Suspected case of hypersplenism as a cause of anaemia, thrombocytopenia and leucopenia in a Miniature Horse gelding

A 23-year-old Miniature Horse gelding was presented to the Lloyd Veterinary Medical Center with a 3-week history of decreased appetite, lethargy and mild intermittent colic. A complete blood count revealed leucopenia, characterised by neutropenia and lymphopenia, as well as anaemia, thrombocytopenia and hyperproteinaemia whereas hypertriglyceridaemia was noted on serum biochemistry profile. Bone marrow evaluation was nondiagnostic and the horse was negative for antiplatelet antibody testing, Coombs test, equine infectious anaemia virus and Anaplasma phagocytophilum. The horse was hospitalised for 36 days and received supportive care, antibiotics, corticosteroids, dextrose-containing fluids and a whole blood transfusion. Following initial improvement and stabilisation, the horse became severely anaemic and acutely recumbent on Day 36 and was subjected to euthanasia. Post-mortem examination provided a diagnosis of hypersplenism with a markedly enlarged spleen along with histiocytic phagocytosis of erythrocytes and platelets. Examination of bone marrow showed appropriate erythroid hyperplasia and no evidence of myelopthisis or neoplasia. This report describes the first presumptive case of primary hypersplenism in an equid as a cause of pancytopenia.