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INTERNAL MEDICINE & CRITICAL CARE CLIENT FORMS
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What is
thrombocytopenia?
The term thrombocytopenia refers to a condition where a patient has lower
than normal levels of circulating platelets. This may be due to increased
loss (i.e. hemorrhage), increased destruction (i.e. immune disease),
increased consumption (i.e. clotting abnormalities) or decreased
production (i.e. disease within the bone marrow). Immune mediated
destruction of platelets is one of the more common problems we see here.
Why are
platelets important?
Platelets
are cells within the blood that play a critical role in normal blood
clotting functions. They are produced in the bone marrow (like the red
and white blood cells) and are then released into the circulation.
What are the
causes of IMTP?
Immune mediated plated destruction can be due to a variety of underlying
problems that trigger an abnormal immune response. Things such as
infections (bacterial, viral), drugs, certain cancers, etc have all been
implicated as potential causes of IMTP. It is also possible that no
underlying problem is found in which case it is called idiopathic IMTP.
This is the most common cause of life threatening thrombocytopenia in
dogs. In order to diagnose the idiopathic form of the disease however, the
other potential causes need to be ruled out.
What are the
signs of IMTP?
Because thrombocytopenia leads to problems with normal clotting, the most
common signs you may notice at home are bruising, blood in the stool or
the urine or nose bleeds. In some instances thrombocytopenia can lead to
bleeding into the abdomen, chest, brain or spinal cord. In these cases
clinical symptoms may include labored breathing, abdominal distension or
neurologic signs.
How is IMTP
diagnosed?
Routine blood tests will show low platelet levels however the key is in
looking for a cause for the low platelets. Your veterinarian may perform
blood tests to look for specific infectious diseases such as Ehrlichia or
heartworms. Since cancer is also a potential trigger of this disease your
veterinarian may perform chest x-rays or an abdominal ultrasound.If no underlying
cause is found then a diagnosis of primary IMTP is made and
immunosuppressive therapy is begun.
How is IMTP
treated?
The mainstay of therapy, aside from treating the underlying cause, is
immunosuppressive therapy. Prednisone is one of the main medications used
but there are other drugs that may be required as well (i.e. Azathioprine,
Cyclophosphamide). Regardless of the type of therapy that your
veterinarian chooses, frequent rechecks will be an extremely important
part of the plan. If the
thrombocytopenia is severe, your veterinarian may recommend hospitalizing
your pet for observation and more aggressive treatment. Unfortunately, a
blood transfusion will not supply enough platelets to reverse
thrombocytopenia. If the low platelets however have led to blood loss and
subsequent anemia, then a transfusion may be indicated. The prognosis
with IMTP can be quite variable and depends on the underlying cause,
response to therapy or drug complications. Overall, if there is no severe
underlying disease and your pet responds well to therapy, the prognosis is
generally good although lifelong medication may be required.
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