Transient cold agglutinins associated withMycoplasma cynospneumonia in a dog

Abstract

This report details a case of reversible cold agglutinins in a dog with Mycoplasma cynos pneumonia. An 11-month-old female spayed Rhodesian Ridgeback was presented for lethargy and cough. Thoracic radiographs revealed an alveolar pattern present bilaterally in the cranioventral lung lobes. Septic neutrophilic inflammation with suspected Mycoplasma sp. organisms was noted on cytologic examination of a trans-tracheal wash, and the dog was treated empirically with IV ampicillin/sulbactam and enrofloxacin pending culture results. Red blood cell agglutination was noted unexpectedly on several blood film reviews during hospitalization; however, the dog never developed clinical or laboratory evidence of hemolysis. Cold agglutinins were demonstrated based on the results of a saline dilution and cold agglutinin test that showed agglutination at 4°C but not at room temperature (21°C) or 37°C. Based on a positive culture for M cynos, the dog was treated for 8 weeks with oral enrofloxacin. After clinical and radiographic resolution of the pneumonia, repeated saline dilution and cold agglutinin tests of peripheral blood were negative at all temperatures. Reversible, asymptomatic cold agglutinins are common in human patients with mycoplasma pneumonia, but this is the first reported case in a dog.

ACVIM consensus statement on the diagnosis of immune‐mediated hemolytic anemia in dogs and cats

“…Overall, 66 manuscripts were reviewed . The IME values were calculated for 27 infectious agents or types of infection (Figures ), but could not be calculated for many infectious agents either because of the way data were summarized (eg, the number of individual patients with IMHA and an infection could not be discerned) or because an individual patient with IMHA had >1 comorbidity (Supporting Information S2).…”

“…Seventeen studies described dogs with IMHA that had been exposed to drugs or toxins, but only 11 reported cases with sufficient primary data for the calculation of an IME value . The majority of cases (35/36) were dogs exposed to antimicrobial drugs .…”

“…Non‐hemotropic Mycoplasma infection only has been described in 1 cat with IMHA . However, M. pneumoniae causes cold agglutinin hemolytic anemia in people, and infection with Mycoplasma cynos was associated with development of cold agglutinins in a dog . Therefore, it should be considered as a possible trigger in cats with IMHA and other findings compatible with infection.…”

A case of cold agglutinin disease in a bottlenose dolphin (<i>Tursiops truncatus</i>)

“…The dolphin in this case showed no clinical symptoms other than findings on blood tests during the entire disease period. Peripheral skin necrosis has been reported in CAD in dogs and humans [ 13 , 16 , 18 , 21 ], but was not present in this case. This may have been because the anemia did not progress to the level of clinical symptoms or because treatment was initiated before the anemia progressed.…”

“…In humans, Mycoplasma , parvovirus B19, Epstein-Barr virus, adenovirus, influenza virus, and varicella zoster virus infections and syphilis can cause CAD [ 13 ]. Mycoplasma infection is also known to cause CAD in non-human animals, including chimpanzees, horses, dogs, chickens, and swine [ 3 , 12 , 18 , 19 , 22 ]. Mycoplasma spp.…”