Feline Infectious Anaemia

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Previously known as: Haemobartonellosis

Caused by: Mycoplasma haemofelis , previously known as Haemobartonella felis

Introduction

Feline Infectious Anaemia is a regenerative anaemia of cats caused by Mycoplasma haemofelis (Mhf). The disease occurs worldwide and should be considered as a differential diagnosis for any cat presenting with anaemia.

Aetiology

Mhf is one of a group of organisms known as haemotropic mycoplasmas which infect many mammalian species. The causative organism was previously called Haemobartonella felis and thus the disease was known as haemobartonellosis. Polymerase chain reaction (PCR) assays allowing DNA analysis resulted in the reclassification of the organism as a mycoplasma in 2001[1]. Two other haemotropic mycoplasmas (Candidatus M. haemominutum (Mhm) and Candidatus M. turicensis (Mtc)) have also been identified in cats but appear to be less pathogenic[2].


Mhf can vary in shape from cocci to rods and are sometimes present as chains of organisms on the cell surface.


The mode of transmission of Mhf is poorly understood. Several possibilities have been proposed but none have been able to be reliably demonstrated. These include:

  • Biting and fighting activities. Infection by this route has not been able to be demonstrated experimentally.
  • Fleas. The fact that Mhf infection can be prevalent in areas where fleas are uncommon makes this less likely[3]
  • Arthropods. Geographic variation in rates of Mhf infection does exist and could be due to transmission by an arthropod [4].


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 [5], it is recommended that blood donors be screened[6]

Signalment

The major group at risk for Mhf infection are young male cats who spend time outdoors. In many areas of the world an association has been shown between Mhf and retroviral infectionsCite error: Closing </ref> missing for <ref> tag. Treatment with antimicrobials may result in false negatives on PCR so collecting before beginning therapy is pereferable.

Treatment

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[2]. 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.

Enrofloxacin given at 5mg/kg/d is also an effective treatment [7] but is a second choice due to the risk of acute retinal damage in cats.

A blood transfusion may also be required in cases of severe anaemia.

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.

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

Varied prognosis depending on the severity of the anaemia at presentation. If not treated 1/3 of affected animals will die. Antibiotics do not clear the infection so many cats become carriers of the organism however relapses are uncommon.


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(CABI log in required) 		Diagnosis and management of Hemoplasma infections. Lappin, M. R.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Orlando, Florida, USA, 17-21 January, 2009, 2009, pp 655-656, 23 ref.

Bartonellosis and hemoplasmosis in dogs and cats: emerging issues. Lappin, M. R.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Volume 21, Orlando, Florida, USA, 2007, 2007, pp 629-631


Notes

  1. ↑ Niemark H, Johansson KE, Rikihisa Y, et al (2001) Proposal to transfer some members of the genera Haemobartonella and Eperythrozoon to the genus Mycoplasma with descriptions of Candidatus Mycoplasma haemofelis, Candidatus Mycoplasma haemomuris, Candidatus Mycoplasma haemosuis and Candidatus Mycoplasma wenyonii Int J Sys Evol Microbiol 51(3) pp891-9
  2. ↑ 2.0 2.1 Sykes, JE (2010) Feline Hemotropic Mycoplasmas Vet Clinics of North America: Small Animal Practice pp. 1157-1170
  3. ↑ Jensen WA, Lappin MR, Kamkar S et al (2001) Use of a polymerase chain reaction assay to detect and differentiate two strains of Haemobartonella felis in naturally infected cats. Am J Vet Res 62(4):604-8
  4. ↑ Willi B, Boretti FS, Baumgartner C et al (2006) Prevalence, risk factor analysis and follow-up of infections caused by three feline haemoplasma species in Switzerland. J Clin Microbiol 44(3):961-9
  5. ↑ 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
  6. ↑ 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.
  7. ↑ 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

References

  1. Niemark H, Johansson KE, Rikihisa Y, et al (2001) Proposal to transfer some members of the genera Haemobartonella and Eperythrozoon to the genus Mycoplasma with descriptions of Candidatus Mycoplasma haemofelis, Candidatus Mycoplasma haemomuris, Candidatus Mycoplasma haemosuis and Candidatus Mycoplasma wenyonii Int J Sys Evol Microbiol 51(3) pp891-9
  2. Sykes, JE (2010) Feline Hemotropic Mycoplasmas Vet Clinics of North America: Small Animal Practice pp. 1157-1170
  3. 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
  4. Hagiwara, MK (2009) Anemia in Cats: Is It Mycoplasma? Proceedings of the 34th World Small Animal Veterinary Congress
  5. Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2)W.B. Saunders Company
  6. Czerski A, Gnus J, Agnieszka Rusiecka A, et al (2009) Usefulness of blood films for the feline infectious anaemia diagnosis Acta Sci. Pol., Medicina Veterinaria 9(4)pp. 21-28

Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial


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