Jazzy has IMT - Doberman Forum : Doberman Breed Dog Forums
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post #1 of 17 (permalink) Old 08-19-2020, 10:58 PM Thread Starter
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Jazzy has IMT

Hi all. Itís been about 3 years since Iíve been on the forum. I surely have missed the knowledge that I always got by reading posts from so many experts in the breed.

My girl Jazzy desperately needs your prayers and wisdom.

In February of this year, Jazzy was diagnosed with Immune Mediated Thrombocytopenia, or IMT for short. Iíve already done a site search and read every thread I could find a mention of this.

On February 15th, I came home for lunch to let my two out. Immediately, I saw that Jazzyís right eye was filled with blood. She wasnít like that when I left that morning. I thought she must have poked her eye or something. Oh how I wish it had been a simple eye poke.

Long story short, got Jazzy to the vet that evening. Vet checked her eye and among several things, sent me home with some drops and a tentative diagnosis of Uveitis. After a couple of days, went back for a follow up and my vet wasnít satisfied. She sent me to an
eye specialist over 2 hours away.

The specialist was unsure what was going on. Everything checked out that there was no damage to her eye. They did a blood test and sent me off with more eye drops. They also took her blood pressure and it was dangerously high, 210, so she gave me amlodipine for that.

The phone call I got the next day got us closer to Jazzyís problem. The blood test revealed that Jazzyís platelet count, measured in thousands, was 18. The healthy reference level is 175-400.

I was then sent to another specialist, an internist, in the same area as the eye specialist, 2 hours away. Sigh.

Changing my schedule around at work and getting my shift covered, off we went. $1700 later with an ultrasound to check her stomach area for cancers etc, he gives me the diagnosis of IMT.

IMT diagnosis, because the ultrasound came back fine as well as everything else he checked. He did another blood test and was checking for a tick borne disease. He sent me away with antibiotics as a precaution in case it was related to a tick. He also started her on a high dose of prednisone.

It was not related to a tick and they had me stop the antibiotics. After 4 days on the prednisone, she had another blood test to see if the prednisone was working. She had improved to 48.

I know this is long, so Iíll wrap it up. Jazzy has had bi-weekly blood tests since March. Her platelet count climbed to a healthy 272.

We began to slowly decrease her prednisone dosage so as to get her off of it and see if the IMT had resolved itself.

Things were looking good for awhile. For each step down and subsequent blood test, Jazzyís platelet count remained in the acceptable range.

We went from 60mg once per day down to 10mg once per day. I was feeling good and it looked like we were going in the right direction.

When we attempted 10mg every other day for two weeks, Jazzyís count took a nosedive from 275 to 80.

He raised her back to 20mg daily and added a new pill, Azathiaprine. Her counts went back up into the 300ís. Sheís had so many blood tests, I canít remember all of the counts.

Then Jazzy decided that eating her platelets wasnít enough and she decided to start bleeding from her nose. She had a weepy eye, not the original bloody one, and she had bloody discharge. Thatís when I discovered it coming from her nostril on the same side.

They checked her out at my regular vet and also rechecked her blood pressure. We hadnít done anything with that since the original test way back. It was still way high.

The internist raised the dosage on her blood pressure medicine.

We started again to wean off the prednisone and she dropped again. Went back to the last dosage where she was doing well and that is where we stand right now.

Jazzy had another blood test today to see if her platelets have gone up. Should have the results tomorrow.

If you are still with me after this novel, here is where I need help if anyone has any first hand knowledge or know anything about this.

We know Jazzy is thrombocytopenic, but the immune mediated part means we donít know why she is destroying her own platelets. It has to be caused by something.

I think itís something related to either her eyes, nose or a combination of something in that area. Or her head in general. She shakes her head quite a bit throughout the day.

Nothing wrong with her ears. They have been checked thoroughly. Okay, fine. Sheís shaking her head for a reason. Why? Her eye is still very weepy. Why?

I guess you can see Iím grasping for straws. Iím worried about Jazz being on this prednisone for so long. Her face has started to atrophy and lose muscle tone. I read about all of the side affects for long term prednisone use.

When we try to get her off of it, it does not work. I worry about her getting a secondary infection or problem because we have her immune system suppressed to keep her from destroying her platelets.

I hate to sound gloom and doom as Iím an optimist by nature. If my baby being sick wasnít enough stress, life threw me another curveball.

I lost my job of 30 years due to COVID 19. Iím not getting the poor meís as I know there are a lot of people in my situation. Those are the breaks. Lol.

Needless to say, all of this vet stuff and blood tests are draining me, no pun intended. The importance thing is my girl. She is my heart. She will be 8 years old next month. Iím hoping to have her around longer, but I will say Iím getting discouraged.

Iím rambling at this point, so I will leave it here for now. Anything or any ideas you guys may have is appreciated.

Thanks so much,

Janet


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post #2 of 17 (permalink) Old 08-20-2020, 12:48 AM
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Not much I can say except I'm sorry you guys are going through thisóhang in there and give your girl a smooch from me.
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post #3 of 17 (permalink) Old 08-20-2020, 09:23 AM
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Thank you for sharing this information with us. It is never too much information because you never know if this might help someone else with a similar problem in the future.
I am so sorry for what you are going through. These things come out of nowhere and then it seems when it starts raining it suddenly pours.

I have never heard of this condition and can offer no help. But, I will be searching info on it and share with other of my dog friends in case they have heard of similar.

Thoughts and prayers are with you today for Jazzy and that you will find work soon. Losing a job after giving it 30 years would be a blow enough to knock you down.

"Lots of people talk to animals...Not very many listen, though...That's the problem. " ~ The Tao of Pooh
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post #4 of 17 (permalink) Old 08-20-2020, 10:13 AM
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Praying for you and Jazzy.
I have no advise but keep posting as this might help someone else in the future.
Keep us posted or if nothing else we are here for you just to have some folks to talk with during your toughest times.

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post #5 of 17 (permalink) Old 08-20-2020, 10:29 AM
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So very sorry you are going through this. I've never heard of it. She's lucky to have you. Sending lots of love her way.


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post #6 of 17 (permalink) Old 08-20-2020, 12:03 PM Thread Starter
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Jazzy has IMT

Thank you all for your well wishes. It has been stressful, but probably more so for me than Jazzy.

Except for her increased appetite and thirst from the prednisone, she acts perfectly normal. She still has her crazy prey drive and is constantly on the lookout for lizards to catch

Her blood test results came back and she is up to 118. Still low, but not worried because the estimate says ďadequateĒ. They said the lower number is related to it ďclumpingĒ.

Iíve learned more than Iíve ever wanted to learn about platelets. They count them two ways. One is by machine and the other by a person.

When I asked about how platelets were counted and the vet explained about the ways, I remember saying...So someone really sits there and counts starting at 1, 2, 3, 4, 5 etc?
Considering you have to go to the hundreds of thousands I just couldnít imagine.

They do smears on slides and count how many on a slide and then multiply. Ohhhhhh. That makes more sense. People laugh because Iím a very ďliteralĒ person.

Thanks again. I will keep you updated. Here is a fairly recent photo. She was giving me the ďI would like a treat pleaseĒ look.




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post #7 of 17 (permalink) Old 08-20-2020, 04:28 PM
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Hi sweetheart! Stop worrying your mommy so much.

Best wishes for you guys. THX for keeping us updated.
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post #8 of 17 (permalink) Old 08-20-2020, 06:17 PM
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My thoughts and prayers are with you both. What a difficult time you are going through. I wish you the best.
Stay strong!!!
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post #9 of 17 (permalink) Old 08-20-2020, 06:25 PM Thread Starter
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I just received my text for the new medicine the Doctor wants to switch Jazz to. I now have sticker shock. $335 for a one month supply.

I have already called 1-800-Petmeds and at first they were way higher than Walgreens Pharmacy. The nice young lady I talked to did something and now we are down to $260.

Much better, but still not something I can afford. Are there any other options?

I will be calling my vet tomorrow and seeing what we can do.

Thank you all for your prayers and well wishes. My girl is not a quitter and neither am I. Iíll have to figure something out.

Janet


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post #10 of 17 (permalink) Old 08-20-2020, 06:41 PM
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Hi Janet

You mentioned having a concern about continuous Prednisone usage. I can't help you with Jazzy's IMT. However, I can give you a bit of insight into long term Pred use in a Dobe.

First... Remember that all dogs potentially react differently to Prednisone. Some side effects, such as increased thirst and corresponding excessive urination are pretty much universal. Others, for example: Skin infections, gastric problems and alopecia really depend on the dog.

We have a lot experience with long term Pred use. Our senior is 10 1/2 years old and has been on Prednisone or a derivative since he was a puppy. Without going into specifics, he had a congenital issue that was mostly corrected by surgery, medication and alternative methods like cold laser therapy. His only alternative was to be euthanized. I'm very glad that we took the difficult (and expensive) route.

When it was all said and done, the one thing that we could never wean him off was Prednisone. Or these days, Prednisolone. I am happy to say that today he is totally healthy and happy, although he still has some mobility issues.

So... Some of the side effects that we encountered:

-Excessive thirst and urination. This was a bit of problem as the pup was barely able to walk early on. Eventually he adjusted to the meds and it ceased to become a problem.

-Increased appetite and rapid weight gain. This occurred over a very short period of time. The solution was obvious. We carefully monitored his weight and diet, adjusting accordingly. We continued to do so until it was no longer necessary. Today he is naturally lithe and controls his own eating.

-His began to lose his hair. As his skin was unaffected, and it was strictly a cosmetic issue, initially we ignored it. This was, of course after a full thyroid blood panel and looking at other obvious possibilities. Eventually we switched to what he is on today and all his hair grew back.

The bottom line is that, in my experience, a Dobe can benefit from the long term use of Predisone if carefully monitored.

The most important thing for us was carefully and continuously comparing symptoms, side effects and dosage. This was especially important early on. We titrated our dog to the lowest possible dosage while keeping his symptoms mostly at bay and being constantly aware of any of the many listed side effects. Every attempt to completely wean him off ultimately resulted in some return of impaired motor functions. As he got older, everything kind of evened out. Today his dose is negligible when compared to his post surgery days.

In any case... Today we still have the pup and he is pushing 11, partially due to Prednisone.

Edit to say: This experience was what finally convinced us to have quality pet insurance for all future dogs.

John Lichtwardt
Portland OR
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post #11 of 17 (permalink) Old 08-20-2020, 09:19 PM Thread Starter
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Jazzy has IMT

Quote:
Originally Posted by 4x4bike ped View Post

We have a lot experience with long term Pred use. Our senior is 10 1/2 years old and has been on Prednisone or a derivative since he was a puppy.



The bottom line is that, in my experience, a Dobe can benefit from the long term use of Predisone if carefully monitored.
Today his dose is negligible when compared to his post surgery days.

John Lichtwardt
Portland OR
Thank you so much for your reply John. Itís been awhile since I have been on the forum, so not sure if I am doing this correctly.

What is the prednisone derivative you use? Is it basically the same thing?

What is the dosage amount? Right now, she is taking 20mg. Before the vet started weaning her off, she was taking 70mg.

Janet


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post #12 of 17 (permalink) Old 08-20-2020, 11:21 PM
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Hi again Janet.

He is on Prednisolone. I am not sure what the reasoning was behind the change. Just that it worked. From what I understand Prednisone is metabolized in the liver to make the active drug Prednisolone. Giving Prednisolone bypasses the need for liver involvement. Keep in mind, I am not a vet, so this is just what I am remembering from quite a while ago. Last time we discussed it here, dobebug pointed out that it is a drug often used for treating cats, as they seem to have a harder time with Prednisone than dogs. I am sure that your vet would explain it to you.

As far as dosage, I am not sure, as he now lives with my son and when I medicate him his doses are in a pill dispenser. He has been down to one dose every 48 hours for years and I think it is a 20 mg pill, but I would have to check. Still, what our boy is dosed with would pretty much be irrelevant with respect to your Jazzy.

BTW... I walked him 3 days last week and the little guy is still as strong as an ox. He is never sick. He has none of the illnesses associated with middle and late years in Dobermans. His heart is great. However his physical disabilities have become a bit more obvious as he advances in years. Still....

John Lichtwardt
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post #13 of 17 (permalink) Old 08-22-2020, 01:11 AM
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Very sorry to hear about this. The loss of a job is equal to a loss of a parent, sibling, spouse, child. It is suffocating. And to have your puppers sick too is just a tad bit too much. Hang in there. I hope this turns around for you and you get answers on everything.
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post #14 of 17 (permalink) Old 08-22-2020, 05:39 AM
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Hi Jan , Like some of the others - I had never heard of this . So thanks for educating some of us .

Thoughts your way for you and your girl and give her a big hug for us .

Ken
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post #15 of 17 (permalink) Old 08-22-2020, 08:45 AM
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I've got no words of wisdom but I'm thinking of you and sending good vibes and juju your way.

Hugs to you and your beautiful girl. I'm so sorry to hear about your job less on top of everything else.



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post #16 of 17 (permalink) Old 08-22-2020, 09:15 AM Thread Starter
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Jazzy has IMT

Thanks so much everyone for your kind words. It helps so much. Makes you feel less alone when you have so many others out there who love their babies as much as I do mine.

I have some good news. I wanted to share this in case anyone else has trouble paying for pet meds.

I found ďGoodRxĒ. They have an app in the App Store and Google Play. Itís free to use and when you look up a drug, it will give you a cost list to quite a few pharmacies. Costco, Walmart, Kroger, Walgreens, CVS etc.

Iím including two photos so you can see it. Once you get the list, you click on the pharmacy of your choice and it brings up a coupon with ID numbers the pharmacy uses to give you the discount.

GoodRx also has a monthly Gold plan where you can get additional discounts on over a thousand different prescriptions. $5.99 individual and $9.99 family plan. You donít have to do a subscribed plan. You can just use the free version.

Instead of paying $335 for Jazzyís new prescription, GoodRx got me down to $110. Itís still a lot, but much better than the other figure. I also checked her other two meds and instead of paying $29.94 for 45 pills of her blood pressure medicine, amlodipine, I can get 60 pills for $8.00! Her thyroid from $29.75 at the vets office down to $12.

Itís only been a couple of days, but Jazzy seems to be tolerating the new medicine with no side effects. Hope it continues.

The pills are huge. Both are oblong and the 100mg is flesh colored. I told my Mom that every time I give Jazzy one, I feel like Iím feeding her a finger!

Hope everyone has a great day!


Janet


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post #17 of 17 (permalink) Old 08-22-2020, 09:21 AM
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Dogs Age: Baby boy
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What great news!! Those are much better prices and takes the sting out of it a little.

You are definitely not alone here! We all love these babies to death and actually beyond.



Kin's Sweet Revenge aka Sugar December 31/18

Coco Loco RIP April 16/09 to December 21/18
Coco Loco is offline  
The Following 2 Users Say Thank You to Coco Loco For This Useful Post:
4x4bike ped (08-22-2020), Bluedobie (08-22-2020)
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