Changes

The mode of transmission of Mhf is poorly understood. It is thought that it may be transmitted through biting and fighting activities, although this has not been able to be demonstrated experimentally. As transmission has been shown to occur through blood transfusion, it is recommended that blood donors been screened³.

The mode of transmission of Mhf is poorly understood. It is thought that it may be transmitted through biting and fighting activities, although this has not been able to be demonstrated experimentally. As transmission has been shown to occur through blood transfusion, it is recommended that blood donors be screened³.

==Signalment==

==Signalment==

==Clinical signs==

==Clinical signs==

Infected cats most commonly present for lethargy and decreased appetite. Physical examination findings are non-specific and can include signs of anaemia, such as mucous membrane pallor, tachypnoea and tachycardia, pyrexia and occasionally splenomagaly and [[Icterus|jaundice]]. Pyrexia is frequently intermittent and spikes when parasite numbers are highest ³.  The anaemia can be severe and rapidly fatal in some cases.  

Infected cats most commonly present for lethargy and decreased appetite. Physical examination findings are non-specific and can include signs of anaemia, such as mucous membrane pallor, tachypnoea and tachycardia, pyrexia, and occasionally splenomagaly and [[Icterus|jaundice]]. Pyrexia is frequently intermittent and spikes when parasite numbers are highest ³.  The anaemia can be severe and rapidly fatal in some cases.  

==Differential diagnosis==

==Differential diagnosis==

There are multiple causes of both regenerative and non-regenerative anaemia in cats which must be considered as differential diagnoses when investigating anaemia in cats.  

There are multiple causes of both regenerative and non-regenerative anaemia in cats which must be considered as differential diagnoses when investigating a case of an anaemic cats.  

Mhf infection can be definitvely diagnosed by identification of organisms on a blood smear, appearing as cocci or rods and sometimes forming short chains of organisms. However, examination of a single blood smear is less than 50% sensitive ⁵ as the animal's immune response causes organisms to disappear from the blood stream for several days, often to reappear a few days later. It was found in one study that smears should be examined every four days over a minimum of three four day cycles⁵. As there could be eight days between presentation and diagnosis this is clearly not an ideal means of diagnosis. It also has the potential for misidentification.  

Mhf infection can be definitvely diagnosed by identification of organisms on a blood smear, appearing as cocci or rods and sometimes forming short chains of organisms. However, examination of a single blood smear is less than 50% sensitive ⁵ as the animal's immune response causes organisms to disappear from the blood stream for several days, often to reappear a few days later. One study found that smears should be examined every four days over a minimum of three four day cycles⁵, making it possible to have eight days between presentation and diagnosis - clearly not ideal. It also has the potential for misidentification of organisms.  

The gold standard for diagnosis of Mhf infection is polymerase chain reaction (PCR), which detects the 16S RNA gene. The test is widely available through veterinary diagnostic laboratories.

The gold standard for diagnosis of Mhf infection is polymerase chain reaction (PCR), which detects the 16S RNA gene. The test is widely available through veterinary diagnostic laboratories. There are two types of PCR tests; conventional PCR which uses the presence or absence of bands on a gel to assess infection, and real-time PCR assays which uses fluoresence to mark a segment of DNA unique to the organism, making it highly sensitive and species-specific and thus the test of choice². Treatment with antimicrobials may result in false negatives on PCR so collecting before beginning therapy is pereferable.

==Treatment==

==Treatment==