“Case of the Month” – August 2018
Miao Miao, a 4-year-old male domestic shorthair cat, was brought to the UC Davis veterinary hospital with persistent nosebleeds. Based on previous medical issues, his owners were aware that he had some variation of a blood platelet disorder (causing an inability to properly clot blood), but the exact make-up of that was never discovered. At UC Davis, specialists with the Internal Medicine Service, ran a complete range of tests to attempt to discover the root of his bleeding issue. A complete blood count showed that Miao Miao was not anemic, had no evidence of inflammation, and a normal platelet count. An ultrasound was also performed, which showed that Miao Miao had no evidence of bleeding into any of his other bodily cavities.
The team felt it was best to keep Miao Miao hospitalized for a few days to ensure he did not develop significant bleeding, and to discuss his case with other clinicians and researchers. Through a collaboration of UC Davis emergency, internal medicine, and research specialists, a unique cause to Miao Miao’s bleeding was found.
Dr. Ronald Li, a critical care specialist with the UC Davis veterinary hospital’s Emergency Room, operates a state-of-the-art platelet physiology laboratory with equipment and capabilities found in only a handful of veterinary centers around the world. By utilizing Dr. Li’s laboratory equipment and expertise, Miao Miao’s platelets were analyzed using state-of-the-art testing of his platelet function. Dr. Li discovered that Miao Miao has a congenital platelet disorder—Glanzmann thrombasthenia (GT)—that has never been reported in a cat. GT causes Miao Miao’s platelets to be nonfunctional and lack expression of a protein called integrin, which is important for the formation of blood clot.
In humans and dogs, GT is caused by a genetic mutation in the genes responsible for making a platelet protein that is essential for clot formation. Dr. Li is currently analyzing Miao Miao’s DNA to further characterize his genetic mutations. He hopes to identify the mutation so that cats with a similar bleeding disorder can be tested in the future.
Since Miao Miao is the first cat ever diagnosed with GT, there is currently no standard protocol of treatment. It will most likely continue to put him at risk of spontaneous bleeding the rest of his life. One method that has worked in similar cases is the use of Yunnan Baiyao. This Chinese herbal formula, which has antihemorrhagic effects, was popularized during the Vietnam War. Vietcong soldiers were known to carry the holistic medicine to stop the bleeding of wounds incurred during battle. Miao Miao’s owners report it seems to be successful in treating his bleeding.