2 Brothers BOTH have had Mast Cell Tumors removed from their skin and Low Plateltes. Need guidance.

[Charles B]

I have 2 brothers, Obi and Righty. Last year during normal yearly check up Righty had low platelets. 100,000K. We monitored monthly and he continued to drop all the way down to 19k. We started him on prednisolone and over 3 months watched him rise back up to 300,000K Plus. His brother Obi was fine. During that process I noticed a bump on Obis head. We discovered 3 Mast Cell Tumors on him. All 3 were removed. The we noticed one on Rightys head so we had that removed. All where sent to the lab and have clean margins and confirmed as Mast Cell Tumors. Because of this my Vet recommended to take them to a cancer Dr to have them checked out. Both received Ultrasounds(Righty did have a previous one) and they both came back clean and normal. Both also had fine needle aspiration biopsys of their spleens and they came back normal. But now Obi has low platelets. 129,000K . During all this neither have shown signs of bruising anywhere. I check their bellys, mouth and eyes. No clinical signs of low platelets. Both are acting normal and playing and eating(they graze all day on dry food and receive wet twice a day).

The only strange thing I noticed is when Righty started prednisolone 10mg daily he went from 12.8 to 11.2 LBS. He was holding at 11.2 and never went below. He was super tired and did not play at all and hardly ate. When we started to taper him down he started eating again and playing again. Now he seems to be slowly getting weight back at 11.8. And he never grew his belly hair back when they shaved him after being on prednisolone for a few weeks. Its still short but may be comming back.

I have no idea what to do at this point has they have been to 4 vets. They have done CBC and other blood test but no ideas yet. I am sure they want to do bone marrow biopsy but is that the right thing to do. Can something else because causing low platelets in both and these tumors. Any ideas or suggestions would be appreciated.

 

[silent meowlook]

I would go ahead and see the recommended oncologist for a consult. I wouldn’t waste time and money on anyone who isn’t a specialist at this point.

I posted a link to some info below.

Mast Cell Tumours | International Cat Care

Mast cells are a type of cell widely distributed in the body and help in the normal immune response.

icatcare.org

 

[Charles B]

I would go ahead and see the recommended oncologist for a consult. I wouldn’t waste time and money on anyone who isn’t a specialist at this point.

I posted a link to some info below.

http://[URL]https://icatcare.org/advice/mast-cell-tumours/

[/URL]

Hello,

Thank you. The both have already bee to the oncologist. She performed a ultrasound and biopsys and found them all clear. She told me Obis blood work was ok, but it was not his platelets where low also. I discovered this a month later after printing out the paperwork for my records.

 

[FeebysOwner]

Are you saying Obi's platelet count was low when the oncologist said his blood work was OK? If so, I guess the first thing to do would be to follow up with the oncologist about this aspect. Perhaps, they can give you a viable explanation. If not, then consulting with her about this is still the right way to go to start off with. It might be important if you also point out that Righty once had a low platelet count that was resolved with Prednisolone - as well as mentioning the side effects he had. Maybe she would not be inclined to jump right to recommending a bone marrow biopsy. Ideally, if she is part of a specialty group that employs internal medicine specialists, she could get them involved. If she isn't, perhaps she could recommend one.

Has anyone done a blood smear to take a look for cell abnormalities - not all cell abnormalities mean cancer. Or have they checked for various viral conditions that can be connected to low platelet counts? Things like stress, up to and including the tumors and even the tumor removal and all that was entailed, can provoke viral flare ups that might affect the platelet count.

 

[Charles B]

Are you saying Obi's platelet count was low when the oncologist said his blood work was OK? If so, I guess the first thing to do would be to follow up with the oncologist about this aspect. Perhaps, they can give you a viable explanation. If not, then consulting with her about this is still the right way to go to start off with. It might be important if you also point out that Righty once had a low platelet count that was resolved with Prednisolone - as well as mentioning the side effects he had. Maybe she would not be inclined to jump right to recommending a bone marrow biopsy. Ideally, if she is part of a specialty group that employs internal medicine specialists, she could get them involved. If she isn't, perhaps she could recommend one.

Has anyone done a blood smear to take a look for cell abnormalities - not all cell abnormalities mean cancer. Or have they checked for various viral conditions that can be connected to low platelet counts? Things like stress, up to and including the tumors and even the tumor removal and all that was entailed, can provoke viral flare ups that might affect the platelet count.

She said his blood work was fine. So I just went with it. I then seen the low platelet count when looking over the paperwork before I filed it away yesterday. I was at the oncologist because of the Mast Cell Tumors. She wanted to check the spleen because issues in the spleen can cause low platelets and can be the starting point for mast cell tumors. I would rather not get into the bone marrow biopsy. The internal medicine department has also seen him. I have a Dr that has he specializes in this disorder that is at the same vet as the oncologist. He is the DR that started him on Prednisolone. He stated that with no clinical signs of low platelets it may just be clumping or normal for him. He feels we should just monitor until he shows signs. So we did this. We took him slowly off the pred, and kept watching his platelets go up and up. Then 1.5 months after being off we are down to 100,000k. I am ok with this answer but.......Both their previous visits for 4 years have shown normal levels 300,000k so we know they can have normal levels. I do not believe they have had a blood smear. Righty has had slides made for review for clumps. And they have seen clumps. But I am unsure of if this proves anything. Could you provide a link to what type of smears you are talking about. They have not had any viral tests. What viral conditions would cause this? They may have herpes as they have had issues in the past the Vet things where caused by it. Righty is a super scaredy cat. Obi not so much. Righty does not like the vet. I did not know stress can cause blood work issues.

I will add a note. Righty had his Mast Cell Tumor the whole time he was on Prednisolone for the platelet issue. It remained flat and you could barely see it. Once off the Prednisolone it started to grow. It was 2cm then became raised and went to 3cm. I am just adding this info in case it is helpful.

Both boys have a sister Lefty. She will be getting blood work in a few months as her normal yearly visit. She has had NO mast cell tumor that have show up.

Thank you for responding and your input. I am grateful. Any more info you have is great and anyone else that has ideas.

 

[FeebysOwner]

Both their previous visits for 4 years have shown normal levels 300,000k so we know they can have normal levels. I do not believe they have had a blood smear. Righty has had slides made for review for clumps. And they have seen clumps. But I am unsure of if this proves anything. Could you provide a link to what type of smears you are talking about. They have not had any viral tests. What viral conditions would cause this?

Clumping is common in cats and does make the platelet count look low. Whether or not that can happen intermittently, I don't know. Since Righty had slides made for clump review, I am guessing that is the smear I was talking about. If that were to be true, then they apparently did not find cause to believe it is an immune-mediated or infectious disease related, but you could ask to confirm that. The two viral conditions that I know of most commonly related to low platelet count is FIV and FeLV, but there may be others, and I don't know if other symptoms/blood work numbers would be equally impacted. Something else you can ask about. There are also tick-borne illnesses that can trigger platelet loss. Finally, from what I know, most all other things being ruled out, that points to bone marrow evaluation.

Steroids seem to be used in many cases, especially ones deemed idiopathic to elevate platelet levels. But there are other steroids (immuno-suppressive drugs) that might work as well as Prednisolone without the same side effects as what Righty experienced. Maybe in these cases, intermittent treatment is required when the counts get too low. That about sums up my knowledge!!

All these are things to ask about - whether or not the oncologist is the correct one, I am not sure. That is why I wondered if an internal med specialist has been/could be involved.