Immune-Mediated Hemolytic Anemia in Cats with Feline Infectious Peritonitis
Feline infectious peritonitis (FIP) is caused by mutated feline coronaviruses. Immune-mediated hemolytic anemia (IMHA) arises due to immune-mediated erythrocyte destruction and can be non-associative or associative with diseases such as FIP. Records of cats with FIP were reviewed to find those with...
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MDPI AG
2025-07-01
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| Online Access: | https://www.mdpi.com/2076-0817/14/7/660 |
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| author | Petra Černá Marieke Knies Marleen Assink Samantha Evans Séverine Tasker Danièlle A. Gunn-Moore Katrin Hartmann Katharina Buchta Samantha Taylor Solène Meunier Regina Hofmann-Lehmann Nicole Jacque Allison Koonce Casandra Jacobs Ashley Gillett Michael R. Lappin |
| author_facet | Petra Černá Marieke Knies Marleen Assink Samantha Evans Séverine Tasker Danièlle A. Gunn-Moore Katrin Hartmann Katharina Buchta Samantha Taylor Solène Meunier Regina Hofmann-Lehmann Nicole Jacque Allison Koonce Casandra Jacobs Ashley Gillett Michael R. Lappin |
| author_sort | Petra Černá |
| collection | DOAJ |
| description | Feline infectious peritonitis (FIP) is caused by mutated feline coronaviruses. Immune-mediated hemolytic anemia (IMHA) arises due to immune-mediated erythrocyte destruction and can be non-associative or associative with diseases such as FIP. Records of cats with FIP were reviewed to find those with associative IMHA based on exclusion of other causes of anemia and a positive saline agglutination test and/or Coombs test. The inclusion criteria were met for 45 cats (26 (58%) cats with effusive and 19 (42%) with non-effusive FIP). Median hematocrit was 18% (interquartile range [IQR] 13–20). Anemia was non-regenerative in 36 (80%) cats and regenerative in 5 (11%) cats; 4 (9%) cats had no reticulocyte count available. Concurrent thrombocytopenia was present in 18 (40%) cats. All 45 cats were treated with nucleoside analogs, and 44 (98%) cats with glucocorticoids; in 5 (11%) cats, glucocorticoids were added after starting antiviral treatment due to persistent anemia. Median follow-up was 72 days (IQR 14–246); at the time of last follow-up 33 (73%) cats had survived while 12 (27%) had died or were euthanized. Of the 33 surviving cats, 17 achieved remission of both FIP and IMHA. In three cats, FIP remission was achieved, but IMHA relapsed; in one of these, IMHA relapsed twice. FIP relapsed without IMHA in two cats, and both FIP and IMHA relapsed in one cat. In 9 cats the antiviral and glucocorticoid treatment is still ongoing at the time of the publication. Although FIP is likely an uncommon cause of associative IMHA, as more cats with FIP are treated with antiviral therapy, it is important to consider IMHA as a possible cause of anemia in cats with FIP. |
| format | Article |
| id | doaj-art-bfb5e4e8c817477987c0df9ae43ee93e |
| institution | DOAJ |
| issn | 2076-0817 |
| language | English |
| publishDate | 2025-07-01 |
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| series | Pathogens |
| spelling | doaj-art-bfb5e4e8c817477987c0df9ae43ee93e2025-08-20T03:08:13ZengMDPI AGPathogens2076-08172025-07-0114766010.3390/pathogens14070660Immune-Mediated Hemolytic Anemia in Cats with Feline Infectious PeritonitisPetra Černá0Marieke Knies1Marleen Assink2Samantha Evans3Séverine Tasker4Danièlle A. Gunn-Moore5Katrin Hartmann6Katharina Buchta7Samantha Taylor8Solène Meunier9Regina Hofmann-Lehmann10Nicole Jacque11Allison Koonce12Casandra Jacobs13Ashley Gillett14Michael R. Lappin15Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USADepartment of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CT Utrecht, The NetherlandsIVC Evidensia Small Animal Referral Hospital Arnhem, Meander 10, 6825 MB Arnhem, The NetherlandsDepartment of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USABristol Veterinary School, University of Bristol, Bristol BS40 5DU, UKThe Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UKLMU Small Animal Clinic, Centre for Clinical Veterinary Medicine, LMU Munich, 80539 Munich, GermanyLMU Small Animal Clinic, Centre for Clinical Veterinary Medicine, LMU Munich, 80539 Munich, GermanyInternational Cat Care Veterinary Society, Tisbury SP3 6HJ, UKClinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, SwitzerlandClinical Laboratory, Department of Clinical Diagnostics and Services, Center for Clinical Studies, Vetsuisse Faculty, University of Zurich, CH-8057 Zurich, SwitzerlandIndependent Researcher, San Jose, CA 95113, USAPleasant Valley Veterinary Clinic, Little Rock, AR 72212, USADesert Veterinary Medical Specialists, Peoria, AZ 85382, USAThe Humane Society of Sarasota County, Sarasota, FL 34237, USADepartment of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USAFeline infectious peritonitis (FIP) is caused by mutated feline coronaviruses. Immune-mediated hemolytic anemia (IMHA) arises due to immune-mediated erythrocyte destruction and can be non-associative or associative with diseases such as FIP. Records of cats with FIP were reviewed to find those with associative IMHA based on exclusion of other causes of anemia and a positive saline agglutination test and/or Coombs test. The inclusion criteria were met for 45 cats (26 (58%) cats with effusive and 19 (42%) with non-effusive FIP). Median hematocrit was 18% (interquartile range [IQR] 13–20). Anemia was non-regenerative in 36 (80%) cats and regenerative in 5 (11%) cats; 4 (9%) cats had no reticulocyte count available. Concurrent thrombocytopenia was present in 18 (40%) cats. All 45 cats were treated with nucleoside analogs, and 44 (98%) cats with glucocorticoids; in 5 (11%) cats, glucocorticoids were added after starting antiviral treatment due to persistent anemia. Median follow-up was 72 days (IQR 14–246); at the time of last follow-up 33 (73%) cats had survived while 12 (27%) had died or were euthanized. Of the 33 surviving cats, 17 achieved remission of both FIP and IMHA. In three cats, FIP remission was achieved, but IMHA relapsed; in one of these, IMHA relapsed twice. FIP relapsed without IMHA in two cats, and both FIP and IMHA relapsed in one cat. In 9 cats the antiviral and glucocorticoid treatment is still ongoing at the time of the publication. Although FIP is likely an uncommon cause of associative IMHA, as more cats with FIP are treated with antiviral therapy, it is important to consider IMHA as a possible cause of anemia in cats with FIP.https://www.mdpi.com/2076-0817/14/7/660FIPPIMAIMHAcoronavirus |
| spellingShingle | Petra Černá Marieke Knies Marleen Assink Samantha Evans Séverine Tasker Danièlle A. Gunn-Moore Katrin Hartmann Katharina Buchta Samantha Taylor Solène Meunier Regina Hofmann-Lehmann Nicole Jacque Allison Koonce Casandra Jacobs Ashley Gillett Michael R. Lappin Immune-Mediated Hemolytic Anemia in Cats with Feline Infectious Peritonitis Pathogens FIP PIMA IMHA coronavirus |
| title | Immune-Mediated Hemolytic Anemia in Cats with Feline Infectious Peritonitis |
| title_full | Immune-Mediated Hemolytic Anemia in Cats with Feline Infectious Peritonitis |
| title_fullStr | Immune-Mediated Hemolytic Anemia in Cats with Feline Infectious Peritonitis |
| title_full_unstemmed | Immune-Mediated Hemolytic Anemia in Cats with Feline Infectious Peritonitis |
| title_short | Immune-Mediated Hemolytic Anemia in Cats with Feline Infectious Peritonitis |
| title_sort | immune mediated hemolytic anemia in cats with feline infectious peritonitis |
| topic | FIP PIMA IMHA coronavirus |
| url | https://www.mdpi.com/2076-0817/14/7/660 |
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