What is immune-mediated Thrombocytopenia (ITP)?

ITP is a disorder in which your pet’s immune system targets and destroys platelets. The immune system makes antibodies that coat the surface of the platelets, which causes the spleen to recognize them as foreign and destroy them. ITP is an uncommon blood disorder in dogs, and rare in cats. In many cases, there is no obvious inciting cause for ITP, and it is called primary, or idiopathic. ITP is more common in dogs than in cats. In dogs, females are twice as likely as males to develop ITP, and it is most common in middle-aged dogs. Certain breeds are over-represented, including the cocker spaniel, miniature and toy poodles, and Old English sheepdogs.

What are common ITP signs in dogs?

• Bleeding

  Bruising, nosebleeds, bleeding gums, blood in urine or stool, and blood in vomit 

• Anemia

  Pale or white gums, lethargy, decreased appetite, exercise intolerance, rapid heart rate, and fast breathing 

• Purpura

  Purple spots inside the mouth or on the tongue, or dry purpura on the extremities 

• Other signs

  Blindness, seizures, or other neurologic signs from bleeding in the brain, and difficulty breathing from bleeding into the lungs 

How is ITP managed in dogs?

Immune-mediated thrombocytopenia (ITP) in dogs is treated with a combination of medications and supportive care, and sometimes surgery:

• Immunosuppressive drugs

  These drugs, like prednisone, are the primary treatment for ITP. They work by blocking the immune system from destroying platelets. If prednisone doesn't work, other immunosuppressants like azathioprine, cyclosporine, or mycophenolate may be used.

• Blood transfusions

  A blood transfusion may be necessary if there is significant blood loss or to replace red blood cells.

• Supportive care

  This includes cage rest, limiting exercise, and avoiding activities that could cause bleeding. Other supportive care may include supplemental oxygen, IV fluids, antibiotics, and anti-nausea medications.

• Splenectomy

  In rare cases, a surgical procedure to remove the spleen may be necessary if medications don't work or the condition recurs. 

What is the prognosis for dogs with ITP?

ITP is a serious disease, and not all dogs respond to treatment. It's estimated that over 70% of dogs respond well, but the remaining cases may not survive. 

Management tips for dogs with ITP   

At-home needs include:

• Easy access to food and water, and a comfortable location

• Strict consistency with medications—do not stop unless directed by your veterinarian

• Monitoring for changes in gum color, energy level, appetite, thirst, urination, and defecation

In a crisis situation:

Contact your veterinarian immediately if your dog becomes lethargic, is unable to walk, has abnormal gum color or difficulty breathing, or suddenly collapses.