{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:56:52Z","timestamp":1784116612912,"version":"3.55.0"},"reference-count":20,"publisher":"American Veterinary Medical Association (AVMA)","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"sc_a1\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the discriminatory potential of selected clinical and routine laboratory markers to differentiate primary immune thrombocytopenia (pITP) and secondary immune thrombocytopenia (sITP) in dogs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a2\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective diagnostic accuracy study including dogs with severe immune thrombocytopenia (platelet count [PLT] &lt; 50 X 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L) presenting between 2014 and 2024 to a single university veterinary hospital, which were identified by laboratory database search and subsequent review of medical records.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 17 dogs with pITP and 36 with sITP. Dogs with pITP had significantly lower PLT (median, 8 X 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L [IQR, 3 to 21]) and C-reactive protein (CRP; median, 20.5 mg\/L [IQR, 6.4 to 76.6]) compared to dogs with sITP (PLT median, 25 X 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L [IQR, 13 to 35] and CRP median, 72.7 mg\/L [IQR, 37.3 to 137.3]) and were significantly more likely to present with bleeding diathesis. The combination of bleeding diathesis, PLT &lt; 8.5 X 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L, and CRP &lt; 25 mg\/L had a positive likelihood ratio of 8.8 for pITP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a4\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The combination of bleeding diathesis, PLT, and CRP concentration shows potential for differentiating between dogs with pITP and sITP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a5\">\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Differentiating between pITP and sITP is imperative, as treatment is widely different. The results of the current study could potentially be used to help guide clinical decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/ajvr.25.06.0226","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T13:41:53Z","timestamp":1756820513000},"source":"Crossref","is-referenced-by-count":1,"title":["A combination of clinical and laboratory markers can be used as a tool to differentiate between primary and secondary immune thrombocytopenia in dogs"],"prefix":"10.2460","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0564-2136","authenticated-orcid":true,"given":"Nanna","family":"Bak-Jacobsen","sequence":"first","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisbeth R.","family":"Jessen","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie M.","family":"Gr\u00f8nlund","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne H.","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne K. H.","family":"Krogh","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise N.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Langhorn","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"key":"B1","series-title":"Vet Clin Pathol","first-page":"17","article-title":"Immune thrombocytopenia (ITP): pathophysiology update and diagnostic dilemmas","volume":"48","author":"LeVine DN","year":"2019","unstructured":"LeVine DN, Brooks MB. Immune thrombocytopenia (ITP): pathophysiology update and diagnostic dilemmas. Vet Clin Pathol. 2019;48(suppl 1):17\u201328. doi:10.1111\/vcp.12774"},{"issue":"2","key":"B2","series-title":"J Vet Intern Med","first-page":"700","article-title":"Detection and dynamics of anti-platelet antibodies in thrombocytopenic dogs with and without idiopathic immune thrombocytopenia","volume":"34","author":"Shropshire S","year":"2020","unstructured":"Shropshire S, Dow S, Lappin M. Detection and dynamics of anti-platelet antibodies in thrombocytopenic dogs with and without idiopathic immune thrombocytopenia. J Vet Intern Med. 2020;34(2):700\u2013709. doi:10.1111\/jvim.15737"},{"issue":"8","key":"B3","series-title":"J Am Vet Med Assoc","first-page":"960","article-title":"Underlying diseases and clinicopathologic variables of thrombocytopenic dogs with and without platelet-bound antibodies detected by use of a flow cytometric assay: 83 cases (2004\u20132006)","volume":"235","author":"Dircks BH","year":"2009","unstructured":"Dircks BH, Schuberth HJ, Mischke R. Underlying diseases and clinicopathologic variables of thrombocytopenic dogs with and without platelet-bound antibodies detected by use of a flow cytometric assay: 83 cases (2004\u20132006). J Am Vet Med Assoc. 2009;235(8):960\u2013966. doi:10.2460\/javma.235.8.960"},{"key":"B4","series-title":"J Am Anim Hosp Assoc","first-page":"250","article-title":"Primary immune-mediated thrombocytopenia in 30 dogs (1997\u20132003)","volume":"44","author":"Putsche JC","year":"2008","unstructured":"Putsche JC, Kohn B. Primary immune-mediated thrombocytopenia in 30 dogs (1997\u20132003). J Am Anim Hosp Assoc. 2008;44:250\u2013257. doi:10.5326\/0440250"},{"issue":"5","key":"B5","series-title":"J Vet Intern Med","first-page":"2507","article-title":"Plasma concentration of thrombopoietin in dogs with immune thrombocytopenia","volume":"38","author":"Brooks MB","year":"2024","unstructured":"Brooks MB, Brooks JC, Catalfamo J, et al. Plasma concentration of thrombopoietin in dogs with immune thrombocytopenia. J Vet Intern Med. 2024;38(5):2507\u20132517. doi:10.1111\/jvim.17152"},{"issue":"4","key":"B6","series-title":"J Vet Intern Med","first-page":"1958","article-title":"ACVIM consensus statement on the diagnosis of immune thrombocytopenia in dogs and cats","volume":"38","author":"LeVine DN","year":"2024","unstructured":"LeVine DN, Kidd L, Garden OA, et al. ACVIM consensus statement on the diagnosis of immune thrombocytopenia in dogs and cats. J Vet Intern Med. 2024;38(4):1958\u20131981. doi:10.1111\/jvim.16996"},{"issue":"1","key":"B7","series-title":"Am J Vet Res","first-page":"124","article-title":"Development of a sensitive immunoradiometric assay for detection of platelet surface-associated immunoglobulins in thrombocytopenic dogs","volume":"63","author":"Scott MA","year":"2002","unstructured":"Scott MA, Kaiser L, Davis JM, Schwartz KA. Development of a sensitive immunoradiometric assay for detection of platelet surface-associated immunoglobulins in thrombocytopenic dogs. Am J Vet Res. 2002;63(1):124\u2013129. doi:10.2460\/AJVR.2002.63.124"},{"issue":"3","key":"B8","series-title":"Vet Clin Pathol","first-page":"355","article-title":"Prospective diagnostic accuracy evaluation and clinical utilization of a modified assay for platelet-associated immunoglobulin in thrombocytopenic and nonthrombocytopenic dogs","volume":"44","author":"Bachman DE","year":"2015","unstructured":"Bachman DE, Forman MA, Hostutler RA, Corn S, Lin J, Kociba GJ. Prospective diagnostic accuracy evaluation and clinical utilization of a modified assay for platelet-associated immunoglobulin in thrombocytopenic and nonthrombocytopenic dogs. Vet Clin Pathol. 2015;44(3):355\u2013368. doi:10.1111\/vcp.12281"},{"issue":"2","key":"B9","series-title":"J Vet Intern Med","first-page":"1022","article-title":"A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs","volume":"38","author":"Brooks MB","year":"2024","unstructured":"Brooks MB, Goggs R, Frye AH, et al. A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs. J Vet Intern Med. 2024;38(2):1022\u20131034. doi:10.1111\/jvim.16985"},{"issue":"12","key":"B10","series-title":"Kleintierpraxis","first-page":"893","article-title":"Clinical findings, diagnostics and treatment results in primary and secondary immune-mediated thrombocytopenia in the dog","volume":"45","author":"Kohn B","year":"2000","unstructured":"Kohn B, Giger U. Clinical findings, diagnostics and treatment results in primary and secondary immune-mediated thrombocytopenia in the dog. Kleintierpraxis. 2000;45(12):893\u2013907."},{"issue":"2","key":"B11","series-title":"J Vet Med Sci","first-page":"127","article-title":"C-reactive protein concentration in dogs with various diseases","volume":"70","author":"Nakamura M","year":"2008","unstructured":"Nakamura M, Takahashi M, Ohno K, et al. C-reactive protein concentration in dogs with various diseases. J Vet Med Sci. 2008;70(2):127\u2013131. doi:10.1292\/jvms.70.127"},{"issue":"8","key":"B12","series-title":"Vet World","first-page":"2150","article-title":"Characterization of serum protein electrophoresis patterns and c-reactive protein in canine tick-borne diseases","volume":"14","author":"Asawakarn S","year":"2021","unstructured":"Asawakarn S, Taweethavonsawat P. Characterization of serum protein electrophoresis patterns and c-reactive protein in canine tick-borne diseases. Vet World. 2021;14(8):2150\u20132154. doi:10.14202\/vetworld.2021.2150-2154"},{"issue":"5","key":"B13","series-title":"Can Vet J","first-page":"514","article-title":"Outcome based on treatment protocol in patients with primary canine immune-mediated thrombocytopenia: 46 cases (2000\u20132013)","volume":"57","author":"Scuderi MA","year":"2016","unstructured":"Scuderi MA, Snead E, Mehain S, Waldner C, Epp T. Outcome based on treatment protocol in patients with primary canine immune-mediated thrombocytopenia: 46 cases (2000\u20132013). Can Vet J. 2016;57(5):514\u2013518."},{"issue":"4","key":"B14","series-title":"Vet Med Sci","first-page":"1495","article-title":"Causes of thrombocytopenia in dogs in the United Kingdom: a retrospective study of 762 cases","volume":"9","author":"Mart\u00edn-Ambrosio Franc\u00e9s M","year":"2023","unstructured":"Mart\u00edn-Ambrosio Franc\u00e9s M, Seth M, Sharman M, et al. Causes of thrombocytopenia in dogs in the United Kingdom: a retrospective study of 762 cases. Vet Med Sci. 2023;9(4):1495\u20131507. doi:10.1002\/vms3.1091"},{"issue":"5","key":"B15","series-title":"J Small Anim Pract","first-page":"305","article-title":"Prognostic factors and long-term outcome in dogs diagnosed with primary and secondary immune thrombocytopenia in Ireland","volume":"66","author":"L\u00f3pez-Bail\u00e9n E","year":"2025","unstructured":"L\u00f3pez-Bail\u00e9n E, Duclos A, Mullany D, Le Boedec K, Cuq B. Prognostic factors and long-term outcome in dogs diagnosed with primary and secondary immune thrombocytopenia in Ireland. J Small Anim Pract. 2025;66(5):305\u2013313. doi:10.1111\/jsap.13833"},{"issue":"11","key":"B16","series-title":"Ann Hematol","first-page":"3007","article-title":"Bleeding risk assessment in immune thrombocytopenia","volume":"102","author":"Mishra K","year":"2023","unstructured":"Mishra K, Jandial A, Sandal R, et al. Bleeding risk assessment in immune thrombocytopenia. Ann Hematol. 2023;102(11):3007\u20133014. doi:10.1007\/s00277-023-05466-1"},{"issue":"3","key":"B17","series-title":"J Am Vet Med Assoc","first-page":"346","article-title":"Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia","volume":"238","author":"O\u2019Marra SK","year":"2011","unstructured":"O\u2019Marra SK, Delaforcade AM, Shaw SP. Treatment and predictors of outcome in dogs with immune-mediated thrombocytopenia. J Am Vet Med Assoc. 2011;238(3):346\u2013352. doi:10.2460\/javma.238.3.346"},{"issue":"4","key":"B18","series-title":"Vet Clin Pathol","first-page":"421","article-title":"C-reactive protein concentration in dogs with primary immune-mediated hemolytic anemia","volume":"38","author":"Griebsch C","year":"2009","unstructured":"Griebsch C, Arndt G, Raila J, Schweigert FJ, Kohn B. C-reactive protein concentration in dogs with primary immune-mediated hemolytic anemia. Vet Clin Pathol. 2009;38(4):421\u2013425. doi:10.1111\/j.1939-165X.2009.00146.x"},{"issue":"21","key":"B19","series-title":"Vet Rec","first-page":"647","article-title":"Retrospective study of 871 dogs with thrombocytopenia","volume":"164","author":"Botsch V","year":"2009","unstructured":"Botsch V, K\u00fcchenhoff H, Hartmann K, Hirschberger J. Retrospective study of 871 dogs with thrombocytopenia. Vet Rec. 2009;164(21):647\u2013651. doi:10.1136\/vr.164.21.647"},{"issue":"3","key":"B20","series-title":"J Vet Intern Med","first-page":"1041","article-title":"Development and implementation of a novel immune thrombocytopenia bleeding score for dogs","volume":"32","author":"Makielski KM","year":"2018","unstructured":"Makielski KM, Brooks MB, Wang C, Cullen JN, O\u2019Connor AM, LeVine DN. Development and implementation of a novel immune thrombocytopenia bleeding score for dogs. J Vet Intern Med. 2018;32(3):1041\u20131050. doi:10.1111\/jvim.15089"}],"container-title":["American Journal of Veterinary Research"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/86\/11\/ajvr.25.06.0226.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/86\/11\/ajvr.25.06.0226.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/86\/11\/ajvr.25.06.0226.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T15:28:20Z","timestamp":1762529300000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/86\/11\/ajvr.25.06.0226.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":20,"journal-issue":{"issue":"11"},"URL":"https:\/\/doi.org\/10.2460\/ajvr.25.06.0226","relation":{},"ISSN":["0002-9645","1943-5681"],"issn-type":[{"value":"0002-9645","type":"print"},{"value":"1943-5681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,1]]}}}