Given the immunosuppressed status of these patients secondary to ciclosporin and prednisolone therapy, reverse barrier nursing is essential, especially if the patient is having cytotoxic drugs administered [ 4 ]. Protocols should be put in place to minimise the risk of the IMPT patient contracting hospital-acquired infections [ 8 ]. These include:
• housing the patient in isolation if possible
• reducing the number of staff who interact with the patient to the necessary minimum
• wearing PPE when caring for the patient – the minimum PPE required is a long-sleeved gown, shoe covers and gloves
• keeping specific equipment or medications for the patient separate from those for other patients
• limiting exposure of the patient to areas where other dogs have been walked.
Patients should be fed little and often, and walked regularly to accommodate the polyuria that is a common side effect of corticosteroid treatment. The patient ' s vital signs, to include temperature, heart rate, respiratory rate and mucous membrane colour, must be monitored at least every 4 hours. Petechial haemorrhage, demeanour and pulse quality should also be documented.
REFERENCES
1 Jones L. Help, my patient is bleeding! The veterinary nurse ' s guide to coagulation: part 1. Veterinary Internal Medicine Nursing. 2022. Available from: https:// www. veterinaryinternalmedicinenursing. com / blog / haemostasis-part-1 [ Accessed 24 October 2024 ].
2 McQuinn E. Platelets in animals. MSD Veterinary Manual. 2025. Available from: https:// www. msdvetmanual. com / circulatorysystem / hematopoietic-system-introduction / platelets-in-animals [ Accessed 26 May 2026 ].
3 Day MJ, Kohn B.( eds.) BSAVA Manual of Canine and Feline Haematology and Transfusion Medicine. 2nd ed. Gloucester: BSAVA; 2012.
4 Johnson A. The thrombocytopenic patient. Veterinary Nursing Journal. 2022; 37( 2): 23 – 27. Available from: https:// bvna. org. uk / blog / the-thrombocytopenic-patient-2 / [ Accessed 23 April 2026 ].
5 Brooks W. Immune-mediated thrombocytopenia( IMT). Veterinary Partner. 2024. Available from: https:// veterinarypartner. vin. com / default. aspx? pid = 19239 & id = 4951884 [ Accessed 24 October 2024 ].
6 LeVine DN, Goggs R, Kohn B, Mackin AJ, Kidd L, Garden OA, et al. ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats. Journal of Veterinary Internal Medicine. 2024; 38( 4): 1982 – 2007. Available from: https:// doi. org / 10.1111 / jvim. 17079.
7 Nusbaum, R. Blood transfusions in anemic dogs and cats. Today ' s Veterinary Nurse. 2021. Available from: https:// todaysveterinarynurse. com / hematology / blood-transfusions-inanemic-dogs-and-cats / [ Accessed 24 October 2024 ].
8 Andrews-Jones B. Infection control and biosecurity guidance. RCVS Knowledge. 2020. Available from: https:// www. rcvsknowledge. org / resource / infection-control-and-biosecurity-guidance / [ Accessed 26 May 2026 ].
Once the patient is stable, the medication dose can be gradually reduced to a maintenance level, while platelet counts are closely monitored throughout treatment. Usually, the dose of only one medication is reduced at a time so that any change in the patient ' s condition can be tracked and linked to the change in the medication more easily.
Peach returned to the hospital 3 days after discharge for a planned re-examination and haematological sample. A month after the pRBC transfusion she was bright, alert and responsive, with pink mucous membranes, and cardiovascularly stable. Her platelet count had risen to 265 × 10 9 / l and her PCV had increased to 36.5 %, indicating a strong response to treatment.
Conclusions
IMTP is a serious disease in dogs, and while around 70 – 90 % of dogs respond well to quick and effective treatment, some patients do not respond at all. For dogs such as Peach, successful treatment often requires long-term immunosuppressive therapy.
This case highlights the importance of prompt diagnosis, intensive nursing care and ongoing monitoring in the management of IMTP.
Why should you join BVNA?
Why wouldn ' t you, when membership is only £ 62 a year and gives you access to:
• the digital VNJ( print upgrade = £ 80 / year)
• an independent employment advisory service
• bursaries to support your CPD
• 40 % discount on BVNA Congress tickets
• discounted online and in-person CPD events
• a chance to be a BVNA Council Member.
MEMBERSHIP MATTERS
MEMBERSHIP COSTS RVN from £ 6 / month SVN from £ 4.15 / month Associate from £ 4.92 / month
bvna. org. uk / membership
32 Veterinary Nursing Journal