Page 558 - Problem-Based Feline Medicine

550 PART 8 CAT WITH ABNORMAL LABORATORY DATA

The most common site of loss is the gastrointestinal
HYPOADRENOCORTICISM
tract.
Iron is required for the production of hemoglobin; lack Classical signs
of iron leads to microcytic, hypochromic anemia.
● Weakness, lethargy, anorexia.
Melena or hematochezia may or may not be present. ● Vomiting or diarrhea.
Clinical signs including vomiting, diarrhea and
weight loss that are associated with gastrointestinal
Clinical signs
diseases resulting in chronic blood loss.
Very rare in cats.
Gastrointestinal parasites (hookworms) and fleas
can result in iron deficiency anemia in kittens. Cats are usually presented for evaluation of depres-
sion, lethargy, vomiting, diarrhea and anorexia (see
Clinical signs of end-stage liver disease or portosys-
page 253).
temic shunts including failure to thrive and central
nervous system disease. Bradycardia in the face of shock may be present due
to hyperkalemia.
Melena or hematochezia may or may not be present.
Clinical signs of anemia are unusual, because the ane-
The primary disease generally is chronic and low
mia is mild.
grade; acute blood loss usually does not result in iron
deficiency and thus is usually regenerative.
Diagnosis
Diagnosis Normocytic-normochromic, non-regenerative anemia
Mild to severe microcytic-hypochromic, non-regenera- usually with a PCV of 15–27.
tive anemia. ACTH stimulation to document hypoadrenocorticism.
Mean corpuscular volume is generally < 39 fl.
Bone marrow iron stores subjectively are decreased. Treatment

Decreased serum iron concentrations and increased Treatment of shock and hyperkalemia acutely.
total iron binding capacity.
Glucocorticoid and mineralocorticoid supplementation
Thrombocytosis and occasionally neutrophilia are pres- (see page 254).
ent from non-specific bone marrow stimulation.
Serum bile acids, ultrasound, contrast studies, scinti-
HYPOTHYROIDISM
graphy and hepatic biopsy can be used to document
portosystemic shunts or end-stage liver disease.
Classical signs
● Lethargy, weight gain.
Differential diagnosis
● Poor coat, seborrhea sicca, slow hair
Any cause of non-regenerative anemia. regrowth after clipping.

Treatment Clinical signs
Control underlying disease. Extremely rare cause of anemia post-thyroidectomy or
I 131 treatment.
Ferrous sulfate 50–100 mg/cat, PO, q 24 hours.
Most cats maintain enough thyroid function and never
It requires weeks to months to correct iron deficiency
become anemic.
since the gastrointestinal transferrin system can only
absorb small concentrations of iron daily. Obesity, lethargy and pale mucous membranes.