Haemobartonella - I need help for a co-worker

[k9Karen]

I'm a bit out of place on the cat board (as you can tell from my 'handle'), but I have a co-worker who is at wits end. She recently lost 2 cats. One about 2 months ago from unknown causes. She did not appear ill, just died in her sleep one night. She was about 2 years old, was current on all vaccines, negative for FIV, Feline leukemia, etc when tested. she had been "partially wild", but my friend had her for over a year. She was about 4 - 6 months old when she adopted her. The second cat died this past Sunday. He was also current on all vaccines, and tested negative to the FIV, etc. He became lethargic and wouldn't eat on Tuesday. He was about a year old, and was received from a neighbor as a small kitten - they were unable to continue to care for him. My co-worker took her cat to the vet who ran blood work, including a PCR for Haemobartenella felis (now a Mycoplasma something-or other). I do not know all the lab results, but the cat was severely anemic (packed cell = 11) and the amylase was elevated (over 2000). Results of the Haemobatenella PCR (sent to the Univ. of Illinois through Antech lab) are still pending. The vet said the diagnosis was most likely either Haemobartenella or Autoimmune hemolytic anemia. An immunity panel (Coombs, ANA, etc.) was also ordered, and results of that are also still pending.

We have both tried to research Haemobartenella on the 'net with limited success. The cat's symptoms certainly fit the description of the infection. We were unable to find out how her cat could have contracted this infection. When this organism was thought to be a rickettsia, it was assumed that it had to be vector-borne (most likely tick or flea), but now that it has been reclassified as a mycoplasma, as a microbiologist, I know that those organisms do not normally require a vector for transmission - they are most commonly contracted through direct contact with someone/something that carries the infectant, but no article we were able to find said anything about transmission.

I have two questions.

First: Does anyone have any good links that can help educate my friend in either of these illnesses in cats.

Second: If this is Haemobartenella, can it be spread from cat to cat? She still has one surviving, elderly cat that she is extremely concerned about.

Thanks for your help

[Traci]

Karen, hemobartonella can be found during any search, but I would first enter feline hematology and look for sub-category hemobartonellosis.

Most text defines it as rickettsial and yes has also been classified as mycoplasma. As for transmission, who knows, but cats can be carriers without clinical symptoms in which it can manifest during times of stress or secondary health conditions or prior exposure to FELV/FIV. I'm pretty sure that even after recovery, the cat can remain a carrier for life, but as far as transmitting to other cats, this is one area that seems foggy at best. I've always assumed it *is* transmittable, simply due to the carrier status.

If the Coombs and ANA, etc come back negative (unlikely), in that event, be sure to have your friend rule out cytauxzoonosis (a protozoal), and often undiagnosed condition that can mimic the clinical signs of hemobart, and is usually fatal.

Advise your friend she may need to be prepared for a blood transfusion in the event the PCV falls into critical range...and to follow vet's treatment plan agressively (this includes pred and doxycyline, IV fluids where necessary)

[k9Karen]

Thanks Traci. In a very long post, I guess I left something out. The surviving cat shows no symptoms and appears to be fine. If the PCR comes back positive for Haemobartenella infection, should the lone surviving cat be tested? If positive, should he be treated? The sick cat was being treated with doxycycline and prednasone before it died. With a PCV of 11, wouldn't that be classified as in the critical range? The vet did not suggest a transfusion, and that is one of the things that is of concern - why wouldn't that have been considered? Stress in the home may definitely have been a factor. The cats' owner just had her mother pass away after a lengthy battle with breast cancer.

I inferred from what I was able to find on the 'net that this infection is still a bit of a mystery. She is still waiting for the lab test results to try to figure out what happened. With the transmission uncertain or unknown, she is afraid that her remaining cat could become ill, plus she would like to get another cat or kitten later on when everthing calms down a bit. She would like to know if the infection could be spread to a new cat in the household. Do you know if there any information or research that indicates that this is spread cat-to-cat?

[Traci]

Re: the transfusion...yes the hematocrit was in critical range...however, several factors to consider prior to transfusion: was a donor cat available/an acceptable cross-match.....or was there whole blood plasma available? Also, the vet could have been concerned with DIC or shock (or presumed an unfavorable reaction from a transfusion)

Here is a link to a conference on feline anemias, in one section, it gives transmission data, but is still foggy as to whether or not it can be transmitted to other cats (other than through intrauterally, etc)....use the "next" button at end of article to see more on the feline anemias...

Feline Infectious Anemias

As for testing, I would first have your friend ask her vet to consult with a veterinary university in the hematology dept for most recent data on transmission factors and/or risks. If the dept has any data that suggests it is possible between non-genetic siblings, then yes, I would definately have kitty tested with the full serology (pending also on current Coombs/ANA profile results)

One note on the potential exposure to FELV/FIV. Snap tests in the clinic are fairly reliable, but false-negatives do occur. While this is reaching, you did say the 2-year old was partially wild....if only one snap test was performed, there is always the potential she could have been a carrier. Do you know if the current immunology profile included FELV/FIV? (we usually include this with Coombs/ANA/Toxo, etc as an added measure)....also, was a necropsy performed on either cat?

[k9Karen]

I know the FIV and FeLV tests were performed again at the time the cat became ill. They were done in the office, and to the best of my knowlege were not part of the send-out immunity panel. I will know more when the results are received.

A necropsy was not performed on either cat. Funds were not available for that type of testing. There is no definite link between the deaths of the two cats. It's just with the deaths so close together, it is of concern. They could be pure coincidence, or involve the same illness. There was no reason to suspect anything infectious with the first cat. It appeared to be a sudden death, and she thought maybe an aneurism or something like that. Of course, if the second cat is found to have had AIHA, it will prove that the 1st cat's death was totally unrelated.

[Traci]

My first thought on sudden deaths usually is saddle thrombus, in which your friend may never have been able to detect it prior. Given the age and health status of the kitty, that would be my first guess. However, toxins, seizure activity, trauma, choking, hemmorhage, shock, heartworm, any number of things could have attributed to a sudden death.

If the snap test was performed at the time of illness, it was probably reliable, they are still a pretty sensitive assay, and in the face of illness, had FELV been a concern, I would imagine it would have shown on the marker clearly.

When is she expecting the results? If possible, can you let me know the findings?

[k9Karen]

The blood work was drawn 9 days ago. The vet told her 5 days for the results, but as of Tuesday this week (7 days), they were still unavailable. I was not able to ask yesterday, and of course today is a holiday. With any luck, the results will be available tomorrow, or Monday at the latest. I'll let you know what they show if she chooses the share them with me.

Thanks again for your help.

[Traci]

If the serum was sent to Antech, the vet should be able to call Antech and get up-to-date results (rather than wait for mail or fax).