A six-year-old male castrated mixed breed dog presented to the Cornell University Emergency Service for collapse after receiving an intralesional triamcinolone injection. The patient presented in shock with a hemoabdomen and no trauma history. Point of care bloodwork disclosed metabolic acidosis, hypoglycemia, hypoproteinemia, significantly prolonged clotting times (PT and aPTT), and decreased platelet count. After intensive stabilization involving fluid boluses, intravenous dextrose, and multiple transfusions, imaging results (thoracic radiographs and abdominal ultrasound) found no cause for the hemoabdomen. The patient's two remaining differential diagnoses were anticoagulant rodenticide poisoning and disseminated intravascular coagulation (DIC) triggered by anaphylaxis from the steroid injection. A Factor VII Coagulant Activity Assay was used to diagnose anaphylactic shock. The patient developed acute liver injury post-shock. He was treated supportively and discharged one week.later when coagulation times normalized platelet count improved. The patient later developed immune mediated thrombocytopenia (ITP), a unique complication to the anaphylactic shock.