Our seemingly happy, healthy three year old dog, Bella, has Immune-mediated thrombocytopenia IMTP. Heres how it played out.
Last Saturday I arrived home after helping out at the school fete and saw what looked like dried blood on Bella’s leg. Upon further inspection she had smears of blood all over her tummy. There was one drop of blood on the floor too, but no apparent source or injury. She seemed OK in herself, wasn’t behaving oddly. Later that evening I thought I saw blood around her gums, and so we assumed she had hurt her mouth. On Sunday she did a Poo that had dark blood in it. This fitted with our assumption and we didn’t really worry too much about it.
We had an immunisation appointment at the Vet that afternoon just before we were about to go I noticed red/violet blotches across most of her tummy and into her groin area. The vet suggested we hang off on the immunisation and do a blood test to see if it revealed anything. Her red blood cell count was good and it was going to take a bit longer for her platelet results. We were instructed to observe her and call back tomorrow.
However, later that night the Vet called. He said her platelet count was quite low. We took her back immediately for further blood testing and to start medication. It was revealed at this point, that the area where hair had been shaved for earlier testing, was horrifically bruised. We were given 4 types of medication to administer multiple times each day.
We had to go back for a second check of her red blood count. It had dropped notably, but was still in the lower ranges of ‘normal’. She seemed more lethargic. We were looking for signs of a bloated tummy, pale gums and/or laboured breathing. These were indicators her condition was getting worse.
When I came out of the bedroom in the morning Bella didn’t greet me. She was laying in her bed and seemed to be struggling to keep her eyes open. There was no tail wag! She seemed bloated. I tried a few things to coax her out, when she didn’t move for her favourite treat I took it to her and offered it. She didn’t take it! I woke the Mr. up and told him I though she had rapidly deteriorated, he agreed, we took her straight to the Vet. Shortly before we left she Vomited. A massive, rancid smelling, red, alarming vomit. A triage nurse checked her over and put us straight into a room to wait for a vet. Her red blood count was low, too low. She needed a blood transfusion. This boosted her a little and she had to stay in hospital all day, then we moved her to an overnight emergency vet facility.
We picked her up in the early am and took her back to our local vet. We learned her red blood count had dropped again and she stayed there for the day under observation. She didn’t have any platelets. Her appetite had vanished and she was still bruising. We collected her in the evening and took her back to the overnight emergency vet facility. I noticed the term ‘waiting for her to respond’ was being used more often now.
We picked her up in the early am and took her back to our local vet. Her red blood count had dropped even further, we admitted her to hospital again. It was likely she was going to need another transfusion shortly. Bella was a shadow of herself, clearly unwell and she had no energy. It was heartbreaking. That evening we collected her for transport to the emergency centre, where she’d be staying for the entire weekend. The tone of the talk was changing now, terms like – ‘if she doesn’t respond’, ‘window of time’ and ‘making decisions’ were used in reference to the coming Monday.
We were able to visit her and take her out into the yard at the vet hospital. She seemed a little brighter but she had terrible uncontrollable Diarrhea. Black and tar like, indicating the presence of digested blood. Melena is the term used to describe this fecal matter. It was awful. Her red blood count was low. I felt quite optimistic, regarding her recovery, due to her general demeanour.
1 am the phone rings. Her red blood count is so low she needs a transfusion if she is to have any hope of responding to the medication.
The aim being to get her immune system to stop attacking her platelets. Once she has platelets her blood will clot and all the bleeding will stop. if the bleeding stops her red blood count will rise and her energy will return. An upward cycle will be in play.
We agree without hesitation to go ahead with a second transfusion.
We found out later that day that the fresh blood, which is platelet rich, was not available. She received stored blood, which boosted her red blood cells but is not as beneficial as fresh under these circumstances. The hope being that her body would have enough energy to start creating platelets. Soon.
1 am the phone rings. There are two immature platelets on her slide!
When we pick her up that morning to take her back to her regular vet we find out they have doubled. She has been eating every 4 hours. Her Melena has almost totally deceased. These are all extremely encouraging signs!
We check her into our regular vet for observation during the day. When we collect her that evening, we find out her body is creating platelets! Both mature and immature. We are allowed to bring her home, keep her contained and quiet and take her back for another test Tuesday evening.
She is still anemic but her red blood count is slowly and steadily climbing. Her appetite is voracious. Her Melena has stopped. She wags her tail sometimes.
We dont have to go back to the vet until Friday!
Every Day brings some little improvement or an element of her behaviour that she displayed prior to her IMTP incident, comes back into play.
She is generally quick to tire and sleeps a bit more than what would have been usual. Its three types of medication, twice a day, which we give to her in peanut butter from our fingers.
Her poo is starting to look brown. She barks sometimes, then promptly falls into a deep sleep exhausted. She eats more than she used to and has a great appetite.
Each day brings one or two improvements in both her looks and behaviour, this morning she exposed her tummy for a scratch! It looks positive right now.