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Published on: December 27, 2017
Primary immune-mediated thrombocytopenia in a cat
S Tasker1, A J Mackin, M J Day
1Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, University of Edinburgh.
Insights
A Somali cat with chronic hematuria had immune-mediated thrombocytopenia. Treatment with dexamethasone successfully resolved the condition after other immunosuppressants failed.
Area of Science:
- Veterinary Internal Medicine
- Immunology
- Hematology
Background:
- Immune-mediated thrombocytopenia (ITP) is a rare but serious condition in cats.
- Diagnosis involves identifying anti-platelet antibodies and ruling out secondary causes.
- Chronic intermittent haematuria can be a presenting sign.
Observation:
- A young female Somali cat presented with chronic intermittent haematuria and petechiae.
- Severe thrombocytopenia and megakaryocyte hyperplasia were identified.
- Direct marrow immunohistochemistry detected anti-megakaryocyte autoantibody (Immunoglobulin G).
Findings:
- A diagnosis of primary immune-mediated thrombocytopenia was made after excluding secondary causes.
- Initial immunosuppressive therapy with prednisolone, azathioprine, and vincristine was ineffective.
- Thrombocytopenia resolved following a switch to dexamethasone therapy.
Implications:
- Dexamethasone may be a more effective treatment for feline primary immune-mediated thrombocytopenia than other immunosuppressants.
- This case highlights the importance of thorough investigation for ITP in cats presenting with haematuria.
- Further research into feline ITP treatment protocols is warranted.
Abstract:
A young female Somali cat was referred for investigation of chronic intermittent haematuria. Petechiae were found on the ears and ventral abdomen and further investigation revealed severe thrombocytopenia and megakaryocyte hyperplasia. Direct marrow immunohistochemistry detected anti-megakaryocyte autoantibody (Immunoglobulin G), but extensive investigation failed to find secondary causes of immune-mediated thrombocytopenia, so a diagnosis of primary (autoimmune) immune-mediated thrombocytopenia was concluded. Thrombocytopenia persisted despite aggressive immunosuppressive therapy (prednisolone, azathioprine and vincristine) but resolved after oral prednisolone was replaced with dexamethasone.
