Evans syndrome is a rare but serious autoimmune condition in which the body’s own immune system mistakenly attacks and destroys both red blood cells and platelets. The loss of red blood cells leads to anaemia, causing weakness and lethargy, while the destruction of platelets increases the risk of spontaneous bleeding. If left untreated, the condition can progress rapidly and become life-threatening.

Blood products play a vital role in the management of Evans syndrome, though they do not offer a cure. Instead, they serve as a crucial supportive measure, stabilising the patient and buying valuable time for immunosuppressive treatment, most commonly steroids, to take effect. These medications work by reducing the immune response and halting further destruction of blood cells. Once the immune system is suppressed, the bone marrow can begin to replenish the lost red blood cells and platelets.

A notable case in our practice involved Bella, a four-year-old Maltese, who was diagnosed with Evans syndrome.

In May 2024, Bella was being cared for by her owner’s mum while her owner was on holiday in Canada. Four days in, Bella’s owner received a concerned phone call from her mum, saying Bella wasn’t eating and didn’t seem quite herself. She thought it might be due to separation anxiety, as Bella had acted like this before. Unfortunately, a day later, Bella’s owner received the devastating news that Bella had collapsed and was being rushed into the veterinary hospital. After blood tests, the vets discovered that her red blood cell count (also known as the packed cell volume) was just 5%, in a healthy dog this typically ranges from 35–50%. Bella was then diagnosed with Immune-Mediated Haemolytic Anaemia (IMHA) – an autoimmune disease in which the immune system mistakenly attacks and destroys the body’s own red blood cells. It was also discovered that she has a rare blood type, so Pet Blood Bank UK were contacted and organised a donor for a blood transfusion, which ultimately saved her life… for the first time.

When her owner returned home, Bella was discharged from the veterinary hospital and transferred to our care here at Shepton Vets, where we began stabilising her condition and gradually reducing her daily medication from eight tablets a day. After blood tests every 2–4 weeks for seven months, she was medication-free and healthy.

Unfortunately, four months later, in April 2025, she became lethargic and declined so rapidly that the medication being administered couldn’t act quickly enough for her body to respond. Bella was immediately brought to us after collapsing at home. After further tests, she was diagnosed with Evans syndrome. Her red blood cell levels were dropping rapidly, so a donor dog was urgently needed for a blood transfusion. Panda, a two-year-old Lurcher belonging to a member of staff in our farm office, stepped up to be a hero by donating blood—and once again, Bella’s life was saved by the kindness of another.

Bella now visits us every four weeks for check-ups to monitor her blood and reduce her medication to a manageable dose. Her condition is currently stable, and to look at her, you wouldn’t know she is living with a chronic illness. She’s a very happy and sweet girl who still loves to cause mischief. Bella was previously a ‘Pets As Therapy’ dog and always has to say hello to everyone on her walks and visits to us.

With timely intervention, including the use of blood products and immunosuppressive therapy, Bella’s condition stabilised. In some cases, patients can be gradually weaned off steroids, while others may require long-term, low-dose therapy to prevent relapse.

The use of blood products, whether for autoimmune conditions like Evans syndrome or toxicities such as rodenticide ingestion, highlights the importance of prompt diagnosis and tailored treatment in veterinary emergency care. It also demonstrates the vital role of organisations like Pet Blood Bank UK, who provide life-saving supplies in critical moments.

Pet Blood Bank UK exists to help save the lives of pets in need by providing a blood service for vets. They operate 24 hours a day, seven days a week, to ensure blood is always available. Donation sessions are hosted at various locations across the country, where pet owners can bring their dogs to donate blood in a calm and stress-free environment. One of these locations is our Wells branch, where we host sessions every eight weeks – the next one being Saturday 19th July.

To find out more, check eligibility, and sign your dog up, visit the Pet Blood Bank website: www.petbloodbankuk.org

Blood transfusions help to save the lives of thousands of dogs like Bella every year. Every unit of blood can help save the lives of up to four other dogs. Sign your dog up to be a lifesaver today.