| Saving Eddie: A Vet's Quick Response to IMTP |
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Following instinct saved a pup’s life By Debbie Evert
 Eddie was one sick puppy.
On March 4th, the five-year-old shih-tzu was his spunky self, full of energy and fun. The following day his condition turned 180 degrees and he was holding onto life.
“He was lethargic, and his body was hot,” Tracy Knupp, Eddie’s mom, said.
Tracy and her husband Mike Knupp found blood on one of Eddie’s toys on the floor. Believing Eddie might have cut his gum on the rawhide he gets 10 minutes a week, they didn’t think much beyond that. Then they realized Eddie hadn’t had his supervised chew treat. As Tracy and Mike examined their pup more closely, they noticed one of Eddie’s eyes was bloodshot. She called the vet and Mike took him in immediately.
X-rays revealed blood in Eddie’s lungs. His blood platelet count was dangerously low at 6,000.
“Until the platelet count drops to 75,000, you’re at no risk at all,” Ricia Walker, DVM says. “Below 75,000, you can’t clot if injured. If it drops below 25,000, you can spontaneously hemorrhage into a body cavity.”
Eddie was hemorrhaging throughout his body. He was diagnosed with Immune mediated thrombocytopenia (IMTP).Immune-mediated diseases result when the body's immune system fails to recognize its own cells and tissues and begins to attack them as if they were foreign invaders. In immune-mediated thrombocytopenia, the immune system attacks and destroys platelets.
In addition to IMTP that attacks the platelets, there are other auto-immune diseases that attack the red blood cells. According to www.morrisanimalfoundation.com/meisha, “canine AIHA/IMHA (auto/immune mediated hemolytic anemia) is a serious, often fatal blood disorder. Abnormal antibodies stick to the red blood cells and cause the body to believe they are a ‘foreign invader.’ The dog’s immune system attacks the red blood cells and destroys them, leading to anemia.”
A body needs platelets for the blood to clot. A “low normal” platelet count for a dog is 175,000 – 200,000.
Dr. Walker sees IMHA or IMTP every couple of months in her two years at Pet’s First Animal Hospital.
Often, the situation is idiopathic; she doesn’t know how Eddie contracted IMTP. He had no overt symptoms.
“This is not an uncommon disease,” she said. “But, it is truly life threatening.”
Eddie’s condition stabilized throughout the weekend, but he was still critical. The platelet count dropped to 5,000, however with the use of steroids and an immunosuppressive drug the count raised to 35,000 by Monday. When tested Thursday, six days after his first symptoms, Eddie’s count raised to a normal 223,000.
“We were totally devastated,” said Ute Knupp, Eddie’s grandmother. She became an integral part of Eddie’s road to recovery as one of his caregivers.
Eddie was on a 24-hour watch at home for the first three days following his release from the hospital. After he stabilized, Grandmother Knupp watched as Eddie went outside to potty and play so he didn’t exert too much energy when mom and dad were at work.
This normally spunky pup was still lethargic because of his daily regimen of prednisone and other medications to help stabilize his blood platelet count.
In addition to daily meds, Eddie visited Dr. Walker once a week for blood tests.
“We still always worry, appointment to appointment,” Tracy said.
“This is not a condition for the faint of heart,” Tracy said. “Dr. Walker truly has a vested interest in us.”
Eddie had a relapse May 25 as his platelet count dropped again. With care from Dr. Walker and her staff as well as his family, this spunky pup is back on his way to good health.
Stress affects any disease process. Dr. Walker told the Knupps a dog interprets good and bad stress the same. So, they monitor his activity level as well as the amount of time he’s left alone.
“Walks are shorter, and we have to be careful he doesn’t cut himself when his platelet count is low,” this doting dog mom said.
When the Knupps got Eddie, they made a decision to take care of him. Eddie’s normal routine for the past 5 years is to go to work with dad during the day or go to Grandma’s house. He’s had regular visits to see Dr. Walker before IMTP became the focus of this adorable Shih-Tzu’s life. After a minor back injury, Tracy and Mike took him to the chiropractor and to get accupuncture.
“Yes, we baby him,” Tracy admitted. “Not everyone considers their pets to be their kids and I’m not saying they should. But, there are so many things that can happen. A responsible pet parent needs to take that into consideration when getting a pet.”
Those involved in caring for Eddie agree on two things. First, Eddie’s life was saved because of their quick response to his changing condition.
“One of the most important things is to listen to your gut,” Walker recommends. “If you think there’s something wrong, take your pet to your vet. Sure, it might cost you a vet bill, but it could save his life.”
 The Knupps “absolutely saved Eddie’s life by getting him in so soon,” Walker confirmed.
Mike, Eddie’s dad, said he was glad he didn’t let his “sense of duty (to go to work first and wait on taking his pup to the vet) get in the way.”
Secondly, caregiver/Grandmother Knupp agrees. “What really saved him was that we were so in tune with him.”
Most of the patients I’ve seen for this are off meds and will be ok,” Walker concluded. The goal is for Eddie “to live a completely normal life and keep this in remission.”
SIDE:
In addition to IMHA or IMTP pet parents need to watch out for another life-threatening blood disorder.
According to www.petplace.com, Evans Syndrome refers to a condition in which the following two conditions exist at the same time – Immune mediated thrombocytopenia (IMTP) and Immune mediated hemolytic anemia (IMHA). Both of these are complex diseases that result in destruction of the platelets (thrombocytopenia) and red blood cells (anemia). IMTP is a condition where the body is destroying its own platelets and IMHA is a condition in which the body is destroying its own red blood cells. Subsequently, the result is a low platelet and low red blood cell count (anemia).
Thrombocytopenia refers to an abnormally low blood-concentration of platelets, which are blood cells that promote blood clotting after injury to the lining of the blood vessels. When the concentration of platelets becomes too low, bruising and bleeding may occur.
Bleeding disorders can be either relatively minor problems or rapidly life threatening. The severity of the problem depends on both the amount of bleeding, and on the site of bleeding.
Bleeding may be obvious, as is the case with open cuts or nose bleeds, or it may be harder to detect. Bleeding into the stomach or intestines, for example, may be visible as dark, tarry stool that an owner may not notice. Likewise, bleeding under the skin, or into body cavities including the joints, abdomen (belly), or chest may be difficult or impossible for the owner to identify.
Any time an animal exhibits bleeding either with no known provoking injury, or excessive or prolonged bleeding after a known injury, a diagnostic investigation is warranted.
Dr. Walker recommends pet parents who want to read more about these conditions or others, to use an Internet search engine and type in the name of the condition you want to research. Additionally, she suggests using veterinary school’s websites which have .edu addresses.
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Happiness is like a cat. If you try to coax it or call it, it will avoid you; it will never come. But if you pay no attention to it at all and go about your business, you’ll find it rubbing up against your leg and jumping into your lap. -William Bennett
