Therapeutic application of canine adipose tissue-derived mesenchymal stromal cells in a dog with refractory immune-mediated thrombocytopenia, with diabetic ketoacidosis, and gastrointestinal bleeding induced by immunosuppressive treatment.

Refractory immune-mediated thrombocytopenia (ITP) in dogs is a condition with a poor prognosis due to the poor response to immunosuppressive therapy and the adverse effects of long-term drug administration. This case report describes the successful management of refractory ITP using stem cell therapy in a dog that experienced severe side effects from immunosuppressive treatment. The patient experienced recurrent relapses when prednisolone (PDS) tapering was attempted during conventional immunosuppressive therapy, necessitating prolonged use of PDS; this led to complications, such as diabetic ketoacidosis and chronic gastrointestinal bleeding. In this case, the dog was treated with canine adipose tissue-derived mesenchymal stromal cells (cAT-MSCs) administered intravenously at four-week intervals for eight sessions. Following MSC therapy, refractory ITP was successfully treated without PDS, and the side effects associated with prolonged use of PDS and multiple immunosuppressants were resolved. Although further investigations are needed for the clinical application of cAT-derived MSCs in ITP, cAT-MSC injections could be an alternative treatment option for refractory ITP in veterinary medicine.