My cat’s mysterious anemia is probably cancer

[anxiousvesper]

I posted earlier this year about my cat, Tosie and her sudden anemia with no known cause.

Well, she responded well to steroid therapy for 6 months until her hematocrit suddenly tanked again. We all assumed the cause was tapering off her steroids too quickly. It wasn’t.

Her internal medicine specialist reached out to us today to let us know that she likely has cancer. They found some abnormally shaped white blood cells which pointed toward either feline leukemia (which was ruled out) or lymphoma.

All her tests before this were normal, aside from her hematocrit and a brief, slightly lowered platelet count. She’s had at least 5 ultrasounds this year, all normal. The most recent ultrasound was only a month ago and showed no tumors or abnormalities. I just can’t believe this is happening.

My wife and I are devastated. Tosie isn’t even four years old. She is FeLV and FIV negative. I know that one type of lymphoma, small cell GI lymphoma, is very treatable with a fairly good prognosis. But all the other types are a death sentence.

I don’t know why I came here other than in the hopes of finding anyone who might understand. My family and friends don’t get it. They don’t understand why I can’t stop crying, or why it isn’t so easy for me to just put her to sleep.

I always joked that she’s my daughter when people asked if I had kids but I realize now that I truly do mean it. She has a piece of my heart in hers and if she passes, I’ll be left with that hole in my chest for the rest of my life.

I’m sorry to anyone who was following Tosie’s progress and may see this. I wish more than anything I had a better update. Please hold all your fur babies tight and give them a kiss from me.

 

[KittyFriday]

I'm sorry. I know there are people here who have experience with lymphoma and can provide more specific advice. I just wanted to drop in and say that I, along with others here, absolutely do understand. These kinds of illnesses are a major punch to the gut, because we love our babes and want nothing more than for them to be happy, healthy, and with us for a very long time.

 

[mrsgreenjeens]

I think we ALL understand what you are going through . I don't have any human kids, so my furry kids are my babies too, and every time I lose one of them, a piece of my heart goes with them. One time several years ago my husband said we couldn't get any more cats because he just couldn't stand the pain of losing them anymore. That lasted only six months, but seemed like a lifetime to me. (that was four cats ago now).

You don't have a firm diagnosis yet, but if the steroids are (were?) helping, is she back on them again. Is she on other medication to build up the Hematocrit? I know steroids are part of the protocol for small cell lymphoma, so wouldn't think it would hurt to go back on them if she isn't. Of course, your Vet would know best. I hope they are able to figure out exactly what is causing this in order to treat it accurately. In the meantime, there is no reason to put her to sleep right now unless she is suffering and there is no hope. I've had three chronically ill cats who lived for three years each. I watched them closely and always promised them I wouldn't let them suffer. When the bad days overtook the good days, then it was time.

 

[anxiousvesper]

I think we ALL understand what you are going through . I don't have any human kids, so my furry kids are my babies too, and every time I lose one of them, a piece of my heart goes with them. One time several years ago my husband said we couldn't get any more cats because he just couldn't stand the pain of losing them anymore. That lasted only six months, but seemed like a lifetime to me. (that was four cats ago now).

You don't have a firm diagnosis yet, but if the steroids are (were?) helping, is she back on them again. Is she on other medication to build up the Hematocrit? I know steroids are part of the protocol for small cell lymphoma, so wouldn't think it would hurt to go back on them if she isn't. Of course, your Vet would know best. I hope they are able to figure out exactly what is causing this in order to treat it accurately. In the meantime, there is no reason to put her to sleep right now unless she is suffering and there is no hope. I've had three chronically ill cats who lived for three years each. I watched them closely and always promised them I wouldn't let them suffer. When the bad days overtook the good days, then it was time.

We do plan to fight it, so long as she won’t suffer. Especially if it’s small cell lymphoma, which we are hoping for at this point since it’s the most treatable option. We’re coming to terms with the fact that there is pretty much a 0% chance this isn’t cancer. I can’t find a single thing anywhere on the internet or in any veterinary medicine textbooks that could point toward a condition other than cancer that would cause physical, abnormal changes to white blood cells

She is still on the steroids, she’s actually on two (Atopica and Prednicortone) from when we thought this was just anemia caused by dangerously low folic acid levels.

Her vet will call sometime tomorrow to tell us our options. We’re trying hard to stay hopeful but honestly, I’m a bit scared to hope. It seems like every time I’ve gotten my hopes up, even just a little, something absolutely heinous happens. I sometimes wonder if im some sort of cosmic jinx.

I’ll update tomorrow after I speak with the vet. Maybe we’ll get lucky this time.

 

[FeebysOwner]

Hi. So sorry to hear about this confusing issue with Tosie. Usually, something will show up on an ultrasound if there is lymphoma involved, even with small cell GI. If nothing else, it might be enlarged intestinal lymph nodes or thickened intestines, as examples. If all looks good on Tosie's ultrasounds, then I would ask the IM vet what the odds are that it would be this form of lymphoma. Have they done testing to determine if this regenerative or non-regenerative anemia?

I know you are working with an IM vet, but have they consulted an oncologist with the test findings so far? Maybe even an infectious disease specialist, and/or an immunologist? Have they thought about consulting with a vet university who often sees cases that many practicing vets, even specialty ones, do not?

 

[anxiousvesper]

Hi. So sorry to hear about this confusing issue with Tosie. Usually, something will show up on an ultrasound if there is lymphoma involved, even with small cell GI. If nothing else, it might be enlarged intestinal lymph nodes or thickened intestines, as examples. If all looks good on Tosie's ultrasounds, then I would ask the IM vet what the odds are that it would be this form of lymphoma. Have they done testing to determine if this regenerative or non-regenerative anemia?

I know you are working with an IM vet, but have they consulted an oncologist with the test findings so far? Maybe even an infectious disease specialist, and/or an immunologist? Have they thought about consulting with a vet university who often sees cases that many practicing vets, even specialty ones, do not?

Tosie’s anemia was originally classified as non-regenerative, however the past two blood panels have shown regeneration again. In fact, the regeneration has grown with each blood test. Her vet has been stumped to say the least. Her past hematocrit values since the big drop have been hovering around 27.5-28%.

Her vet did contact a local veterinary university for a second opinion on Tosie’s blood sample and they agreed that the differential diagnosis was either lymphoma or feline leukemia. So her vet went ahead and tested that blood sample for the leukemia and it returned negative, leaving only lymphoma unfortunately.

 

[lwndlnd]

I posted earlier this year about my cat, Tosie and her sudden anemia with no known cause.

Well, she responded well to steroid therapy for 6 months until her hematocrit suddenly tanked again. We all assumed the cause was tapering off her steroids too quickly. It wasn’t.

Her internal medicine specialist reached out to us today to let us know that she likely has cancer. They found some abnormally shaped white blood cells which pointed toward either feline leukemia (which was ruled out) or lymphoma.

All her tests before this were normal, aside from her hematocrit and a brief, slightly lowered platelet count. She’s had at least 5 ultrasounds this year, all normal. The most recent ultrasound was only a month ago and showed no tumors or abnormalities. I just can’t believe this is happening.

My wife and I are devastated. Tosie isn’t even four years old. She is FeLV and FIV negative. I know that one type of lymphoma, small cell GI lymphoma, is very treatable with a fairly good prognosis. But all the other types are a death sentence.

I don’t know why I came here other than in the hopes of finding anyone who might understand. My family and friends don’t get it. They don’t understand why I can’t stop crying, or why it isn’t so easy for me to just put her to sleep.

I always joked that she’s my daughter when people asked if I had kids but I realize now that I truly do mean it. She has a piece of my heart in hers and if she passes, I’ll be left with that hole in my chest for the rest of my life.

I’m sorry to anyone who was following Tosie’s progress and may see this. I wish more than anything I had a better update. Please hold all your fur babies tight and give them a kiss from me.

I'm so so sorry. It's truly devastating. I cannot share my own experience, as I haven't had any cats with such problems, but I wanted just to hop in and offer you some support, as it's the only thing I could do. Did your vet talk about further tests or steps? Maybe you should get a second opinion or smth? Sorry if you already did that, I don't know much about Tosie's story. I'm thinking of you and hoping for the best for you both.

 

[anxiousvesper]

Tosie’s anemia was originally classified as non-regenerative, however the past two blood panels have shown regeneration again. In fact, the regeneration has grown with each blood test. Her vet has been stumped to say the least. Her past hematocrit values since the big drop have been hovering around 27.5-28%.

Her vet did contact a local veterinary university for a second opinion on Tosie’s blood sample and they agreed that the differential diagnosis was either lymphoma or feline leukemia. So her vet went ahead and tested that blood sample for the leukemia and it returned negative, leaving only lymphoma unfortunately.

I forgot to add that, yes, her ultrasounds have all been completely normal. She has no problems with diarrhea or constipation except for a short bout of diarrhea around the 3month mark of her anemia treatment. We were given probiotics for her and the GI issues went away and haven’t come back.

She’s also had multiple panels done to assess how her organs are doing since she’s been on steroids for almost 9 months now. All the results came back completely normal. Kidney, Liver, Pancreas….everything normal. I’m so exhausted. I truly thought this was just to folic acid deficiency and now it’s likely cancer. Her vet is completely perplexed. Every time she sees her she remarks on how well Tosie looks. Her weight is stable. Her fur is gorgeous and shiny and soft, and she grooms it well. Her eyes are bright with no jaundice or discoloration. Anyone looking at her wouldn’t even know she was sick.

 

[lwndlnd]

I forgot to add that, yes, her ultrasounds have all been completely normal. She has no problems with diarrhea or constipation except for a short bout of diarrhea around the 3month mark of her anemia treatment. We were given probiotics for her and the GI issues went away and haven’t come back.

She’s also had multiple panels done to assess how her organs are doing since she’s been on steroids for almost 9 months now. All the results came back completely normal. Kidney, Liver, Pancreas….everything normal. I’m so exhausted. I truly thought this was just to folic acid deficiency and now it’s likely cancer. Her vet is completely perplexed. Every time she sees her she remarks on how well Tosie looks. Her weight is stable. Her fur is gorgeous and shiny and soft, and she grooms it well. Her eyes are bright with no jaundice or discoloration. Anyone looking at her wouldn’t even know she was sick.

I've read some studies and articles about lymphoma, even tho I've never experienced it with any of my pets. There are usually at least some signs that something is wrong, as vomiting, diarrhea, weight loss or smth. It all sounds very odd and confusing. I understand your tiredness and exhaustion, but maybe try talking to other vets? Maybe they can come up with other differential diagnosis or suggest running some more specific tests. Usually getting second opinions and other perspectives can give some answers in cases like that. Fight for your kitty. But please, don't forget taking care of yourself, it is really important. Also my vet always says, "don't treat test results, treat the symptoms".

 

[anxiousvesper]

I'm so so sorry. It's truly devastating. I cannot share my own experience, as I haven't had any cats with such problems, but I wanted just to hop in and offer you some support, as it's the only thing I could do. Did your vet talk about further tests or steps? Maybe you should get a second opinion or smth? Sorry if you already did that, I don't know much about Tosie's story. I'm thinking of you and hoping for the best for you both.

Our vet will be calling tomorrow to discuss Tosie’s options. I can post another update then, assuming I don’t get terrible news. In which case I might be a little slower on the updates.

Her previous health problems started last summer when she developed severe, chronic anemia seemingly out of nowhere. We tested her for absolutely everything to find a cause. Multiple bone marrow biopsies, tests for infectious diseases, tests for poisoning, tests for FELV and FIV and FIP, internal bleeding, dental issues, and on and on….everything came back normal. We found that she had a severe folic acid deficiency during a final Hail Mary blood test, and her vet said that even though it’s rare, it’s possible the deficiency could have caused the anemia. She began steroid treatment and her hematocrit shot up like a rocket, she was up to 50% at one point and everything seemed so great. We really thought we’d found our answer until her HCT plummeted down to 27% from 43% in the span of 6 weeks.

We’ve done so many tests to figure out what this is everything just kept coming back normal. A week ago she gave blood for a full blood panel (her bazillionth one at this point) and suddenly there were abnormal lymphocytes. The vet sought a second opinion and it was agreed it’s likely lymphoma.

At this point I worry there’s nothing left to do but wait and hope we have the chance to fight it.

 

[anxiousvesper]

I've read some studies and articles about lymphoma, even tho I've never experienced it with any of my pets. There are usually at least some signs that something is wrong, as vomiting, diarrhea, weight loss or smth. It all sounds very odd and confusing. I understand your tiredness and exhaustion, but maybe try talking to other vets? Maybe they can come up with other differential diagnosis or suggest running some more specific tests. Usually getting second opinions and other perspectives can give some answers in cases like that. Fight for your kitty. But please, don't forget taking care of yourself, it is really important. Also my vet always says, "don't treat test results, treat the symptoms".

She did have a couple days to maybe a week of diarrhea about 6 months ago while on her steroids for anemia. And she also had weight loss during the time we were trying to discover the anemia. Our vets told us that often cats with anemia, especially anemia as severe as Tosie’s, lose weight due to lowered appetite caused by the anemia.

When we started her on steroids her appetite shot back up and she actually gained quite a bit of weight. So much that the vet said we should make sure not to let her gain any more as she didn’t want her to have to deal with potential side effects caused by future obesity on top of the anemia. Since then her weight has been fairly stable. She lost about 0.5lbs over the past two months because we’ve been monitoring her food intake and being careful not to over feed.

But now I’m terrified that these were symptoms of cancer all along and we were so focused on the anemia that we missed it.

 

[FeebysOwner]

One can never know. Bear with me for a fairly brief story. My cat is not anemic, her lymphocyte count is/has been within range. She has other health issues, but her urine/stools have always been regular. No vomiting, and stable weight. It took 3 ultrasounds, 2 FNAs, and finally a PARR Assay done on tissue from an enlarged intestinal lymph node to diagnose T and B cells which they are labeling small cell GI lymphoma. That was a year ago. Not much has changed since, and she is not currently being treated either with Pred or chemo. So, lymphoma doesn't always have a pattern.

I am not saying there are any comparisons between our cats, but I am saying there are cases that just don't follow 'standard' protocols (for lack of a better term). You likely didn't miss anything at all. This was all done on my cat as a precaution due to faulty x-rays and one thing just led to another.

 

[KittyFriday]

I'm sorry you're having to go through this. I've never been through anything like this with a cat, but my pup has had health issues for over a year now and the vets are totally stumped. Like your girl, he generally appears to be healthy most of the time but his labs indicate something is wrong, but no one has any real idea as to what. It is incredibly frustrating, because a confirmed diagnosis could lead to a treatment plan. But the doctors at the vet school told me that sometimes you catch things too early for there to be any obvious course of action, and sometimes you just never do know exactly why something happened.

I hope you are able to get some answers, Tosie is very lucky to have people who are so dedicated to her care and well-being.

 

[anxiousvesper]

One can never know. Bear with me for a fairly brief story. My cat is not anemic, her lymphocyte count is/has been within range. She has other health issues, but her urine/stools have always been regular. No vomiting, and stable weight. It took 3 ultrasounds, 2 FNAs, and finally a PARR Assay done on tissue from an enlarged intestinal lymph node to diagnose T and B cells which they are labeling small cell GI lymphoma. That was a year ago. Not much has changed since, and she is not currently being treated either with Pred or chemo. So, lymphoma doesn't always have a pattern.

I am not saying there are any comparisons between our cats, but I am saying there are cases that just don't follow 'standard' protocols (for lack of a better term). You likely didn't miss anything at all. This was all done on my cat as a precaution due to faulty x-rays and one thing just led to another.

I’m so sorry to hear that your cat has been diagnosed with SCL, but I’m very glad to know that not much has changed for her! I really hope it stays that way and that she lives a long, happy life with you🩷

 

[FeebysOwner]

I’m so sorry to hear that your cat has been diagnosed with SCL, but I’m very glad to know that not much has changed for her! I really hope it stays that way and that she lives a long, happy life with you

Thank you, but I wasn't trying to elicit that. She is 18+yo and has lived a long life compared to Tosie - so far. All I really wanted to do is assure you that you didn't necessarily miss anything, and to never let that play on your mind. Some things are what they are, and it doesn't matter what we did or did not know, as that would probably not have changed a thing.

My thoughts, hopes, and prayers are with Tosie. Please keep us posted as you see fit.

 

[iPappy]

A anxiousvesper I am so sorry to hear about all this resurfacing with Tosie, after you've already been through so much with her. I was literally thinking of you guys just a few weeks ago!
As lwndlnd said, "don't treat test results, treat the symptoms." I had blood work ran on Tag a few months before his diagnosis of cutaneous lymphoma, and the blood work was an absolute mess but he was still so happy. As scary as the "what if's" are right now, try to look at her and notice that she looks normal, acts normal, and that she is a happy little girl and nothing is definite yet. I know for a fact that you will provide her with the most excellent care no matter what!

 

[anxiousvesper]

Update:

We spoke to the vet. She let us know that unfortunately Tosie’s HCT dropped 3% from the blood test last month. But she also told us that the abnormal lymphocytes they found were few. It was not a large population, but they were concerned about their presence at all which is why they sent the samples for a second opinion.

We’ll be meeting with a veterinary oncologist on Tuesday for more blood tests and potentially to schedule another bone marrow biopsy, depending on what the specialist says.

Our vet is trying to calm us down (I’m sure she didn’t miss my obvious crying over the phone lol ) by telling us that even though lymphoma is a viable differential at this point, that it still isn’t certain. She says it could be some sort of lymphocyte disorder or FeLV, despite the multiple negative recent FeLV tests. I truly hope it isn’t FeLV. We have 3 other cats…

So yeah. Maybe I’ll have a better update for you all in the future.

 

[lwndlnd]

Update:

We spoke to the vet. She let us know that unfortunately Tosie’s HCT dropped 3% from the blood test last month. But she also told us that the abnormal lymphocytes they found were few. It was not a large population, but they were concerned about their presence at all which is why they sent the samples for a second opinion.

We’ll be meeting with a veterinary oncologist on Tuesday for more blood tests and potentially to schedule another bone marrow biopsy, depending on what the specialist says.

Our vet is trying to calm us down (I’m sure she didn’t miss my obvious crying over the phone lol ) by telling us that even though lymphoma is a viable differential at this point, that it still isn’t certain. She says it could be some sort of lymphocyte disorder or FeLV, despite the multiple negative recent FeLV tests. I truly hope it isn’t FeLV. We have 3 other cats…

So yeah. Maybe I’ll have a better update for you all in the future.

I’m proud of you and sending you all the good vibes I can.

From what I’ve read, FeLV and FIV are transmitted through the deep wounds, despite many people believing that it can happen through the saliva or smth. I can’t be sure it’s true about FeLV, bc I’ve read more about FIV, but you can definitely read some studies to know for sure. You have a lot on your mind to worry about things even more and I’m so sorry it’s happening. But I’m glad you will be getting second opinions, maybe this will clear some things out.

When it comes to lymphoma, it’s a rapid condition and usually symptoms are present, as well as a large amount of abnormal lymphocytes. What about lymph nodes throughout the body, are they normal? Can your vet do fine needle aspiration cytology from lymph nodes to see what’s going on in there?

 

[di and bob]

My cats have FeLV, the one that was diagnosed was so sick, he couldn't walk, the vet said his blood cell count on both red and white were almost zero, he didn't know how he kept going. He is still with me 3.5 years later. How I don't know. the vet explained if they can just hang on long enough, the bone marrow makes more cells. He said he has seen SO many miracles with cats, they seem magical. I didn't even test the other two, his brother and mother because it wouldn't matter. I had already nursed them through Distemper when they were strays that showed up and so many others died. I almost forced him to eat some Delectable Lickables, he survived on a few licks a day. we even dug his grave. I started him on DMG an immune system supplement, and LifeGold, a supplement for cancers. all three still get it every day. I'm afraid to stop.....
It's SO hard to live with this hanging over your head. i understand how completely shattered you are, while the rest of the world just keeps on going. While yours has stopped.
Don't give up, just keep on going until your little one can't go on anymore, then still hold on and love her all you can. Just take one day at a time and love that little girl with all your heart. Be grateful for every minute you have with her. I will pray for you both......

 

[anxiousvesper]

I’m proud of you and sending you all the good vibes I can.

From what I’ve read, FeLV and FIV are transmitted through the deep wounds, despite many people believing that it can happen through the saliva or smth. I can’t be sure it’s true about FeLV, bc I’ve read more about FIV, but you can definitely read some studies to know for sure. You have a lot on your mind to worry about things even more and I’m so sorry it’s happening. But I’m glad you will be getting second opinions, maybe this will clear some things out.

When it comes to lymphoma, it’s a rapid condition and usually symptoms are present, as well as a large amount of abnormal lymphocytes. What about lymph nodes throughout the body, are they normal? Can your vet do fine needle aspiration cytology from lymph nodes to see what’s going on in there?

Well, there definitely was not a large amount of abnormal lymphocytes present which is nice at least. It was a very small amount. Tosie’s only real symptom is the anemia.

Our vet did look back at the ultrasound from last month where they checked her kidneys and other abdominal organs. There were no abnormalities, other than a very slight enlargement of the spleen which has unfortunately been the case for Tosie since she became anemic. It went away briefly during the period we got her anemia under control and then came back when the anemia came back.

Her blood test on Tuesday will be sent to cytology. Especially immuno cytology (it was a super long name so I may have got that wrong). Then the oncologist will decide is we should do a bone marrow biopsy again or a FNA. Im not sure what exactly they would aspirate with an FNA though seeing as we have found zero growths so far ()