Characterization of The Anemia of Inflammatory Disease in Cats with Abscesses, Pyothorax, or Fat Necrosis

Abstract

The purpose of this study was to describe the anemia of inflammatory disease (AID) in cats with naturally-occurring inflammatory diseases, such as abscesses (n = 12), pyothorax (n = 6), and fat necrosis (n = 3). Exclusion criteria were positive FeLV/FIV tests, neoplasia, nephro-, hepato- or endocrinopathies, and blood loss anemia. CBC, clinical biochemistry, measurements of serum erythropoietin, iron, total iron-binding capacity (TIBC), ferritin, acute phase proteins, erythrocytic osmotic fragility (OF), and Coombs' tests were performed. A decrease in hematocrit of 1-28% (median, 10%) occurred within 3-16 days (median, 8 days). The anemia was mild (n = 11), moderate (n = 8), or severe (n = 2). In most cases it was normocytic normochromic, non-regenerative (n = 18), or mildly regenerative (n = 3). Sixteen cats had leukocytosis and 5 mild hyperbilirubinemia. The Coombs' test results were negative for 8 cats and positive for 1 cat. OF was increased in 2 out of 14 cats. Hypoalbuminemia (n = 18) and hyperglobulinemia (n = 16) resulted in a lowered albumin/globulin-ratio in 19 cats. Iron and TIBC were low in 2/19 and 6 /19 cats, respectively. The ferritin concentrations were normal in 7 cats and increased in 12 cats. The acute phase proteins alpha1-acid-glycoprotein and haptoglobin were increased in 14/14 and 13/14 cats, respectively. Erythropoietin was normal (n = 4), mildly increased (n = 7) or severely increased (1). Two cats were euthanized due to their underlying disease, 3 cats needed blood transfusions. AID in cats is usually mild to moderate, non-regenerative, and normocytic normochromic. It can be clinically relevant causing severe and transfusion-dependent anemia. AID seems to be multifactorial with evidence of iron sequestration, decreased RBC survival, and insufficient erythropoietin production and bone marrow response. Specific and supportive therapy, including transfusions, can reverse these processes.

Prognostic Factors in Cats with Feline Panleukopenia

“…In this study, anemia was not associated with negative outcome, an unexpected finding considering that gastrointestinal blood loss, coinfections (4.8% of cats were infected with FeLV), serious bone marrow suppression, or sepsis‐associated anemia of inflammatory disease 30 represent severe and serious complicating factors. Because of the relatively long life span of erythrocytes, marked anemia is less common in CPV and FPV, unless intestinal blood loss is severe, but nonregenerative anemia can be seen with FPV infection 31,32 .…”

Pulmonary Abnormalities in Dogs with Leptospirosis

“…Furthermore, blood loss can occur via the gastrointestinal or respiratory tract. Severe inflammatory reactions may impede hematopoiesis 34 …”

The feline acute phase reaction

“…Transferrin, apolipoprotein A1, retinol binding protein, cortisol binding protein and transthyretin, are other negative APPs. No data about the possible role of albumin as a negative acute phase protein in cats are available, and although it has been reported to decrease in many feline inflammatory conditions (Thomas, 2000;Ottenjann et al, 2006) it has not been proven whether this decrease depends on extravasation of albumin from vessels to inflamed tissues or to true decreased hepatic production. Similarly, no information on the role in cats of the other negative APPs is so far available.…”