Hypofolataemia in five cats with immune-mediated haemolytic anaemia.

Abstract

BACKGROUND: Folate deficiency has been reported in humans and dogs with immune-mediated haemolytic anaemia (IMHA) but not in cats. METHODS: Cats with IMHA and without primary intestinal disease were included. Serum folate was measured at varying timepoints following IMHA diagnosis. RESULTS: Five cats (three with non-associative IMHA and two with possible concurrent acute pancreatitis) were followed for a median of 300 days (range: 40‒540 days). Serum folate concentration was evaluated 36 times (median: 6 per cat; range: 1‒19) and ranged from 5.1 to 20.1 ng/mL (median: 7.4 ng/mL), including nine samples in three cats receiving folic acid (400 µg/day). Hypofolataemia in the 27 samples without supplementation was detected in all cats on at least one occasion (median: 3 times; range: 1‒4) for a total of 13 episodes. The median time to detection was 13 days after diagnosis (range: 1‒310 days). The median haemoglobin concentration at the time of hypofolataemia was 7.01 g/dL (range: 3.9‒9.92 g/dL). Oral folate supplementation normalised folate concentration (median: 16.0 ng/mL; range: 11.8‒20.1 ng/mL) in all nine tested samples. LIMITATIONS: Small sample size and lack of a control group prevented analysing the IMHA and folate link. CONCLUSIONS: Hypofolataemia occurred in all five cats with IMHA, possibly due to increased demand.