Case summary
A 7-year-old female entire Birman presented with acute-onset haemorrhagic
vulvar discharge. Moderate, normocytic, normochromic, non-/pre-regenerative
anaemia, along with a moderate mature neutrophilia, were seen on
haematology. Saline test for agglutination was positive. No haemotropic
mycoplasmas were identified. Serum biochemistry revealed severe
hyperbilirubinaemia. Retroviral testing was negative. Serology for
toxoplasmosis revealed a titre of 1:512. Abdominal ultrasound identified a
large uterus, containing at least three advanced-stage fetuses, two of which
failed to exhibit independent motion or cardiac activity. Ovariohysterectomy
was performed. Histology demonstrated mild, multifocal suppurative
placentitis, with Gram staining revealing no evidence of bacteria. Complete
resolution of the anaemia was seen within 1.5 months of
ovariohysterectomy.
Relevance and novel information
Immune-mediated haemolytic anaemia (IMHA) in association with pregnancy has
not been previously reported in cats. This case represents a potential novel
cause for IMHA in cats, which resolved following ovariohysterectomy.