue to get better. I hope dog parents out there never have to go through this. Thank you both again for doing this blog and giving me hope!!!

  38. Dear Sirs /Madam
    My dog is diagnosed also with IMT/ I really like to get in touch with the person who wrote this blog. I am from Israel and we are getting treatments in Beit Gagan Vet Center . (Part of the Hebrew University in Jerusalem)/
    How can I details.
    Thank you Anat

  39. We know exactly what you are going through. We have a boxer (Isabella) that had this but she also had the anemia. Along with that problem she apparently had a stroke in her spine which caused her back feet to
    knuckle so she was walking on the tops of her feet. Once we got her blood counts back to normal we then had to take her for weeks and weeks of therapy. Thank the Lord for the Heal Vet Clinic in Dallas. We found some booties online that kept her feet in the correct position and with acupuncture and under water treadmill treatments she is back to walking on her pads again. We were also told that she should never have any vaccines again. I am glad your story ended well like ours.
    We did have a scare last year because one of other dogs contracted distemper even though he had been vaccinated. Since Isabella had a blood transfusion I was worried after finding out that our other dog had distemper. Well, she had it too. Luckily she was older and apparently it’s not as bad on adult dogs.
    Thank you for sharing your experience. I know it is a difficult thing to go through.

  40. We are going through this now. I am at a loss as it is a roller coaster ride. Her numbers keep going up and down as they test her PCV but her platelets are normal. This week they found a spot on her gum. She is only 8 years old. This has been going on since June. We have been on steroids, melatonin, docycycline, pepcid, telmisartan, etc. Our PCV numbers go up and down and I don’t understand why. Our vet is wonderful but I am so frustrated and worried she isn’t going to survive this. She is on the maximum dosage for meds so there is no room for movement if she goes down hill.. Thank you for sharing your experience.

  41. Our dog, Jackson, was sneezing and itching prompting a trip to the vet on 10/10/19. I expected to hear he had allergies, instead it was that he had 0 platelets. We took him to the specialty vet hospital and got the IMT diagnosis. He is holding his own now, almost two weeks later, but we are bracing for the journey ahead. Thanks so much for sharing Dexter’s and your story!

  42. Your story is very helpful to many getting this horrible diagnosis. My dog first got IMHA and after remission several months now has ITP or IMT. When this all started my dog is at an emergency clinic getting blood transfusion and I am being told things that were unimaginable about my precious dog and started off in shock. Then I did what momma bears do – Research – Research – Research. When I went back to the vet, I realized quickly, she doesn’t have enough expertise in this immune mediated disease and she agreed. I went to an internal medicine vet and I stayed with her for the 7 months of treatment and I studied, learned, asked questions and always knew, if I am not knowledgeable, someday a vet will make a mistake or I will miss something. That already happened several times in 2 different vet clinics. Thankfully I knew better. I am not down on vets but they have their limits and majority will not tell you this fact. These are rare diseases, so of course they are not exposed or experienced and may only have the basics for treatment but not necessarily know or have the time to be as involved as needed.. There are exceptions to what I am stating but we need to proactive in ensuring our vet is up to the challenge.

    You are such an inspiration of what I am saying. You not only learned all you could but you took so much time to tell us your story. I love the details, explanations, thoughts, questions and the things you didn’t know. Great job and thank you for giving us a place to see we are not alone even though it feels that way. It is one of the hardest jobs in my life besides surviving my own autoimmune diseases. Good Bless You!

  43. So happy to find your blog~ our 4 year old lab- Tilly was diagnosed with ITP shortly after Thanksgiving.
    You have given me so much information- thank you, as we were completely blind-sided by the diagnosis and treatment.
    Merry Christmas!
    The Alexander Family
    Greensboro, NC

  44. thankyou for sharing your experience. We have a 21 month Alaskan malamute… which had some of the symptoms. Joint pains originally suspected of immune induced pyroarthritis. Only bright red blood seen in vomit on 3 occasions in october 2019. On admission into hospital as joint pains …. they found vit B12 deficiency and reduced platelets… started her on doxycycline only 14 days…. platelets went up 270+ and symptoms all subsided… tested for tick diseases internal lab… all negative…. checked bloods again December 2019 platelets down and rechecked to 19. No known cause identified nor any clinical symptoms…dog eating and drinking pooping normally no bruising or bleeding or vomiting. January 2020 we have asked for PCR on tick Bourne diseases… as doesn’t explain how platelets went up after 2 days on doxycycline. Only other changes in were nobivac L4 vaccine was given August 2019. She was on vanguard before… she is now 21 months old…. all scans including CAT/MRI negative…. last step is sending bloods to external lab. yours came back +ve from lab… did you get to the bottom of the IMT? was it from the tick bacteria? Any insight us great.

    1. Sometimes you just never know what causes these horrible immune diseases. What I do know is you want to be careful going forward with anything that can trigger an immune response negatively (ie vaccines).

  45. Just wanted to thank you for the amount of hope and information you provided for all of us dog parents. My dog was diagnosed with this horrible disease during a check up after I noticed a lack of appetite and reached out to the vet. Unfortunately the amount of medication prescribed didn’t save my poor Mimi. She passed peacefully on 3/13 at home and in my arms and that is so far the hardest thing I’ve ever gone through. I’m only 19 and this was my childhood dog so I was devastated. Thank you for providing so much information to all the dog parents and keeping us updated on your beautiful pup.

  46. Hello, I just came upon your blog about your dog having ITP. I just went through the same thing with my dog Abby, I live in Southern Columbia County in PA just over the hill from Knoebels Amusement Park, which I’m sure you’ve heard of. I’m not sure what part of NE PA you live in, but you must be close to the emergency vet in Plains or Clark’s Summit, PA. I noticed bruising on my dogs belly on Friday Oct 30,2020 and took her to my vet, they kept her over night and the blood test revealed the ITP, other than that she really didn’t seem sick, she didn’t eat her food the night before but every day gets sick now and then she was still eating her treats and a bite or two of my food but then I noticed the bruising so I knew I had to take her right away to get checked but I had no idea what it would be. Went back Saturday to pick her up and take her to an emergency vet in whitehall, pa which is about an hour and half away but so was the one you went to to I went south instead of north. Abby had 0 platelets since Friday and her RBC’s dropped some and with Covid-19 I couldn’t go in with her or see her and being so far away and no job because of Covid-19 really sucks. Anyway they did blood transfusions and finally ended up doing a IVIG infusion to try and get her some platelets cause she wasn’t making any. I went to pick her up the following Wednesday,Nov. 4th 2020 the longest she’s been away from home ever and away from me but I was glad to bring her home and still not sure she was going to make it. Her platelets are 14. Had to take her back to my vet for bloodwork check up on Friday Nov. 6 and her platelets were 54. Still on lots of meds from emergency vets and taking her for lots of bloodwork check ups but now her platelets are normal get RBC’s are low but coming up slowly and get WBC’s are high but they think because of the steroids and other meds. She’s still get doing better everyday, praying she brats this and is around for a couple more years she will be 10 in April. Abby is a treeing walker coonhound who I rescued after being abused in Kentucky. I’m in debt so much twice as much as you were no insurance and no job but I love her and I’ll find a way to make it somehow. Feel free to email me. Thanks for the blog, I learned more than what I have the last 3 weeks.
    Cindy

  47. Thank you for this blog on IMT. Unfortunately IMT took my sweet cocker spaniel Roman a couple days ago. I’ve been devastated and lost trying to find the reasons as to why. He was happy and exhibiting normal behavior in the morning, but by the afternoon he had a horrible nose bleed. After 36 hours in the hospital, he wasn’t responding positively to any of the treatments, nor did a blood transfusion work. I just don’t understand how this could have happened so fast. The doctor called me at midnight and advised I get there ASAP because he was in critical condition. I’m happy I at least got to the hospital in time, so he knew I was with him. It was the hardest thing I’ve ever had to do. But he’s no longer in pain and is in a better place. Thank you for this blog. It has been very helpful.

    1. I am o incredibly sorry for your loss. IMT is so dreadful and it comes on without warning. Sending you my deepest condolences.

  48. Our dog Buster had a broken tooth removed in December 2020. He was in recovery and we got a call that his platelets dropped to zero. We had to rush him to the emergency vet. He was in the hospital until they got him stable. He was weaned off all meds by March 2021. He has been doing great. We followed up with our regular vet in June 2021. His blood work is great. His vet gave us two options for his long term treatment. Monitor his blood work every 3 months or put him on 10 mg of steroids twice a week for the rest of his life. I thought the goal was to get them off the steroids. He does have skin and eye allergies that we have fought year around for years now. I am not sure what the right option is? Any thoughts would be appreciated!

    1. Hi Donna. I am sorry Buster is going through this. My dog’s internal medicine veterinarian told us that getting the dog off steroids was the goal. We were able to do that. I truly believe getting my dog to the vet and working with an internal medicine specialist saved my dog’s life. I would recommend you seek the services of an internal medicine vet with experience in this disease. I love our regular vet, but I knew that an internal medicine vet is who my dog needed to see.

      My internal medicine vet followed a specific protocol of medicines and treatments that my dog’s regular vet would not have.

      Here is my first post about IMT and what treatments the internal medicine vet used: https://fidoseofreality.com/help-for-dogs-fighting-imt-immune-mediated-thrombocytopenia/

      Keep in mind every dog is different and I am not a vet, but if Buster were my dog I would see an internal medicine specialist. You may need to go to a university.

      This was my dog’s update a year after IMT:https://fidoseofreality.com/dog-with-imt/

      And as of this writing, his platelets are normal and he has not had a relapse, thank dog.

      Keep me posted and all my best

  49. What about giving rabies and other vaccines to a dog with this immune disease? My dog has this but vet said no more vaccines. What can I do?
    Thank you,
    Charlene

    1. We no longer do vaccines per our dog’s internal medicine vet. We get titers blood work each year and each state differs. I am not sure where you are located but check your state or country rabies vaccine laws. I am allowed a waiver and we do titer testing. Amazingly my dog has more than enough rabies protection and other vaccine protection. A dog with an immune system disease like this can have deadly side effects if vaccines are given according to our internal medicine board-certified vet.

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