Hemophilia

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Sex predisposition, Breed predisposition, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Pathophysiology, Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Monitoring, Prevention, Control, Sequelae, Prognosis, Sources, Publications, Vetstream contributor(s),
Contributors Prof Bernard Feldman DVM PhD
Dr Severine Tasker BSc BVSc DSAM CertSAM DipECVIM-ca MRCVS

Introduction

  • Comprises a number of different conditions in cats: Hemophilia A, Hemophilia B and Hemophilia of Maine Coons.
  • Males predominantly affected.
  • Signs : mild-moderate-severe bleeding tendency, commonly seen as hematomata on body surface or hemarthrosis.
  • Prognosis : prolonged bleeding after surgery or trauma, may be fatal.

Diagnosis

Clinical signs

  • Hematomata  Hemophilia: subcutaneous hematoma  .
  • Bleeding at/after surgery, particularly neutering.
  • Gingival bleeding after eruption of teeth.
  • Hemarthrosis.
  • Bruising following trauma.
  • Poor adult fertility may be associated with Hemophilia of Maine Coons.

Diagnosis

Differential diagnosis

Bleeding disorders

  • Anticoagulant rodenticide toxicity   Anticoagulant rodenticide poisoning  .
  • Severe liver disease.
  • Other inherited coagulation disorders such as vitamin K-responsive coagulopathy in Devon Rex cats. Hageman (Factor XII  Factor XII deficiency  ) deficiency in cats (reported in DSH, DLH, Siamese and Himalayan) is an autosomal recessive disorder (affecting both males and females) that delays in vitro activation of the APTT and ACT, causing these to be prolonged (often markedly), but does not result in bleeding in vivo .  It has been described in combination with Hemophilias A or B, in which bleeding does occur, due to the Hemophilia rather than the Hageman deficiency.
  • Disseminated intravascular coagulation (DIC)   Disseminated intravascular coagulation  .
  • FIV infection  Feline immunodeficiency virus disease  .
  • Von Willebrand's disease.
  • Thrombocytopenia   Immune-mediated thrombocytopenia     Thrombocytopenia  .

Sequelae

Prognosis

  • Severity of hemophilia is variable - may be severe enough to warrant euthanasia.
  • Mildly affected hemophiliacs can have a relatively normal life expectancy if:
    • Potential causes of hemorrhage are anticipated or avoided.
    • Bleeding episodes treated promptly.

Sources

Publications

Refereed papers

  • Recent references fromPubMed.
  • Gray C, Boag A, Walton J, Barnett, W & Adamantos S (2009)  Haemophilia in Maine Coon cats.Vet Rec164, 65-66PubMed.
  • Brown R (2008) Haemophilia in Maine Coon cats. Vet Rec163, 667PubMed.
  • Brooks M & DeWilde L (2006)Feline Factor XII Deficiency.CompContin Educ Pract Vet28, 148-155.
  • Goree M, Catalfamo J L, Aber S & Boudreau M K (2005)Characterization of the mutations causing hemophilia B in 2 domestic cats.  JVet Int Med19, 200-204PubMed.
  • Kristensen A T, Edwards M L & Devey J (2003)Potential uses of recombinant human factor VIIa in veterinary medicine. Vet Clin North Am Small Anim Pract33, 1437-1451PubMed.
  • Littlewood J D & Evans R J (1990)A combined deficiency of factor VIII and contact activation defect in a family of cats.Br Vet J146, 30-35PubMed.
  • Maddison J E, Watson A D, Eade I G & Exner T (1990)Vitamin K-dependent multifactor coagulopathy in Devon Rex cats.JAVMA197, 1495-1457PubMed.
  • Maggio-Price L, Dodds W J (1993)Factor IX deficiency (hemophilia B) in a family of British shorthair cats.JAVMA 203,1702-1704PubMed.

Other sources of information

  • Stokol T (2005)Disorders of haemostasis.  In: E. Villiers and L. Blackwood (ed.),BSAVA Manual of Canine and Feline Clinical Pathology, 2nd ed. BSAVA, Gloucester, pp 83-98.

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