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Author Topic: Sick cat with severe anemia  (Read 7849 times)
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stoverny
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« on: November 09, 2011, 01:45:46 PM »

HI all,

We have a blind cat, 18mo, who has developed severe anemia within the last week or so, and the vet can't seem to figure out the cause.  We first brought him in on Saturday and he had a PCV of 13 (should be 30 or above).  He is still eating although less, and has lost 1.5 lbs (from 10 to 8.5lbs). 

My wife and I took Banjo back to the vet yesterday and she said his PCV has gone up from 13 to 16 - still very anemic, but the vet was encouraged that it had gone up in the 3 days between visits. He still has a fever (approx 104). Vet is still not sure of the cause of the problem but has him on Zithromycin and gave him another cortisone shot. We are bringing him back in for a re-check on Friday.

I was surprised his PCV went up at all, as his reticulocyte numbers were SO low (lab results below). Does anyone know why the PCV might go up in light of his almost non-existent reticulocyte numbers?

I am still not sure what to do now as our vet seems rather stumped. If the PCV does not continue to improve, should we go see an internal medicine specialist? The vet mentioned a bone marrow aspirate (as it appears to be non-regenerative), but she thinks he would need a transfusion first due to his weakened state. Not sure if it is even worth it to put him through that.

I am wondering if I should ask for a fecal test, and maybe even to have the reticulocyte test re-done? I've read it can take time for the regeneration to kick in so maybe the first test was off?

I am also wondering if another antibiotic would be a better choice than zithromax, such as dixyxyxline or clavamox?  She originally had him on regular amoxi-drops but decided to try switching to the zithromax, I suppose because the fever has not gone down.

Re-posting lab test results so far:

Reticulocytes 0.1 (Ref range 0-1)
Absolute reticulocytes 1820 (Ref range <45000)

CPK 46 (LOW) Ref range 56-529
WBC 17.6 (HIGH) Ref Range 3.5-16
RBC 1.82 (LOW) Ref Range 5.92-9.93
Hemoglobin 4.0 (LOW) Ref Range 9.3-15.9
Hematocrit 12.0 (LOW) Ref Range 29-48
MCV 68 (HIGH) Ref Range 37-61
MCH 22 (HIGH) Ref range 11-21
Nuetrophils (HIGH) 13728 Ref range 2500-8500

PCR Mycoplasma: Negative
FIV: Negative
FeLV: Negative

Thank you for any advice/support, we are very worried about him!
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NedF
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« Reply #1 on: November 09, 2011, 01:53:47 PM »

Has he been checked for Felv, FIV or Bartonella? Those can cause anemia. The PCV could go up if the kitty is dehydrated. I hope your vet can find the cause of the anemia and get it treated and that your kitty feels better soon.
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catwoods
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« Reply #2 on: November 09, 2011, 01:57:52 PM »

I don't have any advice on this but I do hope your kitty is feeling better soon.
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catmom5
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« Reply #3 on: November 09, 2011, 02:02:13 PM »

I have a one year old rescue kitten who was very anemic, enlarged liver, trouble breathing, too. It turns out she had (has?) Bartonella (a parasite in her blood stream from a flea bite). She has been taking doxycycline for about a week now and the turn around was fairly rapid and she is a different cat now. They were also looking at FIV, FeLeuk and FIP as possibilities. The tech missed the Bartonella and the pathologist picked it up in her blood. They were also talking about doing a blood transfusion, but her rbc's seemed to be regenerating. (We go to a university teaching hospital and, fortunately, have wonderful resources.)

If you have an internal medicine specialist available, I'd make an appointment ASAP!

Good luck and keep us posted!
catmom5
« Last Edit: November 09, 2011, 03:08:04 PM by catmom5 » Logged
bug
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RIP little angel Katey


« Reply #4 on: November 09, 2011, 02:16:17 PM »

I second the Bartonella test. A past member had a terrible time diagnosing her cat with this parasite. It was a very long road for her and her cat and thanks to their journey, it's one of the conditions that immediately come to mind. Chronic renal failure is also a main cause of non-regenerative anemia, but the fever is not indicative of that. I would get a Bartonella test done immediately. Depending on Banjo's condition and age, you might want to take a blood transfusion into consideration as well. An internal medicine specialist may have more experience dealing with Bartonella, but I do believe Doxycycline is a "big gun" for that, as CM5 has already stated.
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My little babies, you'll always be in my heart. Mom will see you later. Look after each other, ok?
bug
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RIP little angel Katey


« Reply #5 on: November 09, 2011, 02:28:31 PM »

Check out this chart for causes of anemia:

http://www.merckvetmanual.com/mvm/htm/bc/tcir02.htm

Note Babesia and Bartonella for cats.
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My little babies, you'll always be in my heart. Mom will see you later. Look after each other, ok?
lesliek
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Trooper,Remy & Fragile


« Reply #6 on: November 09, 2011, 04:58:02 PM »

I would have a 2nd opinion with a specialist or at a teaching hospital & have a recheck for bartonella & tick born diseases done. Flea & tick bites can cause anemia & the elevated white count seems to indicate some kind of infection. Also FIP,FIV & Felv retests, I just had my 23 yr old diagnosed with FIV.
 Mainecoonpeg had horrible problems with undiagnosed bartonella.  Will your kitty eat red meat ? Adding some steak, rare or raw will help with the iron.
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Sandi K
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« Reply #7 on: November 09, 2011, 08:28:37 PM »

In the labwork that they ran, did they run a protein test and does the labwork show albumin and globulin levels?  I so hope they can figure out what is going on with your little kitty.  I agree, I think a second opinion is needed if your vet seems stumped.  Please keep us posted OK?
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Mandycat
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« Reply #8 on: November 09, 2011, 11:49:53 PM »

I am so sorry that you kitty is so sick.  There are many causes of anemia in cats.  I would suggest having the full CBC with reticulocyte count repeated, and be sure that the blood cells are examined under the microscope as well.  Here is an excellent article on Anemia in Cats. It contains a chart that lists the various causes of the anemia and whether they are regenerative or non-regenerative.

     http://www.walthamusa.com/articles/COUTO97.pdf

A fecal test would also be in order to determine if there is any bleeding in the GI tract.  I would also suggest seeing an Internal Medicine Specialist, and having an abdominal ultrasound done.  You want to rule out any kind of cancer which can cause anemia.  This is a very important test to do when the cause is not apparent.  The ultrasound can show whether there is any active bleeding anywhere regardless of the actual cause.  I hope you find an answer quickly.  I would encourage seeing the specialist ASAP.
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stoverny
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« Reply #9 on: November 10, 2011, 11:37:44 AM »

Hi all,

Thank you so much for the replies.  We are bringing him back for a recheck tomorrow and I am going to ask for a referral to a specialist, as well as a fecal test if I can get a sample.

He was checked for Fiv and FeLV, both negative.  We are waiting on a bartonella test (he tested negative for hemobartonella but she is also checking for bartonella - which I guess are 2 different diseases even though they sound the same).

I am thinking perhaps a B12 injection might help him?  I've also read about adding B12 to his food or also B-vitamin plus iron liquid is available... I am going to ask the vet about all these nutritional things that might hopefully help the little guy.

Thank you again for your generous advice and support!
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Sandi K
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« Reply #10 on: November 10, 2011, 11:43:50 AM »

stoveryny, could you tell from the labwork if they ran the protein test or the albumin, globulin?  I think I would be a little hesitant to start in with B12 injections or some treatments (except for anti-biotics) until you know more what is going on.  Im glad you are going to take him to a specialist.  How is he doing today, is he still running a fever?
« Last Edit: November 10, 2011, 11:58:11 AM by Sandi K » Logged
stoverny
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« Reply #11 on: November 11, 2011, 11:59:17 AM »

Great news!  Took Banjo in for a re-check this morning and his PCV had gone up from 16 to 24!  And his fever was gone and he had also gained 1/4 lb!  He seems much brighter and energetic and has been eating great the last couple of days.

Vet did give a B12 shot and also is re-testing his reticulocytes.  We are still waiting on the bartonella test results but keeping him on the azithromycin in the meantime since he seems to be improving.

He actually wanted to play with one of his toys today, first time in over a week - wife and I were ecstatic!

Thank you again for all of your generous advice!
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catwoods
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« Reply #12 on: November 11, 2011, 02:46:56 PM »

I'm very glad to hear Banjo is improving!
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merrihart
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« Reply #13 on: November 11, 2011, 03:07:49 PM »

Oh, that's such good news!
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lesliek
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Trooper,Remy & Fragile


« Reply #14 on: November 11, 2011, 03:36:14 PM »

That is great news ! I hope the bartonella results are negative, but if not it seems this antibiotic is working for it.
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