Blue‒Green Neutrophilic Inclusions in a Cat With Severe Hepatocellular Injury

A 5-year-old female spayed domestic long-haired cat presented with fever, lethargy and inappetence. Haematologic evaluation revealed mild neutrophilia with a regenerative left shift and moderate thrombocytopenia. A review of a peripheral blood smear identified a moderate number of blue‒green neutrophilic inclusions. Further characterisation revealed that these inclusions exhibited broad-spectrum autofluorescence, were negative for Prussian blue staining, and were positive for Sudan Black staining. Biochemical analysis demonstrated severe acute hepatocellular injury characterised by markedly increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities with mild hyperbilirubinemia. Following hospitalisation and supportive care, the cat showed clinical improvement. The cat was alive on Day 279 follow-up with normal ALT and AST values.