Immune Mediated Hemolytic Anemia (updated)

[Furballsmom]

The app Relax My Cat might only be available through your smartphone.

MusicForCats.com is an online website. I noticed there are numerous YouTube videos for relaxing cats as well.

 

[babiesmom5]

B babiesmom5

Took Apollo to the vet today. His PCV was 32! Back on track! Vet wants to start weaning him off prednisone so it’s back to 5mg once a day. He goes back next week. He’s acting 80% back to normal; he’s still hiding (but I don’t know if it’s because he doesn’t feel good or if he’s just avoiding the fighting between two of my other cats) and he doesn’t want too much affection. He’s also gained a pound from the two and a half he lost so yay on that.

That's great news! I hope he continues to improve, but I would keep a close eye and monitor PCV periodically.

 

[white shadow]

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I'll leave this with you as well - it's a specialized online community of people with experience in managing feline anemia, so, if it's experienced people you're looking for, that's where you should go. (~20 years experience, 2000+ members)

Here you are: Feline_Anemia Users Group - Yahoo Groups
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[fromthevalley]

B babiesmom5

Hi sorry to bother but did your cats energy levels ever get to normal? Currently while his pcv is normal, and I understand he’s recovering and is on prednisone, he’s just not acting normal. He didn’t hide under the bed, but he hid in my parents room unless he needed food or the bathroom before we had a diagnosis. Now he comes out to socialise. But when I try and pet him, or try to engage in play, 90% of the time he shrugs it off and goes back to moms room. The vet wasn’t concerned but she was looking at the now, I was just thinking of the future.

 

[babiesmom5]

Yes, it did. He acted normal, played normal, ate normal and was otherwise his old self. He did not hide. He bantered with his siblings, ran through the hours, up and down stairs, and did not hide at all.

His PCV hovered in the high 20's to low 30's but mostly stabilized around the high 20's. While this is not ideal, the vet said he apparently compensated well.

I'd say as long as he is eating well, and his PCV is normal, I would give it a bit more time, maybe a couple of weeks. If his behavior is still more subdued, I would consult with your vet again. Maybe something else is going on. Please keep us posted.

 

[babiesmom5]

Thinking about your cats situation (not quite back to normal energy levels) made me recall something else which I should pass along.

A low red blood cell count CAN cause changes in the heart muscle, as it DID with my boy. Not long after he was diagnosed with IMHA, and after his PCV returned to normal, I noticed an increased respiratory rate and he still was a bit lethargic. I took him back to the vet who suggested a cardiology consult.

Echocardiogram of his heart showed he had Restrictive Cardiomyopathy. This is a disorder of the heart muscle that results in a decreased ability of the heart muscle to relax and fill with blood. It can eventually lead to heart failure as well as arrhythmias. A low red blood cell count leads to an increased blood volume in the heart and secondary volume overload of the heart.

So my boy was put on Pimobendan, a heart medication, for a period of time. After a few months, and once the IMHA was brought totally under control, the heart condition completely reversed. After that, he had a completely normal heart thankfully!

So I tell you this just to make you aware of the potential of heart problems as result of the IMHA. The good news though is that it, if it occurs, it can be reversed once the IMHA is fully under control.

 

[fromthevalley]

Thinking about your cats situation (not quite back to normal energy levels) made me recall something else which I should pass along.

A low red blood cell count CAN cause changes in the heart muscle, as it DID with my boy. Not long after he was diagnosed with IMHA, and after his PCV returned to normal, I noticed an increased respiratory rate and he still was a bit lethargic. I took him back to the vet who suggested a cardiology consult.

Echocardiogram of his heart showed he had Restrictive Cardiomyopathy. This is a disorder of the heart muscle that results in a decreased ability of the heart muscle to relax and fill with blood. It can eventually lead to heart failure as well as arrhythmias. A low red blood cell count leads to an increased blood volume in the heart and secondary volume overload of the heart.

So my boy was put on Pimobendan, a heart medication, for a period of time. After a few months, and once the IMHA was brought totally under control, the heart condition completely reversed. After that, he had a completely normal heart thankfully!

So I tell you this just to make you aware of the potential of heart problems as result of the IMHA. The good news though is that it, if it occurs, it can be reversed once the IMHA is fully under control.

Hah! Oh wouldn’t that be ironic. I have a cat that has hypertrophic cardiomyopathy - her left ventricle wall has been slowly thickening since she was two and now she is five and fluid is slowly filling her lungs from congenstive heart failure.

 

[babiesmom5]

I too had a cat with HCM years ago, but with proper care and medication, she lived to 20 years old. I wish the same, or better, for your HCM kitty!

But Restrictive Cardiomyopathy and Hypertrophic Cardiomyopathy, are two very different heart problems.

HCM is progressive and, while treatable, cannot be reversed.

Restrictive Cardiomyopathy can be a temporary heart problem secondary to other issues like Anemia, is treatable and can be reversed.

Just watch your cat's breathing rate. Is his diaphragm expanding with more exertion than usual? Does he tire easily? Does he need to stop and rest after a little exertion like chasing a ball or going up steps like my boy did? Is he hiding more? If so,
I would contact your vet.

 

[fromthevalley]

I know some of you asked for an update so here it is:

So on Sept 26th his PCV was at 32 and he was acting 90% normal, so the doc dropped him from 10mg of prednisone (5mg in the morning, 5mg at night) to just 5mg in the morning (or at night, my choice). About a week after that he was still improving and he was 95% back to normal (I think the other 5% was crankiness from having to take pills). Doc wanted to see him end of Oct slash beginning of Nov. ish.

About two weeks ago I notice he lost a bit of weight - not a whole lot, no one noticed besides me and it took me a wee bit to notice. He bulked up quite a bit from being on 10mg a day, so I assumed he just wasnt eating as much. I wasn't worried because the weight I noticed was more his normal weight - he was two pounds past his usual weight when he went to 10mg. I really wish I had worried. By the end of that week he was back to hiding, moving like an old man, and was skin and bones! At the vet we found his PCV dropped dramatically to 13! Doc wanted to do a bone marrow biopsy and possible transplant, but they are both not even close to being an option - I'm barely scraping buy with their bills as it is. Doc immediately bumped him back up to 10mg, and if he doesn't improve by next week it'll be 15mg. Right now he's got more spunk back, so I'm hoping it's just not the pills. Sadly, it looks like he's going to be one of those cat's who will be on meds the rest of his life unless something more advanced is done.

 

[FeebysOwner]

Hi. I will have to go back and see if I can find your OP, so I can better understand what is going on. So, on the hope I am not saying something wrong - having a med option that allows him to live is a good thing. So much of what I read on this site, meds don't work.

I hope others on this site come along and read your post and can better help you. Do you have a thread from before that you can give a link to?

 

[fromthevalley]

Do you have a thread from before that you can give a link to?

Yeah gimme a mo to go grab it.

 

[white shadow]

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Hi fromthevalley.

I don't know if you're aware, but there's a specialized online community just for anemia. It's a group of people with the sole focus of managing their cats' anemia. They've been active online for many years and have accumulated the collective experience of hundreds of people and cats.

It's the #1 go-to place online for this specific condition.

Do you want me to dig out the info and post back with it? It would just be the connection/link to them, not any direct reply to your specific question. Just let me know.
.

 

[fromthevalley]

FeebysOwner Immune Mediated Hemolytic Anemia

 

[fromthevalley]

.
Hi fromthevalley.

I don't know if you're aware, but there's a specialized online community just for anemia. It's a group of people with the sole focus of managing their cats' anemia. They've been active online for many years and have accumulated the collective experience of hundreds of people and cats.

It's the #1 go-to place online for this specific condition.

Do you want me to dig out the info and post back with it? It would just be the connection/link to them, not any direct reply to your specific question. Just let me know.
.

Please. That would be fantastic. Ta.

 

[white shadow]

.
OK
It turns out, they started up in 2000 and have had 2200+ members in that time.

Now, they use email for their back and forth posts, so it doesn't look like these forums. That's how 'forums' were done before forums came along. I always recommend that people get a new, separate email account - like a Yahoo - to use strictly for these groups. It really helps to manage the info flow.

Here's their homepage: Feline Anemia Users Group - Yahoo Groups

Don't be a stranger here, though, and do keep us posted as things go along.

IMHA has to be one of the all-time singularly most difficult conditions for caregivers.
.

 

[fromthevalley]

.
OK
It turns out, they started up in 2000 and have had 2200+ members in that time.

Now, they use email for their back and forth posts, so it doesn't look like these forums. That's how 'forums' were done before forums came along. I always recommend that people get a new, separate email account - like a Yahoo - to use strictly for these groups. It really helps to manage the info flow.

Here's their homepage: Feline Anemia Users Group - Yahoo Groups

Don't be a stranger here, though, and do keep us posted as things go along.

IMHA has to be one of the all-time singularly most difficult conditions for caregivers.
.

Thank you!

And it is. I’m just so frustrated. Where did it come from!!! Why did he do soooo good for weeks then bam! Ugh. I have five cats and four have some issue or another, and the fifth thinks she’s a dog! I seem to collect the problem children.

 

[white shadow]

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My dear, should you find the origin of IMHA............you shall have won the lottery of a lifetime!
.

 

[jcat]

FeebysOwner Immune Mediated Hemolytic Anemia

Mod note: These threads have been merged for better comprehension.

 

[babiesmom5]

Thanks for giving us an update. I am so sorry that your cat has regressed after his Prednisolone was reduced, but to be honest, I am not surprised. Cats with IMHA usually require fairly high maintainence doses of Prednisolone to maintain proper PCV(as mine did), and in addition, may require additional medications, (as mine did) to maintain without regression.

While a bone marrow biopsy is the definitive diagnostic method for IMHA, my cat was 15 at the time and he was treated on a presumed combination of IMHA and anemia of chronic inflammatory origin. My vet's theory was to give him the optimal chance of responding, treat for the treatable with BOTH increase immunosuppression as well as hormone supplementation.

Following an initial blood transfusion, he was treated with Methylprednisolone (4mg) twice a day, plus Atopica (.14ml) twice a day (an immunosuppressant), and in addition he received Darbepoetin injections monthly. Darbepoetin is a hormone which is effective in treating anemia associated with CKD in cats. Note: my cat DID NOT have CKD. His kidneys were fine. But Darbepoetin is a hormone which stimulates the erythropoeiesis (red blood cell making) process in the bone marrow.

The two pronged approach of "immune suppression" via the steroid plus the Atopica, plus the "hormone stimulation" of the Darbepoetin did the trick for my boy. His meds were tweeked now and then depending upon his PCV, but this was what worked.

I would consult with your vet. Like I said previously, IMHA is a difficult disease to manage, but with proper treatment, it can be effectively managed. Hang in there!

 

[fromthevalley]

Update 11/23

Apollo’s PCV is down to 15 from his last appts 17, and he is also down to 8lbs (he is usually around the 12-13lbs area). He is also running a mild fever. He was given an antibiotic called veraflox. He goes back Tuesday.

The doc I saw today (not my original vet, just one of the ones who also works there) also wanted to deworm him. I thought it wasn’t advisable to deworm a cat on antibiotics and a fever?