IMHA

My kitten Fuzz Lightyear was diagnosed with IMHA in May of this year.  His red blood cell count at that time was a 7 which is dangerously low.  He had been licking wall, concrete and started eating litter which are all signs of anemia.  They recommended a blood transfusion which we did and he seemed to bounce back.  He completed a small round of steroids as well and was fine until the beginning of August when his wall licking all of a sudden returned.  We took him in and sure enough his numbers were back down to around 12.  Healthy range for a cat is around 28-50.  He started on another steroid round with no immediate results so the vet added another med, Cyclosporine which is another immunosuppressive.  This drug is working but now he is having a fairly severe flare up of what looks to be an URI/possible Feline Herpes.  His eyes are constantly weeping and his nose is always snotty and running.  His nose has started bleeding over the last week as he has sneezed so many time that he has blown a blood vessel.  He is very congested.  The vet prescribed and antibiotic as well as an antiviral.  He has to take all of these meds twice a day so he is currently taking 8 pills a day.  On a good note, his anemia has responded to the immunosuppressives and his blood count is back up but I feel like now he can't fight the virus because we are keeping his immune system down.  The vet recently reduced his steroid down to from 20 mgs a day to 15 and after 2 weeks we can take it down further provided he displays no more anemic behaviors.  We are about 7 weeks into this course of treatment and poor Fuzz looks absolutely miserable.  He is still eating and drinking but the rest of the day he just sleeps.  I feel terrible for him and am very stressed about the next course of action.  He is getting sores on his nose from all the sneezing and weeping.  Hoping someone on here has some suggestions or experience with this.  I have already checked out most the websites regarding the disease but there isn't much info on secondary viruses/infections.  I guess I should give the antivirals some time to kick in as he just started them 3 days ago.  Please keep my Fuzz in your thoughts!!

Is your vet sure that the IMHA isn't secondary to a bacterial infection?  Often it is caused by certain bacteria.  The bacteria changes the coating of the red blood cells which triggers the immune response.

He is currently on his second round of antibiotics and according to the vet his white blood cell count was in the normal range which indicates no infection I think?  Also, would the anemia return 2 months later if it as caused from the bacterial infection?  I would love for it to be something easier than IMHA.

I don't know much about IMHA, but from what I read, corticosteroids such as prednisone would not be given in "a short round", but rather long term, possibly for life, starting with a high dose, then tapering off later, if I understand what I am reading.  So if Buzz was only on steroids for a short while, that might account for his RBC count dropping again back in August.

As far as the congestion, etc., I don't know what to advise.  I would normally suggest the use of L-Lysine, but don't know what's it's effect would be with IMHA.  Did the Vet say?  Of course, putting him in a steamy bathroom could help with the congestion.

So....did your Vet run all kinds of tests to determine for sure itws IMHA.  I understand there are several tests that can be run other than just analyzing the blood results.  But it's fairly rare in cats.  As Denice stated, it's normally secondary to something else.  Could even be to vaccinations.