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Evans Syndrome/imha/itp Diagnosis - What Do I Do Next?


Guest MeAndMouse
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Guest MeAndMouse

My girl, Mouse, was diagnosed with Evans Syndrome (IMHA and ITP) last Thursday, 8/20. The vet did a CBC and blood smear and sent her home with 40mg of prednisone a day. I asked for a specialist referral, but the soonest I could get an appointment was 9/9.



Mouse seemed to be more energetic after starting the prednisone, otherwise I probably would have taken her to the ER at the specialist. She had a checkup at the same vet yesterday (although a different doctor saw her for some reason), and her hematocrit was the same and platelets were up but still low. They said keep giving her prednisone and check back in 5 days.



I’ve been researching a ton and am very skeptical of this vet. Everything you read about Evans syndrome says you need to determine if there’s an underlying cause (do x-rays, sonographs, tick panels, etc.) and the vet has said nothing about this. The first vet basically said it could be from vaccinations, a toxin, etc. and it’s difficult to pinpoint, but said nothing about secondary cases. And there are so many other things that were not mentioned to me… gastric protectants, thromboemolism chances, tissue hypoxia, etc.



I guess I just don’t know what to do at this point. Do I go to another vet for a second opinion? Do I just do nothing and get the recheck in 5 days? Do I take her to the ER?



* More reasons I’m skeptical of this vet:


At the appointment yesterday, the vet brought out the bloodwork from both appointments to show me. The one from the first appointment showed almost everything at 0! “See, this has gone from 0 to X, so it’s increased. And this has gone from 0 to X, so it has also increased." This seemed really bizarre to me, but I didn’t say anything. I looked more closely at the bloodwork at home, and both tests were from the first appointment! I do remember the first vet running two tests, but I didn’t know it was because the first one showed all zeros. So the vet last night sat there showing me comparisons for the wrong day! This still blows my mind.


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For Mouse's sake and your peace of mind I would certainly seek another opinion. :goodluck

 

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I had never heard of Evans Syndrome either, just looked it up.

 

I second the idea of having another vet see her. For myself, and my peace of mind, I wouldn't wait until September 9. You will be uneasy and afraid, and Mouse will feel that. My NY vet called those visits well-checks for the owners.

 

Fingers and paws crossed for only good news.

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I personally think it's best to see a specialist for autoimmune diseases as they have more experience. My boy had a different autoimmune disease and our GP vets gave him a much too low dose of steroids so he just continued to get worse. Have you put her on a gastro-protectant now - this is very important?

 

Also, have a look at this forum for dogs with autoimmune diseases - lots of very knowledgeable people there:

 

http://cimda.co.uk/smf/index.php

 

 

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That's IMHA isn't it? If so then I've seen it before and know how rapidly devastating it can be, You need a vet you can trust and that vet needs to be onto it and treating it now. I think I'd take a second opinion too unless you can get reassurance from that vet.

 

 

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All of that is way too scary to rely on a single vet, especially one you don't have a high degree of confidence in. Seek a second opinion as soon as you can.

 

Perhaps if you call the specialist that can put you on a wait list for an earlier appointment. And/or call your local Evet and see if they have any recommendations for you for a different specialist.

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Guest MeAndMouse

Hawthorn - Yes, I'm giving her Prilosec.

 

We've got an appointment on Monday at 8am with a vet a friend recommended, so fingers crossed.

 

Thanks for all the advice!

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