Low white blood cell count - could it be FIP? Something else? Cat feeling very poorly and not eating

[Kat.]

Hi! I'm so sorry for creating a new thread so soon but I'm seriously freaking out and wanted to put all the right words in the title to make sure people who know these things find it.

My almost 4 year old boy was positive for coronavirus since he was 1 and was misdiagnosed with FIP - since than it was my biggest fear.

For some background, at the end of January he swallowed a toy and got extremely sick - we almost lost him but he ended up having intestinal surgery and recovered fine. I'm just mentioning it because I've read that stressful situations is a contributing factor in cats developing FIP.

So on Friday I noticed that he didn't wake me for food and was sleeping all the time but everything else was fine - he was eating, going to the bathroom, etc. He's usually a very very active cat but sometimes has a couple of very lazy days so I didn't think too much of it. It didn't improve until Sunday so I called the vet and got an appointment on Monday morning. His fever was 40C so they did a blood test and it came back with low white blood cell count (I've attached the pictures of his results) and elevated SAA (I still don't quite understand what that is). FIV and FeLV came back negative and FCoV 'faintly positive' (which I already knew). They didn't do any further testing because they said it doesn't look like FIP (no anemia and they couldn't feel any fluids in his stomach) but they also couldn't rule it out. He got started on antibiotic called Synulox, got IV fluids and something to reduce fever, also B12. After going home on Monday he was back to his old self, just a bit less energetic. Took him back to the vet yesterday, his fever was 39.3C, and then later rose to 39.7C. We were at the vet for 4 hours because he kept shaking from the fluids so it took forever to finish up. He also peed himself at one point (not the first time this happens at the vet). He looked ok after going back home, was fairly active and spent a lot of the time grooming himself (poor guy was soaked in urine) but lost his appetite in the evening (he would eat snacks but not his food - I've tried several different brands and he only ate a little bit of one).

This morning he ate very little, took him back to the vet where he got his treatments and also threw up while there (it was a ton of hair so the vet said it's probably because he groomed so much yesterday). His fever was 38C before he got any treatment so that seems like improvement? They also finally removed his catheter so I thought he would feel much better because he hates that thing. Anyway today he acted completely different than two previous days after coming back from the vet - immediately went to sleep and been laying down/sleeping ever since. They also rubbed appetite stimulant to his ear but he it didn't help - he only snacks at first and now stopped eating completely. It looks like he's feeling way worse today.

I'm not supposed to be going to the vet tomorrow (should doing antibiotic injection at home) but they said to come back on Friday for repeat bloodwork. I feel like the vets are not the best in my country, and this particular doctor today was very dismissive so I'm worried they're not going to do the right tests. I'm really worried it's FIP or something bad the vets aren't catching.

I just really need any advice - does any of this sound like FIP? Or something else? I really don't want to rush him to an overnight vet and my vet is closed now so I can only call them after 11 hours at the earliest. I don't know what to do. Please help
Also, is the priority to get your cat to eat something, or not to mess up his stomach while sick? He's not eating anything anymore but these last couple of days he had several different foods, and he has a sensitive stomach that's easy to irritate. I have a couple other brands I could try but he never had those so I feel like even if he eats, it's going to end up with diarrhea. Should I try anyway?

 

[FeebysOwner]

Hi. I can only tell you what the fSAA is supposed to be related to - and that is inflammation potentially brought on by a number of causes, including infectious diseases. I have included some articles (IMO, complex) about it (see below) in case it is of any help to you.

I am a bit miffed that he was misdiagnosed with FIP that long ago, and now having vets wonder about it again. I feel there is an underlying issue that is causing your cat's issues - UNRELATED TO FIP - and while that doesn't mean whatever it is could not evoke a mutation of the corona virus to FIP - at your cat's age it is a bit less likely for FIP to erupt without a provocation.

I wish I could offer more support.
Feline serum amyloid A Rapid Test Kit-saa - BALLYA (ballyabio.com)
Evaluation of feline serum amyloid A (SAA) as an inflammatory marker. - Abstract - Europe PMC

 

[Kat.]

Hi. I can only tell you what the fSAA is supposed to be related to - and that is inflammation potentially brought on by a number of causes, including infectious diseases. I have included some articles (IMO, complex) about it (see below) in case it is of any help to you.

I am a bit miffed that he was misdiagnosed with FIP that long ago, and now having vets wonder about it again. I feel there is an underlying issue that is causing your cat's issues - UNRELATED TO FIP - and while that doesn't mean whatever it is could not evoke a mutation of the corona virus to FIP - at your cat's age it is a bit less likely for FIP to erupt without a provocation.

I wish I could offer more support.
Feline serum amyloid A Rapid Test Kit-saa - BALLYA (ballyabio.com)
Evaluation of feline serum amyloid A (SAA) as an inflammatory marker. - Abstract - Europe PMC

I get a sense FIP is just that diagnosis that vets go to if they can't explain things, and they see a positive corona virus test. Misdiagnosis happened at a different clinic (I never went back there again) and they barely looked at him, did some rapid FIP test (that I later read was not at all accurate) and told me there was almost nothing they could do. I've read about FIP before so I knew it wasn't as simple to diagnose so I went for a second opinion and apparently he was extremely constipated? I'm still unclear on what happened there, as things never perfectly added up to me but anyway... Here we are again. I'm stuck in this place where it obviously *could* be FIP because some symptoms really fit but I've also had that experience of wrong diagnosis (to be fair he wasn't diagnosed with it this time, it's just the only thing that's been mentioned to me by name and I'm clinging to it) so I'm skeptical.

Thank you so much for the articles! It's really helpful, I'm going to look into it right away, I want to have as much information about what could be going on with him as possible.

 

[fionasmom]

I would offer some food. You are between a rock and a hard place with his sensitive digestion vs. the fact that it is not good for him not to eat.

 

[Kat.]

Tried everything yesterday and couldn't get him to eat. The only thing he ate were these Applaws puree treats. Gave him one this morning too, and he immediately vomited. Taking him to the vet in 20 minutes

 

[Kat.]

We're back! I asked for repeat bloodwork, his white cells are still down (although now down in a different way, I'm still trying to figure if any of that means anything). Vet said nothing is showing up on his bloodwork to indicate a specific problem, except that there's a virus. I asked for them to print me out his results while leaving and I can see some things are elevated but I guess that's normal if the vet didn't say anything? Attached just in case.

They gave him for nausea something called Prevomax, and fluids again, and said not to force him to eat for now. He's not even eating those snacks anymore, I can't understand if it's nausea or not. The only thing he 'ate' was he licked some hairball paste from my finger. Because he swallowed stuff he's not supposed to before and was throwing up they also gave him that while liquid and did an X-Ray (I know there's a name for it but can't remember) and said it's moving fine so it doesn't look like it's blocked (although last time nothing showed up in tests too). But I really don't think he swallowed something again.

 

[FeebysOwner]

All said fSAA is a marker for inflammation, for whatever reason caused the inflammation. Are there other testing options to look for the cause of the inflammation? Things like pancreatitis? How about a deeper look into why your cat's kidney & liver numbers are elevated? A closer look (ultrasound?) at digestive tract inflammation?
What about some sort of anti-inflammatory medication?
Are there other tests that could be done to look at other viruses?
Could there be parasitic issues?

How long before you need to try to get him to eat again? Have you considered the baby food meat? Most cats, even sick ones, seem to like it and I wouldn't think it would be too bad for his sensitive stomach. I don't know what brands you have available, but Beechnut, Goya, and Gerber Stage 2 are the ones I am aware of. What about boiled chicken? Neither of these options are nutritionally complete for a cat, but it would be better than nothing, especially if it could help him to start eating again.

BTW, I am guessing you mean barium (re: 'white liquid') was given to your cat in preparation for the x-ray?

 

[Kat.]

All said fSAA is a marker for inflammation, for whatever reason caused the inflammation. Are there other testing options to look for the cause of the inflammation? Things like pancreatitis? How about a deeper look into why your cat's kidney & liver numbers are elevated? A closer look (ultrasound?) at digestive tract inflammation?
What about some sort of anti-inflammatory medication?
Are there other tests that could be done to look at other viruses?
Could there be parasitic issues?

How long before you need to try to get him to eat again? Have you considered the baby food meat? Most cats, even sick ones, seem to like it and I wouldn't think it would be too bad for his sensitive stomach. I don't know what brands you have available, but Beechnut, Goya, and Gerber Stage 2 are the ones I am aware of. What about boiled chicken? Neither of these options are nutritionally complete for a cat, but it would be better than nothing, especially if it could help him to start eating again.

BTW, I am guessing you mean barium (re: 'white liquid') was given to your cat in preparation for the x-ray?

The doctor today very briefly mentioned pancreatitis but for some reason didn't seem to think it was the case. He had intestinal surgery on January 29th and they did mentioned his pancreas was affected but he seemed to recover very well but maybe this could be some delayed reaction? They actually didn't say anything about elevated kidney and liver numbers, didn't even mention it, said they were all good and I just saw it when I took bloodwork results home. I got into contact with athe owner of a shelter here, who takes care of very sick cats, including FIP, and asked for advice. She suggested doing an ultrasound at a different clinic and I made an appointment tomorrow morning.

I didn't even think it could a parasite but the shelter owner also asked when was the last time he had a prevention treatment for it (nor sure if it's the right wording in English). We have to do one before every vaccination.

The vet said to not worry about the food and just let him not eat but I kind of hate that option. I managed to give him a couple of Applaws puree chicken treats but nothing else. I'm going to look into the brands you recommended!

Yes, I mean barium, thank you.

And thank you for continuing to comment on this!! It really helps to talk to someone, I know no one is going to diagnose me on an internet forum but this is really really helpful

 

[FeebysOwner]

She suggested doing an ultrasound at a different clinic and I made an appointment tomorrow morning.

Since you have a rapport with this shelter owner, ask her if she knows how they handle tissue samples during an ultrasound if they see something 'suspicious'. Here they are called a fine needle aspiration cytology (FNA) and it really is nothing more than drawing cells/fluid with a needle from the area of question - things like lymph nodes, for example. They will then analyze the FNA material for further assessment.

I didn't even think it could a parasite but the shelter owner also asked when was the last time he had a prevention treatment for it (nor sure if it's the right wording in English). We have to do one before every vaccination.

You can also ask the shelter owner about a fecal PCR - it looks for all sorts of parasites, as well as bacteria and various viral conditions. Probably a little more 'inclusive' than just giving your cat an all purpose (de)wormer. Just a thought...

Pancreatitis can be in the form of acute (usually more serious) or chronic. Even when an acute case is treated, there is no guarantee it won't become a chronic condition - and normally treatment involves fluids and food - sometimes anti-nausea medications - and even pain meds may be necessary to help get a cat through what they call flare-ups. That is why I, personally, would want to follow up on getting food down him, so it might be best to ask the vet why stop feeding him and for how long.

I am glad you have a resource in the shelter owner!

Keep us posted!

 

[Kat.]

Ohh, thank you so much for the tips and info! Will absolutely bring it up with a new vet tomorrow and with the shelter owner. She also said in her opinion it's important to get him some food into him. It's night here but I've had this gel from his surgery recovery so gave a bit to him and he licked it from my finger. I know that's not food but at least he's showing some interest in something that's edible. Going to try absolutely everything to get him to eat tomorrow

 

[Furballsmom]

Hello!
(I wish TCS members would utilize this thread more often for people, but in any case), hopefully it's of use to you;

Any Good Tips To Get Your Cats To Eat? Share Them Here!