In this episode, host Alyssa Watson, DVM, talks with Andrew Bugbee, DVM, DACVIM, about his recent Clinician’s Brief article, “Immune-Mediated Thrombocytopenia in a Dog.” To start, Dr. Bugbee explains the differences between primary and secondary cases of ITP, highlighting the platelet “cutoff” for spontaneous bleeding and some of the disease sequelae you may encounter. He then elaborates on therapy and follow-up, with steroids as the primary medication and several drugs that can be considered for secondary use.
Key Takeaways
Primary ITP is more common and often leads to the lowest platelet counts.
Secondary ITP can be associated with anything that causes immune system stimulation.
You can consider platelet counts of 30k-40k as the cutoff for spontaneous bleeding.
Steroids are the primary treatment because they work fast and inhibit innate and adaptive immunity.
Secondary agents (modified cyclosporine, mycophenolate, azathioprine, and vincristine) are commonly used to spare the steroids and/or to improve efficacy.
Many patients can be tapered off meds within ~5 months but close monitoring is a must—ITP relapse rates are around 50%.
Contact us:
Podcast@briefmedia.com
Where to find us:
Twitter: @cliniciansbrief
Instagram: @clinicians.brief
The Team:
Alyssa Watson, DVM - Host
Alexis Ussery - Producer & Multimedia Specialist