Page 547 - Problem-Based Feline Medicine

24 – THE ANEMIC CAT 539

If vitamin K antagonists are the cause of the hemor- ● Some normal cats will appear hypertensive due to
rhage, vitamin K1 should be given subcutaneously at epinephrine release from the stress of measuring the
1–5 mg/kg, q 12 hour for 24 hours. Dose is depend- blood pressure.
ent on the type of anti-coagulant ingested. Warfarin can
Renal and endocrine causes of hypertension should be
be treated with 1–3 mg/kg and long-acting products
excluded by bloodwork and urinalysis.
should be treated with 3–5 mg/kg. Oral administration
of vitamin K1 is initiated on day 2 at 1–5 mg/kg, q 12
Treatment
hours for 2 weeks (warfarin) to 6 weeks (long-acting
anti-coagulant) depending on the type of anti-coagulant ACE-inhibitors, calcium channel blockers, beta-blockers,
ingested. and sodium restriction are used to manage systemic
arterial hypertension in cats.
Vitamin K1 given intravenously can result in an ana-
phylactoid reaction. See appropriate sections for specific treatment recom-
mendations (page 134).
When vitamin K1 therapy is discontinued, the cat
should be returned in 72 hours for assessment of an
ACT or prothrombin time. If increased at that time, two
NON-REGENERATIVE ANEMIA
more weeks of therapy should be prescribed prior to the
(< 60 000 RETICULOCYTES/mL)
next evaluation.
ANEMIA OF CHRONIC DISEASE***
HYPERTENSION*

Classical signs
Classical signs
● Chronic lethargy, anorexia and depression.
● Sudden onset of blindness with dilated
pupils from retinal hemorrhage.
● Epistaxis. Pathogenesis
● Evidence of diseases causing hypertension,
especially renal disease or Activation of leukocytes by the primary disease results
hyperthyroidism. in the production of cytokines like interleukin 1.
In the face of inflammatory cytokines, macrophages
Pathogenesis fail to release iron to be used for red blood cell pro-
duction.
Systemic arterial hypertension in cats is usually from
renal disease, hyperthyroidism, hyperadrenocorti- Red blood cell life span is slightly shortened.
cism and idiopathic (essential).
Response of the bone marrow to erythropoietin may be
blunted.
Clinical signs
Systemic arterial hypertension can result in hemor- Clinical signs
rhage; retinal hemorrhage and epistaxis are most
Diseases associated with chronic inflammation, usually
common.
infectious or neoplastic, can result in anemia of chronic
With the exception of epistaxis, volume of blood loss is disease.
usually small and so anemia is rare.
Clinical signs are those usually related to the primary
disease with minimal clinical findings associated with
Diagnosis the anemia.

Systolic blood pressure > 175 mmHg using a Doppler The anemia is generally mild compared to those asso-
system is abnormal. ciated with FeLV or immune-mediated diseases.