Successful treatment of pyruvate kinase deficiency and inflammatory bowel disease comorbid with exocrine pancreatic insufficiency and hypocobalaminaemia in a cat

Abstract

AbstractA 3‐year‐old Abyssinian cat presented with chronic diarrhoea and weight loss. Blood examination and abdominal ultrasound examination identified severe macrocytic hypochromic anaemia and thickened intestinal walls. Pyruvate kinase deficiency and inflammatory bowel disease (IBD) were diagnosed based on gene analysis and intestinal biopsy findings, respectively. Additional blood evaluation identified exocrine pancreatic insufficiency (EPI) and hypocobalaminaemia. To eliminate the primary cause of haemolysis, we performed splenectomy, which stabilised the progression of anaemia for approximately 37 days. However, anaemia progressed on day 43 after splenectomy; therefore, 1 mg/kg prednisolone (PO q24h) was administered for stabilising erythrocytes and management of IBD. Significant improvements in the severity of anaemia, echinocyte counts and gastrointestinal clinical signs caused by IBD and EPI were observed with gastrointestinal diet, cobalamin and pancreatic enzymes supplementation. Prednisolone dose was then tapered to 0.5 mg/kg PO every 72 hours. There was no relapse of severe anaemia or signs of IBD or EPI.