Koko most likely has IBD - a new journey for me

The lab results are still not back.

I called the vet early this morning (not back yet) and again around 1PM. The person who answered the phone put me on hold and when she came back on told me they were back, but the vet would need to call me to talk to me. Didn't bode well.

I needed Frontline anyway so drove up there to talk to the vet face to face. When I arrived, the vet tech had Koko's folder out and was talking to the lab. Apparently the results weren't back. The lab told them 2 - 4 business days and the weekend doesn't count. So they got the results on Friday and the earliest they will be available is tonight. So I may or may not get the results even tomorrow if they are on the 4 day side of 2-4 days.

The person who misled me is new and was filling in for someone at lunch. The real receptionist knows me well and told me she will keep an eye out for the results and call me when they actually get in. Usually the vet reads them first before a call is made, but I have connections there.

I hate the wait.

And just because I'm on a roll, found both fleas and ticks in the house this morning. Early spring is heavenly, but the dogs are already bringing the little buggers inside. Great.

Oh Amy! Well - at least the reason for "the vet call" isn't foreboding. But the wait sucks! :heart2:

OH come on.... AMY.... the waiting and the screwup thinking the results were in and now dealing with fleas/ticks hno: THIS has been such a problem everywhere due to this warm winter we all had and the early/HOT March. I am carefully checking the dogs too. They are already on Frontline... but they can still bring them inside AW HUN.... we are all waiting along with you on Koko's results. :cross:

Koko does NOT have cancer!!!!!!!



However, the FeLV test on the blood marrow is not yet back. Probably won't see that until Thursday morning.

I asked the question, if not cancer or FeLV, what could cause this? The best guess right now is a disease called Immune Mediated Hemolytic Anemia (IMHA). It can be triggered by a number of things, including FeLV or FIV, by a blood infection caused by a parasite (fleas or ticks), or a number of other things.

She was negative on the FIV test and if negative on FeLV, then the first assumption is that it was an infection in her blood. She'll go on doxy for a while, we'll up her prednilisone dosage and retest her blood 10 days later.

The scary thing about IMHA is that are 2 versions - primary and secondary (secondary meaning something else caused it and did not arise on its own). If primary, it is pretty much fatal, and in fact she would have probably died by now. If secondary, you work on the triggering factors to control it, and there is a good chance that she will live a normal life. We'll have a series of blood tests in her immediate future, and regular ones once her blood levels stabilize.

So although I'm still a bit scared, I'm much relieved that we've eliminated cancer.

I can breath a little bit now.

And THERE is the miracle I was praying for
She will get out of this Amy, she will!

I AM ALSO SO RELIEVED to hear the news of NO CANCER!!!!!!!!!!!!!!! OH Amy, thank goodness. AND let's just hope and pray that if it is IMHA - it is the secondary condition you pointed out :nod: :cross: and it will be treatable

Thank goodness no cancer! Btw, anemia can be also activated by IBD. All that malabsorption and GI troubles, it does happen.

Well, the FeLV test results came back. She tested positive for FeLV.

My vet couldn't answer all the questions I threw at her, most importantly, since they only found it in her bone marrow, is she shedding the virus?

So I immediately texted my friend who has Koko's 2 littermates, who btw, happen to be patients of Dr Elsey (inventor of Cat Attract), who works with a vet college research facility and is very up on the topic. She of course immediately called Dr. Elsey.

His take: All 4 cats from that litter got it from their mom and will test positive for FeLV. That means that my Muddy has it also. However, since it was only in her bone marrow and not her blood, that she' most likely not shedding it, which means she isn't infecting the other cats. (yes, we have more follow up questions for him on that topic) There was another cat in that colony that gave birth a few weeks before Koko/Muddy that did have FeLV, and 3 out of 4 of her kittens tested positive for it. Lucky Pierre is the surviving cat from that litter and lives in the house. It's possible that he is harboring it in his marrow also.

The FeLV will ultimately manifest itself in all 4 cats, and before he was even told, he guessed that Koko was the only female. Females are the weaker of the sex (sorry girls), and are typically the first to show signs of the disease. It will most likely show up differently in every last one of them, usually in things like cancer and other things. (I'm following up with Elsey on whether Muddy's idiopathic cystitis could have developed from it)

My vet just called back and she did a consult with a specialist in this area who also agreed that while in the bone marrow, she isn't shedding the virus.

Not sure how long we'll have with her. The real question is how long can we control the anemia. As long as that remains stable, she can live indefinitely. If it continues to degrade, it will take her life. So the diagnosis is better than cancer, but still bad. We'll have more time with her as we would have if it had been cancer.

Time to up the Love and Cheese Danish, as there isn't much more to do than that. Of course we'll research supportive therapies and incorporate them if they will help.

So at least 2 or 3 out of 7 cats with FeLV in my household. That is certainly not how I expected the day to go today. I'm so surprised I don't know what to think right now.

One step at a time Amy. Don't overwhelm yourself tonight, just take it in and let it out for the time being. You need to take care of yourself as well okay?

I have to look at it this way. Having nine years with a FeLV positive cat is an amazing accomplishment in and of itself. The poor babies simply got the bad luck of the draw. We know they got it from their mom, but the question becomes how the heck have they all remained healthy so long? Transmission of the disease in kittens usually happens in the uterus, but could the disease be reinforced through feeding? These babies were orphaned at 10 days old, so perhaps it changed the nature of how they would have carried the disease?

And it scares me to know that no amount of blood tests would have identified this. How many cats out there harbor the disease, get sick and its blamed on something else? Vets typically don't test for FeLV from bone marrow. That's a really expensive test.

The implications have me reeling.

NO CANCER!!!!!!!!!!!!!!!!!!!!

Amy, I don't know if you remember, but IMHA is what we fought with Tuxedo for four years. It's one of the primary reasons we moved out of the RV and into a house back in 2004, so we could be a short drive from his vet.

Some questions and ideas.

1) FeLV. FeLV can be harbored in the bone marrow or IS harbored in the bone marrow if kittens were exposed?
2) That she tested positive for FeLV means... this IS FeLV? Or it means she was exposed to it, and this still might be IMHA?


I don't know if you want to consider treatment outside of Love & Cheese Danish. :heart3: You may not know right now either. But when collecting information for decisions, some thoughts:

3) Koko is still making red blood cells, yes? And the components of white blood cells? I'd need a quick refresher "course" on this from Stan (Tuxie's vet), but he presented atypically at first too, with both depressed white and red blood cells (and various components thereof). He had a bone marrow aspirate done to determine if his bone marrow was capable of producing red blood cells. Because it was determined he was capable of it, he was given Epogen (epoetin) to help his body create red blood cells, and Nupogen (to help his body create neutrophils - a component of white blood cells). The Epogen was.. every other day, if I remember correctly, and Nupogen was daily for a while, again, if I remember correctly.

The problem with at least the Epogen is that over time, if primary IMHA, the kitty's body can become "immune" to it, and it stops working. We did hit that point with Tuxedo. He was treated (not at the same time) with both Baytril and Doxycycline, to see if it was a secondary IMHA, caused by something in his blood. Obviously they looked for all the known little buggers - hemobart, etc. When everything was negative, and Baytril and Doxy hadn't solved the problem, he was then treated with an immuno-suppressive dose of prednisolone. He responded to that well, at first.

Is Koko receiving prednisone or prednisolone? The cat's body has to work less if it is prednisolone. Then that stopped working for Tuxie. That was the final time Stan was "out of bullets" as Tuxie could take no more blood transfusions (his body treated any blood in a transfusion after the first one as an invader - when mixing for transfusion, it would coagulate, meaning it was impossible to provide the transfusion. This doesn't always happen, but can. So if, at any point, you're considering a blood transfusion, be aware that you may only have on transfusion as an option). After having chatted with various cat blood specialists, Stan gave him a shot of depomedrol, since the pred was no longer working to suppress his immune system (his body was attacking and destroying his own red blood cells as if they were a virus or something). This was what saved his life. :nod: He got them every two weeks, then every three, then every month, etc. etc. etc. until... he needed half doses every six months, then a half dose after one year... and he hasn't had a depo injection now since June 2010.

But I wanted you to be able to ask about Epogen and/or Nupogen as possibilities to help Koko. I wanted you to know that if pred doesn't seem to be helping, it is DEFINITELY worth trying Depo instead. The mechanism of action is different enough. :nod:

4) I know you're in the preliminary stages of exploring options. But has anyone discussed alpha interferon?

5) And there is a large biotech firm in Thailand with a very small division (it may have been spun out, in fact). They have what APPEARS to be an effective treatment for FIV and FeLV. There are no clinical trials, no studies - they're looking for funding and a U.S. partner, in fact. But they are treating animals in Thailand with it, and it is CURING them. In fact, it's also curing parvo. It is a different type of antiviral. I have to go look up the name, I don't remember it offhand. I have NO IDEA if there is any way for your vet or a University Vet to import the stuff. Oh - the name of the drug is RetroMad1. :nod: You may want to spend a little time on it, or ask your vet to. BioSatria. Just came to me. That's the name of the division (or now company?) that is making the antiviral that is working.

Momofmany said:

I have to look at it this way. Having nine years with a FeLV positive cat is an amazing accomplishment in and of itself. The poor babies simply got the bad luck of the draw. We know they got it from their mom, but the question becomes how the heck have they all remained healthy so long? Transmission of the disease in kittens usually happens in the uterus, but could the disease be reinforced through feeding? These babies were orphaned at 10 days old, so perhaps it changed the nature of how they would have carried the disease?
And it scares me to know that no amount of blood tests would have identified this. How many cats out there harbor the disease, get sick and its blamed on something else? Vets typically don't test for FeLV from bone marrow. That's a really expensive test.
The implications have me reeling.

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Amy, my understanding was that approximtely 20% of cats exposed to FeLV will harbor it in their bone marrow, and that only a percent of those will actually get sick with FeLV later in late. That was the link I couldn't find, the one that had that information. Still haven't found the site. The odd thing may be that Koko does have IBD, and that's what stressed her system into getting sick from FeLV. :dk:

http://www.furryfriendsfarm.org.my/in-the-press/retromad1-new-drug-packs-big-promise/

http://www.biosatria.com/

http://blog.lepak.com/2011/02/au-tests-retromad1-new-wonder-drug.html

I know Au's story is testing RetroMad1 for FIV, but it has been tested on kitties with FeLV. And sorry - it's Malaysia, not Thailand. :anon:

Laurie, as always, THANK YOU for that information.

Koko is on Prednilisone.

FeLV causes IMHA. IMHA comes in primary and secondary forms, and if it had been primary, she would have died by now. One of the leading causes of secondary IMHA is FeLV (and FIV).

I have a couple of questions being fed to Dr. Elsey about using prednilisone with FeLV cats. Since it's an immune depressant, will it make the FeLV worse? What are the current immune supportive therapies available right now? And what is the latest research about it turning into something that can shed and infect the other cats in the household.

Last check her white blood cell count was normal, and the total red cell count was normal, although the various components within the red cells were off. Her platelets were WAY low. The cells in her bone marrow were normal.

So we have to fight the anemia, but not at the expense of aggravating the FeLV. She's immune compromised to start with, so how far do you take drugs like pred used to suppress the immune response of anemia?

The vet suspected we'll have a year with Koko. I want to beat those odds.

LDG said:

Amy, my understanding was that approximtely 20% of cats exposed to FeLV will harbor it in their bone marrow, and that only a percent of those will actually get sick with FeLV later in late. That was the link I couldn't find, the one that had that information. Still haven't found the site. The odd thing may be that Koko does have IBD, and that's what stressed her system into getting sick from FeLV. :dk:

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I don't think she has IBD. When they saw the weight loss and inflammation markers in her blood, they assume IBD because that was the easy diagnose. Yes she vomited from time to time but nothing as serious as cats with IBD would do. Cats with IMHL vomit also. That aligns with the blood results pointing to anemia.

It's looking more like the FeLV triggered the IMHA. If we hadn't tested for cancer, we would have never found this.

And the vets take on harboring it in their bone marrow: a good many of these cats get sick from other illnesses that are never linked to FeLV, therefore they aren't really sure how many cats harbor it without ill effect or not. Unless you actually test the bone marrow, it never shows up in their blood.

Amy, it's also definitely time for a visit to the holistic vet. Or a different one. But when Lazlo was anemic because of his cancer, we used pred - not an immuno-suppressive dose, just an anti-inflammatory dose (5 mg) - but it wasn't helping with the anemia. His holistic vet put him on Yunnan Biyao http://en.wikipedia.org/wiki/Yunnan_Baiyao . The traditional vets marveled at how quickly his RBC returned to normal. We only had to use it twice, for a little over a week each. :nod: It comes with a small tea-pill to stop bleeding (which he needed because of the ulcer, but Koko wouldn't), and then ... I think 10 pills that you give every three days or so. Laz had them every two days for the first three, then every three days.

Momofmany said:

I don't think she has IBD. When they saw the weight loss and inflammation markers in her blood, they assume IBD because that was the easy diagnose. Yes she vomited from time to time but nothing as serious as cats with IBD would do. Cats with IMHL vomit also. That aligns with the blood results pointing to anemia.
It's looking more like the FeLV triggered the IMHA. If we hadn't tested for cancer, we would have never found this.
And the vets take on harboring it in their bone marrow: a good many of these cats get sick from other illnesses that are never linked to FeLV, therefore they aren't really sure how many cats harbor it without ill effect or not. Unless you actually test the bone marrow, it never shows up in their blood.

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Interesting. :nod: But glad you caught it!!!!

LDG said:

Amy, it's also definitely time for a visit to the holistic vet. Or a different one. But when Lazlo was anemic because of his cancer, we used pred - not an immuno-suppressive dose, just an anti-inflammatory dose (5 mg) - but it wasn't helping with the anemia. His holistic vet put him on Yunnan Biyao http://en.wikipedia.org/wiki/Yunnan_Baiyao . The traditional vets marveled at how quickly his RBC returned to normal. We only had to use it twice, for a little over a week each. :nod: It comes with a small tea-pill to stop bleeding (which he needed because of the ulcer, but Koko wouldn't), and then ... I think 10 pills that you give every three days or so. Laz had them every two days for the first three, then every three days.

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That was my friends first suggestion: time for Chinese herbals. We both have a vested interest in this as we both have cats from this litter. She does Chinese herbals for herself and has access to a hollistic vet that uses them. Between the 2 of us, we'll find the right supportive supplements for this.

LDG said:

Interesting. :nod: But glad you caught it!!!!

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Interesting yes, but not a topic that I really want to be pursuing. Yes, you are hearing sarcasm coming out of my fingers as I type.

Of course what triggered the FeLV at this time may remain unknown. Since it appears earlier in females than males, then I suspect it's just her genetics working against her.

Momofmany said:

That was my friends first suggestion: time for Chinese herbals. We both have a vested interest in this as we both have cats from this litter. She does Chinese herbals for herself and has access to a hollistic vet that uses them. Between the 2 of us, we'll find the right supportive supplements for this.

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Excellent! I'm sure you will. :nod:

and, of course, more