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In this episode, host Alyssa Watson, DVM, is joined by John M. Thomason, DVM, MS, DACVIM (SAIM), to talk about his recent Clinician’s Brief article, “Top 4 Primary Immune-Mediated Disorders in Dogs.” In part 1 of this 2-part conversation, Dr. Thomason focuses on the diagnosis and management of IMHA and ITP. You’ll hear vital details for both conditions including the right way to handle blood smears and slide agglutination, which IMHA cases are hypercoagulable (spoiler: all of them), and if vincristine actually helps in ITP (spoiler again: it does).
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Key Takeaways
IMHA and ITP involve antibody-mediated destruction of cells (type II hypersensitivity) and can be either primary (not associated with an underlying cause; often the case with IMHA) or secondary (associated with an underlying cause, eg, tick-borne infections and ITP).
Beyond a CBC, blood smears are very useful to identify agglutination (1 drop of blood from a purple-top + 4 drops saline), spherocytes, potential infectious organisms, and an accurate platelet count.
Steroids are the cornerstone of IMHA therapy, with transfusions when necessary, secondary immunosuppressants, and anticoagulants like clopidogrel.
Immunosuppression for ITP is similar, but a dose of vincristine at the outset should help platelet counts rebound faster.
Treatment can work well for many dogs with ITP, whereas IMHA carries an overall worse prognosis.
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The Team:
Alyssa Watson, DVM - Host
Alexis Ussery - Producer & Multimedia Specialist