Incidence of microcytosis in hyperthyroid cats referred for radioiodine treatment

Abstract

Objectives The study aimed to document the incidence of erythrocyte microcytosis in a population of hyperthyroid cats referred for radioiodine (RAI) treatment. Microcytosis has been observed but not described in feline hyperthyroid patients and is associated with hyperthyroidism in humans. Methods Retrospective clinicopathological data were collected for cats undergoing RAI between January and December 2017. Microcytosis was defined as mean cell volume (MCV) <41.3 fl using the ADVIA 2120 haematology analyser (Siemens) and identified on blood smear examination by a haematology laboratory scientist or board-certified specialist in veterinary clinical pathology. Hyperthyroidism was classified as mild (total thyroxine [TT4] 60–124.9 nmol/l), moderate (TT4 125–250 nmol/l) or severe (TT4 ⩾251 nmol/l) immediately before RAI. Data were analysed descriptively and using a Pearson correlation coefficient to test the relationship between TT4 and microcytosis, and time elapsed between first diagnosis and MCV. Results There were 41 female and 37 male cats with an age range of 7.2–20.8 years. Most cats were non-pedigree (98.7%). Microcytosis (median MCV 39.8 fl, interquartile range 32.3–41.2) was present in 29.5% (23/78) of the cats. Of the 23 microcytic samples, 86.9% (20/23) were confirmed as such on smear examination. Of mildly, moderately and severely hyperthyroid cats, 23% (6/26), 28.1% (9/32) and 40% (8/20) were microcytic, respectively. Two microcytic cats had low red blood cell counts (<6 × 1012/l) and low haemoglobin concentration (<8.2 g/dl). There was no correlation between TT4 or time elapsed from first diagnosis and MCV. Microcytosis resolved in 77.7% (7/9) of cases with follow-up. One microcytic cat had significant comorbidities (portosystemic shunt). Conclusions and relevance Microcytosis was present in a significant proportion of hyperthyroid cats, most without clinically significant comorbidities, and resolved in some following RAI.