Cerebral haemorrhage in a pregnant Standardbred mare with Evan's syndrome

Abstract

Summary A 3‐year‐old pregnant Standardbred mare was treated at the University of Helsinki Equine Teaching Hospital for severe idiopathic immune‐mediated thrombocytopenia and haemolytic anaemia (Evan's syndrome). Despite initial improvement with supportive care and immunosuppressive doses of corticosteroids and azathioprine, the mare died from a fatal cerebral haemorrhage on Day 21 of treatment.

Platelet transfusion in thrombocytopenic horses

“…However, if thrombocytopenia is the primary problem, haemorrhage becomes the most relevant risk, which can be life‐threatening if uncontrolled or occurring intracranially, as shown in the report by Väänänen et al . () in this issue. This poses the questions how the risk of bleeding can be assessed in thrombocytopenic horses and at what point intervention in the form of a platelet transfusion is needed.…”

“…Fortunately, even if clinically noticeable bleeding occurs, it is rarely associated with severe or fatal complications as those described by Väänänen et al . (). A considerable number of studies in people have documented that the prophylactic platelet transfusion trigger can safely be lowered from the previously used 20 x 10 9 /l to 10 x 10 9 /l without significantly increasing the risk of bleeding (Byars and Greene ).…”