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.