Treatment of Evan’s syndrome by leflunomide and desmopressin in a mixed-breed dog

A 9-year-old, male, mixed-breed dog was presented with severe lethargy, pale and icterus mucous membranes, gingival hemorrhage, and hematochezia. On physical examination, petechiae and echimosis on the penis were observed. The complete blood count revealed severe regenerative anemia and thrombocytopenia. Urinalysis indicated hemoglobinuria and bilirobinuria, and abdominal sonography showed splenomegaly. A series of diagnostic tests was performed based on the suspicion of Evan’s syndrome (concurrent immune-mediated anemia and thrombocytopenia). The therapeutic program was started with prednisolone combined with leflunomide followed by desmopressin and erythropoietin, lasted 1 month, and the animal showed progressive recovery. During 6 months follow-up, no complications were detected in the mentioned case.