Peer-reviewed veterinary case report
Immune-mediated anemia diagnosis and treatment in 19 cats
By Kohn, Barbara et al.·Published in Journal of veterinary internal medicine·2006·Clinic for Small Animals, Germany·View original on PubMed →
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Original publication title: Primary immune-mediated hemolytic anemia in 19 cats: diagnosis, therapy, and outcome (1998-2004).
- Species:
- cat
Plain-English summary
A group of 19 cats diagnosed with immune-mediated hemolytic anemia (IMHA) showed symptoms like severe anemia, with red blood cell counts as low as 6%. Most of these cats were young males, and many had additional health issues. Treatment included blood transfusions, steroids, antibiotics, and fluids. While some cats improved, 4 were euthanized over time due to complications, and about a third had relapses. Overall, the prognosis for cats with this condition seems better than for dogs.
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Abstract
Immune-mediated hemolytic anemia (IMHA) occurs less frequently in cats than in dogs. The value of the Coombs' test (CT) has been questioned, but detailed surveys of its use are lacking. The objective of this study was to describe 19 cats with primary IMHA (pIMHA) and to examine the diagnostic value of the direct CT. The CT was performed in 92 cats; it was negative in 5 healthy, in 9 sick nonanemic, and in 55 cats with different types of anemia. The CT was positive in 18 anemic cats (2 feline leukemia virus (FeLV) positive, 1 with cholangiohepatitis, 15 with no underlying disease). Moreover, agglutination persisted after saline washing in 5 anemic cats (1 lymphoma, 4 pIMHA). Inclusion criteria for pIMHA were a positive CT (15) or persistent agglutination (4), and the exclusion of other diseases. The age of the 19 cats ranged from 0.5 to 9 years (median, 2 years); male cats were overrepresented. The PCV on admission was 6-22% (median, 12%). The anemia was nonregenerative in 11 cats. Additional abnormal laboratory results were leukocytosis (2), lymphocytosis (6), hyperbilirubinemia (13), hyperglobulimemia (10), and increased liver enzyme activities (10). Initial treatment consisted of blood transfusions (10), crystalloids (11), prednisolone (19), antibiotics (19), and H2-blockers (11). Four of 17 cats were euthanized 9, 63, 240 and 2,160 days after initial presentation (mortality rate, 23.5%). Relapses were reported in 5 of 16 cases (31%). Thus, pIMHA appears to occur more frequently than recognized previously, with a more favorable prognosis in cats than in dogs. The CT was useful in identifying immune-mediated pathogenesis.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/16496936/