Low White And Red Blood Cells In Cat - Anemic. Please Help!

clytical

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Hello everyone,
My cat Figaro will be turning three in March. He's always been super energetic, playful, curious and an avid hunter (much to my dismay). We do get him de-wormed in the fall and spring, as he does like to go outside in our fenced backyard under supervision. He's had all of his vaccinations and was neutered. We don't let him out much in the winter, only when the weather is warm. Located in Edmonton, AB Canada so the weather the the winter is pretty cold. Today is -33. Anyways, the last couple of weeks I've noticed him to be more of a finicky eater. We use to free feed our cats, and my other cat Lynx developed diabetes, and since he finishes whatever he finds, we now have to feed them timely. I try to feed Figaro as much as he wants. So he has had some changes to his diet, not eating much as he did when it was free-fed but even when he was free fed, he would eat a bit and leave. I have this rock from the ocean in my room, that he discovered and would start licking it throughout the day for a few weeks. Initially I thought it was because of the salty taste. Then when I let him outside for a bit, he would lick the concrete. So I searched online and read that it could be anemia. We took him to the vet and I asked for an extensive blood test. The vet said he could also feel a slight heart murmur (which I read online that could be cause by anemia as well) He was 4.8 kilos in July, and is now 4.6 which isn't too much a of significant weight loss. The vet called us and said he needed another blood sample, because both his white and red blood cells were low, and feared for FIV and FelV. We brought him right away and he took the sample. We were relieved to find out that the test was negative. Now he has requested an xray to see if there are any tumours or inflammation. He has not yet tested for parasites or worms. Figaro does hunt. I hope that it's parasites and not bone marrow related complications. So we are now waiting for an appointment for xray.

Here is is Hematology results: WBC (white blood cell) - Results 3.1 (Should be between 3.9-19.0) RBC (red blood cell) is 4.0 (Should be between 7.1 -11.5) so he is anemic for sure. Hemoglobin is 85 (should be between 103-162) Hematocrit is 0.26 (should be between 0.29 0 0.45) and his reticulocyte is 76.0 - degree of bone marrow response, which 75-175 range is considered moderate. Also he circled on the biochemistry section his CK - creatine kinase, which is 850 and should be between 64-440 so that's very high. I read online that high CK means disturbances of the muscle cell integrity. In addition to primary muscle disease, like trauma, inflammation or dystrophy, diseases of other organs can lead to secondary muscle involvement, which will be indicated by increased serum activities of the CK. His ALP levels are slightly low it's 9 when it should be between 12 - 59. Any feedback or comments would be appreciated.

 

Mamanyt1953

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I do NOT want to second guess your vet, but is it possible that he has ingested a toxin of some sort while out of doors? And that's just a rather wild guess.
 
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clytical

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I do NOT want to second guess your vet, but is it possible that he has ingested a toxin of some sort while out of doors? And that's just a rather wild guess.
Thanks for the reply. He hasn't been going out much lately due to the cold. But if all these tests are negative, I wouldn't rule out that maybe he ate something. I don't know how they could catch that though?
 
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clytical

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This is purely a guess, but since he goes outside, did your Vet check for Feline Infectious Anemia, which can be caused be flea or ticks? We've had a few cases of it here on TCS. Here is one thread about it: cat 10 years old feral to a point but losing weight drinking some only broth fever......
Thank you for the reply and the thread link. He hasn't gone out too much recently, but we mentioned to the vet about worms and such. He made it seem that that would be the last possible reason for his low white/red blood count. We're taking him for an xray tomorrow to rule out anything tumours, inflammation and bleeding in the chest cavity. He says the belly feels soft and normal though. There goes another $165, but peace of mind I suppose. In the meantime though, Figaro is not as active as he is, sleeping more, and eating very little. I'm trying to feed him anything that I can. From soft wet food, but then sometimes he'll only eat dry food, and when he doesn't want anything, I'm giving him tuna...but he's not eating much in general.
 

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Hello everyone,
My cat Figaro will be turning three in March. He's always been super energetic, playful, curious and an avid hunter (much to my dismay). ... He has not yet tested for parasites or worms. Figaro does hunt. I hope that it's parasites and not bone marrow related complications. So we are now waiting for an appointment for xray.
...
I'm not sure the last time he hunted, but since he does hunt and has spent time outdoors, probably rooting around in the soils, etc. ... I'd check to see if toxoplasmosis has taken hold [caused by T. gondii parasite]. It could be he is showing early phases of some kind of parasite? (I'm not a vet, and maybe your vet has gone over this already!)
 
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clytical

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I'm not sure the last time he hunted, but since he does hunt and has spent time outdoors, probably rooting around in the soils, etc. ... I'd check to see if toxoplasmosis has taken hold [caused by T. gondii parasite]. It could be he is showing early phases of some kind of parasite? (I'm not a vet, and maybe your vet has gone over this already!)
Hi,
Thanks for the response. The vet is kind of using that as a last resort test. We mentioned that being a concern since he does go out and catch bird and mice. I will push for it when we find the results of xray.
 

Mamanyt1953

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Thanks for the reply. He hasn't been going out much lately due to the cold. But if all these tests are negative, I wouldn't rule out that maybe he ate something. I don't know how they could catch that though?
That's done by a blood screen (sometimes urine) for toxins. What did the vet say? Any news?
 
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clytical

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That's done by a blood screen (sometimes urine) for toxins. What did the vet say? Any news?
Hello,
Came back from the vet just an hour ago. We did chest cavity x-ray, and stayed for the results. Looks clear of any tumour or anything abnormal. Waiting for the remainder of the blood work, the section for the heart and see if there are any abnormalities. Also got a dewormer just in case. The one where you put behind the neck, parting the fur. That's the one we usually do for him, but only a couple of times a year. Vet says its usually only good for a month. Got it just in case. I suppose we'll continue with investigating if the remaining blood work comes suspicious. In the meantime I've been trying to feed him some food with high iron. We had to go to another place for the xray and then send to our original vet. The vet at the Animal Hospital where we did the xray said that his numbers aren't too low that's emergency status, but thinks because his CK levels are high, there may have been an injury that caused some blood loss internally, or maybe he injested something that caused the regenerative anemia. Waiting to hear back from our own vet to see what he recommends, along with the remaining test results. Will ask for maybe iron supplements, and then do test again in a month. Not sure what else to do.
 

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Thank goodness for the good news that you did get, although it still leaves us with more questions than answers! Keep us posted! I've go a candle lit for you guys!
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clytical

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Thanks everyone.

Yeah I’m still concerned because test after test and we’re still not getting a diagnosis. Although I am happy that he’s tested negative for FIV, FELV and no visible tumours. His bone marrow is also working fine according to blood work. One of my pharmacist friends suggested maybe an ulcer, but I don’t see visible blood in his stool nor is he throwing up. His appetite is some what up, but still sleeps a lot. Does slightly darker stool signify blood in stool? How dark and tarry looking must it be? Still waiting on the remaining portion of his blood work that deals with his heart. His ck levels were high in blood work which could signify a trauma or injury he sustained that caused blood loss. We also did deworming just in case, haven’t tested for that. In the meantime not sure If I should be giving any iron supplements? Been feeding lots of meaty pate wet food and he was interested in canned tuna so I’m giving him that too.
 

Mamanyt1953

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Given that he is anemic, iron is probably indicated. I would ask your vet to recommend a source of iron that will be easy on his system, and readily absorbed.
 
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clytical

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Thank you everyone. Figaro is doing better. Still no real diagnosis, but he is on antibiotics and is also being given a Sulcrate suspension which is an anti-ulcer medication. His appetite is good, eating lots, not licking concrete anymore but likes to lick the rock in my room. I've been putting the antibiotic on it and he eats it up, also sprinkled some nutritional yeast which is high in b12 and folate acid. We will be doing blood work next week to see if his numbers have improved at all.
 

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I am a human physician in Internal Medicine, not a vet, but the physiology of human haematology is similar to feline haematology. However the haemolysis may suggest that this is from a faulty collection and I would await a repeat specimen.

Further human tests should include serum B12, serum iron and a Bone Marrow, as mentioned by Dr Edwards in cats, and serial blood counts would be useful. I would treat my human patient expectantly and see what eventuates. Your vet seem to be doing this.

If this blood count were from a human it would suggest that there has been a recent haemorrhage. The CK, which is elevated to approximately double maximum normal, is consistent with inflammation, but NOT consistent with infection as the white cells are reduced, not increased. Remember, however, that I am not qualified to comment on feline pathology

I doubt whether any faulty diet would cause this blood picture in humans.

With all best wishes,
Geoffrey
 
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clytical

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I am a human physician in Internal Medicine, not a vet, but the physiology of human haematology is similar to feline haematology. However the haemolysis may suggest that this is from a faulty collection and I would await a repeat specimen.

Further human tests should include serum B12, serum iron and a Bone Marrow, as mentioned by Dr Edwards in cats, and serial blood counts would be useful. I would treat my human patient expectantly and see what eventuates. Your vet seem to be doing this.

If this blood count were from a human it would suggest that there has been a recent haemorrhage. The CK, which is elevated to approximately double maximum normal, is consistent with inflammation, but NOT consistent with infection as the white cells are reduced, not increased. Remember, however, that I am not qualified to comment on feline pathology

I doubt whether any faulty diet would cause this blood picture in humans.

With all best wishes,
Geoffrey
Thank you Geoffrey! Sorry for the late response. Figaro's blood work came back all normalized on February 20th. He has been good the last couple of months but now he's relapsed again.
 
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clytical

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UPDATE:

Hello,

My name is Celine. My three year old cat Figaro suffered a case of anemia back in January. I took him in because I noticed he was licking rocks and had a decreased appetite. I was right in doing so because the blood test showed he had low red and white blood cells. He was tested negative for FIV, FELV, and had blood screenings to check his organs and heart, had an XRAY done to check for masses, there was no black stool or anything to suspect internal bleeding or ulcer. The vet gave him antibiotics for two weeks, and I had a dewormer done...after about a month, his third blood test was great and he was normalized. We never found out what happened.

Just this week, again I noticed he was licking rocks/cements like crazy, much more manic than last time. I took him in right away and the blood test confirmed he was anemic again, this time worst than before. I was kind of shocked and thought we were over this. The vet said we should have given his antibiotics for a longer period, he was suspicious of it being infectious anemia, with mycoplasma and blood parasites. So he's now performing three blood tests, one blood smear, one for any blood parasites, and another one called the Coombs test to see if his immune system is destroying his red blood cells. He was diagnosed as regenerative anemia last time, which means his immune system is working hard to make up for loss of red blood cells. He is eating a little bit, not as much as before but I try to feed him as often as I can. And he's currently on antibiotics as we're waiting for the results. He's not in need of blood transfusion yet.

Has anyone dealt with anemia? Or any relapse of anemia? Any feedback would be appreciated.
 

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UPDATE:

Hello,

My name is Celine. My three year old cat Figaro suffered a case of anemia back in January. I took him in because I noticed he was licking rocks and had a decreased appetite. I was right in doing so because the blood test showed he had low red and white blood cells. He was tested negative for FIV, FELV, and had blood screenings to check his organs and heart, had an XRAY done to check for masses, there was no black stool or anything to suspect internal bleeding or ulcer. The vet gave him antibiotics for two weeks, and I had a dewormer done...after about a month, his third blood test was great and he was normalized. We never found out what happened.

Just this week, again I noticed he was licking rocks/cements like crazy, much more manic than last time. I took him in right away and the blood test confirmed he was anemic again, this time worst than before. I was kind of shocked and thought we were over this. The vet said we should have given his antibiotics for a longer period, he was suspicious of it being infectious anemia, with mycoplasma and blood parasites. So he's now performing three blood tests, one blood smear, one for any blood parasites, and another one called the Coombs test to see if his immune system is destroying his red blood cells. He was diagnosed as regenerative anemia last time, which means his immune system is working hard to make up for loss of red blood cells. He is eating a little bit, not as much as before but I try to feed him as often as I can. And he's currently on antibiotics as we're waiting for the results. He's not in need of blood transfusion yet.

Has anyone dealt with anemia? Or any relapse of anemia? Any feedback would be appreciated.
We had an anemic that was immune mediated, but because he had a few other health problems going on, I feel inhibited his recovery.
Fingers crossed that they can figure this out and give you good news and good treatment plans!!
He's a gorgeous cat BTW, saw the original picture in the first post.
Some cats really like onion free, plain baby food (meat and broth only). If he's anemic, it's CRITICAL he gets no onions so read those labels!
Antibiotics IME have made a lot of my animals (and myself, ugh) feel kind of "off" and food isn't a big thing. Hopefully it's just that and he'll be back to eating well soon.
 
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clytical

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UPDATE:
***UPDATE: Figaro has received a blood transfusion and needs support for his diagnostic tests. He's currently on steroids and antibiotics awaiting a costly Bone Marrow test ($800.00) and the vet has suggested an ultrasound ($600) to check for any internal bleeding.
***UPDATE2: Figaro has undertaken the bone marrow aspiration, ultrasound/abdominal xray and many blood tests. Hoping for something treatable. The vet said his spleen was slightly enlarged, but that could be for many reasons, likely due to his anemia. Still need to find out the reason he's losing red blood cells.
***UPDATE3: Bone Marrow tests have shown that there are no bad cells in the sample, which rules out lymphoma. Verified that Figaro is Non-Regenerative Anemic where his Bone Marrow response is inadequate when compared to the increased need of red blood cells. Vet and specialist have narrowed down to possibly leukaemia, infectious anemia (although tested negative twice for blood parasites) but most likely they think it is an Immune Mediated Anemia.
 
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