Update on Sonny
I wanted to follow up on Monday’s blog with some new information about Sonny’s condition.
We now know that Sonny has a rare condition known as Immune-Mediated Thrombocytopenia (IMT). Essentially IMT is an autoimmune attack against the dog’s own platelets. Sometimes this condition is brought on by an external factor, such as an immunization. That’s known as Secondary IMT. Sonny’s condition, however, was not brought on by any external influence, so he has Primary IMT.
Sometimes the cause of Primary IMT can be discovered, but often it never is. When the cause can not be determined, that’s called “idiopathic”.
So Sonny has Primary Idopathic Immune-Mediated Thrombocytopenia. Say that three times fast.
The treatment is to suppress Sonny’s immune system so that it will stop attacking his platelets. Right now the doctors have him on a heavy dose of Prednisone–80mg per day–split into two doses. Some of you may recall that our dog Loki had Addison’s Disease, and that condition was also treated with Prednisone. By comparison, Loki was only taking 5mg of Prednisone per day.
The doctors looked at Sonny’s blood, and there’s no question that his bone marrow is producing platelets. There are also no signs of abnormal cells, which rules out cancer.
Generally speaking, the prognosis is good for dogs who suffer from IMT. Often after overcoming the acute phase and slowly weening off the Prednisone no further treatment is required (although for the rest of his life Sonny can never have another vaccination or any other immune-boosting drug).
Over the past 5 days Sonny has completely stopped bleeding (he was throwing up blood on Monday morning when I rushed him to the vet), the swelling on his back and in his legs is gone, his energy level has returned to normal, he’s eating and drinking normally, his fever is gone and he’s clearly happy and pain-free.
What doesn’t make sense is that Sonny’s platelet count was still zero when we had a CBC done on Wednesday. The doctors are baffled, because there should have been some improvement on such a heavy dose of Prednisone. The blood work also doesn’t support how good Sonny seems to be feeling, and the complete absence of the physical manifestations he had (no more bleeding, swelling, fever, etc).
I’m taking Sonny back to the vet this morning for another CBC. We are all very hopeful that Sonny’s badass, yet highly confused, immune system has allowed some platelets to survive.
Thanks to everyone for your well-wishes. This has been really hard on all of us, and your words of kindness have helped.
9:10 AM Update: We have platelets! We just got back from the vet, and Sonny’s platelet count has improved from zero on Wednesday to 31! Also, his red blood cell count was low on Wednesday, but is now normal. It will take more time and treatment for his platelet count to return to normal levels–about 200–but we’re feeling very encouraged by the improvements.