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Immune-Mediated Thrombocytopenia (ITP) in Dogs

What Is Immune-Mediated Thrombocytopenia in Dogs?

Immune-Mediated Thrombocytopenia (ITP) in dogs is a serious blood disorder characterized by the immune system’s attack on the body’s platelets. Typically affecting middle-aged dogs, this condition poses significant health risks.

ITP can be categorized as either primary or secondary. Primary ITP, also known as idiopathic, occurs when the immune system inexplicably targets and destroys platelets. Secondary ITP, on the other hand, arises due to underlying factors such as cancer, infections, or exposure to toxins or drugs, triggering an immune response against platelets.

What Are Platelets?

Platelets, essential for blood clotting, are produced in the bone marrow and circulate in the bloodstream. Dogs typically maintain platelet counts ranging from 200,000 to 500,000 per microliter of blood, with a minimum of 20,000 to 50,000 required to prevent spontaneous bleeding and bruising.

Stored in the spleen, platelets respond to damaged blood vessels by forming plugs to stop bleeding. In a healthy dog, platelets are cleared by the liver if not utilized within eight to 12 days, prompting the bone marrow to replenish them.

However, in dogs with ITP, platelets are destroyed prematurely by the immune system within approximately one day of their production. This rapid destruction leads to insufficient platelet levels to effectively manage bleeding, putting affected dogs at risk of severe complications. Consequently, timely veterinary intervention is crucial to manage this medical emergency effectively.


ITP-induced platelet deficiency leads to internal bleeding and bruising due to the inability to form blood clots effectively. Signs indicating your dog may be affected include:

  • Unusual bruising
  • Petechiae: Tiny bruises appearing as pinpoints on the skin and mucous membranes (e.g., gums, vulva, or penis)
  • Ecchymoses: Larger bruises
  • Abnormal bleeding
  • Melena: Dark, tarry stool indicating bleeding in the upper gastrointestinal tract
  • Bloody diarrhea or blood present in the stool
  • Gum bleeding
  • Epistaxis (nosebleeds)
  • Blood spots in the eyes
  • Hematemesis (vomiting blood)
  • Bloody vaginal discharge
  • Blood in the urine
  • Lethargy
  • Reluctance to engage in physical activity
  • Reduced appetite
  • Pale mucous membranes
  • Fever
  • Enlarged lymph nodes
  • Rapid or labored breathing
  • Anemia resulting from blood loss


ITP tends to affect middle-aged female dogs more frequently and is relatively common.

Although ITP can affect any dog breed, certain breeds, such as Cocker Spaniels, Standard and Toy Poodles, and Old English Sheepdogs, are believed to have a genetic predisposition. Within specific families of Cocker Spaniels and Scottish Terriers, a familial predisposition has been observed.

Primary ITP is more prevalent than secondary ITP in dogs. Triggers for secondary ITP include:


  • Calgrow Forte
  • Divizole F Bolus

Infectious diseases

  • Tick-borne diseases like Lyme disease, babesiosis, ehrlichiosis, anaplasmosis, and Rocky Mountain spotted fever
  • Leishmaniasis
  • Leptospirosis
  • Heartworm disease
  • Parvo
  • Canine distemper
  • Salmonellosis

Cancer, notably lymphoma and hemangiosarcoma

Disseminated intravascular coagulation (DIC)

Toxins, including zinc and xylitol

Venomous snake bites

Although there have been suspicions of ITP as a rare side effect of vaccine administration, studies have not conclusively proven such an association.


If your dog displays symptoms suggestive of ITP, notably abnormal bleeding or bruising, your veterinarian will begin by gathering a comprehensive medical history, including details about any medications your dog is currently taking and recent tick exposure. It’s essential to inform the veterinary team if your dog has a familial predisposition to ITP.

Next, your vet will conduct a thorough physical examination and likely recommend diagnostic tests. These may include:

  • Complete blood count (CBC), which assesses platelet levels
  • Biochemistry profile to evaluate organ function and electrolyte levels
  • Coagulation tests to ensure proper blood clotting function
  • Tick disease panel to screen for tick-borne illnesses like Lyme disease

Additionally, a urinalysis and fecal examination are commonly conducted. Platelet levels in your dog’s blood can be confirmed through microscopic examination. Further investigations, such as a bone marrow biopsy and imaging studies such as X-rays and ultrasound, may be recommended to identify potential underlying causes of ITP.

Diagnosing primary ITP involves excluding all potential causes of secondary ITP first, making it a diagnosis of exclusion.


Dogs diagnosed with ITP typically require hospitalization for proper stabilization and treatment. Initial interventions may involve a blood transfusion, particularly in cases of acute and significant blood loss, or a plasma transfusion to rapidly boost platelet counts.

The primary treatment approach for ITP involves administering medications aimed at suppressing the immune system to halt the destruction of platelets by the dog’s body. Steroids like prednisone are commonly prescribed for this purpose, despite the potential for short-term side effects such as increased thirst, urination, and appetite. However, the benefits of treatment outweigh these transient effects.

Supportive care measures may also be implemented based on the dog’s specific symptoms, including supplemental oxygen, intravenous fluids, antibiotics, and anti-nausea medications.

In rare instances where medication fails to adequately manage ITP or if the condition recurs persistently, surgical intervention in the form of a splenectomy—removal of the spleen—may be considered. By removing the spleen, which plays a role in removing platelets from the body, platelet levels can be preserved and maintained at a more optimal level.

Living and Management

After your dog’s hospitalization and initial treatment, regular veterinary follow-ups are essential to track their progress and response to therapy. Immunosuppressive medications are often prescribed for an extended duration, sometimes lifelong, depending on the underlying cause of ITP. The aim is to maintain the immune system at a controlled level with the lowest effective dosage of medication.

With proper treatment, most dogs can enjoy a fulfilling life post-ITP diagnosis, particularly if the underlying cause is promptly addressed. Recovery rates range from 70% to 90% among dogs diagnosed with ITP.

However, certain signs may indicate incomplete recovery, including:

  • Presence of black, tarry stool
  • Elevated blood urea nitrogen levels
  • Requirement for a blood transfusion due to severe underlying illness

Recurrence of ITP is not uncommon, with rates as high as 30%, typically occurring within two to three months of the initial diagnosis. In cases of recurrent ITP, splenectomy—surgical removal of the spleen—can induce remission in about 60% of affected dogs.

Regrettably, for dogs intolerant to immunosuppressive medications, blood transfusions, or splenectomy, ITP can be life-threatening or may necessitate humane euthanasia.


Certain factors contributing to secondary ITP can be mitigated through preventive measures. Maintaining year-round tick prevention is crucial for all dogs, particularly those with frequent outdoor activities, such as hiking or spending time in wooded areas.

Reducing exposure to infectious diseases and avoiding encounters with venomous snakes can also lower the risk of ITP in dogs.

Immune-Mediated Thrombocytopenia in Dogs FAQs

What is the prognosis for dogs diagnosed with immune-mediated thrombocytopenia?

While 70% to 90% of dogs with ITP achieve full recovery, approximately 30% may face mortality or humane euthanasia due to a less favorable prognosis.

What is the life expectancy of dogs with immune-mediated thrombocytopenia?

With prompt and aggressive treatment, ITP typically does not significantly impact a dog’s lifespan.

Are there any natural remedies for immune-mediated thrombocytopenia in dogs?

There are no known natural treatments to suppress the immune system once ITP develops in dogs. However, certain all-natural tick preventives like Wondercide can aid in reducing the risk of tick-borne diseases. It’s important to use these in combination with veterinary-prescribed tick prevention measures.

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