Evan's Syndrome

Anyone ever dealt with it? I've got a 2 year old girl coming in with it. Here's the description of it:

Evans Syndrome refers to a condition in which the following two
conditions exist at the same time – Immune mediated thrombocytopenia
(ITP) and Immune mediated hemolytic anemia (IMHA). Both of these are
complex diseases that result in destruction of the platelets
(thrombocytopenia) and red blood cells (anemia).

Not a happy little diagnosis. She's on her way to our vet emergency for a transfusion since her platelet count is so low it isn't registering on blood work.......

never heard of it - doesn't sound good at all. poor little mite!

I hadn't heard of it till last week! One of our volunteers almost lost their pug due to this. He's now home and on pred and cyclosporine. Do you want me to have him email you?

I've only heard of IMHA. I guess I have more experience with immunocompromised pets in general. Down the road, she'll need a home with someone who can afford to have her bloodwork checked and to get transfusions. She will get infections more easily and will probably run up bills in meds and treatment. She could probably benefit from probiotics and living in a clean home. Extra care should be taken for things like making sure she doesn't drink from puddles or standing water. She probably can't be vaccinated safely, but your vet should be able to write a letter so you don't get in trouble with the county and regulations. I know all this is for the future, but just what comes to mind. She would also probably really benefit from seeing a specialist (I'm sure there are immunologists in the vet world...I've never thought about it). My coworker has a boxer who is severely immunocompromised. She consistantly has infections in her vulva and on her skin, and was on pred long term. She's had 3 blood transfusions and has cost her owner over $6,500 in vet bills...and my coworker works at the vet's with me (meaning she isn't charged for every little thing).

All that being said, with supportive care and an educated aware owner, I wouldn't doubt that she won't be able to live an okay life. I've never heard of the two together, but no disease out there has a set timeline for a pet's life.

Good luck with her. I'll keep her in my thoughts. Update us if you can. The immune system is a very interesting part of life. Unfortunately, though, sometimes when it doesn't function as it should, the unpredictablility can be hard to deal with. Strong positive thoughts for your girl, though! She will feel sooooo much better after the transfusion.

Brenda wrote:I hadn't heard of it till last week! One of our volunteers almost lost their pug due to this. He's now home and on pred and cyclosporine. Do you want me to have him email you?

Not as yet, but I may ask for help later. She's staying at our vet emerg for a transfusion and is seeing the specialist tomorrow. Although all her diagnostics show her as in crisis, she's still a pretty alert little girl which surprised everyone.

She's in our emergency and referral hospital--one of the best and I will see what the specialist thinks. She needs a fair bit of work up still. So the Evan's isn't confirmed yet, but looks likely. She's cute as a button.

thminis wrote:I've only heard of IMHA. I guess I have more experience with immunocompromised pets in general. Down the road, she'll need a home with someone who can afford to have her bloodwork checked and to get transfusions. She will get infections more easily and will probably run up bills in meds and treatment. She could probably benefit from probiotics and living in a clean home. Extra care should be taken for things like making sure she doesn't drink from puddles or standing water. She probably can't be vaccinated safely, but your vet should be able to write a letter so you don't get in trouble with the county and regulations. I know all this is for the future, but just what comes to mind. She would also probably really benefit from seeing a specialist (I'm sure there are immunologists in the vet world...I've never thought about it). My coworker has a boxer who is severely immunocompromised. She consistantly has infections in her vulva and on her skin, and was on pred long term. She's had 3 blood transfusions and has cost her owner over $6,500 in vet bills...and my coworker works at the vet's with me (meaning she isn't charged for every little thing).

All that being said, with supportive care and an educated aware owner, I wouldn't doubt that she won't be able to live an okay life. I've never heard of the two together, but no disease out there has a set timeline for a pet's life.

Good luck with her. I'll keep her in my thoughts. Update us if you can. The immune system is a very interesting part of life. Unfortunately, though, sometimes when it doesn't function as it should, the unpredictablility can be hard to deal with. Strong positive thoughts for your girl, though! She will feel sooooo much better after the transfusion.

we're no strangers to immune compromised dogs or to dogs on immunosuppressives.

She's likely going to be on pred and azathioprine--but we'll see what Dr. Mason says. As to her adoptability......well, I may end up with a fourth dog whether I want one or not. The reality is there's no line up for expensive, health compromised, immune compromised, no cure for this dogs.

northernwitch wrote:

thminis wrote:I've only heard of IMHA. I guess I have more experience with immunocompromised pets in general. Down the road, she'll need a home with someone who can afford to have her bloodwork checked and to get transfusions. She will get infections more easily and will probably run up bills in meds and treatment. She could probably benefit from probiotics and living in a clean home. Extra care should be taken for things like making sure she doesn't drink from puddles or standing water. She probably can't be vaccinated safely, but your vet should be able to write a letter so you don't get in trouble with the county and regulations. I know all this is for the future, but just what comes to mind. She would also probably really benefit from seeing a specialist (I'm sure there are immunologists in the vet world...I've never thought about it). My coworker has a boxer who is severely immunocompromised. She consistantly has infections in her vulva and on her skin, and was on pred long term. She's had 3 blood transfusions and has cost her owner over $6,500 in vet bills...and my coworker works at the vet's with me (meaning she isn't charged for every little thing).

All that being said, with supportive care and an educated aware owner, I wouldn't doubt that she won't be able to live an okay life. I've never heard of the two together, but no disease out there has a set timeline for a pet's life.

Good luck with her. I'll keep her in my thoughts. Update us if you can. The immune system is a very interesting part of life. Unfortunately, though, sometimes when it doesn't function as it should, the unpredictablility can be hard to deal with. Strong positive thoughts for your girl, though! She will feel sooooo much better after the transfusion.

we're no strangers to immune compromised dogs or to dogs on immunosuppressives.

She's likely going to be on pred and azathioprine--but we'll see what Dr. Mason says. As to her adoptability......well, I may end up with a fourth dog whether I want one or not. The reality is there's no line up for expensive, health compromised, immune compromised, no cure for this dogs.

There are some suckers like me out there! I hope she is ok, that sounds like quite a lot for a little girl to handle.

From what I've read they either respond to treatment within the first couple of weeks or they don't. If she doesn't then we'll let her go. She's actually another pug rescue's dog who was adopted as a puppy. the owners have lost their jobs and couldn't afford her care. The other pug rescue is a long drive away, she's not healthy enough to transport and the head of the rescue is just about to head to the US on holidays. So I said we'd take her until (1) the rescue decides if they can afford her care, (2) she's healthy enough to transport or (3) she needs to be let go.

Estimate of her vet care is 4 to 6 thousand dollars at this point.

And with all the pred and other meds, she needs a foster home (and later an adoptive home) with someone home a fair bit so she can get out to pee.

northernwitch wrote:"There are some suckers like me out there! I hope she is ok, that sounds like quite a lot for a little girl to handle"

Just call me Sucker #2--you'll notice who's fostering her, right? and you'll notice my crew of not exactly in the best health dogs......

I'm the Island of Misfit Dogs.

Yeah I did happen to notice that. It's ok, I might be getting the cleft palate girl Monday.

I do hope she responds though, it makes me sad to see them with such a tough road ahead.

Saira wrote:

northernwitch wrote:"There are some suckers like me out there! I hope she is ok, that sounds like quite a lot for a little girl to handle"

Just call me Sucker #2--you'll notice who's fostering her, right? and you'll notice my crew of not exactly in the best health dogs......

I'm the Island of Misfit Dogs.

Yeah I did happen to notice that. It's ok, I might be getting the cleft palate girl Monday.

I do hope she responds though, it makes me sad to see them with such a tough road ahead.

Me, too, Saira. She's darn cute. I went back to see her since I'd never met her. Poor little muffin is pretty bloated--there may be bladder issues--was on oxygen and a zillion IVs.

I need to be independently wealthy or whore myself out to a millionaire with a love for damaged dogs. Working for a living is seriously interfering with the rescue work--as every owner surrender proves.

What a sad situation, it really sounds like there are gonna be some tough decisions to make. Poor little mite. If you find that millionaire, Blanche, hold him captive until you empty his bank account.

Well, the other pug rescue has decided to surrender her to us and is going to try and help us cover her vet costs. They feel, and I agree, that with their director out of town for the next couple of weeks it makes more sense for her to stay with us. At least that way there isn't any potential for conflict over decisions--not that there would be as they are a great rescue.

Poor little mite. I've never heard of this before, but in the "rescue game" there is always something to learn.
I really hope all goes well for her, Blanche. Does she have a name?

northernwitch wrote:the Island of Misfit Dogs.

That's funny, that's what I've always called our house!

We've dealt with IMHA before ("we" as in NIPRA) but Evans Syndrome is a new one to me. Best of luck to you & the little one! I know that IMHA can be extremely difficult to get under control on it's own so I can't imagine having other things to deal with on top of that. I'll be keeping her in my thoughts.

H the P wrote:Poor little mite. I've never heard of this before, but in the "rescue game" there is always something to learn.
I really hope all goes well for her, Blanche. Does she have a name?

Yes, she does. She was called Daisy, but since we've had many Daisys I'm probably going to call her Maisie. If anyone has any suggestions for names that sound like Daisy (she does know her name) I'm open to hearing them.

She's a sad case on some levels. She's the result of a pregnant bitch that came into rescue and Daisy was one of the pups. Was adopted out to a great family in 2007 (I got her age wrong--she's 3). But the family recently lost their employment and simply couldn't afford her care.

I heard from the VEC (Vet Emerg Clinic) this morning. Unfortunately, she had a pretty bad transfusion reaction and hasn't responded to the meds to treat that. She's been vomiting and running a fever. But in spite of it, the vet says her colour is better, her heart rate is down (good and bad) and she wags that little tail madly anytime someone visits her. All of which breaks my heart a bit.

Oh, Blanche, please keep calling her Daisy, if only after my dear old much missed Daisy. She was such a dear girl, and I know she would have loved this little one to bits.

H the P wrote:Oh, Blanche, please keep calling her Daisy, if only after my dear old much missed Daisy. She was such a dear girl, and I know she would have loved this little one to bits.

It's a record keeping nightmare, unfortunately, Janet. The VEC treated another pug of ours named Daisy for PLE (same vet, too) and we've had three or four Daisys so we try not to duplicate names. In this case, we want to REALLY keep our records and the vet records clear since both Daisys were fawn, both had immune mediated issues and were both treated by the same vet.

[quote="northernwitch"]

H the P wrote:.... All of which breaks my heart a bit.

It seems like there is always one of them breaking my heart with thier suffering. It is amazing our hearts keep going.

I wish I could be there to help. These kinds of cases are why I am involved in rescue.