i'm just now finding this site and had to post a reply because my cat also has immune-mediated hemolytic anemia. she also has immune-mediated thrombocytopenia (same as the anemia but with her platelets). molly's condition appears to have been chronic- she started showing signs of the platelets when she was only 1/5 years old (she's 3 now). she first started having bruises on her face the size of golf balls in nov. 2006- i thought it was a bug or something biting her, but it turned out her platelets were starting to get low so she bruised easily. they did a blood test and saw the low platelet count but chalked it up to "her being a cat." yes, the idiot vet (she was a relief vet) actually admitted that to me. then in feb. 2008 she had bleeding in her gums that i thought was from biting weird on her dry food. then 3 months ago, she had her first petit mal seizure (didn't know that's what it was at the time, she didn't flop around like a fishy), black stool (i thought she was constipated, turns out it was blood), and lethargic.

i'm mentioning all of these symptoms b/c they were seemingly unrelated, but they are all symptoms of IMHA and IMthrombocytopenia. for a cat to have one of these disease is rare, but to have both is incredibly rare.

as for you figuring out what caused the anemia, it's likely there was no cause. there are two types- primary (no underlying cause) and secondary (caused by trauma, cancer, or an infectious disease). molly has primary. the only way to tell which is by literally testing for everything under the sun.

this is key: if your cat has trouble with her red blood count again, have the vet do a bone marrow aspirid test, which will tell them if your little one is making her own red blood cells. that's how you'll be sure it's IMHA. and watch for the other signs of bruising (google the IM thrombocytopenia for other symptoms) to be sure she doesn't have both. in molly's case, one appeared to cause the other b/c it went undetected for so long.

molly was just in the hospital for a week- needed a blood transfusion when her red blood count went down to 10 (it was 13 when i brought her in), and thankfully it has been going up. she's now been at home for a week and is on prednisone twice a day, chlorambusil once daily, and just finished up clavamox (anti-biotic) in case she developed anything in the hospital.

rather than just increasing the dose of the prednisone, chlorambusil is an alternative, stronger, complementary drug. it's used in chemotherapy, but don't let that scare you. cats have such a high capability to resist the side effects of the drugs, and it's more important to get the numbers up and keep your kitty healthy. the goal is to then decrease the dosage to either control the disease, or hopefully eliminate it all together.

another word of advice, take your cat's temperature every day. if it gets to be 103, rush her to the vet. molly developed a fever of 105-107 from being on doxycyclin (anti-biotic) while in the hospital. it's not common, but it does happen.

you just need to be sure that your vet is treating your cat aggressively. also, make sure your cat is eating and drinking a lot. prednisone increases thirst, but it makes it difficult for cats to fall asleep at night, so be mindful of giving it to her in the evening early enough before her bedtime. and check your cat's stool- if it's dark, it's blood. anemia is so dangerous b/c blood vessels can burst anywhere- that was the cause of molly's seizures, but it can also result in heart trouble or an aneurism (no idea how to spell that, sorry). molly actually had the blood vessels in her ear burst, so you could see the blood in her ears when you looked through a bright light.

other symptoms that your cat's red blood count is getting too low (besides eating litter, pale tongue and gums) is a purple coloration on the ears. this is because the blood isn't oxygenating and is cause for concern.

sorry if all of this is too much information, but i'm just hoping that molly's story can help someone else. she's not out of the woods yet, but she's getting there. she had her first check-up last friday when they decided to put her on the chlorambusil because her numbers weren't coming up quite fast enough. next visit is this friday, so fingers crossed. she's such a strong kitty

if anyone has questions or has more information on the anemia or thrombocytopenia, please let me know.