Evans syndrome following cesarean section and ovariohysterectomy in two cats: a rare postoperative complication

Abstract

This case report describes the diagnosis and treatment of immune-mediated hemolytic anemia (IMHA) and thrombocytopenia in two cats that underwent ovariohysterectomy following cesarean section. Both cats were presented at different times with dystocia. Cesarean sections were performed based on clinical evaluations including maternal condition, fetal heart rate, and labor progression, and were followed immediately by ovariohysterectomy. On postoperative days 1 and 4, respectively, both cats developed rapidly progressing, scattered bruising on the abdomen, despite being clinically stable. Physical examination revealed ecchymoses across the abdomen and other regions. Laboratory results indicated mild anemia with reduced hemoglobin, hematocrit, erythrocyte, and platelet counts. IMHA and thrombocytopenia were diagnosed based on clinical signs and the presence of spherocytes on blood smears. Immunosuppressive therapy led to full resolution of hematologic abnormalities in both cases. To the authors’ knowledge, this is the first report of IMHA and thrombocytopenia developing in cats following cesarean section and ovariohysterectomy. Although the exact underlying cause remains unclear, it is possible that surgical stress may have played a role to the development of immune-mediated hematologic complications in these cases.