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Tuxedo's not responding to treatment anymore

post #1 of 28
Thread Starter 
Some of you may remember, Tuxedo was diagnosed with an autoimmune disease a little over a year ago. It causes his system to attack his red blood cells as if they were a virus. He went on immune suppression drugs (first leukeran, then 5mg of prednisone twice a day), and for a while there had to have daily shots of human drugs that caused his bone marrow to produce red and white blood cells again (epogen and nupogen). The Epogen and Nupogen worked, and kicked his bone marrow back into production mode. We kept him on immune suppression until sometime back in February, when his red blood cell count normalized and stabilized (40 is average normal, below 24 is anemic). Doc had us start weaning him off the prednisone. Everything was going fine. But once we switched to once every other day, his red blood cell count fell off the map again (to 17 from 33). We immediately put him back on prednisone twice a day - and it didn't change. So we started him on Epogen again. Climbed back up to 23. (He's been at the vet every other day for several weeks now). Then it climbed to 27, and we were all so relieved. The next visit - it had fallen to 17. No known reason. Just that cats, sometimes, stop responding to epogen.

That was last friday. Monday it was still 17. Today it was 16. We've already consulted all the experts, and our vet has spent the last week doing more research. Just in case they missed testing him for a blood-borne disease, they've put him on doxycycline (sp?). Not helping. He's on specially made iron supplements. All the vet could come up with is switching him from prednisone to an anabolic steroid. It's being compounded for him now, and we can pick it up tomorrow morning.

Tuxie's nose, mouth and foot pads are so white. And he doesn't do much except sleep. He does come to visit us in the kitchen or the bedroom from time to time, and all we can do is try to keep our spirits up for his sake. He's gone from 10.5 pounds to 9 pounds - and is losing about an ounce a day now. The problem is not that he's not eating - he is. It's that his system isn't metabolizing it the way it should. If the anabolic steroids don't work, if things keep moving at the pace they have been, Tuxie's only got several weeks left to live.
post #2 of 28
Oh no! Tuxie is in my thoughts and I hope that he makes a turnaround soon! But if that is not the case, then I hope he is at peace!

post #3 of 28
Oh Laurie, I'm so sorry to hear about this!! You and Gary and Tuxie are in my thoughts and close to my heart.

Have you tried and/or talked to your vet about Transfer Factor? Tammie's (MsJazz2U) Jake also has/had an autoimmune disorder that manifested itself in infected sores on his skin. I know you probably don't have time to read the whole thing, but skim thought her posts here: Jake, Very Sick It literally saved his life. Absolute miracle. I know Tammie can give you more information on it...but I thought it would be worth passing on in case you haven't considered it. Just seeing Jake's recovery has made me a believer!
post #4 of 28
No suggestions here -- just lots of vibes and prayers for Tuxie and for you. So sorry to hear of this setback.
post #5 of 28
Sending lots of good vibes to Tuxedo.
post #6 of 28
So sorry to hear of Tuxie's latest problems. I hope you find the best solution for him and for you.
post #7 of 28
Tuxie will be in my thoughts!
post #8 of 28
I'm keeping you and Tuxie in my thoughts - sending lots of vibes to help Tuxie regain strength
post #9 of 28
I am so sorry to hear about Tuxedo. I think it's one of the hardest things you can face, when a beloved pet becomes so sick. You two are both in my thoughts.
post #10 of 28
Thread Starter 
Thank you so much for all the thoughts, prayers and good vibes sent Tuxedo's way!!!

I will repeat once again that I LOVE our vet!!!!!!!!

He spent several nights researching the problem, and found something at the Institute of National Health. He checked back through Tuxedo's file (which is so thick it could be for a 20 year old cat already!) and noted that there was a correlation between the use of antibiotics and high red blood cell count. Apparently, there's a chance that instead of being an autoimmune disease, it could be an as yet unknown blood disease (apparently not so uncommon in cats). He said that Tuxie's currently got an elevated protein count, which would also correlate to this theory.

So.... he's now on both Doxycyline and CEFA drops. Stopping the prednisone shut down his adrenal glands, so he didn't eat over the weekend and he lost 6 more ounces. Dr. Bladek apologized for that major oversight, and corrected it with a shot of dexamethasone (a more powerful steroid in the same class as prednisone). That was Monday - BUT his red blood cell count had stabilized at 16 (remember, below 24 is anemic and around 40 is normal).

The GREAT news - he perked up a bit Monday night, and yesterday he was chowing down everything we gave him. He was back to bounding up the stairs (instead of just lying on a pillow downstairs) - followed Gary around as per usual - resumed his perch on top of the curio in the living room (tallest thing in the house). Boy were we hopeful about this numbers today, and.... his red blood cell count was up to 20, and he hadn't lost or gained any weight (Tuesday's eating offset Monday's not eating).

He's still chomping away, and the anabolic steroids should really help him bulk up quickly now that he's eating again. The antibiotics seem to be working, and we have got our fingers crossed that his red blood cell count will continue to rise.

Tuxedo - as Gary and I whisper to you many times a day - be a good "red blood cell" boy!!!!!!!!!!!!!!!!!! He is SUCH a fighter - what a cat. We love him so much!!!!!!!!!!!!!

post #11 of 28
Awww, lots of prayers to you and Tuxedo!!! I am so glad to see that there was a positive increase!!
post #12 of 28
oh Laurie what wonderful news....

I didnt know that Tuxedo had these problems and I read this thread with my heart in my throat.... but what wonderful words to read on your last post

what a wonderful boy you are Tuxedo - keep fighting sweeetheart
post #13 of 28
Fabulous news Laurie!!
post #14 of 28
Good boy, Tuxie!!! Way to go!!!
post #15 of 28
Glad to hear he's feeling better, He sounds like a fighter
post #16 of 28
I just found this thread, else I would've responded sooner. I am so glad to hear of the recovery he has already had, and I pray that he continues to recover!
post #17 of 28
That's very good news! , Tuxedo!
post #18 of 28
Yay, Tuxie!!! Keep it up, fella!
post #19 of 28
post #20 of 28
Good to hear. He remains in my thoughts.
post #21 of 28
What wonderful news Laurie - I'll keep sending good vibes Tuxie's way to help his recovery - Tippy sends lots of purrs and headbutts.

What a wonderful vet you have - it's lovely that he takes such care over this.
post #22 of 28
Thread Starter 
Darn it! His red blood cell count is down at 18 - but Doc's not discouraged. He gained three ounces (we boiled a chicken and have been feeding him as much kitten kibble, wholesome treats and chicken with broth as he'll eat, and he's been a gobbler ). We've added an iron supplement to the mix. So now we're back to 1/2 tablet of prednisone a day - along with the rest of the medicine, and that should help keep his appetite up.

Unfortunately, Tuxie's not acting anemic. He needs as much rest as he can get. But Doc doesn't want us to confine him to one room - he'll just stress out. Maybe Tuxedo knows something we don't know yet.... we can only hope!
post #23 of 28
Good to hear he has put on some weight. He remains in my thoughts.
post #24 of 28
Tuxedo - we are praying that you continue to improve. Good luck to you.
post #25 of 28
Mmmm all that tasty food is sure to keep his weight up! Well done Tuxie. Sending loads of healthy vibes so you continue to improve
post #26 of 28
Thread Starter 
The latest news isn't good. He's lost 6 oz. since last Friday - he's down to 8 lbs. 4 oz. The strange thing is he eats every time we give him something, and Gary's practically following him around the house with a bowl of food. He must not be eating on his own.

...and his hematocrit's down to 15. They gave him a shot of B-12 today, and because they're worried about his weight and eating - thus potentially his hydration, they gave hima bag of saline/water to make sure he's OK over the weekend.

We're taking what info we can find on Transfer Factor into the vet with us Monday. If it won't interfere with the meds (that don't seem to be doing anything anyway) and can't hurt him, then we'll give it a shot.

C'mon Tuxie - we need you to get better!!!!!!!!!!!!!!!!
post #27 of 28
I just said a prayer for your little Tuxedo Bless his heart, and yours for being so good to him. What a wonderful vet you have.

I'll keep you all in my thoughts...please keep us updated.
post #28 of 28
I do hope you find a solution to this. It is so worrying for you. Please get better, Tuxie.
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