My poor kitten is really sick, vet is clueless, any ideas?

It's so strange that the first vet said "I don't know what's wrong."  It just seems that @catwoman707 and I both came to the same conclusion without even seeing the cat, but hearing the description of what the vet saw on x-ray and what the lab tests showed, that it looked a lot like HCM.  I can understand her saying "There's nothing I can do," because there was nothing more she could do except tell you what it MIGHT be and send you off to a cardiologist to get a cardiogram and see if there's enough heart muscle to work with so that medications might help.  I'm surprised she didn't even suggest HCM, but maybe she didn't have enough experience to think of HCM as a possibility.  Every vet I know that hears a heart murmur is quick to send the client for an echocardiogram.  HCM is not common, but it's not uncommon either.  The symptoms signs you described are pretty classic.   In any case, when you do get a firm diagnosis, whatever it is, you might want to send her a copy, just for her own education, because it might help someone else's cat in the future.  Most of us on TCS have our knowledge because of past experiences, so sometimes that may give us an edge in putting two and two together. And vets are humans too, and not all of them grduated near the top of their class.  I know several locally that I would not go to for any reason.  I'd rather drive a couple of hours to one of the vet schools near me with anything really complicated, but we're lucky here.  We have two good vet schools within reach, Georgia and Alabama.

I hope you are able to get your cat in very quickly, both for his sake and for yours. I'm really sorry that you and Swarley are going through this.

Im surprised the vet didn't recommend blood transfusion-now we have to deal with two issues-anemia=and heart disease-

if you can find a internal medicine vet that is what you need at the minuim and a place that can do blood transfusions IF they deam it-I would say those levels are extremely critically low-usually when the hemocrit is below 20 is when they transfuse-your guy is at 9?! So one option is putting him on oxygen in the meantime and ultrasound of that heart ASAP.

when you call the vet to get him looked at make sure you tell them that he is having trouble breathing and severe anemia=if they are a good hospital-they can deal with this.

I have to reread the lab results=In my experience-I had a severe anemic cat who did get transfusion but it didn't work-it was not heart related-entirely different issue-she was auto immune mediated nonregenitive anemia-which means her body was not producing enough red blood cells to carry oxygen-there are several things that cause this-but the bloodwork from your kitty is pointing cardiac-

the levels of minerals can be elevated for heart disease=so get him in a place where they can try putting him in oxygen to at least see if they can set up ultrasound of his heart=we need to see whats structurally going on to cause this

then getting an experience internal medicine vet that can help guide you-they may be able to give meds to help the heart-but wont know until that ultrasound is done ASAP.

depending on the meds=some is available as injection so they can do that right away-other meds are pills or treats-but we wont know...sending you tons of hugs and you did the right thing getting kitty looked at.. sorry about the typos=on my break and wanted to write this fast=I will fix them in a bit.

Somehow I did think you were going to be able to get him in somewhere today.  As all three of us have said (@foxxycat, @catwoman707 and myself), there is no time to waste.  There are a lot of really nasty things that can happen with this disease, even worse than him just slipping away due to lack of oxygen, so it's imperative that you get him seen ASAP even if you have to take off work. 

I fully agree, he is so young and has a strong heart, but in his current state may very possibly be doing damage by the lack of oxygen and his severe anemia.

I am also in complete agreement that there are many, many vets out there who lack experience and education, this I had to learn from being in rescue for many years, and prior would have never thought to question any vet.

Doctors, surgeons, lawyers, hairdressers, etc. they're not all equal by no means, scary but so true.

Your vet who said she had no idea what to do, even after reading his blood results is VERY worrisome to say the least.

He should have been referred to a cardiologist immediately, been placed in an oxygen tented crate and given blood.

This isn't to say that he may infact have such a malfunctioning heart that in the end there isn't much that can be done to help, BUT the fact is, she doesn't know this, none of us do, only someone who specializes in heart disorders can say what can be done.

I hope you are able to get him in to the University of Illinois right away.

any update?

foxxycat said:

any update?

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Sorry for the delayed reply. I took Swarley to the Uof I and they kept him overnight and gave him a blood transfusion and some fluids. They found that he has IMHA cause by feline leukemia that was hiding in his bone marrow. At this point, they can do more tests and potentially give him some medicine and see how that goes, but his prognosis would be only be a few years at best and we would have to keep him separated from our other cat. She also said she didn't think euthanasia would be a bad choice at this point, so, at least we know what it is, but unfortunately it is unfavorable news . Any advice?

Swarley McChunk said:

Sorry for the delayed reply. I took Swarley to the Uof I and they kept him overnight and gave him a blood transfusion and some fluids. They found that he has IMHA cause by feline leukemia that was hiding in his bone marrow. At this point, they can do more tests and potentially give him some medicine and see how that goes, but his prognosis would be only be a few years at best and we would have to keep him separated from our other cat. She also said she didn't think euthanasia would be a bad choice at this point, so, at least we know what it is, but unfortunately it is unfavorable news

. Any advice?

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i'm so sorry for this diagnosis.

i understand how hard the decisions will be for you to make. please know that the decisions you make in your Swarley's care/treatment will be made with your love for him foremost in your mind and heart, and so for the best of reasons and with his best interests in mind.

foxxycat said:

Im surprised the vet didn't recommend blood transfusion-now we have to deal with two issues-anemia=and heart disease-

if you can find a internal medicine vet that is what you need at the minuim and a place that can do blood transfusions IF they deam it-I would say those levels are extremely critically low-usually when the hemocrit is below 20 is when they transfuse-your guy is at 9?! So one option is putting him on oxygen in the meantime and ultrasound of that heart ASAP.

when you call the vet to get him looked at make sure you tell them that he is having trouble breathing and severe anemia=if they are a good hospital-they can deal with this.

I have to reread the lab results=In my experience-I had a severe anemic cat who did get transfusion but it didn't work-it was not heart related-entirely different issue-she was auto immune mediated nonregenitive anemia-which means her body was not producing enough red blood cells to carry oxygen-there are several things that cause this-but the bloodwork from your kitty is pointing cardiac-

the levels of minerals can be elevated for heart disease=so get him in a place where they can try putting him in oxygen to at least see if they can set up ultrasound of his heart=we need to see whats structurally going on to cause this
then getting an experience internal medicine vet that can help guide you-they may be able to give meds to help the heart-but wont know until that ultrasound is done ASAP.

depending on the meds=some is available as injection so they can do that right away-other meds are pills or treats-but we wont know...sending you tons of hugs and you did the right thing getting kitty looked at.. sorry about the typos=on my break and wanted to write this fast=I will fix them in a bit.

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It sounds like I have a situation very similar to yours, unfortunately . The blood transfusion only brought his RBC up to about 15% and towards the end he did start having a bit of a reaction, but it was managed easily, thank goodness. I am just struggling with the best course of action right now as the vet seems to think the heart problem is the least of our worries at the moment and is questioning whether Swarley will even be able to make it out of the hospital. She said his is one of the rare non-regenerative cases where his body isn't able to fight off the illness, so there is only so much that can be done. He would have a few years left if we are lucky, and in those few years he would probably be sick a lot and would almost certainly develop lymphoma in his stomach at some point . He is just so young, I have a hard time believing that euthanasia at this point is a good option . I want to thank you for all of the hugs sent as I definitely need them right now!

mickNsnicks2mom said:

i'm so sorry for this diagnosis.

i understand how hard the decisions will be for you to make. please know that the decisions you make in your Swarley's care/treatment will be made with your love for him foremost in your mind and heart, and so for the best of reasons and with his best interests in mind.

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Thank you so much for your support! It's just so hard to wrap my mind around right now. He's just so young that I never even dreamed euthanasia would be presented as an option. I don't want my poor little guy to suffer, but I also don't want to put him down if he will be able to have some quality time left at home. So, I guess for now, I wait for more results.

I just am shocked. The leukemia hiding in the bone marrow is something that can happen.

Would you be able to keep him at the hospital for a day or so to see how he does? Or?

I don't know what to say. I am shocked. That all this is happening to such a young cat.

      Hugs and prayers. The practical side of me agrees with the vet but my heart says No! I don't know what to say.

Maybe there is someone who can chime in who lived through this? And if its non regenitive-sadly there is not much else that can be done. My Flash had a level of 17. and transfusion only gave us 21. and a heart murmur.

they wanted me to give her pred to stop the immune system from attacking her red cells-but she wasn't killing them-they just mass produced blank copies of useless proteins-so there was nothing more I could do.

The blood transfusion gave us 3 weeks. Looking back I sometimes wish I had not done this and just let her go but then I didn't want to give up. I wanted to make sure it was what she wanted...We thought it might have been that parasite that attacks the red cells and put her on antibiotics but after the PCR test of the blood it wasn't that-In a way it was the hardest 3 weeks of my life-I cried a lot. and spent so much time with Flash. She didn't know she was sick. She just wanted to go outside and play. I didn't let her because it was in October and getting cold-they told me to keep her warm due to the anemia-so I used to wrap her in flannel and sit in a chair by the brook-she slept in my lap even with the wind blowing-this was the only time she ever slept on me. In the house she slept beside me. But outside she was a permanent lap cat. And didn't discover this until she became ill. Every morning before work I would walk with her to the brook and she would let me carry her back to the house then the afternoon I would do the same.

In the end I let her go before she became critical.I drove the vet crazy calling and asking if its time..i canceled the appointment 3 times..by the end she was still eating and grooming but I couldn't hold off anymore. I just didn't want her to have a seizure or something horrible where we were 40 min away from the ER. I still regret doing it too soon. But I just felt it was time. She was not happy all the time. And she kept looking at me with that look that everyone talks about. my other half said we did it too soon. She could have had a nother day. but the vet isn't open on weekends and I was working..i did it for selfish reasons. So I am mixed on when is the right time. I can't turn back time but at least I know we tried everything. I only hope you have peace in your heart when you decide its time.

My heart is breaking for you.

I am so sorry for this news, I can only imagine how you must be feeling right now......

For the leukemia to be hiding in the bone marrow tells me he must have been born with it from his momma.

In which case there is no getting around it, and why it would be in the marrow like that.

It's always so hard to understand why, how can this be that a young boy like him will have his life cut so short, nobody knows, all you can do now is think of him and his quality of life, how he is feeling or suffering, and be very grateful to have given him your love and companionship for the short life he has had, and when you/he are ready, set him free.

Terribly sad and tragic, I am so saddened.  

I too am shocked because your first vet did the second leukemia test and it was still negative, so she suspected leukemia but it didn't show itself on the test.  I learn something every day here.  I never knew leukemia could "hide" in the bone marrow.  I am glad you got him to a place where they had the knowledge and the skill to keep him alive and make him feel better a little bit longer and find out what was going on.  I was so afraid you would get home from work and find he had already crossed the bridge, so I'm glad that didn't happen.  As bad as this diagnosis is, it would have been worse to lose him and never know.  The blood transfusion hasn't even gotten him all the way up to a comfortable level, but I'm sure he feels better than he did.  Now you are faced with that decision that you can only make one day at a time, and usually with feedback from your cat.  I have no experience with this, and @foxxycat did go through something similar but it wasn't called leukemia, just nonregenerative anemia, so strange that the bone marrow was producing "blank copies" instead of cells.  That was another mysterious and heartbreaking case. 

If Swarley were my cat, I would do just what I did when FIP started picking off my kittens -- go searching the vet literature and learn everything I could about it.  It's easier to make choices when you know what you are dealing with.  I know you will make the decision that you believe is kindest for him.  At this point, I guess you just have to see if he responds to treatment well enough to come home from the hospital.

Oh I'm so sorry to hear about Swarley's news...I am glad you got him to a vet and got a diagnosis, though. Its always better to know. It will have to be your's and Swarley's decision what to do in the end. It is not easy to hear this news or decide, I know. Remember your love for Swarley. It shows through all the care and help you've found for him throughout this. Definitely look into all the possible prognoses and support you could provide Swarley in order to make a more informed decision.

Swarley McChunk said:

Thank you so much for your support! It's just so hard to wrap my mind around right now. He's just so young that I never even dreamed euthanasia would be presented as an option. I don't want my poor little guy to suffer, but I also don't want to put him down if he will be able to have some quality time left at home. So, I guess for now, I wait for more results.

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i just wanted to check on you and your Swarley...sending 's.