Iron deficiency and treatment response in cats with chronic gut

Abstract

BACKGROUND: Iron deficiency in humans with chronic inflammatory enteropathies (CIE) is associated with active disease and anemia-related morbidity. OBJECTIVES: To compare iron deficiency prevalence in cats with CIE versus low-grade alimentary lymphoma (LGAL) and secondarily, determine the effect of iron deficiency on short-term clinical response in CIE cats. ANIMALS: Twenty-eight client-owned cats with primary gastrointestinal disease, including 14 CIE cats and 14 LGAL cats. METHODS: Prospective study. Cats were enrolled when they presented for gastrointestinal endoscopy. Iron panel (serum iron, ferritin, total iron binding capacity), CBC, cobalamin, serum amyloid A, methylmalonic acid, and clinical disease severity were evaluated. Cats were categorized as "normal" or "iron deficient" using calculated transferrin saturation. CIE cats were reevaluated 14, 30, and 90 days after initiation of non-standardized gastrointestinal disease treatment. Clinical response was compared based on iron and anemia status. RESULTS: Iron deficiency was diagnosed in 7/28 cats (2/14 CIE, 5/14 LGAL cats) at enrollment and developed in four additional CIE cats during follow-up. While 9/28 cats were anemic at enrollment, neither anemia (relative risk [RR], 0.90; 95% confidence interval [CI], 0.13-5.50) nor iron status (RR, 0.4; 95% CI, 0.10-1.5) was associated with treatment response. Transferrin saturation was lower in LGAL cats (22%; 95% CI, 20%-27%) than in CIE cats (30%; 95% CI, 26%-39%). CONCLUSIONS AND CLINICAL IMPORTANCE: There was high prevalence of iron deficiency over the first 90 days of treatment in CIE cats. Iron deficiency did not affect short-term response to individualized treatment of gastrointestinal disease.