Feline Polycythemia Vera

gomezopotamia

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Update on Gomez: He's fantastic. He was previously on 100mg of hydroxyurea everyday and we now have reduced it by skipping Mondays and Fridays. He seems more like himself than he has since the PV started about a year and a half ago.

He has his first checkup in three months scheduled tomorrow, but I'm super optimistic that things will go well.

I would like to note for some of you who may not see immediate results in the hydroxyurea, it took daily dosages of over a month before we began to see results. And even then, it just began with a drop in the white blood cell lines. My vet nearly discontinued the hydroxyurea but I insisted we keep trying and it did eventually start to work.
 

gomezopotamia

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Quick update on Gomez: Yesterday's hematocrit was at 35.1. So even with the reduced dosage of hydroxyurea we are still very well managed.
 

sherryla

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GREAT news!!!! Congrats!!!! Sooo happy for you and especially Gomez!
 

mstammy

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I was so happy to find this forum. As I type this, my kitty Tammy is in the hospital being treated for polycythemia Vera . The vet is still not 100% sure that is what she has. This whole experience has been a daily roller coaster and I am so worried about my cat . Last Monday 10/26, I came home from work and found my cat frantically running around (not normal cat running around ) she was foaming at the mouth and panting and hid behind the dryer . I was able to get her out and rushed her to my vet where they determined her red blood count was super high . They referred me to a 24 vet specialist where she has been since . They have her on IV fluids which has helped her levels some but not dramatically . They did body scans and ultrasounds and both of those came back normal so , the vet thinks it is a primary case. They started her on meds (not sure of the name) last night but so far nothing has changed . My vet has not mentioned taking out blood but I am going to ask about that tomorrow . I am just so worried about bringing her home and she has another episode but I cannot avoid to keep her hospitalized much longer . Her blood count as of tonight was 78[emoji]128542[/emoji]. Any advice anyone can give would be appreciated . Thank you
 

lunarleslie

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Hello Tammy's mom,

Welcome to the forum! I would definitely ask your vet about doing a phlebotomy. The first step is getting the RBC count down as soon as possible to avoid seizures. If the ultrasound and other tests did not reveal any tumors or heart problems, then there is no "secondary" cause and that's usually when they are diagnosed as having "true" polycythemia, or polycythemia vera.

Hydroxyurea is a medication that many of our cats on this forum are on. It sounds scary, and many of us were hesitant to use it, but it seems as though cats tolerate it pretty well, and it does the job of keeping the RBC's at bay. One main concern with the medication is that it can also reduce the WBC count, which makes it harder to fight off infection. However, my cat Motley has not had this happen and he's been on the medication for about two years now. The hydroxyurea takes a while to start working, that's why phlebotomy may be a good, temporary fix in the meantime.

I hope this helps! Please keep us posted on your Tammy :)

Best wishes for you both,

Leslie
 

mstammy

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Hi Leslie , thanks for replying to me!
Tammy came home Monday night and her blood level was at 68.
I talked to my vet about the phlebotomy and she thought Tammy was ok at that level since she was on iv fluids for a week , it brought her down some . She was at like 78.
The weird thing too is her sugar kept running low at the vet . The first night we brought her home she did ok at first but then she went in this deep sleep and I was very concerned about her . I woke her up and gave her some can food and she has done pretty well since then .
She seems like her normal self today which makes me happy but , I feel we are still not out of the woods yet. She is taking 150 mg of hydroxyurea and another med each evening to help with her sugar . I have also been feeding her can food more often. She goes back to the vet Tuesday so I am nervous about what her count will be but it has helped reading all of these posts because I read a lot on here that you have to be patient and try different things to see what will work for your cat so I have my fingers crossed ! I will send another update after she goes to the vet Tuesday .

Thanks again
Linda
 

sherryla

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 Hi Tammy's Mom,

Phlebotomy necessary to bring the blood count down, then Hydroxyurea 200 mg should keep levels in check. My Murphy is going strong 7+ years after being diagnosed. He suffered a seizure in the middle of the night, and I rushed him to our nearby 24/7 vet hospital. After several blood lettings (his #s were 76%), he has been on an every other day med cycle. I have the med compounded and empty the capsule contents in his wet food. He is thriving and active at 12 years old. His levels remain stable at 46-51%

Hang in there; I know how concerning and stressful the process can be at first, but I assure you that the situation has a happy ending.
 

hannah2587

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Our cat Willie Nelson was diagnosed with Polycythemia Vera one year ago, almost to the day. After an initial diagnosis and tests ($3500), two phlebotomies ($1200 each), 100mg of hydroxyurea Monday, Wednesday, and Friday each week ($60 for 3 months), and blood tests ranging from 1-4 a month ($75-$150) each, Willie's hematocrit typically sits around the 67% mark most of the time. This is too close to the danger zone for us, but unfortunately his liver levels were elevated when the dose was changed to every other day.

A few weeks ago Willie's blood tests came back showing elevated bilirubin levels and decreased white blood cell counts. Today he is going for an ultrasound of his liver and gallbladder ($400-500).

Unfortunately, the cost of Willie's vet bills are becoming a burden. We have spent over $10,000 on his medical care over the last year. He seems happy and other than one grand and one petite meal seizure (that we know of) is his normal self.

We are hoping that the hydroxyurea is not damaging his liver. Because of the cost of phlebotomies, taking him off of hydroxyurea and doing a phlebotomy only treatment is not an option for us. I'm pregnant, we are about to move across the country and we are going to be losing my income in June. I've been so upset for days trying to find another solution!

We take him to an animal hospital over an hour away, and after reading all of these posts it seems that the prices we pay far exceed those that I am seeing. Can anyone offer an opinion - is our vet just extremely expensive? I see some people are paying $250 for phlebotomies which we could absolutely afford.

Our dosage seems quite high compared to others as well. Is it more typical for cats to receive a lower dosage 20-30mg every day instead of 100mg three times a week?

Any help you can offer would be greatly appreciated. Willie is like my child and I do not want to lose him. I have been a wreck all morning searching for others with the same experience.
 

gomezopotamia

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Hi Hannah,

I'm so sorry to hear about the difficult time you've been having with your kitty and your pending move. I know how awful that feels. I wish I had more information and help to give, but I'll offer what little I have.

The cost of your phlebotomies is a bit high. I think we were paying about $500 (give or take, it's been over year and I've forgotten) and that was at a specialty vets office (Tufts Vets in Massachusetts.)

We also pay less for the hydroxyurea. I get 40 100mg compounded pills for $26. I have mine compounded and shipped from pethealthpharmacy.com

My cat Gomez receives a dosage of 100mg 5 days a week. Currently his hematocrit is in the low 30s. So, he's actually on a higher dosage than Willie Nelson. I wonder if a higher dosage would help? Especially if you can get the medication for less elsewhere.

Of course there's the concern with his new liver issues. Usually you hear about kidney problem arising from the use of this medication. Gomez's kidney values have been slightly effected by the hydroxyurea. However he had a previously exisiting kidney condition.

Have you had ultrasounds of the lover done in the past? The liver problems may be unrelated to the hydroxyurea. I'm wondering (and I'm not a vet here!) if the elevated bilirubin is coming from his liver breaking down the excess RBCs? I know that in the beginning of Gomez's fun with polycythemia he also had elevated liver values, which eventually normalized when we got the blood count under control.

As for the reduced WBCs, this seems to be a pretty normal thing for hydroxyurea. If the bone marrow is suppressed both the RBCs and WBCs will be effected. Gomez's WBCs always seem to be low. We just watch his energy levels and signs of infection. So far he hadn't had any problems.

Keep us posted on the ultrasound results. And please ask us questions. Or if you just want to talk, we are here for you.

Take care and good luck.
 

donutte

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When you say phlebotomies, do you mean just the regular blood panel, or something very specialized? For a full senior blood panel (which is CBC, T4 and checks kidney and liver functions, and probably some other things), it's about $200, which is considered high. Specialized blood tests can cost more, so not sure if you are talking about normal stuff or not.

But if it's just normal stuff, then $1200 is outrageous.

Edit: Just read up on cat phlebotomies and was thinking in terms of human beings. I didn't realize it was just basically pulling blood out for the sake of reducing the number of red blood cells. Not sure how much that normally costs, but I could ask my vet when I see them again just out of curiosity. They seem to have set the bar on expensive as far as I'm concerned, but I can't even imagine them charging that much.
 
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gomezopotamia

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A phlebotomy is when blood is drawn and often replaced with saline (to maintain the same volume). It's not a blood test/panel. Some cats need to be sedated or even anesthetized (totally depends on the cat). This might be bringing the cost of the procedure up for some.
 

donutte

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A phlebotomy is when blood is drawn and often replaced with saline (to maintain the same volume). It's not a blood test/panel. Some cats need to be sedated or even anesthetized (totally depends on the cat). This might be bringing the cost of the procedure up for some.
Yep just read that (and edited my post). I could see the sedation costing more.
 

gomezopotamia

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Ugh! I just saw your edit. Now I feel like a jerk, lol.

But, yeah. Even so. $1200 seems so high.
 

sherryla

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I live in Massachusetts, where the cost of everything is HIGH, and I must say: your vet bills are extremely excessive! A simple blood screening should have been able to diagnose the Polycythemia Vera. My boy Murphy was diagnosed 8 years ago, and after a few phlebotomies he was placed on Hydroxyurea 200 mg every other day. He now has semi-annual blood tests, and the hydroxyurea doses have not affected other values. He is alive and well, and he is thriving. His numbers now range from 47-53; when diagnosed his number was over 76!

Hang in there with the hydroxyurea, and make sure your vet is committed to making adjustments to best resolve your furbaby's issues.

My thoughts are with you!!

Always,

Sherry
 

luvmybengal

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Like so many of you, I am grateful for this thread.  Even the veterinary office/hospital/surgical center where I take my adult male Bengal, said it was their first time.  Been in business since 1971 and have 20 doctors, sooooooo.

We went in for a visit initially due to constipation, he had broken a treat jar and over indulged!  Just when I had gotten him to lose that pound of three he needed to lose.  That episode lead him to lose lose two pounds.  At that time all of his xrays and blood work were great!  I was told I had a super healthy cat with no signs of any issues, except a large stretch out stomach that would shrink over time.  The emergency room visit that included xrays, blood work, sedative, an enema, and a couple of medications ran me $687.

Two and a half weeks later I took him in because he be was not moving his hind quarters, didn't want to drink water, and gotten very quiet (my Bengal is LOUD and VERY vocal!).  I scheduled a regular office visit which involved xrays, blood work, a couple of medications and ran me $598.  This is when they gave me the diagnosis (PCV 58) and suggested immediate hospitalization.  Being that I couldn't afford it I opt'd for the water/hydration under the skin.  I was taking him 1-2x daily, running me $35 during the day and $48 at night.  Lucky for me, he was CHOWING DOWN on his wet food.

I missed a day, and he loss use of his hind legs, and had an eye that was closed to half the normal size with lots of liquid exuding from it.  I thought he had had a stroke. Called the vet to get a hospitalization quote and update on condition.  They suggested the health care credit care that provides zero interest for 6 months.  The estimated bill was to be $2500.

The poor boy was at the hospital (PCV 68) for 3 days and 2 nights which he didn't eat, didn't sleep, and didn't respond to any treatments.  They found his glucose levels to be negligible so lost site of the Polycythemia and treated that instead.  No amount of fluids changed his blood viscosity (PCV 77), and not amount of glucose or bolises (term/spelling unknown) made any difference to his sugar.  This ended up costing me approximately $2800.

Finally authorized the blood pull before taking him home, which dropped his PCV from 77 to 68.  This only cost me $100 for the phlebotomy and $89 for the sedation (best deal out of everything).  I have been given steroid pills to administer daily, and a hydration pack so I can poke him once daily* and give him 100oz of fluids.  After having him for 40 hours I am already seeing a return of his symptoms.  Things my wild Bengal never allowed that he now depends on me:  Grooming; Carrying around; Putting up or Taking down from places; HAND FEEDING at times; touching his belly; wiping his tush**; Putting a cone on his head to administer fluids; touching his feet; washing him with a wet towel; and listening to his heart.

* I messed this up! :(  I feel terrible and terrified about tonight. I poke clean through, then down, and finally got it right the third time.  He didn't kill me only because he doesn't have the energy to.

**Yeah, that happens when he can't walk and leaves smudges.  I clean him, and then everywhere he dragged himself through.

So diagnosis options:

1) Internist - Starts at $1000 just to review case

2) Cardiologist - Starts at $1000 without testing

3) Ultrasounds - Initial $580

4) ...

I stopped listening there.

They vet did consult with an internist that had experience with Bengals and learned what I had researched.

1) The sugar/glucose values in Bengals is irrelevant, they do not present like normal domesticated cats.  Their levels rarely are cause for concern or cause health issues (Yeah, that just cost me nearly $900 of the hospitalization bill).

2) His initial PCV of 58 was in normal range for a Bengal cat.  Apparently they have more viscose blood than normal domesticated cats.

3) This was not a sudden/acute issues, but there was a long standing chronic underlying issue with the Marrow or the Heart.  Bengals are known for a congenital Heart defect that usually kills them during their first two years, or presents prior to age 5.  Lucky me to have the 'one' that survived a little longer.

4)  Polycythemia is usually a sign of cancer, but that was most likely not the case here.

5)  Blood draws are only a temporary bandaid until you find the issue treat, cure, or succumb to it.  I may only get two weeks extensions in our case.

6)  Steroids may help if there is a absorption issue in the digestive track, and allergy, or other minor issue that just triggered and episode.

If I had all the money in the world, I would find out what is causing it and make a decision from there.  The Internist pretty much said if it was marrow or heart, we were looking at euthanising.  If cancer, I would NOT DO THE PILLS.  Researching this, as some people have mentioned, it is TOXIC.  They make it clear on all of the medical sites that the pet needs to have their own bed/linens and area so they are not exposing everything to the toxins.  Children, elderly, and anyone wanting to have children can not handle (without protection) the pet and its materials.  WHAT KIND OF LIFE IS THAT for the family, and more importantly for the animal?!?!  It sounds like a caged animal at the zoo.  Same reason humans with cancer, during certain treatments stay in motels so as to not make their homes toxic or contaminate their loved ones.  I wouldn't do this to my handsome beast.

Glad the vet called, may have some hopeful news.  I also need to know when I am being selfish, and when to let go.  I miss his loud voice and his looks the minute I walked in the door, and his bellowing at my bedroom door for breakfast.  Carrying him to/from bed/food/water/liter/sofa breaks my heart.
 

hatchytt

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I know someone (a human :tongue2:) with polycythemia vera. The doctors take a few pints of blood every couple weeks. But I don't think that costs him $400 a month! No reason taking blood should cost that much for a cat either.

I'm not sure of other causes, sorry :(. Maybe a specialist would be helpful.
Wait... It's not called hemochromatosis in humans? I was tested for hemochromatosis when they were trying to figure out what was wrong with me, (turned out to be fibromyalgia).
 

leonardothecat

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Hello all, I have been following this thread as my cat has been diagnosed with PV.

I found him after coming home from a trip acting extremely strange so he went to the ER vet right away.  His RBC levels were at 80% and he suffered a stroke because of how thick his blood had gotten.

He had his first bloodletting done right away which helped him bring it down to 64%.  Because of the stroke, he wasn't very responsive and not showing much signs of life.  He had multiple seizures overnight and His RBC levels climbed up again to 68% and a second bloodletting did not help him.  Things seemed quite bleak but after a night of rest and regular visits over the next 24 hours, his levels dropped down to 56% and suddenly is able to groom, speak, and walk (although very wobbly).  The vets want to move him over to meds as soon as possible.

He is currently still resting at the ER vet, waiting for another bloodwork test in the next 12 hours and will see how his RBC count is.  Otherwise, 3 hours ago he showed a significant improvement in recovery and really hoping for the best.

I'm extremely grateful for this thread for guidance on how to approach this issue.
 

mstammy

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Hello all, I have been following this thread as my

I found him after coming home from a trip acting extremely strange so he went to the ER vet right away.  His RBC levels were at 80% and he suffered a stroke because of how thick his blood had gotten.
He had his first bloodletting done right away which helped him bring it down to 64%.  Because of the stroke, he wasn't very responsive and not showing much signs of life.  He had multiple seizures overnight and His RBC levels climbed up again to 68% and a second bloodletting did not help him.  Things seemed quite bleak but after a night of rest and regular visits over the next 24 hours, his levels dropped down to 56% and suddenly is able to groom, speak, and walk (although very wobbly).  The vets want to move him over to meds as soon as possible.

He is currently still resting at the ER vet, waiting for another bloodwork test in the next 12 hours and will see how his RBC count is.  Otherwise, 3 hours ago he showed a significant improvement in recovery and really hoping for the best.

I'm extremely grateful for this thread for guidance on how to approach this issue.
 

mstammy

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Hello , I have no idea how I reposted your posting . I just meant to reply but, anyway I had a very similar experience with my cat . I didn't think she was going to make it but after a week at the vet, she improved each day and we were able to bring her home. The vet has adjusted her meds a couple times but , she is doing great now ! She goes to the vet about every 4 months to make sure her RBC count is normal and so far so good so stay positive with your kitty! Hoping for the best with your kitty !!
 
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