Coagulation Factor Deficiency in Cats: A Vet’s 2025 Guide to Bleeding Disorders 🐱🩸
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Coagulation Factor Deficiency in Cats: A Vet’s 2025 Guide to Bleeding Disorders 🐱🩸
By Dr Duncan Houston, BVSc
🔍 What Is Coagulation Factor Deficiency?
Coagulation factor deficiency occurs when specific blood clotting proteins (Factors II, VII, VIII, IX, XII, XIII, fibrinogen) are reduced or dysfunctional, leading to increased bleeding risk :contentReference[oaicite:3]{index=3}. Factors are primarily produced in the liver and require vitamin K for normal function :contentReference[oaicite:4]{index=4}.
⚠️ Causes & Risk Factors
- Inherited genetic disorders: Hemophilia A (Factor VIII), Hemophilia B (Factor IX), Factor XII deficiency (common but asymptomatic in cats), Factor II or XIII deficiencies, congenital afibrinogenemia :contentReference[oaicite:5]{index=5}.
- Liver disease: Impaired synthesis of clotting factors, especially in chronic hepatic conditions :contentReference[oaicite:6]{index=6}.
- Vitamin K deficiency: From rodenticides, malabsorption, or cholestatic disease leading to Factors II, VII, IX, X deficiency :contentReference[oaicite:7]{index=7}.
- Acquired coagulopathy: DIC, immune-mediated factor inhibitors, chronic illness, or toxins :contentReference[oaicite:8]{index=8}.
🚩 Signs & Symptoms
- Prolonged bleeding from minor trauma or surgery :contentReference[oaicite:9]{index=9}.
- Bruising (ecchymoses), petechiae, hematomas, nose or gum bleeding :contentReference[oaicite:10]{index=10}.
- Internal bleeding: blood in stool (melena), urine, vomit, or body cavities—leading to weakness, pale gums, tachycardia, collapse :contentReference[oaicite:11]{index=11}.
- Asymptomatic in Factor XII deficiency—prolonged clot times detected only on lab tests :contentReference[oaicite:12]{index=12}.
🔬 Diagnostic Testing
- CBC & biochemistry: Look for anemia, liver disease, thrombocytopenia :contentReference[oaicite:13]{index=13}.
- Coagulation panels: Prothrombin Time (PT) for extrinsic pathway (Factors II, VII, IX, X), aPTT for intrinsic pathway (VIII, IX, XI, XII) :contentReference[oaicite:14]{index=14}.
- Specific factor assays: Measure levels of individual clotting proteins (e.g. Factor VIII, IX) :contentReference[oaicite:15]{index=15}.
- BMBT: Buccal mucosal bleeding time for platelet function.
- Specialized tests: Tests like urea lysis reveal Factor XIII deficiencies :contentReference[oaicite:16]{index=16}.
🛠️ Treatment & Management
1. Inherited Deficiencies
- Hemophilia A/B: Manage episodes with fresh-frozen plasma or whole blood transfusions; lifelong risk during surgery or trauma :contentReference[oaicite:17]{index=17}.
- Factor XII deficiency: No treatment needed unless accompanied by other coagulopathies :contentReference[oaicite:18]{index=18}.
- Prothrombin, XIII, afibrinogenemia: Supportive therapy: plasma/cryoprecipitate transfusions when bleeding :contentReference[oaicite:19]{index=19}.
2. Liver-Related Coagulopathy
- Treat underlying liver disease, consider plasma transfusions in bleeding patients :contentReference[oaicite:20]{index=20}.
3. Vitamin K Deficiency
- Administer vitamin K1 (2.5 mg/kg SC, then PO daily); repeat PT to monitor response :contentReference[oaicite:21]{index=21}.
- Treat any rodenticide exposure or malabsorption causes :contentReference[oaicite:22]{index=22}.
4. Acquired Coagulopathy & DIC
- Treat the root cause (infection, neoplasia, pancreatitis, etc.); manage with fluids, transfusions, and cautious use of heparin in DIC :contentReference[oaicite:23]{index=23}.
🏡 Home & Long-Term Care
- Minimize bleeding risks: avoid rough play, sharp nails, unsupervised outdoor access.
- Notify your vet before any procedures; premedicate or schedule transfusion-ready.
- Use the Ask A Vet app for bleeding checks, reminders, and emergency contact.
- Ensure a calm environment, soft bedding from Woopf & Purrz.
📅 Prognosis & Follow-Up
- Inherited hemophilias: lifelong management; many cats lead normal lives with monitoring.
- Factor XII: excellent — cats are asymptomatic.
- Vitamin K or liver-related: good with early detection & treatment.
- DIC: guarded to poor, depending on underlying illness severity :contentReference[oaicite:24]{index=24}.
- Regular lab checks—CBC, PT/aPTT, factor assays based on your cat's condition.
📝 Reference Table
| Condition | Signs | Treatment |
|---|---|---|
| Hemophilia A/B | Post-trauma/surgery bleeding | Plasma/blood transfusions |
| Factor XII | Asymptomatic | No treatment |
| Vitamin K deficiency | Prolonged PT, bleeding | Vit K1 therapy, address cause |
| Liver disease | Coagulopathy signs | Treat liver, transfusions |
| DIC | Bleeding, thrombosis | Treat cause, supportive care |