Feline Polycythemia Vera

leonardothecat

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Leonardo's RBC level reduced to 45% when visiting the vet.  Leonardo is now back home, it is his 4th day back.  He was brought home earlier in the week, but had a reaction to the IV.  His paw became gigantic, so he had to go back for a few days for some warm compress + antibiotics.  His RBC level was at 58% again when I had to bring him back.  During the time he stayed at the vet for his paw, he seemed normal and active.  They did not give him any treatments for this RBC the second stay.

His first day home, he seemed mostly normal and alert.  I gave him his Hydroxyurea medication for his RBC for the first time.  He ate and drank well.

On his second day, he seemed more lethargic and not as alert.  Wasn't interested in playing with his toys and vomited once.  After vomiting, he ate very well but still didnt seem too enthusiastic about anything.

The third day was mostly the same.  More alert, but not interested in playing with anything.  No vomiting and ate very well still.  Gave him another dose of his medication.

Today, he seems a lot brighter.  Wanting to play and very energetic.  Eating and drinking normally.

Not sure what to make of it all yet but hoping for the best!
 

mstammy

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This sounds like he is improving to me so thats good! I was a nervous wreck the first few weeks after I brought my cat home from the vet . I didn't want to leave her but I had to go to work and each day I came home, she was doing well. Stay positive ! Thinking about you and Leonardo !
 

sophiesmum

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Hello, in a nutshell,my lovely little Sophie was last week diagnosed with Polycthyemia Vera, after having a seizure. Her blood count at its highest was 81%, then dropped after each "bleeding". She was allowed home on Friday, awaiting meds to arrive. Yesterday (Monday) at her follow up blood test, her count was 51%, so a good improvement.
The meds (hydroxurea) arrived today and she needs to take 1 x 100mg for the next week, pending her next blood test in a week's time.
My question is, I am so nervous about giving her these pills, even though I know she has to have them. Can anyone advise how quickly I will notice any side effects? Also the best way of administering? I have years of experience of giving pills to our last cat who had CRF, but a bit more worried about hydroxurea as it's cytotoxic.
She has a twin sister who I need to make sure doesn't go anywhere near these pills.
Any advice would be great, thanks in advance.
 

Ga s

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I don't know how active this thread is anymore, but back in early January when Eddie Soprano was diagnosed with Polycythemia vera after experiencing focal seizures on a Saturday morning, I found you all and read every single entry. I learned more from the input by members here than anything else I read on the internet, including veterinary information sites. There is nothing more educational that reading about the actual experiences of people.

Eddie was admitted to hospital for three days. He was given a thorough workup to rule out kidney tumours and heart disease, then phlebotomized twice and released pending a check on his hematocrit a week later. Two weeks after that it was checked again, he was phlebotomized and started on 85 mg Hydroxyurea every other day. Now two weeks later, hematocrit shows he is responding well to the drug. He has had no side effects whatsoever. He has a good appetite, is active and badass.

I discussed dosing of Hydroxyurea with the internal medicine specialist because on veterinary sites the recommendation is to high dose for a week and then lower the dose. I suggested that a.) since the cancer does not become resistant to the drug if it is underdosed, I see no reason to give the cat a high dose which can result in a possibility of side effects, and b.) with humans who have Sickle Cell Anemia, dosing recommendation is to increase the dose based on response. She agreed with me to give him the maintenance dose first and observe how it affects him. He's not overweight for a cat for his size, 5.3 kg.

His hematocrit on admission was 74. One week later it was 65. Two weeks later it was 68 brought down to 64 with phlebotomy. Now two weeks into chemo, it was 62 and the internal medicine specialist did not perform phlebotomy because he is responding well to the chemo. He has his next appointment on March 22 (one month). I'm very grateful that he's only had 3 phlebotomies because even though he's a very outgoing self confident 'owns the universe' type personality, it is hard on him to have this procedure done. Mostly the I.V. saline administration is a slow process and he was really upset and confused coming out from sedation last time around.

Eddie is 11 years old. Aside from the Polycythemia vera he is a very healthy cat. He's a special guy who has extensive experience raising kittens as a 'foster mommy-daddy'. Two of his 'children' live here with him as well as three other cats. I have been unable to accept foster litters for quite some time because he becomes very attached to the little ones and grieves when they are gone. He has his two grown up 'babies' living with him and that seems to give him the comfort and satisfaction his sort of character requires. He most certainly would not do well in a single cat household.d

I am very grateful for this forum. It was hard reading at times because it was a very difficult emotional situation to find out that Eddie was so sick. But the information I obtained by reading everything has been invaluable for my understanding, decision making, and extremely comforting to know that Murphy had been doing very well 8 years and counting. Also it gives me a sliver of hope that Eddie may go into remission (although yes, a very small sliver) based on the two reports of cats not requiring medication after a couple of years.

Thank you.

gabi.
 

gomezopotamia

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Hello Gabi,

Thank you so much for posting your reply and sharing your experiences with PV. I was one of the regular posters on this thread with my cat Gomez. It’s so difficult to find information on this incredibly rare disease without forums like this.

My cat Gomez stayed on 100mg. daily of hydroxyurea for over two years with no side effects. We also have one of his litter mates that shared food, water, litter boxes, toys etc. and she never had any ill effects from it. He was so well controlled on the drug it was easy to forget he even had PV. However it did take a good month or two for the drug to control his RBCs, for a while we only saw the WBCs drop and were worried the drug might not be working. Always be persistent.

Unfortunately Gomez also had underlying heart problems that untimately took his life (diagnosed before the PV). He passed away last May from heart failure and a saddle thrombus. He was 10 years old. His heart failure was managed well for over a year with the help of various medications.

I would also like to note that the day he passed away his hematocrit was 68, so it was climbing. I don’t know if the hydroxyurea lost its effectiveness causing it to raise which ultimately caused the blood clot that killed him. It’s difficult to say. Either way his heart failure had progressed to the point where it could no longer be controlled.

Ultimately hydroxyurea bought him two years that he wouldn’t have had otherwise. I feel so sad when people don’t try it because of the side effects. Gomez too lived a very active, happy, (often destructive) and mischievous life while on it.
 

Ga s

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Maybe so far Eddie is fortunate that he has no cardiac issues or anything else except the PV.

You did the best possible for Gomez and he was fortunate to have you. When I was in the waiting room at the veterinary emergency clinic, I was thinking how utterly heartbreaking it would be to not have the funds to pay for what needed to be done for Eddie. With six cats I do not bother with insurance. Most of the time the cats get along just fine until they become elderly. Routine things like dental cleanings and annual check ups are not out of this world expensive and the total vet bill per year is significantly less than what insurance for six cats would add up to. My other cats lived to over 18 years. Even though the initial cost of diagnostics and treatment was about three thousand dollars in all, ongoing care is extremely reasonable. His last appointment was less than one hundred dollars and his next appointment is a month from now. My main concern was not financial because I have an annual cat budget set aside. It was 'is ongoing treatment reasonable and affordable? Will he have quality of life'? From what I read on this forum I learned yes, yes, and yes.

Eddie's hematocrit was 60 back in November 2016 when he had his teeth cleaned. I am not going to rake my regular vet over the coals because quite frankly I cannot remember if he said anything about doing an update. At the time, 4 of the cats were going in and out getting bloodwork and dental done. Plus one of the cats gets pancreatitis every winter (I now have a working hypothesis and will try it out next winter....) and I was treating her. (and yes she got it this winter too but by now I am aware of the initial signs and begin medicating immediately. Then she gets bloodwork done to verify and followup when I can tell she's recovered.)

All of Eddie's medical records from the veterinary emergency clinic have been sent to my vet (who has been the family vet since 1993... so he may have dropped the ball this time, nobody died) and he's been in contact with me about Eddie's case. He's been a vet for almost 40 years and so far Eddie is the only PV case he 'never saw'...or now sees. if you know what I mean. He says that in vet school these sorts of conditions were mentioned briefly but since Eddie got diagnosed he's reading up on it all. As we say in my language 'the good priest continues to learn until he dies'. No one knows everything. The best thing is to be humble and keep learning. Eddie didn't die because my vet didn't recognize that there was a problem. And I don't think it would have cost me much less if he'd been diagnosed a year before he was. They would have still had to do all the same series of diagnostics. The only thing that wouldn't have happened was the focal seizure.

We are fortunate that there is a comprehensive veterinary emergency hospital available to us. Eddie is a VIP (very interesting patient). I'm sure given how rare this condition is, they probably have not seen many cases like his or maybe not any. I have not asked the internal medicine specialist yet but will. She's great. I really like her and also the other staff at the clinic. Too bad she can't be my doctor! LOL!

Soon two cats are going in for bloodwork and dental...... it's a revolving door. But that's the responsibility when a person has six little furry buddies. For me home isn't home without pets. My kids seem to have the same problem seeing as how they grew up with pets since birth. One has a German Shepherd and the other has two cats. The dog had a twisted stomach last summer and had emergency surgery (including a splenectomy) at the same place as where Eddie is a patient.

I just find it so ironic that after making dietary mistakes with my first group of cats, all of these are getting a species appropriate diet seeing as how cats are obligate carnivores. The aim of the game is to not have cats develop kidney failure or diabetes or any of the other chronic diseases cats develop from eating kibble. But wouldn't you know it? Doesn't matter what the cats eat, it doesn't mean they won't develop something rare and exotic. It's all been a 'continuing education program' for me as I said to the internal medicine doc.

Thanks for replying to my post to this forum. I'm sorry that your Gomez has departed to (what we call it in this family) 'the happy pigeon hunting grounds'.
 

SniperQ

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Wanted to update my cats status.
We decided to take Nibbles to a holistic vet who specializes in Chinese Medicine. On 9/10/2015 9still having multiple seizures a day) we started feeding Nibbles a Chinese Herbal formula that the holistic vet prescribed to us and within an hour of feeding the cat the herb, she was pretty much normal. No more seizures and she has been seizure free since then. She is more playful and loving than ever.

We also received a second Chinese Herbal formula that we hope will help with the high red blood cell count which we started her on today.

We have an appointment with our vet on 9/22 which will include a PCV test to see where her count is at.

We are hoping to take her off the keppra where it has seemed to fail after a couple of months and rely solely on the Chinese herbs as treatment. I must say we were floored by how quickly Nibbles improved after starting the Chinese Medicine therapy. We only hope that this is finally the answer.

I will keep my post updated as we continue on this journey. It's been a difficult one for sure.

Kevin and Nibbles :)
Hello Kshaley - i am not facing the same issue. Hydroxyurea doesn't work. I can just resort to Chinese herbal formula. Would you mind sharing it with us as well? The condition looks worse - I am worried that phelbotomy won't work for him one day. Pls help!
 

sophiesmum

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I first posted on this thread when Sophie was diagnosed with PV in February 2017. I just wanted to say to other owners also experiencing this condition, don't give up hope. At first the outlook was very uncertain for Sophie, but she has gradually improved to the point of stability and not needing to be 'bled'. The specialist referral vet has also taken a back seat for now as our own vet has happily taken on the case while we have stability.

Sophie has a blood test every 4-6 weeks, alternating between in-house PCV only and an external lab test. Her PCV has gradually reduced down to 42%-44%. She has 1 x Hydroxurea every 6th day. Sophie is slightly immunocompromised because of the Hydroxurea and is more prone to quickly pick up illnesses than a non immunocompromised cat.

Regarding the PCV, we tend to rely the on in-house result rather than lab result, as we have found that the latter can often be misleading and higher than in-house.

Unfortunately Sophie has recently been diagnosed with early CKD, but at least this is a more common condition and we have plenty of experience of it with previous cats.

Perhaps one day Sophie will be confirmed as being in remission from PV, but for now we are just grateful and so happy to have her still with us. We also keep a close eye on her littermate sister, Sheba, for any signs of PV.
 

ivory

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Hello Kshaley - i am not facing the same issue. Hydroxyurea doesn't work. I can just resort to Chinese herbal formula. Would you mind sharing it with us as well? The condition looks worse - I am worried that phelbotomy won't work for him one day. Pls help!
Kevin, what was the name of the Chinese herb? My kitty has polycythemia?
 

ivory

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Can anyone tell me is the replacement saline sq or intravenous? My vet is suggesting sq?
 
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