Cleo's blood work showed she has anemia.......

I took cleo to the vet for loose stools, The vet said she had a high fever and put her on anti-biotics. Her fever has gone down, but she still will not poop in the litter box, and her stools are still soft. Today I took her in for a blood test, when I was told that licking cat litter is a sign of anemia, and bingo she has anemia, but it is not too bad, and the vet said it will get better. But she wants some more blood to send it off to test for a Parasite that causes anemia or to check if it is an immune disorder. Does anyone have any information on this? or experience? thanks.

I do. But please let me preface this with the info that I am not a vet, not trained in any of this, and am sharing info based solely on our experience and some of the information I convey may be wrong - I may have misunderstood what our vet communicated, etc. So.....

We didn't know what was wrong with our kitty, Tuxedo, and it turned out he was EXTREMELY anemic. Here's the thread detailing everything we went through:
Tuxedo Really Needs Board Magic - Start on Page 3 - that's where we really started to figure out what was wrong.

The first thing your vet will (or should) do is eliminate all potential causes of the anemia. There are tick borne diseases that cause anemia. There is a parasite that causes anemia. There is a newly discovered disease called .... darn. I don't remember. It starts with a "b". I'd call the specialist, but he's so busy and barely returns calls as it is, which is why we saw the specialist for diagnosis, but use our normal vet for treatment, and we let him interface with the specialist.

Anyway, the vet will attempt to rule out blood-borne parasitic diseases called Hemobart, Coombs, tick-disease, ANA, and toxoplasmosis. I'm assuming Cleo was or will be tested for FeLV. Bloodwork and ultrasound and/or x-rays will be used to rule out a hormonal or thyroid problems, and something called hepatic shunting. To diagnose the cause of the anemia, your kitty my have to have x-rays and/or ultrasound. Tuxedo had an enlarged heart (indicative of anemia developing over time), and an enlarged spleen, though it turned out there was no internal bleeding.

Bottom line is - there are HUNDREDS of things that could be causing the anemia. If you're lucky, your vet will find one right away. It could be as simple as having accidentally ingested something toxic that cause everything to go haywire. Sometimes they just don't know, but simply have to address treatment.

One of the things they will try to determine is whether or not the anemia is non-regenerative - meaning - is your kitty producing red and white blood cells at all? If your kitty is producing some red and/or white blood cells, you likey have time for the vet to explore all kinds of diagnosis options. It is the "Reticulocyte" count that will indicate to your vet whether or not the anemia is non-regenerative or not. This is an indication as to the level of bone marrow production activity (I think). I believe "normal" reticulocyte (activity? count?) is between 0.2 and 1.0. I don't know where Tuxedo was - but now that he's on Epogen (a drug designed for humans with kidney problems - it stimulates red blood cell growth), his reticulocyte count has risen, and was last measured at 4.1, which means the Epogen is working.

Now - all of these tests and diagnostics can all be performed assuming that the situation isn't critical. With Tuxedo, his "packed cell volume" had fallen down to 12. Normal in an adult cat is 33 - 40. 33 was Tuxedo's normal levels in all prior bloodwork. Below 14-15 is considered critical. Of course the red blood cell count, the white blood cell count and platelette count all figure into the equation, but a low red blood cell count combined with a low packed cell volume (the vet will refer to it as "PCV") means a blood transfusion. These generally work, but sometimes only for a few days, because the cats' bodies treat a blood transfusion like an infection, and their immune systems attack it and "eat up" the blood. So a blood transfusion buys some time - whether its a few days or a few weeks depends upon the cat. But they do become more efficient at attacking new blood, so repeated blood transfusions become less and less effective.

With our kitty, it turned out he had an autoimmune problem that caused his bone marrow to stop working. Translation = they have no idea why it happened. He needed to be anesthetized while they took a core bone marrow sample, and he had both a bone marrow aspirate and a bone marrow biopsy. This was considered a last resort to determine the problem and eliminate cancer, but we were running out of time. I don't know what the difference is between a biopsy and an aspirate, but bottom-line is his bone marrow was checked for both red cell production and white blood cell production. Neither was functioning - but they are able to determine from these tests whether or not the bone marrow CAN work. But they are invasive tests. Bits of his legs and his hip were shaved, and he looked so sad and pathetic when he came home.

So here's a summary. Is the anemia non-regenerative? The reticulocyte count will provide some indication.

They should rule out as many possibilities for the cause of the anemia before considering any invasive testing. This will be somewhat dependent on the combination of the Packed Cell Volume ("PCV") and red blood cell count.

Anemia should be easily treatable if it's diagnosed as the result of a specific disease or hormonal problem, unless it's FeLV, but there are ways to deal with that too. Make sure your vet eliminates FIP. FIP is fatal, and not treatable. I don't mean to scare you, but anemia is one of the symptoms. They don't know what causes FIP, so it's more a process of elimination than anything else. They do know it is a corona virus, so they can check for corona virus titres - but a high level of corona virus titres doesn't mean it IS FIP - (they believe colds are also a corona virus) but a low level of corona virus titres does mean it isn't FIP. Hope that makes sense!

It could be caused by cancer or an autoimmune disease. Cancer can be very treatable in cats as they do not necessarily experience the same problems with toxicity of the drugs as humans do. An autoimmune disease simply means the immune system is acting like there's something wrong, but the doctors can't figure out why.

If Cleo's bone marrow isn't producing red or white blood cells, there are medicines that can help. How long they will be effective is dependent upon the cat. Nupogen (which stimulates white blood cell production) generally works, but with Epogen (which stimulates red blood cell production), over time, some cats develop a resistance to it and it stops working.

I hope it turns out to be something simple and treatable. With our Tuxedo, things are still up in the air, though he has made such fabulous progress since being on the medication that he is totally playful and just a happy, clearly feeling-good cat.

I just reread your post, and I'm glad the vet said it isn't "too bad," although armed with some of this info, I hope you can figure out more precisely what she means by that.

I did want to add that for our boy, we have to suppress his immune system in order for the medications to work. This is being done with prednisone. In a higher dosage than is used for other things, prednisone can act as an immune-response suppressant. He receies .5mg twice a day in addition to the other medications.

can say that Cleo's anemia is regenerative so I take it this is good news for now. The vet said some of the same things you said . She also said for now the anemia is regenerative, but it could change. Her blood work for parasites in the blood came back negative, but the bad news is that the vet. changed her anti-biotic and it caused a bad reaction( loose stools again She is also on predisone(sorry about the spelling).
The vet wants her to be tested for FELV/FIV. she has never been tested, and I am kind of afraid to test her for it, because if she has it my other cats may have it even though they were vaccinated for it 2 yrs ago( Cleo was not). Cleo comes from a large feral colony( I rescued her when she was about 6 wks and she stayed with us because I couldn't find a home for her). My other cats, healthwise are fine. For me the biggest problem is her stools, she will not use the litter box, no matter what. I am at a loss what to do, and do not know how to procede if it isn't FELV, all that needs to be done sounds expensive and I am on a limited income. Thanks again for the info. It really helped.

I don't know how bad her diarrhea is, but could it be she can't make it to the box in time? Also, is she still using the box while peeing, and just not using it for "#2"? If I understand it correctly (remember correctly), there are steps the cat has to take to get up into her litterbox? It could be she doesn't use the litterbox for #2 because she's in discomfort and her need to go is somewhat urgent. Have you tried using a litter pan as opposed to the current litterbox? And have you used an enzyme cleaner to completely remove the smell of where she's already gone before? Chemical cleaners won't do it. Is she going in the same places? Or new ones each time?

BTW - given that she's producing red and white blood cells, is the problem that her reticulocyte count is low? Testing for the various diseases that could be causing it can get expensive. Perhaps talk to your vet about an extended payment plan as opposed to pay-as-you go? Most vets are willing to accomodate responsible and caring pet owners though it isn't a "public" policy.

the litter box. I have changed litters, left the cover off, and even bought a new litter box for her. I understand that she doesn't want to use the litter box, because she associates it with her stools, but she seems to run all over the place looking for a place to "go" , and then will run away from it. Right now I do have her seperated from my other two cats( she is in my son's room), and has no problem with eating. The doctor switched her medicine 1 1/2 days ago, and it made her stool horrible, today the doctor told me to put her back on the antibiotic she was doing better stool wise. I am not sure about the blood work question you asked. I would have to get a copy of the blood work(which I am thinking of doing soon). The doctor thinks she may have FIV, or at least she wants her tested for it, because of the fever and loose stools. I am going to have it done next Wed. Hopefully it will be -, because FIV mostly infects males, and Cleo is only 1 yrs old and has been inside 81/2 months of her life. THanks for all the help and I did read about Tuxedo. I am so sorrry about your loss.

Well, the good news here is that Tuxedo is still with us, it was just a very close call. We still haven't solved the problem, but the medication seems to be working, and his red blood cell count is slowly rising.

Have you tried a litter pan and using a different medium other than litter? Perhaps shredded newspaper? Perhaps a different level of litter? Any way to clean it immediately after she goes - if she uses the box?

I'm so sorry that you're having this problem - and that's really wonderful of your son to be willing to put up with her problem!

Ldg I do not know what started diarrhea, and the vet doesn't know, but it's not like she is going 10 times a day, 1-3 times a day(24hrs) she will have a bowel movement and it is wet, it was getting better, but as I said the vet. changed her medicine, and now she is having wet stools again not watery, just mushy. I have tried changing litters, I have tried putting ripped newspapers down, and even went out and bought new boxes, and have left the box off. Today my husband saw Cleo acting wierd when he was in playing with her, so he picked her up and held her by the litter box, and she started digging, and out came #2. she will not use the litter box at all . She seems afraid to go in, I guess it's because of the stools, but it is frustrating. I am glad about Tuxedo being better, and thanks again for so much info. Cat