Lymphocytic inflammatory bowel disease/alimentary lymphoma in a cat

15 Lymphocytic inflammatory bowel disease/alimentary lymphoma in a cat

Case work-up

Minimum data base

Haematology, serum chemistry, urinalysis and faecal examination were preformed.

Haematology results were within the reference ranges. Serum chemistry showed a mild decrease in albumin to 24 g/l (reference range 28–39 g/l), and mild hyperglycaemia of 6.7 mmol/l (reference range 3.0–5.0 mmol/l), which was thought to be likely due to stress. Serum total thyroxin was within the reference range at 17.5 nmol/l (reference range 13–48 nmol/l).

The serum cobalamin concentration was decreased to 177 ng/l (reference range 251–908 ng/l) and folate was decreased to 6.4 µg/ml (reference range 9.7–21.6 µg/l).

Clinical tip: folate and cobalamin (vitamin B12)

Cobalamin is absorbed in the ileal part of the small intestine. It requires prior binding with intrinsic factor, which comes from the pancreas in cats and the stomach and pancreas in dogs. Deficiency may be caused by poor absorption due to intestinal disease, exocrine pancreatic insufficiency, excessive bacteria in the upper small intestine utilizing the vitamin, or a deficiency in intrinsic factor. In humans who are vegetarians (especially elderly humans), a dietary deficiency is possible; however, this is unlikely in cats as they cannot successfully be vegetarians.

Unlike most other B vitamins, cobalamin is stored in the body. In healthy cats the half life is 11 to 14 days and in cats with GI disease it is only 4.5 to 5.5 days. Clinical signs of cobalamin deficiency in humans include anaemia, thrombocytopenia, neuropathies and digestion abnormalities. In cats (and dogs) the clinical signs are not as well described; however, it has been suggested that response to treatment of intestinal disorders is improved with cobalamin repletion. A high serum concentration of cobalamin does not appear to have clinical significance and may occur with supplementation. The recommended dose for supplementation in humans exceeds the amounts needed to reach serum reference ranges and there is a consideration that there may be positive pharmacological effects.

Folate is absorbed only in the proximal intestine. A deficiency usually indicates small intestinal disease and if it is accompanied by a cobalamin deficiency it likely indicates widespread disease. A high serum folate can be caused by bacterial production, although serum concentrations of this vitamin are sensitive to food intake and a high dietary intake can also increase the serum concentration (Fig 15.1).

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Sep 22, 2016 | Posted by in SMALL ANIMAL | Comments Off on Lymphocytic inflammatory bowel disease/alimentary lymphoma in a cat

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