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.

Boris is a farm cat, but no ordinary farm cat. Firstly, he’s a much adored, affectionate member of his owners’ family, and secondly, he has staged a remarkable recovery from a near fatal mystery incident that led to him losing an eye and being fed through a tube for a week.

Boris’ owners inherited the 5-year-old black moggy with the beef farm that they had taken on a year ago, but he quickly became a much-loved member of the team. So, his owners wanted to do all they could when he was found almost lifeless in a sorry state one morning. He was rushed to the vets for an emergency appointment, almost unrecognisable from the handsome tom he was known to be, due to significant wounds and damage to his head.

Because of the extent of his injuries, swelling and bleeding, it was initially thought that Boris had collided head on with a car. Boris was bleeding from several wounds around his mouth and his head had swollen up resembling a football, whilst his eyes were very bloody and damaged. The first priority was to stabilise him and get him as comfortable as possible with strong pain relief. Then, step by step, the severity of his damage needed to be assessed very carefully, with X-rays and a gentle hands-on examination.

It seemed as though Boris couldn’t see and he could barely breathe due to the swelling around his nose. There was no suggestion of significant damage or fractures elsewhere on his body, but it was too dangerous and high risk to anaesthetise him in order to check his jaw and skull fully in the first 48 hours. Instead, he was hospitalised continuing pain killers, alongside antibiotics, and was intensively assessed for any deterioration.

Two days on from the initial trauma, some of the swelling around his eyes had improved, but he showed no interest in eating and due to the damage around his mouth it wasn’t clear whether it was physically possible for him to. With great care, Boris was anaesthetised successfully allowing the veterinary team to assess his head thoroughly. Surprisingly, an X-ray showed no jaw or skull fractures but there were several wounds around his mouth that needed to be cleaned up. It seemed like both of his eyes were not working correctly and that his right eye was so badly damaged it would need to be removed at a later stage. His claws were not scuffed which did not suggest a car accident, and he had several puncture wounds around his chin that were reminiscent of an animal attack.

Whilst under the anaesthetic and after being cleaned up, it was decided to place a feeding tube for Boris so he could receive nutrition. The swelling around his mouth was still so great that he would probably not feel comfortable to eat for a while yet. A tube was surgically inserted into his oesophagus – the food tube that leads from the mouth to the stomach – and stitched and dressed in place around his neck.

Over the next few days, the swelling around his head receded impressively, he could receive medication as well as food into this tube and this was helping to build up his strength. Once Boris was stable and his owners were happy and confident enough, he was allowed home to be fed through his tube following instruction from the hospital nurse. Boris’ owners took to this task brilliantly, and after a week at home he returned to the practice, much improved, for a check-up. To everyone’s delight he had started eating well and his feeding tube could be removed by the consulting nurse. However, he was still blind and it was evident that his right eye was damaged beyond repair, meaning it would need to be surgically removed.

Boris would need to adapt to be an indoor cat but his owners felt this could be possible, and everyone at the practice agreed as he was no ordinary farm cat – being happy to be kennelled in the cattery for his long period of hospitalisation and showing remarkable affection and acceptance of fuss throughout the traumatic process. The next week, Boris’ eye operation took place and the surgery was a success. He had some post surgical swelling that again transformed his face, but nothing like his initial injuries. After his final surgery and visit to the practice, Boris could put the whole ordeal behind him. It was a mystery how he had got into such a mess, but he was now fully on the mend as a happy, indoor farm cat.

*WARNING*

Graphic images at the bottom of this article.

Milo is a young and curious cat who, like many cats, has lots of adventures outside of his home and who knows what they all get up to! But a few months ago, Milo came home with a painful tail, he was very sad and didn’t want to interact with his owners like he normally would, which prompted a visit to our Sunday morning clinic in Shepton. He was checked over but aside from a painful tail, nothing more was found, so he was prescribed some pain relief to make him more comfortable and was under close observation at home by his owners. When his signs hadn’t improved much, he was brought back for a recheck, this time he was even more unhappy about his tail being touched and was also experiencing some severe diarrhoea. Milo was admitted into the vets for an examination under anaesthesia and some xrays of his pelvis and tail.

Once Milo was asleep, we were able to assess him much more thoroughly. Even under anaesthetic his rectal temperature was very high, above 40 degrees Celsius and we discovered a large wound along the right side of his tail that was initially completely covered by his coat. We cleaned him up, removing the hair and other bits of debris to reveal a really deep wound around the base of his tail, that exposed the internal structures of his tail, pelvis and rectum. Sadly for Milo, the damage extended further with rupture of the rectal wall meaning the wound was further contaminated by faeces too. The only saving grace was that none of the bones appeared to be broken on the xrays.

Our team of vets and nurses can manage a significant majority of cases, but we must be aware of our limitations and identify cases that require more specialist input. We work collaboratively with specialist veterinary referral hospital when necessary and once the specialist work is done, the patients return to our care so that we can continue to support our patients and clients. The damage to Milo’s rectal wall was really serious and required urgent treatment. Without our super surgeon Martin to help us due to annual leave, the best option for Milo was to travel to a nearby referral hospital for specialist surgical repair and post-operative care.

Rectal surgery is very challenging and not without potential complications including a high risk of the surgical site breaking down, this is due to the fragile nature of the tissue, the forces that go through the fragile tissue when going to the toilet and the naturally high bacterial content of this area of the body. Unsurprisingly Milo’s rectal wound did break down a few days after surgery, which left us with very few options, other than to keep the area clean and hope that it would heal on its own. So, Milo was transferred back to our care and visited us twice a week for a sedation to clean up and flush the wound, whilst we waited to see if his own body could repair itself sufficiently. Remarkably, within three weeks the hole in the skin had closed over and within four weeks Milo was off all medication without any issues going to the toilet. A cat’s ability to heal, especially a young cat, will never fail to amaze me, within weeks, Milo’s tail looked like nothing had ever happened.

Poodle crossbreeds make up a large proportion of the dogs that are registered with the practice due to their desirable coat and friendly temperament. The crossbreeds we see are commonly Cockapoos, Cavapoos or labradoodles – but occasionally there are lesser known crosses encountered such as the schnoodle. The schnoodle is born when the poodle is crossed with the schnauzer, which is a characterful and charming dog in its own right. But schnauzers can be predisposed to liver and gall bladder disease, and that is exactly what the delightfully named Crikey the schnoodle had been suffering from.

Last year, blood tests picked up that Crikey had abnormally high ‘liver enzymes’ within his bloodstream. At that time, he was quite happy in himself, but earlier this summer Crikey began to become unwell. He had started to suffer from bloody diarrhoea with vomiting for a few days – known as ‘haemorrhagic gastroenteritis’. This put him completely off his food. He seemed quite sad when he arrived for his appointment at the practice—far from his usual bouncy self that everyone had come to know during his regular routine vet visits.

As everyone was quite concerned about Crikey’s demeanour, he was admitted to be hospitalised for supportive treatment that consisted of probiotic paste, anti-sickness injections, gastroprotectants and intravenous fluids. Blood tests were taken that showed his liver values had worsened further from last time and he was suffering from a degree of pancreatitis – inflammation of the digestive organ the pancreas. After 24 hours at the practice, Crikey felt a little better and hadn’t vomited, but still had terrible diarrhoea and wouldn’t eat a thing. It was decided that he would have to stay in for at least another night, but this then turned into a third night too when he didn’t pick up as everyone had hoped.

Being away from home can add to further worry for a pet owner who is already concerned about whether they will pull through, but Crikey’s owner was relieved to receive regular updates from the night nurse in the form of photos, and videos of Crikey getting all the care and comfort he needed. On the fourth day, after having extra medications added in such as appetite stimulants and further anti nausea treatments, Crikey had an in depth ultrasound scan of his gall bladder, which is closely related to both the liver and the pancreas. This scan revealed that there was a build up of sludgy, thickened bile clogging up around his liver. Samples were taken of Crikey’s bile via an ultrasound guided needle.

Whilst these samples were sent off to the external lab for further testing, Crikey was started on yet further medication, at the risk of becoming a barking pharmacy! This consisted of an antibiotic designed to act within the gall bladder, as well as a drug to help contract the bile duct, assisting flow of bile out from the gall bladder.

Pleasingly, Crikey started to respond better to these medications and appeared noticeably brighter. That evening, he even started eating – which Crikey’s owner was delighted to see in the latest evening phone update.

Results two days later ruled out any evidence of cancer, but showed that Crikey was suffering from an unusual but serious infection in his gall bladder. A type of bacteria known as Pseudomonas was grown in the lab from Crikey’s bile. This bacteria is notoriously difficult to treat and is more commonly found in nasty ear infections. This particular bug had probably travelled up from his gut, through the bile duct to enter the gall bladder and cause sludgy bile as well as discomfort and a lot of sickness!

Fortunately by this time, Crikey was well enough to go home as he had continued to eat and get stronger, but the results indicated he needed an extra antibiotic to get him back to full fitness. After a week’s course of tablets, Crikey was unbelievably back on top form, just two weeks on from a time where his owner thought he might not make it. He continues to thrive at home now on a specialised digestible and low fat diet to ease the pressure on his gut, pancreas, liver and gall bladder. Crikey, he’s a lucky dog!

Sox the cat is not your average moggy. At six years old, this handsome black-and-white neutered tom has already faced more health challenges than most felines will in a lifetime. His journey has been one of ups and downs, late-night dashes to the vet, and a final big decision that may just have saved his life.

For the first three years of his life, Sox was the picture of health, but around his third birthday things began to change. He started to develop cystitis, an inflammation of the bladder. While humans might associate bladder problems with infection, in cats the story is usually more complicated with feline cystitis often linked to stress, with the bladder becoming inflamed even when no bacteria are present.

Sox’s bouts of cystitis came and went, leaving his owner both worried and determined to get to the bottom of things. Tests were run – urine samples, blood work and ultimately X-rays and ultrasound of his bladder – all of which came back normal. That ruled out infections and other obvious causes. So, Sox’s owner turned to the practice’s feline behaviour nurse, and together they worked on strategies to lower Sox’s stress and encourage him to drink more water.

Changes were made at home: multiple litter trays, extra water bowls dotted around the house, cosy spaces just for Sox, and even special pheromone diffusers designed to help cats feel calmer. These adjustments made a difference, and for a time, life carried on as normal.

But earlier this year, Sox faced a crisis. One morning, he simply couldn’t pass urine. In veterinary terms, he was “blocked” – his urethra obstructed, meaning no urine could leave his body. For cats, this is not only excruciatingly painful, but also rapidly life-threatening. Waste products build up in the bloodstream, and ultimately the obstruction can start to cause organ failure.

His owner rushed him to the practice where emergency treatment began. Under anaesthetic, a catheter was passed into Sox’s bladder to relieve the obstruction. He spent several days in hospital before the catheter was removed, and while his recovery was slow at first, he eventually bounced back to his cheeky self.

Life began to settle again. Sox was playing, eating, and enjoying his home comforts. But then came another blow. One day, Sox didn’t come home. Hours turned into a day, then a day and a half. After 36 hours, his worried family found him collapsed in the back garden. His owner recognised the signs immediately – Sox was blocked again.

He was rushed back to the vet, once again in a life-threatening state. The veterinary team stabilised him by decompressing his bladder and placing another catheter. Investigations were repeated – no stones, no infections, nothing obvious to explain the repeated obstructions. But this time something new was clear: Sox’s urethra was very narrow.

By now, Sox and his family were exhausted. These episodes were not only traumatic but also emotionally draining and financially costly. The vet team sat down with his owners to discuss the options.

The first option was to manage the obstruction again and hope for the best. The second was more drastic: a perineal urethrostomy (PU). This surgery involves amputating the penis and creating a shorter, wider urethra, reducing the chance of future blockages. It’s not a decision any cat owner takes lightly. PU surgery doesn’t cure all forms of urinary tract disease, and it can carry risks. But given Sox’s history and the clear narrowing of his urethra, it offered him the best chance of a normal life.

After much thought, everyone agreed surgery was the right path. Sox underwent the procedure, and it was a success. Within a few days he was back home, healing well and gradually resuming his routines. Follow-up checks confirmed the wounds were healing nicely, and Sox was on the mend.

Since then, he hasn’t looked back. His owners continue to keep his stress levels low, sticking with the behavioural changes they put in place years earlier. The combination of surgery and a supportive environment has given Sox a new lease of life – and given his owners peace of mind.

Sox’s story is a reminder of just how complex urinary problems in cats can be. What looks like a simple case of cystitis can, in fact, be a multifaceted condition tied to stress, anatomy, and environment. It also highlights the importance of quick action: both times Sox was blocked, his owner’s speed in getting him to the vet was what saved his life.

Today, Sox is back to ruling his household, enjoying his comforts, and keeping his humans on their toes. Thanks to their unwavering commitment and the dedication of his owner, this six-year-old has many more happy years ahead.

If you would like more information and tips on how to help prevent cystitis in cats, visit our Feline Care Guide page on our website by clicking HERE.

At 10 years old, Novak had always been a healthy cat, so when he suddenly became lethargic and stopped eating, alongside vomiting and diarrhoea, his concerned owner knew something wasn’t right. He was brought to our Wells practice, where our team quickly recognised that Novak needed further investigation and hospitalisation. He was promptly transferred to our Shepton hospital for more in-depth care.

Initial blood tests gave us some clues, but no clear answers as to what was making Novak so unwell. He remained flat and anorexic, so we performed abdominal imaging, which revealed that his intestines were significantly distended with gas. This made us concerned about a possible blockage in his digestive system, although nothing definitive showed on the scan.

With Novak’s condition not improving and the possibility of a blockage still on the table, we discussed our findings with his owner. The only way to know for sure — and to potentially treat the issue — was to perform an exploratory laparotomy, a surgical procedure to open the abdomen and take a direct look inside. Novak’s owner gave their consent for us to proceed and give him a chance.

During surgery, we discovered that Novak’s intestines were inflamed and filled with gas, but thankfully, there was no physical blockage. Instead, we found multiple abnormal pockets — what looked like abscesses — scattered throughout his omentum, a fatty, protective layer within the abdomen that helps isolate infections and supports the intestines and other abdominal organs.

There was also infected fluid present, which indicated that Novak was suffering from peritonitis, a serious and potentially life-threatening inflammation of the abdominal lining, usually caused by infection. In Novak’s case, the inflamed intestines were no longer functioning properly, unable to move food or gas effectively, which explained his symptoms.

We carefully examined his intestines for any perforations, which could have allowed bacteria to escape and cause this infection, but none were found. The abscesses were surgically removed, and Novak’s abdomen was thoroughly flushed with sterile fluid to reduce any remaining bacterial contamination.

To support his recovery, we placed an oesophageal feeding tube, which allowed us to provide nutrition directly until he felt strong enough to eat on his own. Over the next week, Novak began to steadily improve. With time, medication, and gentle care from our team, his appetite returned, and we were able to get him home to his family. After a few more days we were confident enough in his appetite to remove his feeding tube.

Lab results later confirmed that the abnormal tissue was indeed omental abscesses, likely caused by a foreign object, such as a sharp item he may have swallowed or a wound sustained during a fight or accident. Another possibility is that it resulted from a healed intestinal ulcer that briefly allowed bacteria to escape into the abdomen.

Today, Novak is back home and continuing to do well. He’s eating, purring, and enjoying his well-earned rest after such a dramatic illness — and we’re thrilled to see him back to his old self.

This case reminds us how subtle signs in our pets can signal something serious, and how advanced diagnostics, timely surgery, and dedicated post-operative care can lead to a happy ending — even in complex cases.

Boodu, a very fluffy 6 kg Pekingese, has been a regular at our practice for over 13 years. He is well known to all the staff for his extreme reluctance to have his nails clipped. However, his recent visit was under very different circumstances.

As with many older animals, Boodu’s mobility isn’t what it used to be. Combined with the heatwaves we’ve had this summer, a bit of slowing down and reduced exercise was to be expected. More recently though, he appeared to be struggling with getting around — particularly when going upstairs — and had collapsed three times within a 24-hour period. He would often pant before collapsing, then lie on his side for a few minutes before getting up and continuing as normal. He didn’t lose consciousness during these episodes, but they became more frequent over a couple of days.

He was initially seen on a Sunday, when a heart murmur and occasional missed beats were detected, raising suspicion of heart disease. As his breathing was still normal when resting, he was scheduled for further investigations the following Wednesday. However, he re-presented on both the Monday and Tuesday as his episodes worsened. By Tuesday, there was noticeable effort to his breathing, the heart murmur remained, and ‘crackles’ were audible when listening to his lungs. These findings were strongly suggestive of left-sided heart failure causing fluid build-up in the lungs, so he was given furosemide — a diuretic — to remove the presumed fluid.

Over the course of the day, however, there was no improvement. In fact, his breathing worsened, which should not have occurred if left-sided heart failure had been the cause.

We opted to perform chest x-rays, which showed no significant fluid build-up or masses. The next step was a heart scan (echocardiogram) to fully assess how the heart was functioning — and the findings were unexpected.