Help in understanding blood work

Sophie is my most special, weirdest cat (in the avatar). She is one year and three months old. She is spayed and she did not have major heath issues. She just really doesn't like food very much. She is 3.7 kg (8.15 lbs) and could use a pound or two more.

However, for about a month I have been trying to get her on scheduled feeding and also trying to give her as much wet food as possible. When I first got her I only fed her wet two times a week, she developed mild constipation and now I am going crazy trying to transition her to a wet food diet. She is as stubborn as can be in not eating wet, but then again, she really doesn't like anything else - if I give her fish or parmesan she thinks I am trying to poison her, if I sprinkle anything on food she will not touch it.

So while I was trying to get her on a scheduled feeding (at first two meals, now three) I noticed she only eats about 160 kcals/day. Not worrying to death, but still not good enough for a skinny active cat.

Took her to the vet and he gave her some Dermal pills for shedding (she sheds a lot but she NEVER vomits - no hairballs, no anything) and Peritol pills for her appetite. During the 10 days of Peritol she ate about 200 kcal/day. 3 days after the Peritol, she is back on 160 kcal/day.

In the last week she also had tiny drops of blood in her stool twice (perfect stool, otherwise). We went for bloodwork. I made up my mind that if the blood work is fine and she is not anemic I will just address the blood in stool issue but l will let her eat as much (or as less) as she desires for now.

The blood work:

RBC 10.15 (normal 5.00- 10.00)

MCH 11.9 (normal 16.00 - 24.00)

MPV 10.1 (normal 4.00 - 7.00)

T-prot 8.1 (normal 5.4 - 7.9)

Amy 103 (normal 370-1200)

All other stuff in normal parameters.

Vet says "leave the cat alone". He would only worry if the amylase was higher than normal, not lower. He only gave me some ranitidine for her. And although I trust him, I don't know if I should embrace this life philosophy of his and "leave the cat alone".

WHY did he give you the Raniditine?  That is typically given for nausea/acid reducer. 

As far as the blood results, here is something you can look at for a better understanding, but remember, a doctor will take ALL results into consideration, not just individual numbers.  http://airparkanimal.com/frorms/Understanding Your Pets Testing.pdf.  As far as the decreased amylase, I did find on another website that a decrease could indicate malnutrition

  So...you say she doesn't have any major health issues, but does she have some minor ones?  Perhaps ones that your Vet prescribed the Raniditine for?  I just don't know here...I'm inclined to say take these test results and go to another Vet, but, then again, I'm not a Vet, so can only read this as a lay person.  Maybe some others will come along who have more experience with lab results.

I'm not sure why you're worried about her eating 160 kcal a day? Does the vet think she needs to weigh more? Cats, by nature, are lithe, lean animals. They're naturally very thin but muscular. I have an 8 pound cat that eats about 120 kcal per day; I have a 7 1/4 pound cat that eats a little more, but her hips stick out, you can see her back (but not each bump in the spine). My 8 pound cat should probably lose a little (more) weight; my 7 1/4 pound cat is a healthy weight.

Are you sure she should weigh more?

I have the ebook "Understanding Feline Lab Values" by Dr. Jean Hofve. As re: amylase, she says on p. 156

Pancreas tests include glucose, lipase, and amylase. The latter two are notoriously unreliable in cats."

Click to expand...

She discusses glucose a bit, but that's it. That's the only mention of amylase. I suspect this is why your vet isn't concerned.

WHY did he give you the Raniditine?  That is typically given for nausea/acid reducer. 

[...]As far as the decreased amylase, I did find on another website that a decrease could indicate malnutrition

 [...]So...you say she doesn't have any major health issues, but does she have some minor ones?

Click to expand...

Thank you for the link. I am sure she is not nauseated - not only she never vomits, but she enjoys treats like dry freezed chicken, grass bits and cheese bits (junk treats from Grimpet). And she eats, just that she would rather graze, which we can not do because of the other cats. The vet thought that maybe she has acid in her stomach that might cause the drops of blood in the stool. He didn't really provide me with this explanation, I took it from the context. It is my fault that I did not ask this but at that point I was panicked about her amylase level.

The reason why I wanted blood work is because I feared she was anemic, but all other results are within normal parameters.

Minor health issues: 8 months ago she had a bit of an allergy to dust and a sensitivity to light wind (like when you have all windows open in the house), that cleared out with thorough cleaning of the house and her not sleeping on my laptop with her head on the fan exit of the laptop. In the last 4 months she developed a mild constipation (going once every 30-40 hours and crying a bit), but since she eats more wet food she is not constipated anymore. But now there is the blood in the stool thing.

LDG said:

I'm not sure why you're worried about her eating 160 kcal a day? Does the vet think she needs to weigh more?

[..]She discusses glucose a bit, but that's it. That's the only mention of amylase. I suspect this is why your vet isn't concerned.

Click to expand...

Thank you for the info, very informative. 

The vet said that her weight, given her size, is at the lower end of "normal weight" and that she could gain some. She is not skinny as some ferals you see on the street, but I agree that maybe a pound could make her look fit and not hobo And I see the other brats (Harley and Amelie, 8 months old), they are little cat-piggies with cow-like stomachs. They love food more than anything. And then there's Sophie, who finds all food boring (except for some treats, like I mentioned).

I do knot know on her blood results which one is the lipase, but the glucose is 93 (normal 61-120).

I will go to another vet today - last night there was another drop of blood, this time more like a mucus. And no, she does not scoot or leave a foul smell, so I do not think that her glands are the problem, but hopefully this other vet will have an answer.

Yesterday we went to another vet that we were familiar with. He said the blood work is no cause for concern and that the low amylase doesn't mean anything. I have the same opinion from two different vets, so that is really great.

He said that he suspects that the cause of blood on the stool is caused by worms, so he gave milbemax to all my cats (all indoor only, they were not due for a deworming until the beginning of October). Last night Sophie had a hard stool and at the end it was a little bit softer, with hair in it and blood (like drops but on top, not in the stool).

I really don't know what to do. They say not to give it too much thought, but how can I not when she never had blood in her stool, and this week I have seen blood three times?! I would do whatever tests necessary, but she was seen by two different vets (different clinics, different part of the town) and both didn't give a second thought to the issue. When I asked for another possible cause (if not worms, then what else) he said it might be because of constipation. That seems logic enough, because her stools are always hard, but her rear end doesn't look swollen or irritated or red.
 

I did not change the food she eats, just the proportion of wet vs. dry (more wet), but for two months now. And I read like crazy on the internet but all the diagnoses are about diarrhea and blood, not about hard stools and blood. At this point I really can't calm down, because I would never forgive myself if I ignored this and it proves to be more serious.

Well, I have definitely heard of constipation causing a little blood in the stools, so if she is passing hard stools, that could be the problem, even though her bottom doesn't appear swollen or sore.  I would give it a few days also, with the dewormer and see what happens.  Do you add a little water to her wet food?  You might try that, since she seems to get constipated easily, or try adding just a little bit of pumpkin (not pumpkin pie mix, just plain cooked pumpkin) to her food.  That adds a little bit of fiber without bulking the stools.

Try not to worry too much.  With two different Vets checking her out, she's probably just fine.

I am happy to report that for 5 days now there has been no blood. Maybe Sophie needed to be dewormed, if that was the cause I am so relieved now.

At the same time my fussy eater found a food she absolutely LOVES: Thrive complete. I have no idea what they put in this food, but it makes her crazy. Her tail quivers like crazy when I put down the food and she ate a WHOLE 2.64 oz / 75 gr can in one sitting this morning. That never happens.

Thrive: Chicken in chicken stock, vitamins and minerals, Nutritional dietary additives: Vitamin A (5650 IU/kg), vitamin B12 (0.02 mg/kg), vitamin D3 (240 IU/kg), vitamin E (30 mg/kg), vitamin K (1 mg/kg), manganese (1.9 mg/kg), zinc (22 mg/kg), copper (2.5 mg/kg), iron (25 mg/kg), taurine (50 mg/kg), thiamine (20 mg/kg), riboflavin (4 mg/kg), folic acid (1.2 mg/kg), pyridoxine (5 mg/kg), calcium (0.3 mg/kg).

Crude protein 16%, Crude Oils&Fats 2%, Crude Ash 1.5%, Crude fibres 0.1%, moisture 80%. Is it ok? It says it is complete, not like Applaws and Schesir, and she loves it (she doesn't even want to sniff Animonda or Grau or Bozita).

Aw that is just GREAT!

So I jinxed it all

The blood on stool is back again. Bright red blood, sometimes some reddish mucus, on top of the stool, almost every time she goes.

I went to the vet again and he gave me Bezo Pet (http://www.vetuk.co.uk/dog-suppleme...et-cat-laxative-and-lubricant-70g-tube-p-1020). I have been giving it to her for 6 days - 2 days without blood, last night there was blood again, although she is not constipated anymore, due to the Bezo Pet and the extra water I add in the wet food.

She is otherwise eating well, playing, no change in her behavior and no other symptoms.

I really don't know what to do. Vet says if there are no other symptoms to just let her be, but, as I said, blood on stool is not normal so I am not just gonna "let her be".

Right now I am thinking maybe an allergic colitis? Although she doesn't vomit and she doesn't have diarrhea (quite the opposite)? Should I  try to change her diet? She only eats chicken based food, so maybe she developed a chicken allergy? Should I go for low fiber or high fiber? Should I try a low residue diet?

I think that if I don't find a solution soon, I am going to have to consider ultrasounds and colonoscopies and radiographies. She gets quite stressed out at the vet and I do not want to put her through all that, but I know blood is a symptom of an underlying cause and I really want to help her.

This sounds like an irritant, not a disease. Are you still feeding her any dry food? If so, I would consider feeding her only canned for a little while and see what happens.

Do you feed her any treats? If so, I would cut those out too.

To eliminate causes, one thing at a time. If it's not dry food or treats, the next step would be a different protein.

Also, (having nothing to do with what might be wrong with her), you  might start up a new thread with a different title...something to do with "fresh blood in her stools", do attract others to your thread who may have encountered the same problem, and recap what you have done so far.

At this point, I've got no advise other than what LDG has already given .

Thank you LDG and mrsgreenjeens for your replies.

I am thinking irritant too. So I will cut out all treats first. How long do you think it takes for some effect to show up? I mean, I am thinking to cut out treats first week. If nothing changes, cut out dry food the second week. One week sounds ok or should I give it more time?

I will start another thread also.