Anemia / Pure red cell aplasia

Hello, 

My kitten was hospitalized yesterday and I was wondering if anyone with similar experiences/knowledge could help with any info on this.

My kitten, Eevee, is 10 months old and was completely healthy. Over the course of a couple of weeks, she slowly started eating less and less, and was rushed to the hospital yesterday because she was so weak and wasn't eating at all. Her red blood cell count was at 7%. She's been receiving blood transfusions, and this morning, her PCV went up to 15%. They've done a sonogram and blood and urine tests and nothing unusual came up. They're performing a bone marrow biopsy today so I'm waiting on those results. The doctors aren't certain about anything but at this point, they believe Eevee has pure red cell aplasia (PRCA). They didn't sound too hopeful when discussing all of this and the prognosis, but they said she may need to be put on steroids/antibiotics.
 

This all happened so suddenly and I've been in tears worrying about her. She's staying at the hospital at least another day. The worst part is all this waiting and the doctors being unsure about everything. I've been told that her case is rare. If anyone has experienced a similar situation or knows of autoimmune-related diseases, please share what you know. There doesn't seem to be much information available.

Is there possibly anything else that could be found from the bone marrow testing besides cancer or PRCA? If she does have pure red cell aplasia, what is the realistic prognosis? Will Eevee ever be able to eat normally again/recover fully or will she struggle for the rest of her life? Will she be anemic/have non-regenerative anemia for the rest of her life? 

Thanks so much in advance.

Eddrie said:

 
Hello, 

My kitten was hospitalized yesterday and I was wondering if anyone with similar experiences/knowledge could help with any info on this.
 
Thanks so much in advance.

Click to expand...

I just did some research on this for you, so my knowledge is based on what ive read, not direct experience.  It seems like its survivable but requires potentially long term immunosuppressive drugs.

Has your kitten tested negative for FeLV?

See:

http://www.ncbi.nlm.nih.gov/pubmed/9887944

and

http://www.thecatsite.com/t/174443/feline-anemia-red-cell-aplasia

I'm very sorry your and your kitten are going through this.

I've had two cats with bone-marrow / immune-system caused anemic problems. One (Tuxedo) had hemolytic anemia - this means his bone marrow worked properly, and we had to suppress his immune system with steroids, as his body was attacking and killing the red blood cells his bones were making and releasing into the blood stream. It was a lot of ups and downs, MANY MANY vet visits, several close calls, and in the end, it was the switch from oral prednisolone to shots of depomedrol that saved his life. It was a 7 year battle before he went into remission. He is now 13 years old and doing fantastic.

We just had to say good bye to his (actual by birth) brother this past March. All of a sudden - almost overnight - (from Friday night to Sunday morning) - he became very anemic. He had a bone marrow biopsy and blood transfusion. His bone marrow was making new red blood cells - but almost none were even making it into his blood stream. The prognosis for this is vastly different than when their bodies attack them after they make it out of the bone marrow - and is also quite different (usually) between kittens and adults. With aplasia - whether aplastic anemia or red blood cell aplasia - the problem is in the marrow, not the same problem as described above with Tuxedo (hemolytic anemia). But with your kitty being just 10 months old, this difference in prognosis between PRCA in young cats vs older cats MUST be highlighted.

In young cats, there is often a trigger that causes it, and the blood transfusions and the treatment: often antibiotics or steroids or both - can resolve the problem, the blood transfusions buying the time needed for treatment.

In older cats, the problem is often idiopathic, and treatment doesn't help. That's what happened with our Sheldon. He got the blood transfusion to buy him time... but his bone marrow biopsy indicated his bone marrow was ineffective for unknown reasons. There was no treatment, though of course we tried steroids to suppress his immune system. But when those red blood cells from the transfusion ran out (red blood cells transport oxygen to all the cells in the body), that was it.

So many, many vibes the problem had a trigger, and even if the "what" isn't ever known, the steroids and antibiotics will do the job. Many, many vibes for you and your Eevee. PLEASE keep us posted!

E eddrie , I'm almost scared to ask... any news? :cross:

Thanks soo much for your concern. Thank you @StephenQ  for the links. And yes, she tested FeLV negative. Thank you @LDG  for sharing all of your knowledge! I'm so sorry about your Sheldon... I just saw his photos. He was so handsome. 

Eevee was sent home after two blood transfusions and PCV of 21%. Her diagnosis of pure red cell aplasia was confirmed after her bone marrow aspirate, though the cause is still unknown. She's being treated now through immunosuppressive therapy with steroids and cyclosporine and many more vet visits. She's eating again which is great and she's slowly regaining her strength. Hopefully her red blood cell level will stabilize and her bone marrow will be able to generate red cells normally again soon!!

Thanks again. I'll update on her recovery! Xx

Oh this is SO encouraging, E eddrie ! . . :heart2: Continued vibes for Eevee!

Eddrie said:

 
Thanks soo much for your concern. Thank you @StephenQ  for the links. And yes, she tested FeLV negative. Thank you @LDG  for sharing all of your knowledge! I'm so sorry about your Sheldon... I just saw his photos. He was so handsome. 

Eevee was sent home after two blood transfusions and PCV of 21%. Her diagnosis of pure red cell aplasia was confirmed after her bone marrow aspirate, though the cause is still unknown. She's being treated now through immunosuppressive therapy with steroids and cyclosporine and many more vet visits. She's eating again which is great and she's slowly regaining her strength. Hopefully her red blood cell level will stabilize and her bone marrow will be able to generate red cells normally again soon!!

Thanks again. I'll update on her recovery! Xx

Click to expand...

Great news!

Hello,

Not sure if this will reach anyone, but here's an update. We could really use some advice.

It's been two months since Eevee was first admitted to the hospital for blood transfusions and tests and was diagnosed with Pure Red Cell Aplasia. At first she was put on Prednisolone, 5mg once a day and Atopica, .15mL twice a day. On 5/14 after the first week, her PCV dropped from 21% to 11% so she received another blood transfusion which set her at 13%. On 5/19, her PCV was at 10% and she received another transfusion which upped her PCV to 23%. And at this point, the doctor had given her some weekly supplementation of B12 and hormones, and her CBC showed slight improvement in reticulocyte count (baby red blood cells) although still significantly low... so her medication was increased to prednisolone 5mg twice a day and atopica .25mL twice a day. 

Since then, she's visited the hospital every week to get her PCV checked and hasn't needed any more transfusions, but her PCV's remained stagnant in the low to mid 20's. She is now on prednisolone 5mg once a day and atopica .25mL twice a day. 

Her last check up was on 7/3. Her doctor said her reticulocytes were normal but not elevated, so there still isn't a dramatic response from her bone marrow. He wants to wait a couple of weeks to see if we need to change plans or if we will taper her meds.

I trust Eevee's doctor but I'm also frustrated with her progress... He did say that it could take up to two months for her to respond to therapy, and it's now been two months without significant improvement. I'm wondering if there's anything else that could be done/anything I could bring up with the dr. If anyone has any experience/advice, it would be greatly appreciated. Would folic acid help? or vitamin B12 injections? and could switching from Prednisolone to Depo-Medrol help in her case?

Thanks xx E.

One of my kitties had IMHA about 6 years ago.  His Hgb was only 3.3. He also lost ALL platelets and white count was 1.5.

Not a pretty picture... It was touch and go for several weeks.  Miraculously he recovered and is a very healthy and happy kitty today.

Of the 17 vets at the hospital only one thought that he may make it..

While he was on prednisolone (which probably saved his life) and doxycycline I did whatever natural treatments that could possibly help.

He was on high doses on some vitamins, homeopathic remedies, adrenal glandular extract (since his prednisolone dose was high, started at 15 mg.)

We also did an energy treatment, Tapas acupressure technique,TAT,  very effective for allergies and of course, an autoimmune condition is an allergy turned

on yourself. I really felt that the TAT was instrumental in getting his system to stop destroying his cells.  

Is your vet familiar with treating this disorder? Who read the bone marrow?  I'd wish for a specialist reading the slides... definitely.

Good Luck to you and your kitty.

Hi, thanks for sharing. Her vet took care of the bone marrow aspirate and it seemed as though he is somewhat familiar and knows of a few previous cases, as Pure Red Cell Aplasia is a very rare disorder; I may consider seeking a second opinion. I'll look into TAT. Thanks again!

Hi again,

"Somewhat familiar" is scary, no?  I would think an internal specialist/hematologist would be the way to go... Yeah, probably a lot more expensive, but getting the proper diagnosis and treatment upfront can save you a lot in the long run. Not to mention your kitty...

TAT is quite awesome. I used to sell a program helping people get over their allergies to cats, and also see people in person and over the phone. It was really successful.

I estimate about 80% or so got rid of their allergy, no matter how severe it was.  I don't do this anymore as the founder of TAT prohibits anyone to sell a product using her invention.

I can just vouch for it.  I've seen it work several hundreds of times.   There is plenty of info on the net. But getting with a practitioner may be a better way to go, that

way you can get efficient much faster. The official website (no affiliation) will have a lost of practitioners.  Let me know how you do with it.