Lexi's story started in June 2025 when I noticed one afternoon that she had blood in the iris of both of her eyes. She was still playing and acting normal, so I chose to wait until the next morning to call our vet because it was a Sunday evening. The next morning, I called and talked with our wonderful vet office who asked me to bring her in for an urgent care appointment. Lexi had blood work completed and we were working on getting discharged to come home and wait for results until her platelet level came back at zero. Our vet was in surgery that morning, so the urgent care vet went to speak with him, and the decision was made to hospitalize Lexi overnight to watch her and give her Vitamin K and steroids to boost her clotting. What I thought would be hopefully a scare had turned into one of the worst nightmares for my sweet, sweet girl.

Lexi was diagnosed with Immune Mediated Thrombocytopenia at 11 years old. This comes less than a year after surgery for a torn CCL and meniscus, which was performed at her age to allow her to remain as active as she was.

Shortly after starting medications for IMT, Lexi developed what seemed to be enlarged lymph nodes. I opted to perform a Fine Needle Aspiration to determine if Lymphoma was underlying and finally showing. One of the main concerns for me was that she did have some type of lymphoma or leukemia and it was too early to see the markers in her blood. (It came back as adipose!) After running blood pathology multiple times and platelets bottoming out (back to zero) more than a few times, we found ourselves without answers and were referred to an internal medicine specialist.

The first visit, the IM specialist ran more bloodwork, took X-rays, and performed an ultrasound (amongst other things) to search for obvious signs of cancer or causes of the platelet dysfunction. Thankfully, nothing was found! This felt hopeful, and we agreed that medication management would be important.

Something to note about Lexi's disease is that there are only three medications that are really used for immune mediated thrombocytopenia. The main goal is to suppress the immune system to keep the body from destroying the platelets. Steroids are given to support the body in the meantime but are used with the idea of eventually weaning off of them. Lexi's platelets have bottomed out any time we have attempted to wean her from a higher dose of prednisone. This has led to her continuing the higher dose of steroid and also switching immunosuppressants.

Lexi has developed many additional ailments with IMT. Thanks to the high dose of steroids, she has lost most of her muscle mass and is skin and bone except for her pot belly. I've especially noticed this in her head recently. This is scary for multiple reasons but also makes me very nervous because it increases her risk for rupturing her other CCL, and she was already at an increased risk due to the previous injury. She also had a nasty infection come up rapidly on her back/rump that has recurred once since then in the same spot. I chose to have it cultured the second time to ensure that it was susceptible to the antibiotics we were given prophylactically. Thankfully, it resulted as a general staph infection. However, a similar knot of infection has come up on her nose and is not responding to the antibiotics. She also is having dental changes and has cracked one tooth and also has one that is turning purple as of tonight.

The latest visit to the specialist resulted in changing immunosuppressants to the last option. We also have not been able to bring Lexi's platelets back up to a normal range despite being on the higher dose of prednisone for over a month. Typically, she would respond, and her levels would jump rather dramatically in just a week. This means that she is no longer responding well enough to remain on that steroid, and that had to be changed too.

I realize that we are quickly running out of options for my sweet Lexi. I have been at the vet more than I have ever cared to be in the last 2 years thanks to Axil being diagnosed with heart failure and Cushing's disease and then Lexi's CCL and now this. Between IM specialist appointments, I have had to take Lexi to our local vet as well and even the ER vet.

IMT has been a wrecking ball in my household. I see so many success stories and stories where dogs rarely struggle after being diagnosed. Lexi has been anything but cookie cutter, in my opinion. Anyone who knows me knows that Lexi and Axil are my whole world. I would sell a kidney if it were legal to make sure they have what they need. I'm currently working 50+ hours a week and going to nursing school full time (although a graduate in a couple of weeks). Despite this, I'm asking for help. No amount of planning would have prepared me for both of my very healthy dogs to have multiple, chronic illnesses that require frequent appointments and multiple medications. Medications for Axil (who is stable in his illnesses) are close to $350 a month. This does not include food, preventatives, or any illness/injury that comes up. This also does not include Lexi at all. Each specialist appointment for Lexi is roughly $300 if only bloodwork is collected to monitor her platelet levels. This, again, does not include medications, food, or any additional things that come up.

I am not one to ask for or accept help - especially if I have taken on the situation willingly. If nothing else, please be sure to think of my Lexi.

With love,

Ashley, Lexi, and Axil