Polycythemia in Cats
Characterized as an abnormal increase in the amount of red blood cells in the circulatory system, polycythemia is a rather serious blood condition. More specifically, it entails an increase in packed cell volume (PCV), hemoglobin concentration (the red pigment of the blood cell), and in red blood cell (RBC) count, above the reference intervals, due to a relative, transient, or absolute increase in the number of circulating red blood cells.
Polycythemia is classified as relative, transient, or absolute. Relative polycythemia develops when a decrease in plasma volume, usually caused by dehydration, produces a relative increase in circulating RBCs. Transient polycythemia is caused by splenic contraction, which injects concentrated RBCs into the circulation in a momentary response to epinephrine, the hormone that reacts to stress, anger, and fear. Absolute polycythemia is characterized by an absolute increase in the circulating RBC mass, as a result of an increase in bone marrow production.
Absolute polycythemia, typified by increased RBCs in the bone marrow, can be primary or secondary to an increase in the production of EPO. Primary absolute (called polycythemia rubra vera) is a myeloproliferative disorder characterized by the excessive, uncontrolled production of RBCs in the bone marrow. Secondary absolute polycythemia is caused by a physiologically appropriate release of EPO resulting from chronic hypoxemia (lack of oxygen), or by inappropriate and excessive production of EPO or EPO-like substance in an animal with normal blood oxygen levels.
Polycythemia can affect both dogs and cats. If you would like to learn more about how this disease affects dogs please visit this page in the PetMD pet health library.
Symptoms and Types
Relative
- Vomiting
- Diarrhea
- Lack of water intake
- Excessive urination
Absolute
- Lack of energy
- Low exercise tolerance
- Dark-red, or bluish gums
- Sneezing
- Nosebleeds
- Enlarged abdomen
Causes
Relative
- Vomiting
- Diarrhea
- Diminished water intake
- Kidney disease
- Hyperventilation
Transient
- Excitement
- Anxiety
- Seizures
- Restraint
Primary absolute
- Rare myeloproliferative disorder(bone marrow disorder)
Secondary absolute
- Not enough oxygen in the blood (hypoxemia)
- Long-term lung disease
- Heart disease
- High altitude
- Impairment of blood supply to the kidneys
- Inappropriate EPO secretion
- Kidney cyst
- Swelling of a kidney due to urine being backed-up
- Overactive adrenal gland
- Overactive thyroid gland
- Tumor of the adrenal gland
- Cancer
Diagnosis
Your veterinarian will perform a complete physical exam on your cat, including a chemical blood profile, a complete blood count, a urinalysis, and an electrolyte panel. Your veterinarian will also measure oxygen levels in the blood. Hormone assays (using blood samples to analyze hormones) can also be used for measuring EPO levels. Radiograph and ultrasound images are also useful for examining the heart, kidneys, and lungs for underlying diseases that could be causing polycythemia.
You will need to give a thorough history of your cat's health, including a background history of symptoms, and possible incidents that might have precipitated this condition. The history you provide may give your veterinarian clues as to which organs are causing secondary disease symptoms.
Treatment
For this condition, your cat should be hospitalized. Your veterinarian will decide, dependent on the underlying cause of the polycythemia, whether your cat needs to have some of the excess red blood cells removed by opening a vein - called a phlebotomy, or “letting” - and whether the excess has been caused by low levels of oxygen in the blood, which would require some amount of oxygen therapy. Your cat may also need to be treated with fluid therapy, or with medication if there is a diagnosis of a blood marrow disorder (myeloproliferative/polycythemia vera).
Living and Management
Your veterinarian will schedule follow-up appointments with your pet as necessary to assure a normal packed cell volume, and to follow progress.