Wednesday, January 16, 2013

Immune-Mediated Hemolytic Anemia in Cats with Pancreatitis

   Pancreatitis has been demonstrated in humans and experimentally in rats as a complication of acute hemolysis. Following the identification of a cat with acute hemolysis due to IMHA and concurrent pancreatitis, the aim of this study was to retrospectively investigate if these two diseases are associated in cats.
For this retrospective, case-control study, the author's residency case log of all cases seen at Glasgow University Small Animal Hospital between July 2004 and December 2007 (consisting of 157 client owned feline patients and 674 canine patients), was searched for cats diagnosed with pancreatitis. These cats were included in group 1. A clinical diagnosis of pancreatitis was made on a combination of: clinical signs, measurement of serum feline pancreatic lipase (fPLI) or trypsin-like immunoreactivity (fTLI), and abdominal ultrasonography. A control population sick cats without pancreatitis (group 2) was created from the same database. For each cat in group 1, three sick cats were included in group 2. These cats were randomly selected after age-, sex(including neutered status) and breed-matching to the cats with pancreatitis. IMHA was diagnosed as a hematocrit ≤ 15% and the presence of a positive Coombs' test. The prevalence of IMHA between the two groups of cats was calculated and the difference in prevalence was statistically evaluated with the Fisher exact test. The level of significance was set as p < 0.05.
Of the 157 cats included in the database, 9 were diagnosed at presentation with pancreatitis and three of these cats (33%) had a concurrent diagnosis of IMHA. Only 1 (3.4%) of the 27 cats in group 2 (sick cats without pancreatitis) was diagnosed with IMHA. The prevalence of IMHA was significantly higher in group 1 compared with groups 2 (p = 0.04).
Cats with pancreatitis have an higher prevalence of IMHA compared to other sick cats. The hemolysis occurring during IMHA may therefore be the etiological cause of this disorder in these cats, as previously reported in humans and rats.

American college of veterinary internal medicine forum 2012
Andrea Zoia
San Marco Veterinary Clinic, Padua, Italy

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