Underlying causes of thrombocytopenia in dogs from a Mediterranean mixed primary and referral hospital in Barcelona: a retrospective cross-sectional study of 266 cases.

In thrombocytopenic dogs, severe thrombocytopenia with cutaneous bleeding strongly suggests primary immune thrombocytopenia over other causes.

This retrospective cross-sectional study evaluated the underlying causes and clinicopathological features of thrombocytopenia in 266 dogs presenting to a mixed primary and referral hospital in Barcelona, Spain, between 2021 and 2023. Neoplasia was the most common diagnosis (31.6%), followed by infectious diseases (24.4%), inflammatory or immune-mediated disorders (16.2%), miscellaneous conditions (15.4%), and primary immune thrombocytopenia (pITP) (12.4%). Vector-borne diseases, predominantly leishmaniosis and babesiosis, accounted for 10.9% of cases—an intermediate frequency compared to other European hospital-based cohorts, reflecting regional geographic variation. Clinical bleeding was observed in 42.5% of all dogs and was most prevalent in pITP cases (78.8%), predominantly as cutaneous hemorrhage. Dogs with pITP had significantly lower platelet counts than all other diagnostic groups, making severe thrombocytopenia a useful differentiating feature. Additional clinicopathological distinctions included higher albumin concentrations in pITP compared to infectious disease groups, and elevated globulin concentrations in vector-borne diseases. Fever was more frequently associated with infectious diseases, particularly non-vector-borne causes. Dogs with neoplasia were significantly older than those in other categories. These findings highlight that neoplasia should be a primary differential in thrombocytopenic dogs in this geographic region, and that a combination of severe thrombocytopenia, cutaneous hemorrhage, and normal albumin levels may help clinicians differentiate pITP from other etiologies, guiding diagnostic prioritization and treatment decisions.

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