Babesiosis Induced Evan’s Syndrome (IMAH and ITO) in Two Cocker Spaniel Puppies
Immune-mediated haemolytic anaemia (IMHA) are the most common cause of haemolytic anaemia and immune mediated thrombocytopenia (ITP) is the most common cause of severe thrombocytopenia in dogs. In combinations they are known as Evans syndrome, an autoimmune disease in which dogs’ antibodies attack their own red blood cells and platelets and often fatal.
To successfully manage Evan’s syndrome secondary to canine babesiosis.
Two male Cocker Spaniel puppies of age 6 months of the same litter were presented in our practice with profound anemia and thrombocytopenia with recent clinical signs of hematuria, fever, lymphadenopathy, petechiae, ecchymosis, and purpura. Routine clinical findings included blanched mucous membranes, pounding pulses, and lethargy. Blood routine revealed marked leukocytosis (WBC >23,000 cells/cmm, severe anemia (Hb<2.9 g/dl), and thrombocytopenia (platelets <14,000 cells/cmm. Coombs in both the dogs showed negative results, the saline agglutination tests showed autoagglutination and the presence of spherocytosis was evident. Flow cytometrical analysis confirmed IMHA. PCR and blood smears confirmed Babesia gibsoni. Treatment with diminazene, doxycycline, and prednisone were initiated.
One of the pups showed recurrence of anemic hypoxia and thrombocytopenia within 48 hours and was transfused again with DEA 1.1 negative whole blood. Both the pups responded well to combination of doxycycline @ 10 mg per kg SID, prednisone @ 1 mg per kg tapered to 0.25 mg per kg for 2 and clindamycin 15 mg per kg bid for 2 weeks.
This abstract reports the uncommon Evan’s syndrome secondary to canine babesiosis and its successful management with blood transfusion and combination therapy.