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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 24452
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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Customer: My name is ***** ***** and I am in Maui. It's

Customer Question

Customer: Hi My name is ***** ***** and I am in Maui. It's my 4 y/o tabby who we brought from NY. She has been acting strangely for 2 weeks. Unsteady gait not eating. R/O Feline leukemia, CBC has been done elevated WBC lots of bands, ALB 2.0, elevated bilirubin, nucleated RBC. We haven't done an Xray yet
JA: Thanks. Can you give me any more details about your issue?
Customer: We put her on Clindomycin thinking it was Toxo but the labs don't indicate that.
JA: OK got it. Last thing — JustAnswer charges a fee (generally around $19) to post your type of question to Cat Veterinary Experts (you only pay if satisfied). There are a couple customers ahead of you. Are you willing to wait a bit?
Customer: Sure, and I should get the exact numbers on her bloodwork
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Submitted: 7 months ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 7 months ago.
Denise, can you upload a copy of all of Higgsby's test results to our conversation? I understand that you might not have a copy at home but her vet can give you one which you can scan into your computer and then give me the file link or you can photograph the pages and upload them by using the paperclip icon above your message box (if you can see the icon) or by using an external app such as dropbox.com/
Customer: replied 7 months ago.
Here it is
Expert:  Dr. Michael Salkin replied 7 months ago.
Thank you! The bone marrow is releasing immature red and white blood cells because mature cells are depleted. This can mean that they're being used up in a disease process or a disease process (infection, neoplasia, immune-mediated disease) is preventing cells from maturing properly. The decreased albumin (which is produced by the liver) and slightly elevated bilirubin are clues that there is a hepatic disorder and the immature white blood cells suggest that the hepatic disorder is likely to involve quite a bit of inflammation but not necessarily the inflammation associated with infection. My next diagnostic of choice would be an abdominal ultrasound and ultrasound-guided biopsy of her liver if pathology were readily evident in the ultrasound scan.It's curious that the liver enzymes are not only not increased but actually low normal which can indicate a poorly functioning liver unable to produce those enzymes. Liver function can be tested with a blood test called serum bile acids. Please continue our conversation if you wish.
Customer: replied 7 months ago.
What about the elevated CK which is muscle wasting, does that give any indication to underlying issue?
Expert:  Dr. Michael Salkin replied 7 months ago.
Elevated CKs in cats are most often due to the physical restraint needed to draw blood. I see remarkable elevations in that enzyme particulary if muscle happens to be pricked when blood is drawn. Pirmary muscle diseases (myositis, e.g.) are exceedingly rare in cats. I moved from the Big Island a few years ago to the mainland. I don't know what kind of resources you have on Maui. Does Higgsby's vet have an ultrasound machine or do you have to go to Oahu?
Expert:  Dr. Michael Salkin replied 7 months ago.
Hi Denise,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Michael Salkin