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. 2025 May-Jun;39(3):e70131.
doi: 10.1111/jvim.70131.

Effect of Iron Deficiency on Short-Term Response to Treatment in Cats With Chronic Enteropathies

Maria C Jugan  1 , Cathy Langston  2 , Brandon L Plattner  3 , Alexandra K Ford  3
Affiliations

Effect of Iron Deficiency on Short-Term Response to Treatment in Cats With Chronic Enteropathies

Maria C Jugan et al. J Vet Intern Med. 2025 May-Jun.

Abstract

Background: Iron deficiency in humans with chronic inflammatory enteropathies (CIE) is associated with active disease and anemia-related morbidity.

Objectives: To compare iron deficiency prevalence in cats with CIE versus low-grade alimentary lymphoma (LGAL) and secondarily, determine the effect of iron deficiency on short-term clinical response in CIE cats.

Animals: Twenty-eight client-owned cats with primary gastrointestinal disease, including 14 CIE cats and 14 LGAL cats.

Methods: Prospective study. Cats were enrolled when they presented for gastrointestinal endoscopy. Iron panel (serum iron, ferritin, total iron binding capacity), CBC, cobalamin, serum amyloid A, methylmalonic acid, and clinical disease severity were evaluated. Cats were categorized as "normal" or "iron deficient" using calculated transferrin saturation. CIE cats were reevaluated 14, 30, and 90 days after initiation of non-standardized gastrointestinal disease treatment. Clinical response was compared based on iron and anemia status.

Results: Iron deficiency was diagnosed in 7/28 cats (2/14 CIE, 5/14 LGAL cats) at enrollment and developed in four additional CIE cats during follow-up. While 9/28 cats were anemic at enrollment, neither anemia (relative risk [RR], 0.90; 95% confidence interval [CI], 0.13-5.50) nor iron status (RR, 0.4; 95% CI, 0.10-1.5) was associated with treatment response. Transferrin saturation was lower in LGAL cats (22%; 95% CI, 20%-27%) than in CIE cats (30%; 95% CI, 26%-39%).

Conclusions and clinical importance: There was high prevalence of iron deficiency over the first 90 days of treatment in CIE cats. Iron deficiency did not affect short-term response to individualized treatment of gastrointestinal disease.

Keywords: feline; ferritin; inflammatory bowel disease; iron deficiency anemia.

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Conflict of interest statement

Brandon L. Plattner is employed by the Kansas State Veterinary Diagnostic Laboratory, which offers measurement of iron indices on a fee‐for‐service basis. Alexandra K. Ford was employed by the KSVDL during the study period. The other authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
A combined scatter and whisker plot showing serial clinical disease severity scores in cats with CIE as individual data points (circles) and median and 95% confidence interval (bars). Scoring scale ranges from 0 (no disease) to 19 (severe disease). * denotes p < 0.05; ** denotes p < 0.01. CIE, chronic inflammatory enteropathies.
FIGURE 2
FIGURE 2
A combined scatter and whisker plot showing baseline serum iron (n = 14; A), ferritin (n = 9; B), and TSAT (n = 14; C) in cats with CIE as individual data points (circles) and median and 95% confidence interval (bars). Shaded regions denote laboratory specific feline reference intervals, where applicable. Responders denote cats with complete treatment response based on clinical disease severity scores; nonresponders denote cats with either partial or no response. CIE, chronic inflammatory enteropathies; TSAT, transferrin saturation.
See this image and copyright information in PMC

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