Just wanted to tell the story of Izzie, our loving, faithful, and sweet dachsund who has been diagnosed with ITP. Hopefully our story will help someone else dealing with this terrible disease or maybe somebody will provide us with some insightful guidance.
Izzie was taken to our vet on 4/22/16 after we noticed a long scratch and and severe bruise on her chest, small bruising on the inside of her legs, and small bruises in her ears. We thought an animal had attacked Izzie while she was in the backyard. Our vet treated her with antibiotics and sent us on our way.
Well, fast forward to 4/28/16, and Izzie is bleeding from her mouth and has blood in her stool. We take her back to our vet who diagnoses Izzie with ITP and places her on prednisolone and chlorosporine. Her platelet counts were at 6,000. Our vet treats Izzie for a week and on 5/6/16 Izzie's platelets have dropped even more to 3,000. We are then referred to Mississippi State University's Small Animal Clinic in Starkville, MS. There, her platelets bottom out to 0, but her Red Blood Cells(RBCs) never fall low enough to require a blood transfusion.
MSU switches Izzie to the Atopica brand of chlorosporine at 25mg twice per day, ups her dosage of prednisolone to 10mg per day, puts her on some gastroprotectants and gives her an injection of Vincristine. Her platelet counts consistently stay below 5,000 and on 5/12/15, the vet tells us they will not be doing anymore blood tests over the weekend and they will call it on Monday if she hasn't responded. Izzie stays at MSU through 5/15/16 when she was released to us with a platelet count of 220,000.
We continue the same level of medication at home and Izzie is doing great. Izzie has a follow up appointment with the vets at MSU on 5/31/16 and her platelets have increased to 416,000. The MSU vet sets up an appointment for two more weeks and tells us that she will begin tapering medication at that point.
Unfortunately, by that Friday, 6/3/16, we notice a small bruise on her belly and rush her back to the vets at MSU. Our nightmare is confirmed there- Izzie has relapsed and is back down to 0 platelets. The vets at MSU run a cyclosporine level test and Izzie's cyclosporine levels are low so they increase her dose to 35mg twice per day. They also add mycophenalate motefil to her medication and gave her another dose of Vincristine. However, during this stay at MSU, her platelets never increase higher than 2,000 platelets.
On 6/10/16, we make the decision to give Izzie a IVIG transfusion. On 6/11/16, we bring Izzie home because the vets say either the IVIG is going to work or it isn't. Izzie has a follow up appointment on 6/13/16 to recheck platelets. On 6/13/16, her platelets are at over 816,000. Wow. You would think she would be fully recovered at this point?
Nope, on 6/17/16, Izzie starts vomiting blood, so we rush her to MSU once again where it is confirmed her platelets are back down to 2,000 again. She still has never required a blood transfusion. MSU vets tell us that Izzie's only option at this point is a splenectomy, but she has to have a minimum number of platelets for the surgery so they initiate another IVIG transfusion on 6/18/16. However, it doesn't appears she is responding to the IVIG as well this time as her platelet count on 6/20/16 was only 12,000 and on 6/21/16 her platelet count was at 18,000. The vets want her platelets to be at 60,000 prior to the splenectomy.
We are just at a loss as to what to do to save our angel. We are open to any advice or suggestions of treatment. I recently stumbled upon a study of 5 dogs conducted in late 2014 and 2015 at a German university where the dogs successfully responded to treatment with romiplostim (Nplate). Any luck with this treatment or any advice on getting financial assistance through the manufacturer with this drug?
Thanks for letting me vent!