Oral haematomas as the major presenting sign of primary immune thrombocytopenia in a cat.

Case summary: An unowned, entire male domestic shorthair cat was surrendered to a rescue centre. On physical examination, poor body condition (score 3/9) and pigmented mass lesions on the lateral aspects of the upper gingivae were noted. The oral lesions were identified as haematomas only after examination under sedation. A diagnosis of probable primary immune thrombocytopenia (pITP) was made based on profound thrombocytopenia, rapid response to glucocorticoid therapy and the absence of identified triggers for secondary immune thrombocytopenia. The patient was treated with glucocorticoids and remained in remission 18 months from diagnosis.

Relevance and novel information: pITP is infrequently reported in cats and oral haematomas have not previously been documented as a presenting clinical sign. This case report serves to raise awareness of feline ITP and highlights the availability of evidence-based diagnostic and therapeutic guidelines that were published after the case was treated. While pITP can be refractory to treatment and can be associated with treatment-related morbidity, this case report demonstrates that an acceptable outcome can be achieved, albeit with a requirement for long-term treatment and regular monitoring.