Checking for Mycoplasma haemofelis (PCR): Feline infectious anaemia is caused by hemotropic mycoplasmas that physically attach to the surface of erythrocytes, triggering immune-mediated clearance. Initiating high-dose immunosuppressive corticosteroids without active parasitic coverage can lead to severe systemic replication of the parasite. Running a PCR assay is highly sensitive and mandatory for all presenting cats.

Screening for Feline Leukaemia Virus (FeLV): Underlying retroviral infections are strong secondary triggers for haematologic immune-mediated diseases in cats. Screening via ELISA or PCR for FeLV and FIV must be performed prior to starting chronic steroid regimens, as profound immunosuppression can accelerate viral disease expression and lead to fatal aplastic or neoplastic complications.

The Feline Corticosteroid Standard: Prednisolone is the first-line foundation of therapy. Cats cannot convert Prednisone to active Prednisolone efficiently in the liver, meaning Prednisone should *never* be prescribed. Mycophenolate Mofetil (MMF) serves as a secondary agent with a delayed clinical onset of several days.

When to use Dual Therapy (from Day 1): Initiate dual protocols concurrent with prednisolone immediately if the cat shows signs of severe haemolytic disease, active intravascular haemolysis, severe non-regenerative anaemia, or profound auto-agglutination.

When to use Sequential Therapy: If the patient presents with stable, regenerative extravascular IMHA, starting with Prednisolone alone is standard. Add Mycophenolate or secondary agents (such as Chlorambucil/Cyclosporine) later if treatment fails (PCV drops after 5-7 days of steroids) or severe steroid intolerances appear.