Angelo
Angelo is a 12 ½ year old neutered male Golden Retriever owned by Jeanne of Lincoln Park, NJ. Angelo was diagnosed with Evans Syndrome (autoimmune hemolytic anemia and immune-mediated thrombocytopenia occurring simultaneously) on November 20, 2005.
When Jeanne was asked to comment on Angelo’s symptoms prior to his Evans Syndrome diagnosis she replied, “On the Sunday before Thanksgiving 2005, I took Angelo and his canine brother, Archie, outside as usual. Angelo did his ‘business’ and we were going to go back inside. However, when I looked at Angelo he seemed to be just frozen. I gave a little tug on his leash and he seemed confused so I dropped his leash and ran inside to get my boyfriend. We carried Angelo to the car and immediately drove to the nearest Animal ER.
”Upon admittance to the ER clinic, blood testing revealed a hematocrit of 9.5 and a platelet count of 64. Angelo was pale, jaundiced and very weak. He also had a hepatomegaly/tense abdomen. Angelo was started on Doxycycline, Prednisone, Pepcid and Carafate. When the vet came out to talk with me, it was the first time I ever had heard the words, autoimmune hemolytic anemia and thrombocytopenia. Blood testing, done later in the day, revealed a PCV ranging from 28 at 6 PM to 20 by 2 AM the next morning. On Monday, when we transferred Angelo to our regular Animal Hospital, blood testing indicated his PCV had dropped to 18. I was advised that if the PCV dropped lower then 17 Angelo would need to be transfused. A cross match was done to insure blood would be available if the need arose. Thankfully, the PCV never went lower then 18 so a blood transfusion was not necessary. Ultrasounds, done on Angelo’s organs, showed no cancers. When the tick titer came back negative, the Doxycycline which had been started in case of a tick disease, was discontinued. After 3 days in the hospital, Angelo was allowed to come home to spend Thanksgiving with us. Although he was weak and lethargic upon his discharge from the hospital, thankfully, he did not need to be hospitalized again. His medications, upon discharge from the Animal Hospital, included 60 mg prednisone, twice per day, 50 mg Imuran, once per day and 20 mg Famotidine twice per day. These medications were tough on Angelo but they kept him alive and allowed him to get into remission. One of the side effects from the medications was a 10 pound weight loss, due to muscle atrophy. Angelo lost so much muscle that he developed sores on his lips from biting them while eating. In addition, he could not lie comfortably on his side due to the swelling of his liver. He developed green pustules ( staph infections) that required months of antibiotics and alopecia (hair loss & thinning). He also needed the assistance of a harness to walk.
”As Angelo’s PCV and platelets rose, we started to slowly lower his medications. The prednisone was slowly tapered down to 2.5 mg every other day and then discontinued on October 6, 2006, nearly 11 months after the Evans Syndrome diagnosis. Days between the administration of Imuran were increased until it was discontinued on April 20, 2007. Prior to the Imuran being discontinued it was being given at a dosage of 50 mg every 4th day. Angelo is currently on no medications for the treatment of Evans Syndrome. He does take a Glucosamine/Chondroitin/MSM tablet twice per day, a Pet Tab plus once per day as well as a Derm Cap once per day to nourish his skin. We give Angelo Interceptor for heartworm prevention every 30-40 days year around. At this time I have chosen not to use any flea/tick preventative, even though we have a heavy population of ticks in our area. In regard to vaccinations, Angelo is no longer receiving any vaccinations whatsoever.”
When Jeanne was asked to comment on the current state of Angelo’s health she replied, “Angelo is continuing to do very well. When his last blood work was done on July 3, 2007, his PCV was 40.6 and his platelets were 195,000. He has not regained the muscle in his back legs but he can still trot a bit after his beloved tennis ball and wrestle with his Golden ‘brother’ Archie. Angelo appears to be in no pain due to this muscle loss. I consulted a canine physical therapist and we are helping Angelo at home by taking him for short walks as well as with an occasional swim in a relative’s pool. The most important thing I learned about this disease is that you need to have a good veterinarian who is very familiar with the disease and who is optimistic (while being realistic) towards you and your pet. We credit our Vet, who has been taking care of Angelo since he was 3 months old, for being optimistic from the get go and making sure that everyone that cared for Angelo in the hospital knew it. We also credit the very slow reduction of Angelo’s medications as one of the positive factors in regard to his survival. To Angelo, every day is a celebration and to us, each day that Angelo is with us, is a gift.”