Infection is often asymptomatic, and clinical disease may develop only when the cat suffers stress or is immunosuppressed, for example by feline leukaemia or feline immunodeficiency virus infections.
- Anaemia: pale mucous membranes, lethargy, tachypnoea, exertion, tachycardia.
- Possibly pyrexia.
- Possibly haemic murmur if anaemia is very severe.
- Occasionally jaundice due to massive haemolysis.
- In addition to the anaemia caused directly by the infection, some infected cats also develop an immune-mediated haemolytic anaemia which further increases the loss of red blood cells.
- H. felis can also cause persistent infections, probably in the spleen. Persistently infected cats may become clinically asymptomatic carriers, probably for years, possibly for life.
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