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 be screened³.

The mode of transmission of Mhf is poorly understood and several possibilities have been investigated:

# Biting and fighting activities, although this has not been able to be demonstrated experimentally.  

 

 

As transmission has been shown to occur through blood transfusion due to the ability of the organism to survive in stored blood products for up to 7 days <ref name="Gary">Gary AT, Richmond HL, Tasker S etal (2006) Survival of ''Mycoplsma haemofelis'' and ''Candidatus'' Mycolplasma haemominitum in blood of cats used for transfusions '''J Feline Med Surg''' 8(5):321-6</ref>, it is recommended that blood donors be screened<ref name="Wardrop">Wardrop J, Reine N, Birkenheuer A et al (2005) Canine and feline blood donor screening for infectious disease '''J Vet Intern Med''' 19(1) pp.135-42.</ref>

==Signalment==

==Signalment==

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 choice<ref name="Sykes"></ref>. Treatment with antimicrobials may result in false negatives on PCR so collecting before beginning therapy is pereferable.

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 choice <ref name="Sykes"></ref>. Treatment with antimicrobials may result in false negatives on PCR so collecting before beginning therapy is pereferable.

==Treatment==

==Treatment==

The treatment of choice is doxycycline at 10mg/kg/d for at least two weeks. Only cats who are anaemic and have clinical signs and laboratory results consistent with haemoplasmosis should be treated as the treatment does not reliably eliminate the organism.  

The treatment of choice is for Mhf infection is doxycycline at 10mg/kg/d for at least two weeks. Only cats who are anaemic and have clinical signs and laboratory results consistent with haemoplasmosis should be treated as the drug does not reliably eliminate the organism<ref name="Sykes"></ref>. For this reason a PCR-positive cat may not become negative despite treatment and therapy cannot be used to ensure blood donor cats are free from infection.

[[Fluoroquinolones|Enrofloxacin]] is also a good treatment choice especially in refractory cases when combined with doxycycline.  

[[Fluoroquinolones|Enrofloxacin]] given at 5mg/kg/d is also an effective treatment <ref name="Tasker">Tasker, S, Helps CR, Day MJ et al.(2004) Use of a Taqman PCR to determine the response to ''Mycoplasma haemofelis'' infection to antibiotic treatment. '''JMicrobiol Methods''' 56(1):63-71</ref> but is a second choice due to the risk of acute retinal damage in cats.

A [[:Category:Transfusion Medicine|blood transfusion]] may also be required in cases of severe anaemia.

A [[:Category:Transfusion Medicine|blood transfusion]] may also be required in cases of severe anaemia.

As blood sucking endoparasites, such as [[:Category:Fleas|Fleas]], are thought to spread disease the animal should also receive flea treatment.

Antimicrobial therapy and blood tranfusions should be initiated before PCR results are known, as this may take several days. In cats testing negative for Mhf and failing to respond to therapy, alternative diagnoses should be considered.

Prednisolone is also advised to treat the immune mediated mechanisms and to prevent further erythrophagocytosis.

The use of glucocorticoids to suppress immune-mediated damage to erythrocytes has been suggested. However, as this treatment may cause reactivation of a latent infection it is recommended that they only be used in cats not responding to doxycycline and/or for whom there is no definitive diagnosis.

==Prognosis==

==Prognosis==