Pints for Pups

ITP: immune thrombocytopenia in dogs

When a dog's immune system destroys its platelets, it can't clot. Signs, treatment, and why some dogs need transfusions.

What it is

Platelets are the tiny cell fragments that plug leaks in blood vessels. In immune thrombocytopenia (ITP, sometimes written IMT) the immune system destroys them. Counts can fall to almost nothing, and the dog starts bleeding from small vessels everywhere: pinpoint bruises on the gums and belly, nosebleeds, blood in urine or stool. Like IMHA it can be primary or triggered by infection, cancer or drugs, and the two diseases sometimes occur together (Evans syndrome).1

Warning signs

Pinpoint red spotsOn gums, inner ears, belly. Called petechiae.
BruisingLarger purple patches on thin-skinned areas.
Nosebleeds and bleeding gumsOften the first thing noticed.
Blood in urine or black stoolInternal bleeding.
Lethargy, pale gumsIf enough blood has been lost.

Why transfusions

Platelet transfusions are rarely practical in dogs because platelets don't survive storage, so a dog bleeding badly from ITP is usually given red blood cells to replace what's lost, and sometimes fresh whole blood or plasma. Treatment is immunosuppression, often with a one-time dose of vincristine to speed platelet recovery. Most dogs respond within days, and survival to discharge in one study of 73 dogs was about 90 percent, though relapses occur.2 In refractory cases with life-threatening bleeding, therapeutic plasma exchange has been used successfully.3

How you can help

Dogs with these conditions survive because another dog's owner signed up. Check in one minute if your dog can donate, find a blood bank near you, or join the pack and share this page.

Research and references

Peer-reviewed sources for what's on this page. Each link runs a PubMed search for the paper so you land on the abstract, and often the full text.

  1. 1
    LeVine DN, Brooks MB. Immune thrombocytopenia (ITP): Pathophysiology update and diagnostic dilemmas Vet Clin Pathol. 2019;48(Suppl 1):17-28. PubMed
  2. 2
    O'Marra SK, Delaforcade AM, Shaw SP. Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia J Am Vet Med Assoc. 2011;238(3):346-352. PubMed
  3. 3
    Kopecny L, Palm CA, Naylor S, Kirby J, Cowgill LD. Application of therapeutic plasma exchange in dogs with immune-mediated thrombocytopenia J Vet Intern Med. 2020;34(4):1576-1581. PubMed

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