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Dr. Louis Gotthelf
Dr. Louis Gotthelf, Veterinarian
Category: Cat
Satisfied Customers: 2438
Experience:  35 years owning a dog and cat veterinary practice. President of an animal emergency clinic
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I have a 13 year old male cat that has always lived indoors.

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I have a 13 year old male cat that has always lived indoors. About one month ago he quit eating and I took him to the vet. After blood work, urinalysis, and a xray it was determined that he had a UTI and bladder stones. He has had a couple of UTI's when he was younger but has been healthy ever since. Bladder stone surgery was done and the next day he came home and was very active and feeling good. I gave him about 10 days of antibiotics and then two days after completing them he stopped eating again. I took him back and they said he had an elevated white blood cell count and the vet then started telling me his blood platelets count was 33,000 and his red blood cell count was slightly low also. I asked what his count was before surgery and they said it was 72,000. They checked him for FeLV and was negative. They believe he has an immune system problem. He prescribed antibiotics for infection and 5ml of Prednisolone once daily and after four doses he rechecked and the platelets was back in the 70,000 range. The vet then added Azathioprine (1/4 tablet of 50mg). After two weeks they rechecked and the Platelets were down to 30,000 and his red blood cell count was still slightly low but his white blood cell count was about normal. The vet then increased the Prednisolone to 5mg twice daily and was told to continue the Azathioprine. Now one week later his white and red blood cell count is low and his platelets are at 13,000. They are saying that I could consider checking his bone marrow but the prognosis would not be good. I can't tell anything is wrong with him. He has none of the symptoms most say this will cause. What is your opinion?

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Customer: replied 4 years ago.


Yes I will wait. Thank you

Hi,

My name is XXXXX XXXXX I am the moderator for this topic. I've been trying to find a professional to assist you, but sometimes finding the right professional can take a little longer than expected, as the professionals come online at varying times. I wonder whether you're ok with continuing to wait for an answer. If you are, please let me know and I will continue my search. If not, feel free to let me know and I will cancel this question for you. Thank you!

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Camille - Moderator

Customer: replied 4 years ago.


Yes I will wait

Hi. I'm Dr. Gotthelf. I have been a vet for 33 years and I would like to use my experience to help you with your pet's medical problem.

I think that the problem is the azathiaprine. Many cats will suffer from bone marrow suppression because of a sensitivity to or a toxicity of this medicine. That will decrease the platelets, the white blood cell count and the red cell counts. I would ask the vet if you can stop it for a while and see where the blood counts go. Sometimes a lowered dose given intermittently can work to treat an immune problem.

Most cats with bladder stones do NOT have any infection unless the urine is very dilute, as with an older cat with a kidney problem. DId they do a urine culture to see if there were any bacteria in the urine? After bladder stone surgery, the diet is changed if there are struvite stones present. That special diet will help to decrease the possibility of another stone forming. If there were calcium oxalate stones that formed, then a diet change will not help.
Dr. Louis Gotthelf, Veterinarian
Category: Cat
Satisfied Customers: 2438
Experience: 35 years owning a dog and cat veterinary practice. President of an animal emergency clinic
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Customer: replied 4 years ago.


Thank you,


You have confirmed what I already was reading other places. I will call the vet and discuss. The dosage recommendations I have read some other places say .15 mg per pound every other day. This would be about 1.8mg for my cat which is now receiving 12.5mg daily. They were unable to get a urine sample when I carried him back. They did change his diet to a Special SO diet food. So do you think the 5mg Prednisolone twice daily is still a good idea? Then recheck the CBC in a week or two? They did give me Clindacure and Orbax last Saturday as a preventive measure because of the decrease in white blood cell count.

If the cat is feeling good, I would discontinue all medication for 2 weeks and then re-test the CBC. One problem that we have all the time is the platelet counts on the in-office machines. Often the platelets will clump up and the machine reads a clump of platelets as one platelet. That falsely decreases the total platelet count. If they want to be sure, they would send the blood to an outside lab for a platelet count only. It is done in a different manner.

Without having any evidence of an infection anywhere, the antibiotics may also not be necessary right now, since the white blood cells are normal right now. You should discuss this with your vet.