Cat suffering from anemia

My 13 month old cat was just diagnosed with very severe anemia. I don't doubt my vet however from everything I have read about anemia in cats I'm really confused. He is playful, energetic (I wish I had half the amount of energy he does) and an extremely good appetite. I've read that the symptoms should be lethargy, weakness and loss of appetite, none of which apply. I've started him again on kitten food to see if that helps. So far the vet hasn't prescribed anything, he wants to see him again next week. Has anyone heard of this problem.

Hello and welcome to TCS.

I don't have any experience with this, hopefully someone who has will help with some answers. But I would like to get a bit more information from you. Was blood work done to diagnose this? Was this a routine vet visit or was there another reason you took him to the vet? Were fleas found on him?

He went n because he was having trouble with his right eye which was later diagnosed as uveitis and we were given drops.  While he was with the vet my husband decided to have a blood test done, not for any special reason, just because he was there and felt it might be good idea.  It was then that it was discovered that he was severely anemic.  If we had not taken a blood test we would have just continued with the drops until he saw his regular vet in 10 days.  No, they didn't find any fleas, except for his eye you would have no idea there was anything wrong with him.  From the beginning of December until the middle of March he doesn't even go outside.

Do you have a copy of the blood work? Did the vet tell you what the hematocrit was? (This is a measure of the volume of red blood cells). Were all the other values normal? Did the vet check kidney function?

Did the vet not discuss any possible causes? Anemia in and of itself is not a diagnosis. It is always a symptom of something: ingestion of toxins? Severe flea infestation? Internal bleeding? Was your kitty tested for FeLV? Autoimmune disorder?

I don't know what your vet's definition of "severe" is, we'd need the value of the hematocrit. But if it was in the teens, that might be considered severe by some, but your kitty could still be playful.

If it were actually "severe," I doubt very much your vet would not discuss ANY of this with you and leave kitty untreated. If so, it's time for a new vet.

I have a cat that a few months older than your cat developed anemia. The main thing that concerned us, initially, was his eating litter. Everything was ruled out, and he had to be put under anesthesia to do a bone marrow aspirate to determine if he was capable of producing new red blood cells. He was. It was determined that he had an autoimmune disease that caused his body to think his red blood cells were like a virus. We had to suppress his immune system with steroids. At one point he needed a blood transfusion. Actually, at two points, but his body did not accept the 2nd one. We/he fought for his life with ups and downs, actively for four years, and then he slowly just kept improving. Whatever the problem was now seems to be behind him. :heart2:

Anemia, if caused by ingestion of toxins, a flea infestation, etc. is usually very treatable. Vibes for your boy.

He tested negative for FELV and for FIV.  I can only give you the results that I got from the clinic where he first had a blood test, it shows 0.22 on a reference range of 0.29-0.45 L/L.  My vet did do blood work and was asking me about onions or garlic since they found heinz bodies in his blood work but we have none of that in the house.  The vet seemed to be more concerned the the albumin/globulin count which is low.

That's 22%, where normal is 29% - 45%. In cats, technically 25% or less is considered anemic. High-teens is survivable; low teens, if treated, is survivable for a while; single digit isn't survivable for very long. 22% was a number we were happy with for Tuxedo for some time. When was that blood work done?

Your kitty couldn't possibly have ingested any aspirin, no?

That was another question that my vet asked and I really don't think so, I rarely take them,so they are never out and up to now he won't eat anything that isn't his food, including tuna.  The blood test that I just gave you was taken last tuesday and he saw his vet on thursday but I don't have the percentages of those tests.  He has another appointment on Wednesday so he can see if it's getting better or worse. I switched back to kitten food on Friday hoping that the extra nutrients in it would help until my vet prescribes something. We haven't seen any change in him in the last week. he's as active as ever.

Hmmm.... if it was 22% on Tuesday, and was "severe" by Thursday, that really sounds like some kind of toxin ingested. It's the combination of anemia, low albumin, and heinz bodies that make it look like a toxin. So odd! :rub: Any plants in the house? I'd take a look around - see if there's ANYTHING he could have gotten into, even accidentally. :heart2:

But his being active and having an appetite is great! Hope he keeps it up!!!!

I do hope you'll keep us posted. And hopefully now at least you'll be armed with some questions. Though if he still has anemia and other abnormal figures in his blood work, the next probable step would be the bone marrow aspirate (unless his reticulocytes are normal? Not sure if they'd need to if that were the case). But if he's still anemic on Wednesday, depending on the number, if there are no toxins identified, you may be looking at an autoimmune disease. These can usually be managed with steroids, to suppress the immune response. It can take a while to figure out the right dose, the right one, and keep an eye on his RBC and hematocrit regularly. For our Tuxedo, using depomedrol (a long acting steroid shot, given every two weeks at first) was the difference between life and death. He initially got prednisone (a pill), and that worked for the first year or so - and then it stopped working. This was many years ago, and not as much was known then as now. So our vet called around to feline blood specialists, and the suggestion to use depo instead of pred came up. Thank goodness, because Tuxie would not have survived with out it. And over time, he needed the shots less frequently, to the point that he had his last shot in 2011 (he was diagnosed with the condition early in 2004).

Continued vibes for your boy!

I'm not too sure what his level was on Thursday, I made the mistake of not asking for the results of the blood test, so it may have actually been the same and our vet just considers that severe.  He's going tomorrow afternoon to see his vet and I am going to make sure that my husband asks for all the results.  We have no plants in the house and he won't touch anything (including tuna) that isn't his own food.  I do see him occasionally eating the grass outside but all my cats have done that and I've read that it's normal and our city doesn't allow us to use pesticides.

 

I thank you so much for all your information, Flagstick is my 4th kitty and the first one that is sick that we don't know the reason.  I have to rely solely on what my vet is telling me and even though I trust him, I know that they aren't perfect

What I have for his reticulocyte is - Reticulocyte-Absolute (East)  20.8 (with a tiny 2 beside the 8 - like it would be 8 squared) based on a reference scale of 3-50X10E3/ul.  The report shows that it's right in the middle of normal.

flagstick1 said:

I'm not too sure what his level was on Thursday, I made the mistake of not asking for the results of the blood test, so it may have actually been the same and our vet just considers that severe. 

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Good point. I hope that's the case! (Because that's not really such a bad number. Tuxie was 12% - 14% for some time, and got as low as 7%. It was very scary. ).
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flagstick1 said:

He's going tomorrow afternoon to see his vet and I am going to make sure that my husband asks for all the results. We have no plants in the house and he won't touch anything (including tuna) that isn't his own food.  I do see him occasionally eating the grass outside but all my cats have done that and I've read that it's normal and our city doesn't allow us to use pesticides.

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Wow, that is awesome. I'm sure some homeowners don't agree, but I think it's great they don't allow pesticides!
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flagstick1 said:

I thank you so much for all your information, Flagstick is my 4th kitty and the first one that is sick that we don't know the reason.  I have to rely solely on what my vet is telling me and even though I trust him, I know that they aren't perfect

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It's easy to judge too harshly from afar. :anon: It was just the use of the word "severe" that got to me. :nod:

flagstick1 said:

What I have for his reticulocyte is - Reticulocyte-Absolute (East)  20.8 (with a tiny 2 beside the 8 - like it would be 8 squared) based on a reference scale of 3-50X10E3/ul.  The report shows that it's right in the middle of normal.

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Oh that's good! Tuxie had to have his bone marrow checked because the number was really low. That's part of what was so confusing in his diagnosis: the numbers weren't clearly anything. In fact, his white blood cell count was also low. We had to use both epigen and nupigen (epigen is used for humans, to help boost red blood cell production; nupigen works to boost white blood cell production) on Tuxie - until they stopped working. I don't know if it's the same thing in people or not, but in cats, over time they can develop a ... "resistance" to them. But they are tools in the arsenal, if needed, and not many vets are familiar. So just putting that out there too.

Thank you so much for all your help and information, I will be sure to keep you up to date when I get news tomorrow after his appointment, and I am so happy to hear that Tuxie is doing well

I hope all goes well tomorrow!

And here's a picture of Tuxedo taken yesterday - with his pink nose looking VERY pink, not white! :heart3: His most recent hematocrit put him at 41% - which it was the one before. So we've taken to calling him Mr. 41%.

This is a picture of Flagstick.  We got his results tonight.  His HT has gone up from 22% last thursday to 28% today. The vet is very pleased with that,plus he gained a little weight and has told us to keep letting him eat kitten food, as much as he wants.  His only concern right now is his protein count, it seems that it is high.  97 on a reference range of 60-85 g/l.  We have another appointment in a month so I think that this is good news.  We just need to keep a watch on him for a little while.

GREAT news!

He's adorable!

...and I wonder if the protein count is something that takes longer to come down than it takes the RBC to go up? :dk:

I'm such a space, I just asked how things went Wednesday. Just ignore me - it's been a long week. :anon:

We had Flagstick in for a follow up appointment today and it seems that his RBC count has gone back down to 17%  (he was at 22%, went down to 17% back up to 28 and now back to 17)but the vet doesn't know why.  He is eating like normal, is active (overly so most of the time) and shows no symptoms of anything being wrong.  We had been feeding him kitten food for a few weeks and his count went up but he prefers the adult food.  Our vet says to try as much milk, boost, ensure, ice cream etc as we want as long as he can handle it (e just loves it wants it all the time and so far has not bothered him at all).  Any more suggestions on what to feed him (he does NOT like tuna).

Oh I'm so sorry for the news.

Was his blood profile otherwise normal? There are usually at least clues in the composition of the blood or even the shapes of the cells. Here's an example: http://labtestsonline.org/understanding/analytes/blood-smear/details/

He was tested for the blood borne diseases?

At this point, is your vet treating him with anything just to cover the bases, so to speak? Antibiotics like doxycycline or baytril are used to treat things like bartonellosis, for example.

Or has he prescribed a steroid, like prednisone, to see if that boosts his RBC / HCT? That would indicate an autoimmune disease if he responds to that.

And is he not eating? Is that why he said to let him eat whatever milk products? Because those arent foods to help produce red blood cells. :dk:

He needs B vitamins and protein, iron. Does he like and can he tolerate (not throw up) red meat? On a raw food diet, Tuxie's HCT is 45%.

Your boy needs liver, (raw, seared, or freeze dried. Even freeze dried chicken liver, which most cats love!), raw beef or lamb....

I would also definitely order Yunan Baiyao (available on Amazon). Forget the tea pill, that's to stop bleeding in an emergency. But use one capsule every other day for three pills, then every third day for 3 or 4 more pills. You can read about Yunan Baiyao on Wikipedia.

If the issue is a lack of appetite, and he likes milk products, I'd at least try to avoid stuff with sugar, and go for plain yogurt or sour cream or cottage cheese. Cats kidneys do not do well with actual sugar.

Maybe there's something else going on that the vet thinks calcium is good? :dk:

Oh, another good food for building red blood cells is egg yolks. These can be fed raw or cooked. Easiest to mix some raw yolk into a high animal-protein based canned food.

Vibes for your boy!

I'm posting from my phone and it's PIA to edit. You can cook the beef or lamb or whatever. But see if you can get red meat into him.

And if your vet hasn't outlined next steps, either diagnostics or what he's going to do (like conscription feline blood experts), you might want to consider getting your records and getting a second opinion....

That's "contacting," not conscripting...