Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan-Feb;30(1):147-56.
doi: 10.1111/jvim.13658. Epub 2015 Dec 9.

Demographic Characteristics, Survival and Prognostic Factors for Mortality in Cats with Primary Immune-Mediated Hemolytic Anemia

J W Swann  1 , B Szladovits  2 , B Glanemann  1
Affiliations

Demographic Characteristics, Survival and Prognostic Factors for Mortality in Cats with Primary Immune-Mediated Hemolytic Anemia

J W Swann et al. J Vet Intern Med. 2016 Jan-Feb.

Abstract

Background: Immune-mediated hemolytic anemia (IMHA) is uncommon in cats, but may result in severe disease. Demographic predispositions for development of the disease and prognostic factors for mortality have not been investigated previously.

Hypothesis/objectives: To explore possible demographic predispositions for development of primary IMHA in cats and to investigate possible prognostic factors for mortality.

Animals: 107 client-owned cats with IMHA, of which 72 had primary IMHA and 35 had secondary IMHA, and 9,194 control cats.

Methods: Data were collected retrospectively from records of cats with IMHA, defined by the presence of anemia and concurrent autoagglutination, ghost cells without oxidative damage on fresh blood smear, positive titer in a direct antiglobulin test, or evidence of phagocytosis of erythroid precursors in bone marrow. Odds ratios were calculated to assess the risk of development of primary IMHA in different demographic groups and Cox proportional hazards analysis was conducted to evaluate prognostic factors.

Results: No sex or breed predisposition was identified for the development of primary IMHA in comparison to the control cats, but cats in the age range 2.1-5.9 years were predisposed. Higher total bilirubin concentration and age were significant negative prognostic factors and higher lymphocyte numbers and serum globulin concentration were positive prognostic factors in a multivariable model.

Conclusions and clinical importance: Young adult cats were more likely to develop primary IMHA than other groups, but no apparent male predisposition was identified in this study, contrary to previous reports. Several prognostic factors were identified, which may be helpful in guiding clinical practice in the future.

Keywords: Autoimmunity; Bone marrow; Direct antiglobulin test; Hemolysis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Lymphocyte concentrations in cats with primary or secondary IMHA. Lines represent median and interquartile range. *p < 0.001.
Figure 2
Figure 2
(A) Bone marrow core biopsy section of a cat with numerous foci of iron (H&E stain, 400x). Inset: stainable iron in the same sample (Perl's Prussian Blue stain, 1000x). (B) Bone marrow aspirate from a cat. Macrophage on the right with four intact erythroid precursors phagocytosed, including a basophilic rubricyte, a polychromatophilic rubricyte, and two metarubricytes (Modified Wright's stain, 1000x). (C) Prominent lymphoid follicle in a core biopsy section of feline bone marrow (H&E stain, 200x).
Figure 3
Figure 3
Kaplan–Meier survival curve to compare survival times in cats with primary IMHA (solid line) and those with secondary IMHA (dashed line). Tick marks indicate censored cases.
Figure 4
Figure 4
Forest plot to show the variables included in the final multivariable model constructed using Cox proportional hazards analysis.
See this image and copyright information in PMC

Comment in

References

    1. Mitchell K, Kruth S. Immune‐mediated hemolytic anemia and other regenerative anemias In: Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine, 7th ed St Louis: Saunders Elsevier; 2010:768–769.
    1. Lutz HU, Wipf G. Naturally occurring autoantibodies to skeletal proteins from human red blood cells. J Immunol 1982;128:1695–1699. - PubMed
    1. Barker RN, Elson CJ. Red cell‐reactive non‐specific immunoglobulins and autoantibodies in the sera of normal and anaemic dogs. Vet Immunol Immunopathol 1993;39:339–354. - PubMed
    1. Naik R. Warm autoimmune hemolytic anemia. Hematol Oncol Clin North Am 2015;29:445–453. - PubMed
    1. Scott DW, Schultz RD, Post JE, et al. Autoimmune hemolytic anemia in the cat. J Am Anim Hosp Assoc 1973;9:530–539.