Bone marrow aspiration *and* IFA for FeLV: Is this necessary for diagnosis?

There's been some question about Rumi's FeLV status since his last ELISA test was negative and all his siblings tested negative.  He underwent a bone marrow aspiration yesterday at the specialty hospital- we need to determine the cause of his non-regenerative anemia if he isn't FeLV+- and the internist that evaluated him pre-op ordered an IFA test without consulting me first.  I was under the impression that the aspiration would definitively diagnose him as FeLV+ or negative, so isn't the IFA redundant?  I'm trying to decide whether or not to dispute the charge for the IFA. 

Thanks for reading!  A bit of good news: Rumi's PCV was at its highest point so far at 25%.  I know that's still a low number, but I'm happy that he's made progress since his 12% PCV three months ago   

the3rdname said:

 
There's been some question about Rumi's FeLV status since his last ELISA test was negative and all his siblings tested negative.  He underwent a bone marrow aspiration yesterday at the specialty hospital- we need to determine the cause of his non-regenerative anemia if he isn't FeLV+- and the internist that evaluated him pre-op ordered an IFA test without consulting me first.  I was under the impression that the aspiration would definitively diagnose him as FeLV+ or negative, so isn't the IFA redundant?  I'm trying to decide whether or not to dispute the charge for the IFA. 

Thanks for reading!  A bit of good news: Rumi's PCV was at its highest point so far at 25%.  I know that's still a low number, but I'm happy that he's made progress since his 12% PCV three months ago 

 

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the bone marrow is aspirated to be used in the IFA test, although the IFA test can also be done using blood. 

traditionally, cats with non-regenerative anemia and a negative FeLV test were subject to bone marrow testing. but several recent studies have indicated that bone marrow suppression due to FeLV results in testing positive on FeLV blood tests. of course, the bone marrow can be evaluated for other things. 

detmut said:

the bone marrow is aspirated to be used in the IFA test, although the IFA test can also be done using blood. 

traditionally, cats with non-regenerative anemia and a negative FeLV test were subject to bone marrow testing. but several recent studies have indicated that bone marrow suppression due to FeLV results in testing positive on FeLV blood tests. of course, the bone marrow can be evaluated for other things. 

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Having a sick day here and just want to clarify: If the virus has moved into the bone marrow, they'll test positive on the ELISA?  I'm glad to know the IFA was a routine part of the procedure, at any rate. 

I'm dying to know what the test says, but the holiday weekend means a delayed return on results.  *sigh*  

the3rdname said:

 
There's been some question about Rumi's FeLV status since his last ELISA test was negative and all his siblings tested negative.  He underwent a bone marrow aspiration yesterday at the specialty hospital- we need to determine the cause of his non-regenerative anemia if he isn't FeLV+- and the internist that evaluated him pre-op ordered an IFA test without consulting me first.  I was under the impression that the aspiration would definitively diagnose him as FeLV+ or negative, so isn't the IFA redundant?  I'm trying to decide whether or not to dispute the charge for the IFA. 

Thanks for reading!  A bit of good news: Rumi's PCV was at its highest point so far at 25%.  I know that's still a low number, but I'm happy that he's made progress since his 12% PCV three months ago 

 

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the3rdname said:

 
Having a sick day here and just want to clarify: If the virus has moved into the bone marrow, they'll test positive on the ELISA?  I'm glad to know the IFA was a routine part of the procedure, at any rate. 

I'm dying to know what the test says, but the holiday weekend means a delayed return on results.  *sigh*  

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if the virus causes the bone marrow suppression, yes the cat will test positive on ELISA. IFA is needed to test bone marrow for FeLV. but since your cat has non-regenerative anemia, it probably wasn't necessary to test the bone marrow for FeLV in the first place. so, not redundant but maybe unnecessary. 

Most commonly the bone marrow test is to confirm the positive elisa test results when they are positive, not negative.

Positive elisa results only means the cat has contracted felv, but most of the time a healthy cat will fight it and be rid of it, but during that time will test positive.

The IFA is to confirm whether or not the virus is actually inbedded in the body or just passing through so-to-speak.

If elisa test was negative the chances are the IFA will be negative as well. Not always but usually.

catwoman707 said:

 
Most commonly the bone marrow test is to confirm the positive elisa test results when they are positive, not negative.

Positive elisa results only means the cat has contracted felv, but most of the time a healthy cat will fight it and be rid of it, but during that time will test positive.

The IFA is to confirm whether or not the virus is actually inbedded in the body or just passing through so-to-speak.

If elisa test was negative the chances are the IFA will be negative as well. Not always but usually.

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The problem is that he had a positive ELISA three months ago, when he became severely anemic, and a negative ELISA a couple of weeks ago.  The vet said a positive after becoming symptomatic is usually correct and the virus could be sequestered in the marrow, so they were critical of the negative result (though the tech said it was a very clear negative and unlikely to be false).  The aspiration IFA was meant to put this question to rest once and for all.  It was the vet's opinion that an IFA using blood would also yield a negative, but that doesn't mean the virus isn't hiding in the marrow.  

It's all excessively confusing, if you ask me.  I guess a negative IFA using marrow liquid is about as good a result as you can get.  Except, perhaps, for a DNA test.  

Oh I see, I missed that he had tested positive prior.

Hoping for the best. It is all quite confusing, I agree.

What's the background, where they all came from, age, etc.

The verdict is in: he has Immune Mediated Hemolytic Anemia at the bone marrow level.  No FeLV!   Let this be a cautionary tale for every cat owner with a kitty that tests positive for FeLV: symptoms of the virus do not necessarily mean the cat has the virus.  Insist on an IFA test to rule out a false positive!  

Because his numbers have been steadily, if slowly, improving, the internist is keeping him on the same regimen of cyclosporine and prednisone.  He has a much better prognosis now, and the specter of FeLV has evaporated for good, so the kitties are celebrating with a round of freeze-dried chicken treats and extra snuggles on the house   

Woohoo!!