eCommons

 

Pyometra Induced Immune Mediated Thrombocytopenia in a Labrador Retriever

Other Titles

Abstract

An approximately 9-year-old female intact Labrador presented to her primary care veterinarian with a complaint of increased amount of vaginal discharge, lethargy, and inappetence. She was diagnosed with an open pyometra accompanied by a severe thrombocytopenia and referred to Cornell University Hospital for Animals (CUHA) for treatment. Two weeks prior to her presentation the patient was taken in to her primary veterinarian to be spayed, however bloody vaginal discharge was noted and she was presumed to be in heat, thus ovariohysterectomy was not performed at that time. Initial physical examination at CUHA was unremarkable except for a small amount of bloody vaginal discharge, lethargy and inappetence. The patient's condensed problem list up to that point included; open pyometra and a thrombocytopenia. Differentials for a severe thrombocytopenia were discussed including consumption due to disseminated intravascular coagulation, sequestration by the spleen or other organs, decreased production by the bone marrow due to neoplastic invasion, infection, or other myeloproliferative disorders, or destruction via immune mediated processes. Ultimately the most likely diagnosis given the severe thrombocytopenia (3 thou/uL, reference interval: 186-545) was an immune mediated thrombocytopenia (ITP), likely secondary due to the concurrent pyometra. Due to the surgical risk of pursuing an ovariohysterectomy for removal of the inciting cause; medical management was enacted to treat the pyometra while waiting for immunosuppressive therapy (Prednisolone 30 mg every 12 hours) to improve the number of circulating platelets. An acceptable platelet count was achieved, and the patient was discharged home for a short while before returning for an ovariohysterectomy. Upon re-presentation, the patient had developed diabetes mellitus secondary to high progesterone levels, however with proper insulin therapy in addition to an ovariohysterectomy, her blood glucose levels normalized and since then she has been weaned off insulin therapy. The patient is currently receiving immunosuppressive therapy for her ITP and is doing well at home.

Journal / Series

Volume & Issue

Description

Sponsorship

Date Issued

2017-09-27

Publisher

Keywords

Canine -- Immune-Mediated Thrombocytopenia, Pyometra; Canine -- Diabetes; Canine -- Insulin Resistance

Location

Effective Date

Expiration Date

Sector

Employer

Union

Union Local

NAICS

Number of Workers

Committee Chair

Committee Co-Chair

Committee Member

Degree Discipline

Degree Name

Degree Level

Related Version

Related DOI

Related To

Related Part

Based on Related Item

Has Other Format(s)

Part of Related Item

Related To

Related Publication(s)

Link(s) to Related Publication(s)

References

Link(s) to Reference(s)

Previously Published As

Government Document

ISBN

ISMN

ISSN

Other Identifiers

Rights

Rights URI

Types

case study

Accessibility Feature

Accessibility Hazard

Accessibility Summary

Link(s) to Catalog Record