Feline non-regenerative anemia: Diagnostic and treatment recommendations

Abstract

Practical relevance:Non-regenerative anemia, or anemia with reticulocytopenia, is a daily diagnosis in feline practice.Clinical challenges:The disease processes underlying non-regenerative anemia are many and diverse. A major diagnostic evaluation may be required to correctly diagnose and treat the underlying cause.Audience:All veterinarians caring for cats will face the diagnostic and therapeutic challenge of non-regenerative anemia. Readers will benefit from the review of diagnostic testing and therapeutic options for non-regenerative anemia.Evidence base:This review summarizes the currently available literature informing diagnostic and treatment recommendations related to non-regenerative anemia. The evidence available to support the recommendations in this review is graded as low and includes predominantly expert opinion, case reports and cases series, on which the authors’ interpretation/consensus is based.

Presumptive precursor-targeted immune-mediated anemia concurrent with gastrointestinal lymphoma in a cat

“…Nonregenerative anemia in cats is defined as PCV<20% with aggregate reticulocyte count < 15×10 3 /µl by some previous reports [3,17,25]. The present case showed persistent nonregenerative anemia without the presence of aggregate reticulocytosis.…”

“…The present case showed persistent nonregenerative anemia without the presence of aggregate reticulocytosis. Generally, ineffective erythropoiesis is defined as persistent nonregenerative anemia accompanied by increased particles hematopoietic cellularity with decreased M:E ratios in BM and an absence of aggregate reticulocytosis [2,3,8,25]. The cat in the present study had increased cellularity with decreased M:E ratios in the BM and persistent nonregenerative anemia without the presence of aggregate reticulocytosis in peripheral blood.…”

“…Precursor targeted immune-mediated anemia (PIMA) is known to immune-mediated destruction of erythrocyte precursors and is associated with bone marrow (BM) erythroid hyperplasia and/or erythroid maturation arrest [2,8]. Feline nonregenerative anemia with suspected immunemediated destruction of erythrocyte precursors is called nonregenerative immune-mediated anemia (NRIMA) in the veterinary literatures [3,7,17,21,23,25]. However, we consider that the use of term 'NRIMA' can be confusing because it is not always clear whether the pathogenesis is persistently nonregenerative or preregenerative stage of immune-mediated hemolytic anemia (IMHA).…”

“…Feline NRIMA like presumptive feline PIMA are also few reported and little information is available describing cats more than dogs. [3,7,17,21,23,25].…”

Nicht-regenerative Anämien bei der Katze

“…In den letzten Jahren finden sich vermehrt Fallberichte von nicht-regenerativen Anämien als primäre Erkrankungen des Knochenmarks, wobei v. a. die Pure Red Cell Aplasia (PRCA) und die nicht-regenerative immunmediierte hämolytische Anämie (NRIMHA) an Bedeutung gewonnen haben 3 , 4 , 5 .…”