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猫慢性胃肠道疾病中的贫血、缺铁和钴胺素缺乏。

Anemia, iron deficiency, and cobalamin deficiency in cats with chronic gastrointestinal disease.

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Tennessee, USA.

Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA.

出版信息

J Vet Intern Med. 2021 Jan;35(1):172-178. doi: 10.1111/jvim.15962. Epub 2020 Nov 23.

Abstract

BACKGROUND

Iron deficiency and cobalamin deficiency, as sequelae to chronic gastrointestinal (GI) disease, could result in anemia and increased morbidity in cats with chronic enteropathies.

OBJECTIVE

To evaluate iron deficiency in cats with chronic GI disease and its relationship with hypocobalaminemia, anemia, and disease severity.

ANIMALS

Twenty client-owned cats with primary GI disease.

METHODS

Prospective, cross-sectional study. Cats were enrolled at the time of evaluation for chronic GI disease, after exclusion of comorbidities. CBC with reticulocyte indices, iron metabolism (serum iron and ferritin concentrations, total iron binding capacity [TIBC]), serum methylmalonic acid (MMA), cobalamin, and folate concentrations, pancreatic lipase and trypsin-like immunoreactivity, and disease severity were evaluated.

RESULTS

Anemia (hematocrit <30%), iron deficiency, and cobalamin deficiency were diagnosed in 4/20, 7/20, and 8/20 cats, respectively. Hematocrit (r = -.45; P < .05) and body condition score (r = -.60; P < .01) negatively correlated with MMA. Median TIBC was lower in cats with increased vs normal MMA (218 μg/mL; range, 120-466 μg/mL vs 288 μg/mL; range, 195-369 μg/mL; P = .02). Hematocrit (r = .51; P = .02), reticulocyte MCV (r = .52; P = .02), reticulocyte hemoglobin content (r = .71; P < .001), and percent transferrin saturation (r = .79; P < .0001) positively correlated with serum iron concentration.

CONCLUSIONS AND CLINICAL IMPORTANCE

Functional iron deficiency was common in cats with chronic GI disease. Associations between hypocobalaminemia, iron parameters, and hematologic parameters warrant further investigation on the impact of iron deficiency on chronic GI disease morbidity in cats.

摘要

背景

慢性胃肠道(GI)疾病的后遗症,如缺铁和钴胺素缺乏,可能导致患有慢性肠炎的猫出现贫血和发病率增加。

目的

评估患有慢性 GI 疾病的猫的缺铁情况及其与低钴胺素血症、贫血和疾病严重程度的关系。

动物

20 只患有原发性 GI 疾病的患宠猫。

方法

前瞻性、横断面研究。在排除合并症后,在评估慢性 GI 疾病时纳入猫。评估全血细胞计数和网织红细胞指数、铁代谢(血清铁和铁蛋白浓度、总铁结合能力[TIBC])、血清甲基丙二酸(MMA)、钴胺素和叶酸浓度、胰腺脂肪酶和胰蛋白酶样免疫反应以及疾病严重程度。

结果

诊断出 4/20、7/20 和 8/20 的猫分别患有贫血(红细胞压积<30%)、缺铁和钴胺素缺乏。红细胞压积(r =-.45;P <.05)和体况评分(r =-.60;P <.01)与 MMA 呈负相关。与 MMA 升高的猫相比,TIBC 中位数较低(218μg/mL;范围,120-466μg/mL 与 288μg/mL;范围,195-369μg/mL;P =.02)。红细胞压积(r =.51;P =.02)、网织红细胞 MCV(r =.52;P =.02)、网织红细胞血红蛋白含量(r =.71;P <.001)和转铁蛋白饱和度百分比(r =.79;P <.0001)与血清铁浓度呈正相关。

结论和临床意义

患有慢性 GI 疾病的猫常出现功能性缺铁。低钴胺素血症、铁参数和血液学参数之间的关联需要进一步研究缺铁对猫慢性 GI 疾病发病率的影响。

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