Meet Parker. He is a 1 year old male neutered Shih Tzu who presented to VSB as an emergency for suspected onion toxicity. His owners had noted he got into the trash can and consumed a number of things along with onions. He was noted to be pale and was taken into an ER where he was noted to be severely anemic. He was given 1 transfusion of packed red blood cells but continued to stay anemic.

Upon presentation to VSB, he was noted to be severely clinical (tachycardia, murmur) with pale mucus membranes. His PCV was 8% with a positive slide agglutination and elevated total bilirubin and was administered his 2nd transfusion which brought him up to 24%. This dropped within 24 hours to 12% and was administered his 3rd transfusion. This brought his PCV up to 35% and held for 48 hours but then dropped to 8%. It was then elected to transfer him for IVIG therapy and his 4^th blood transfusion. Within 3 days his PCV was stable at 19%.

Parker was sent home on double immunosuppressive therapy with prednisolone and cyclosporine along with anti-clotting medication called Rivaroxaban. Parker was seen every 3-4 weeks for 7 months with his therapy weaned by 20% each time. He officially graduated immunosuppressive therapy and thriving. We will continue to monitor Parker’s lab work every 3-6 months for the first year and then yearly thereafter. We will also be very judicious with his vaccines over the next 3 years, to ensure we do not over stimulate his immune system.