13-year-old female neutered daschund presented with lethargy. Severe thrombocytopenia was observed on hematology and moderate anemia, HCT 26. A diagnosis of immune-mediated thrombocytopenia was made based on the blood smear examination and the dog was placed on prednisolone. The owner brought the dog again about a week ago for a follow up and the ALT and ALP were very high. Prednisolone dose was reduced. Three to 4 days later, once the dose was reduced, thrombocytopenia happened again. Anemia was still there. Abdominal US was done to rule out any steroid-induced gastric ulcers. I didn’t see any gastric ulcers but there seems to be a soft tissue structure in the stomach.Is it tumor?  If it is not, then we are left with Immune mediated thrombocytopenia and then probably we need to use some alternative drug, othe than prednisoloneThe stool is formed and has balck colour. There is a suspicion of one episode of hematemesis in the last three weeks – the owner has four dogs so she is not sure if the vomiting was from this dog or one of the other dogs –