Sheldon needs a miracle to survive

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ldg

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Background: He looked white on Sunday. Monday his hematocrit was 14. Tues 12. Wed 8. This morning 6. Monday he had blood work, Tuesday an ultrasound, Wed a bone marrow biopsy. Results are not back yet. A rush was put on it. Normal hematocrit (HCT) is 30% - 40%. Below 25% is anemic. Upper teens is survivable indefinitely. Single digits is days. Maybe a week or two - IF the body is not destroying the red blood cells. Sheldon's is.

He received a blood transfusion tonight.

I do not have good news. Shel's hematocrit only improved to 14% (from 6%). They started him on steroids. But his body is killing the RBCs fast. Too fast.  "Everyone at the hospital is praying for him." Sheldon needs a miracle. :heart2:

:bawling:

BUT... his sibling Tuxedo survived this. Come on Shel.... you can too!!!!
 

Columbine

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:grphug2: Oh my goodness. Poor Sheldon. I'm hoping and praying for that miracle for you both. Huge hugs. You're both in my thoughts. :vibes: :vibes: :vibes: :vibes: :vibes:
 

geely

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sending a  prayer your way.
 

cat nap

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Total vibes and prayers are being sent your way!  Come on Sheldon...you can do it.  
 
  
  
    I just read your cat page Sheldon, and you started off your mom on this cat site journey...where she helps so many people...so just know that a lot of us here, are thinking of you.   Mega vibes....
 
 

furry

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Sending him healing right now...

x
 

Docs Mom

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Sending lots of love and jingles for Sheldon's recovery . . .

Lisa and furkids
 

mrsgreenjeens

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See...miracles DO happen
.  Let's pray this one is very long term


Continued vibes
 

the3rdname

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Hooray!  
  Way to go, Sheldon!  It must be a good day for anemic kitties; Rumi is feeling better, too 
  A quick thought: we've started using Pet-Tinic, an iron and B vitamin supplement recommended on an felv support site.  I imagine Sheldon could use something like that, too.
 
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ldg

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Well, good news and not necessarily good news. :heart2:

First of all, I spent an hour or so with Shel this afternoon. :rub: :D

He is definitely looking better - some color, he's alert and bright-eyed. He enjoyed his favorite - brushies - and was purring normally and kneading. He curled his head into my arm, I kept brushing him, and his purr got quieter and quieter - and he fell asleep. :heart2:


He doesn't seem overly stressed. Doc says he's sitting in the front of the cage, watching everything going on, and enjoying / appreciating all the attention he's getting (there's a lot of especially-loving tuxedo cats people there :) ). And Shel IS a sweetie, the most gregarious of our kitties. But he's NOT eating on his own. Even though his HCT is holding (YEP, the 7:00pm check in was STILL 15%!!!!) they didn't want to send him home tonight since he's not voluntarily eating. They want him on the IV fluids (regular ringers lactate) as it helps with oxygen delivery. They'll let him come home tomorrow even if he's not eating on his own, as I can syringe feed him and administer sub-q fluids.


Now the not-so-good news. :(

The biopsy results are in.

Apparently they didn't find cancer, but it still can't be ruled out - it was a "bone marrow biopsy" vs a bone marrow aspirate - that just means a bigger needle. But it might not have been in a spot where cancer is present. That's #1.

#2 is his bone marrow is being characterized as "non-responsive." This is in contrast to Tuxedo's bone marrow aspirate, that indicated his bone marrow was responsive.

His problem is characterized by "erythroid hypoplasia." So I look that up and find this: "If a bone marrow aspirate is performed to evaluate a peripheral anemia, we will want to determine if we have an erythroid hyperplasia or erythroid hypoplasia. Erythroid hyperplasia has increased numbers of erythroid precursors (myeloid / erythroid ratio of 2) in the presence of a peripheral anemia, would indicate the bone marrow is not responding. This suggests the anemia is due to an erythrocyte production problem or an immune-mediated destruction of erythroid precursors."

Basically - what Tuxie had, erythroid hyperplasia, meant that the bone marrow definitely still works, and it's only an issue of immune suppression.
What Sheldon has means that we don't know if it's an issue of immune suppression OR if his bone marrow doesn't work properly anymore for some reason (potentially cancer).

The treatments seem to be the same: immune suppression.

It's just in the presence of HYPERplasia, the bone marrow is definitely still working; in the presence of HYPOplasia, you don't know in advance if the bone marrow no longer works or if it can work if the immune system is suppressed.

The doc indicated that the problem is that we are not seeing Sheldon's HCT rise. Now - it may simply be we need to add another immunosuppressant, and the typical one in the literature, anyway, is cyclosporin A.

The doc overseeing him tonight wouldn't speculate, as she isn't actually his treatment physician. I guess... the summary in the difference between Shel and Tuxie's anemias is that Tux's bone marrow was determined to be working, whereas at this point, we're not sure Sheldon's is or can.

"The first 24 - 48 hours are critical, but we usually see some type of response by now." (Meaning his numbers should be rising. Holding steady is good, of course, but they would EXPECT to see them rising).

:(


:cross: :vibes: Sheldon..... :hugs:
 
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goholistic

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Laurie, I am just now seeing all of this and I'm almost at a loss for words. You've endured so many challenges over the past several months, and I just couldn't even imagine that more could pile on. I am so, so sorry this is happening to Sheldon. 


I am, of course, sending TONS of vibes for your boy......  
    
    


......and MANY hugs for you and the rest of the gang.    
    
    
 

Docs Mom

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I really hope that Sheldon's bone marrow starts WORKING...My last 3 Felv girls that I lost, all had nonregenerative anemia.
It was really frustrating, as I'm sure you are right now.
More hugs and jingles that Sheldon turns the corner for the better...[emoji]128532[/emoji][emoji]128542[/emoji][emoji]9786[/emoji]
 

Columbine

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My heart goes out to you and Sheldon. Tons of :vibes: and hugs to you both. I really hope things turn out well, and that the right drug combo is found soon. You're both in my thoughts.
 
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mphscat

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So very sorry you and Sheldon are going through this. Prayers and good thoughts to both of you. Please keep us posted!
 

feralvr

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I hope that today Shel's HCT rises. :cross: :cross: I was feeling he would stay overnight and good that they are keeping a close watch on him, of course. I wish the results of the bone marrow biopsy were more conclusive - as was Tuxie's BUT apparently the treatment IS the same so here some more ENORMOUS VIBES that today we will hear some positive news on his levels and that he is feeling better, begins to eat on his own and able to go home today. Even if you need to assist feed him - I hope he comes home. :cross: GIANT HUG TO YOU, sweetie. :hugs: :hugs: :hugs: :hugs: :hugs: :hugs: :hugs: :hugs: :hugs: :hugs: :hugs: :heart3: :sun:

:vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes: SHELDON :rub: :heart2:
 
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ldg

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:hugs: :hugs: :hugs:

Shelly's home!!! I was exhausted, went back to sleep this morning. His HCT was down a tad to 14% from 15%. They added an appetite stimulant this morning. It didn't help.

At the afternoon recheck, his HCT was 16%. We got the go-ahead to bring him home. :rub: :clap:

He's on 10mg pred, cerenia (for nausea), pepcid, the app stim (which is doing nothing), and azithromycin. I'm betting the antibiotic is the problem re: his appetite, and once he finishes that (on Wed), he'll get his appetite back.

I'll talk to Stan on Monday, after we take him to have his HCT run at the local vet. We see Stan with Shel on Wed, unless he wants to add another immuno-suppressant to the mix.

But for right now, he's stable, knock wood, and we'll take that! :heart2:
 
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