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Pure Red Cell Aplasia in a Cat

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A 9-year-old male castrated American domestic shorthair cat was evaluated for lethargy, pallor, and anemia. A severe normocytic, normochromic, non-regenerative anemia with a mild leukocytosis and normal platelet count was identified. Testing was negative for feline leukemia virus and feline immunodeficiency virus. Bone marrow aspirate cytology disclosed erythroid aplasia and a mild lymphocytosis. Prednisolone was administered at a dose of 4 mg/kg/day PO and cyclosporine was administered at 5 mg/kg/day PO. Doxycycline was given at 5mg/kg PO BID for 15 days and then discontinued. The patient received three units of packed red blood cells (pRBC) in a 12-day period, and a regenerative response was seen on complete blood count after 26 days of immunosuppressive therapy. The dose of cyclosporine was increased to 6 mg/kg/day three months following discharge. No relapse of anemia had occurred at the time of publication. Pure red cell aplasia (PRCA) is a syndrome in cats that occurs either as a primary idiopathic disorder, or it may ensue secondary to a systemic disease. PRCA is characterized by a severe non-regenerative anemia with bone marrow erythroid hypoplasia or aplasia. The disease is responsive to immunosuppressive therapy, although relapse is common with drug dosage taper or discontinuation and may require life-long maintenance therapy.

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2015-02-04

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