Presumptive immune‐mediated thrombocytopenia secondary to massive Africanized bee envenomation in a dog

Abstract

To describe a case of immune-mediated thrombocytopenia (IMT) after massive Africanized bee envenomation in a dog. While boarding at a kennel, a dog was stung by approximately 300 Africanized bees. During initial veterinary examination, the dog was deemed to be in shock, characterized by collapse, with hypotension, bradycardia, and hypoglycemia. In addition, severe diffuse erythema and edema were noted over the entire body. Supportive care, including IV crystalloid and colloid fluids, dextrose, fresh frozen plasma, oxygen therapy, broad spectrum antimicrobials, dexamethasone, and diphenhydramine was initiated. The dog's condition stabilized over the next 2 days. Forty-eight hours after admission the dog developed hematemesis and hematochezia, and severe thrombocytopenia was identified. Extensive diagnostic investigation revealed no likely trigger other than the Africianized bee exposure, and a diagnosis of IMT was made. Following a red blood cell transfusion and immunosuppressive doses of dexamethasone and gastroprotectant therapy, the dog's condition stabilized, and the platelet count returned to normal after 7 days from initiation of therapy. IMT is a possible sequelae of massive Africanized bee envenomation in the dog.