Rexy has anemia that is of concern

[scarlett 001]

I took Rexy into a 24/7 clinic tonight as she just seemed out of sorts tonight (very very tired etc.). She was diagnosed with cholangitis and cholangiohepatitis (spelling) a week ago. FYI there are inflammatory issues in the liver and bile duct etc. When she seemed "off" tonight, I took her into emergency thinking something was going wrong with her liver (last bloodwork readings for liver were overall good a week ago). Liver was fine tonight, but her anemia has decreased to about 20% or so. Anemia is consistent with her condition. But I have to get this under control with an ESA drug or something if at all possible. I am going to book an appointment with an internal medicine specialist asap to address this as I know how serious deteriorating anemia can become.

Can anyone offer any suggestions or thoughts? I find it so strange how well her liver is functioning and yet she is anemic. This had caught me off guard.

BTW, we did give Rexy a Vitamin B12 shot tonight.

 

[denice]

I haven't dealt with anemia.  I know that LDG has dealt with it.  Her cat's anemia was caused by cancer which is in remission now but I think she did some holistic things to help.   You might want to PM her to find out what she did for her kitty.

 

[ldg]

Actually, I've dealt with severe anemia in two of my kitties. The first was Tuxedo, and we never did discover the source of the problem. He was diagnosed with an "autoimmune disease" that caused his body to attack his red blood cells and destroy them. We used steroids to suppress his immune system for 7 years, and it was very up and down the first several years. And initially, after the bone marrow aspirate that determined his body was capable of making red blood cells, we did use Erythropoietin (Epogen) to stimulate his red cell production. For Tuxie, this had diminishing returns over time, and ultimately it was only the steroid that kept things in check. But it is certainly worth looking into. :nod:

My cancer kitty, Lazlo, had anemia caused by bleeding ulcers, so his treatment isn't comparable.

What meds and therapies were prescribed/suggested? Are you using antibiotics for the infection? And SAMe and Milk Thistle (Silymarin) for the liver?

And has the vet discussed the relationship between cholangiohepatitis and IBD? In one study, 80% of cats with cholangiohepatitis were found to also have IBD. What are you feeding kitty? Because transitioning him to an anti-inflammatory, species-appropriate diet may also help in his recovery.

http://www.thecatsite.com/a/choosing-the-right-food-for-your-cat
http://www.catinfo.org

I would also consider giving him liver or freeze dried liver as a treat. You can cook it or not. Chicken liver is very high in iron. Our holistic D.V.M. recommended feeding extra liver (small amounts daily - don't want to overdo the vitamin A, though it takes a HECK of a lot of liver to get there) daily to help provide nutrients to fight the anemia. Whole Life, Stewart's ProTreat (by Gimborn), and Etta Says all make freeze dried liver that most cats love (and there is essentially no loss of nutrients in the freeze drying process). Most pet stores will carry at least one of those, though they may be in the dog treats section. Just break them into smaller pieces, they have nothing but chicken liver in them.

 

[scarlett 001]

Wouldn't you know it - my regular clinic vet and regular at-home vet are both away for several weeks, so the worst part of this is not having "one" particular vet to talk through this with me. Depending on the weather, time of night and issue, diagnostics required, I have a choice of 4 emergency clinics and have used 3 of them since xmas. So this is making things tougher for me.

Anyhow, her treatment is standard for her liver and bile duct condition:

- Prednisilone (seems to help a lot)

- Subq fluids - 50ml 2x daily

- Starting her on metronidazole today

- She has asthma and usually is on flovent but because of pred, this is not really needed for now at least

- Just started Vitamin B12 injections yesterday

(buprenorphine and mirtazapine on hand if needed but so far, no need to use them)

Note: No signs of IBD in the ultrasound or clinical symptoms. No vomiting, good appetite, no notable weight loss in the past 10-14 days (I have a baby scale at home), normal peeing/pooping. Liver values all quite good on bloodwork. Main symptom seems to be lethargy due to anemia. I have been moving my kitties over to as much wet food as possible, although Rexy does prefer kibble - so might have to research the best kibble (I know wet is better for her condition) so at least if she eats kibble, it is good kibble.

Re anemia: I know where I can get the blood transfusion done asap if she deteriorates before Monday - but otherwise her regular vet will finally be back at work to review file and she is also seeing an internal medicine person at a specialty centre on Monday. So we can talk more about options to deal with the anemia on Monday.

Not yet researched things like milk thistle etc. and liver treats as my other kitty had bladder surgery and another cat was diagnosed with pancreatitis at exactly the same time. So it has been a difficult juggling act.

Anything obvious missing from this list?

You used depomedrol as the steroid to help anemia, correct? I know nothing about this treatment vs. the epogen type drugs. Can you let me know advantages and disadvantages.

 

[cprcheetah]

Has she been tested for Felv/Fiv?  This page talks about anemia: http://www.felinecrf.org/esas.htm  My sisters dog had anemia from a bleeding nose he had that they never did find a cause to, he had to have a blood transfusion at a specialty center but they told her to give him iron.  This page has good information http://www.floppycats.com/anemia-in-cats.html

 

[scarlett 001]

I read the Tanya's anemia page before, and just reread it now. It is comforting as she does give one hope and possible paths for sorting this out. I really do hope that anemia is due to Rexy's liver/bile duct issues and not a cancer.

 

[scarlett 001]

Update is that Rexy is stable over the weekend. Still lethargic and not herself, but pooing/peeing normally, eating well (no vomiting), even did a small groom and will use her scratching pole.

I just hope that we can figure this anemia out and try to stabilize her liver/bile duct conditions (assuming we have the diagnosis correct).

Internal medicine person being seen tomorrow.

 

[goholistic]

I don't have anything to add since I have never experienced anemia first hand, but I wanted to let you know that I'm sending hugs for you  

  and lots of vibes for Rexy.

I'm thinking of you all and hoping that the internal medicine specialist can figure things out.

 

[scarlett 001]

Thank you for good wishes.

I am just so surprised how well Rexy is eating and holding her weight (I have a baby scale at home so I can detect the smallest of weight losses). I would guess that having her appetite gives us more to work with to try and get her back on track. It would be much more worrying if she was refusing to eat in this mess.

 

[ldg]

You used depomedrol as the steroid to help anemia, correct? I know nothing about this treatment vs. the epogen type drugs. Can you let me know advantages and disadvantages.

The depo was specifically to suppress his immune system - it was condition-specific. Your boy is already on pred. If the cause of the anemia is due to an overactive immune system, they'd already have seen that in the blood work. So I don't think depo would help in this instance.

The epogen is used specifically to boost productivity of the bone marrow. This would make more sense as a therapy, but as I don't know the cause.... but it's something to put on the list to discuss with (whichever) vet. :rub:

And wow - you have been juggling a lot!

I don't think the liver treats would be inappropriate for any of your kitties, if you could pick some up.

 

[scarlett 001]

And wow - you have been juggling a lot!

It has been crazy!! One cat Murchie diagnosed with pancreatitis, Rexy with this bile duct inflammation cholangitis etc. issue (hopefully not cancer, probably not, but it is not certain either way). Toffee with bladder stone surgery and tooth issue from dental last month. And kitten with his strange vaccine reaction as well as being neutered tomorrow. And all within a period of a few weeks.

 

[scarlett 001]

Rexy was retested and her anemia was mildly better 4 days since the last test. Was it just the difference between machines at 2 clinics or did the Vitamin B12 help? Time will tell the story. Internal medicine vet said her anemia is not at the stage where you'd start using drugs yet. So I guess that I just have to accept some lethargy. Her potassium was okay on this recheck too.

She still does not have the same energy that she used to have (I hate even writing that). Maybe she never will. The vet says she probably has a "new normal" that I have to get used to. She has enough quality there, but it makes me sad to not quite see the same vim and verve that she used to have. It's been decreasing the past year, but this recent downturn was more notable. Sigh.

 

[cprcheetah]

You may want to ask your vet about weekly Vitamin B injections, at least for a while, they really help out the older kitties and help get them back some of their vim & vigor.

 

[scarlett 001]

 
You may want to ask your vet about weekly Vitamin B injections, at least for a while, they really help out the older kitties and help get them back some of their vim & vigor.

We just started those with the first shot on Friday. How long will it take before one might notice results?

 

[goholistic]

She still does not have the same energy that she used to have (I hate even writing that). Maybe she never will. The vet says she probably has a "new normal" that I have to get used to. She has enough quality there, but it makes me sad to not quite see the same vim and verve that she used to have. It's been decreasing the past year, but this recent downturn was more notable. Sigh.

Aww.....I know the feeling. 

I'm glad to read that Rexy's anemia has improved a little.

 

[scarlett 001]

My new kitty Gryffin (orange kitty) is showing himself to be a fantastic nurse. He has only known Rexy for a very short while, but is just the most open-hearted kitty (just like all of my other cats). I just love that in addition to my love, Rexy gets so much comfort and love from her kitty friends.

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• scarlett 001
• Jan 7, 2014

 

[goholistic]

That's so sweet.  

 

[scarlett 001]

I woke up today with Rexy sitting on my night-table looking at me and there was more spark to her eye. She seems mildly more elevated in mood today. I am hoping that it can last throughout the day. Would be a good sign if it does.

 

[scarlett 001]

Much better day today. Eating fabulously and her eyes and body language look more like her old self. I won't get my hopes up too high, but this does make me feel better today.

 

[cprcheetah]

  That is great news!  Sounds like she may be turning the corner. 

Sending vibes that she continues to improve.