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My indoor male, neutered, cat is 6 years old. He hasnt been

My indoor male, neutered, cat...
My indoor male, neutered, cat is 6 years old. He hasn't been eating much the past two weeks, and has definitely lost weight. He's been lethargic and the past couple of days has not touched his treats, which he begs for. The vet said when he saw him that he is definitely sick and did some bloodwork. Unfortunately, all we know from the bloodwork is that his immune system is working extra hard, his red AND white cells are very low. He is critical. I don't have the money to run a battery of tests as suggested at the local animal hospital. He suggested one more test at his office before I decide what's next. This is a hemoglobin test. Do these symptoms sound like something treatable?
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8/6/2013
Dr. Scarlett
Dr. Scarlett, Cat Veterinarian
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Dr. Scarlett :

What does your vet hope to find out with a hemoglobin test, do you know?

Dr. Scarlett :

Do you know what his hematocrit or PCV is? All his chemistries are normal? Has he been tested for FeLV and FIV?

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Customer reply replied 4 years ago

Hematocrit is 27. I am asking about PCV and chemistry levels. I'm not sure about why he's doing the test, my dad took the cat and he was just filling me as best he could. He did eat half a can of wet food when they got back. He is an only cat, who stays indoors. I think i read feline leukemia is transmitted?


He hasn't had any tests you mentioned yet. Everything gets so costly, I'm already in $600 for bloodwork, fluid and antibiotics. He didn't mention him as being anemic, but that's initially what I thought it was.

Ok, so a Hct of 27% is in the normal range; so not anemic.

Feline leukemia is transmitted by cat bites, but it can also come through the placenta. So if your cat (what is his name?) has never been tested, that might be worthwhile. The cost would probably be around $60.

What antibiotic is he getting? Oral or was in given as an injection to last 2 weeks? Did they start him on any steroids?

It would be helpful if I could actually see the lab results to get a better idea of what your vet might be thinking. Do you think they could e-mail the results to you and you could send them on to me? Since he sounds like he is a bit improved (possibly from the fluid therapy) and has eaten, I don't think you have to jump into anything just yet.
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Customer reply replied 4 years ago
He tested negative for both FeLV and FIV. Total T4 1.9. Protein 10.1, globulin 7.3, alk phosphate 199, CPK 1212- all high. Urea nitrogen 11, calcium 7.7- low. Albumin 2.8. Glucose 101. Potassium 3.8. Cholesterol 169.

His hematocrit is actually 20. WBC 3.1, RBC, 4.4, hemoglobin 6.6. MCV 45, MCH 15.0, MCHC 33.0, no blood parasites. Platelet count 85. Platelet EST adequate. Differential absolute. Neutrophils 1116 (low). Bands 0. Lymphocytes 1860. Monocytes 62.

I just gave him canned tuna and he ate it. Thanks for all your help.
Customer reply replied 4 years ago
He's also on Felovite II and they gave him a vitamin b shot. Also a bag of fluid- convenia I believe?
The proteins are quite high. The rest of the abnormals don't excite me much, apart from the anemia.

Is he running a fever at all? Any fluid build up in his abdomen (does it look normal sized, even though he has lost a lot of weight?) Any coughing or difficulty breathing?

The Convenia is an injection of a long-acting antibiotic, but the volume is only 1/2 cc, generally. So the bag of fluids wouldn't likely have been to help rehydrate him and make him feel better. Vit B injection can't hurt and might help appetite. Felovite II is just a nutritional supplement, I believe.

With the high proteins, I would be concerned about a disease called FIP--Feline Infectious Peritonitis. Sadly, it is a difficult disease to diagnose. There are 2 forms--the "wet" form, where there is fluid build up in places like the abdomen and the lungs, and the "dry" form where there are just plaques of protein coating organs. With the wet form, getting a sample of the fluid can aid in diagnosis. With the dry, there are no areas to sample. There is an FIP (caused by a mutated corona virus) antibody test, but it just tells us if the cat was exposed to corona virus. If it is really high and other tests fit (like the high protein, a cat who is wasting away, fever), then FIP is diagnosed.

Even worse, the disease is not really treatable and usually the cat is euthanized (or dies) within a week or two of diagnosis. :( Here is a website with more info: http://www.VeterinaryPartner.com/Content.plx?P=A&A=681

So double-check with your vet about what test he is really recommending doing. It may be the FIP antibody titer; I can't think of anything that a hemoglobin test would look for.

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Customer reply replied 4 years ago

Moose has no fever and belly looked ok. No trouble breathing, not vomiting or anything. I am not home now, but I am asking my dad to look at his gums to see if they are pale.

 

He rolled over so I could scratch him and nothing felt or looked strange. He's just very bony :( from what I've read it seems like its related to bone marrow failure or liver disease. I'm not sure about the liver disease because the cat was never obese to begin with, but that's not to say he couldn't have formed it through his food.

 

All I know is that his immune system is working over time, and most of his counts that stand out, after researching, all bring me to the liver, and clearly bone marrow problems.

 

FIP says its typical where there's more than one cat or onsets early, but he is alone, does this matter?

 

FYI last year, he didn't move for a whole day, wouldn't eat or acknowledge anyone. We took him to the vet, it seemed like there was an obstruction. After the vet he was back to normal, but he came home with fleas. I did read fleas can bring disease with them. Maybe this is what caused it? Moose started loosing fur on his hind legs during the winter, but I assumed it was an allergy or flea allergy related. I guess I could have been wrong. The fur did grow back, but as of the past two weeks he's been eating less. My dad changed his food because he wasn't eating the blue buffalo at all. When he would change the food, he would eat some. Like I said before, he ate half a can of wet food yesterday, and when I put canned tuna in the bowl he ate some of that. He's holding it down, not throwing up. He's just very weak looking.

Ok, glad he doesn't have a fever.
Fatty liver disease doesn't seem likely. Those cats are usually overweight to begin with, and almost always they become jaundiced (yellow). Their liver enzyme values are sky high, which also doesn't fit with Moose.

Re-reading my last note, I meant to say the fluids likely were given to make him feel better...

Bartonellosis is a disease that is contracted from fleas, but Moose's blood results don't fit that. They can be anemic, but generally their wbc is elevated.

I put in all his abnormal test results and symptoms into this computer module I have access to, but nothing relevant came to light.

When I have a cat that isn't doing well, but really nothing is coming up in the bloodwork, my first thought is always a type of cancer called lymphoma. Lymphoma is the most common cancer in cats and not usually detected in bloodwork. If it is affecting the GI system, you can sometimes feel a mass/lump, but not always. Abdominal ultrasound can sometimes be helpful as an experienced radiologist/ultrasonographer can find enlarged lymph nodes in the abdomen. Lymphoma can affect almost all organ systems. It is treatable and most cats will go into remission if treated, but chemotherapy can run into the couple thousand dollars.

If you are unable to afford more diagnostics (and I think I might go with an ultrasound next), then I would ask your vet about starting Moose on prednisolone. Pred is part of the chemo protocol and will help with pain, inflammation, and will shrink up lymphoma for awhile. It also can help increase appetite and just make the cat feel better.
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Customer reply replied 4 years ago

I just called my vet and he agrees it's worth a shot for the prednisolone. I think he was apprehensive to give something that may harm him, but at this point, the cat is wasting away, so I have nothing to lose. I guess it's much harder when the blood doesn't really show much. I'm grateful you have done so much research for Moose.


 


I'm feeling guilty because I don't want to give up on him if it's something that's treatable, but I just don't have the funds to find out what it is and then have to treat it. And he's a young cat, which makes it even harder to come to terms with. If by some miracle a pile of money falls in my lap I will start next with the ultrasound.


 


Your knowledge was helpful in weeding out other ailments, and honing in on what the problem might really be. I will start him on the steroid, and hopefully that just improves the quality of life he has left.


 


I've attached a picture of Moose taken last fall when he was healthy. Thanks so much for all your help, it's given me a little more hope than I had before!


 


Oh, what a handsome boy! He looks like my clinic cat, Charlie.

I will be rooting for him! Please keep me posted as to his progress!
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Customer reply replied 4 years ago
Just thinking back to last year. He was in worse shape than this. Last year they did an X-ray and ultrasound and he had a blockage. They massaged and moved his tummy around and that did it. I think they said it was hair. Maybe big hair all blockage. He always throws up hair balls he has so much fur. Currently he is urinating but not pooping. He is eating here and there so I would think he should need to. Could he be having issues from a blockage or does this not relate to his blood cell count?
Could the vet palpate anything in his abdomen? If he had a mass in his intestines, like constipation, lymphoma, or an obstruction, as thin as he is I'd think it would be fairly easily felt. Did the vet take an x-ray to look for an obstruction?
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Customer reply replied 4 years ago
No X-ray yet. I don't know if he felt his abdomen, I wasn't physically there, my friend was. To be honest he was quick to say he needs an animal hospital or be put down. I didn't feel comfortable with that answer. If he did have a blockage would that lead to these type of symptoms and blood results? I will call the vet in the morning to follow up. Last year when he was sick, he wouldn't even move or look at you. He was much worse but after finding a blockage and moving his tummy he immediately got better. He stayed overnight to keep getting fluids too. Just before we gave moose his IV of fluids and steroid. After, he was a little more awake and ate some treats. He doesn't visibly look sick except for being thin. Eyes are fine gums are fine. It's confusing because he's not looking like a sick cat other than the weight loss and not eating.Also I have been reading about IBD. I read its not normal to throw up hair balls once a month, but I can tell you my cat would throw big hairballs up at least twice a month. More so the past year. It would smell and they would be in a greenish brown bile. I just thought this was normal. He does have symptoms now relating to IBD. Or it could be lymphoma in his digestive tract causing him not to eat or poop. I'm doing so much reading because I don't want to give up on him yet.
Also, if he had an obstruction, he would probably be vomiting when he eats.
I think an occasionally vomited up hairball in a long-haired cat (once a month) is probably no big deal. If it is happening multiple times a week, then we have a problem.

I'm still leaning toward cancer.

Let me know how he does after a few days on the steroids!
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Customer reply replied 4 years ago
Ok so whatever little food he has eaten would come back up? Is it normal for cats with cancer to not visibly look sick other than the weight loss because he's not eating? He kinda perked up after fluids and the pill and had some treats. When he had a blockage last time he couldn't eat at all but looked in much worse condition than this.

I just think its odd that he's urinating but not pooping when he has had a little big of food.

His hair balls were much more frequent than once a month. I'd say maybe 4 times a month and like I said they were gross. I just assumed normal because he has so much fur and he was always cleaning himself.

Blockage or lymphoma would show up on an ultrasound also? Which is more effective for this an X-ray or ultrasound?

Could a blockage even be correlated to low blood cell counts?
A large obstruction, like due to a hairball, should cause vomiting of food or small amounts of diarrhea with not much else. It depends on where in the GI tract the obstruction is. An ultrasound would be the best, XXXXX XXXXX as it would give more information that a plain x-ray.

If he hasn't really been eating much, I wouldn't expect much in the way of stool.

A blockage due to a hairball shouldn't really affect his bloodwork. Plus I would expect abdominal pain and worsening symptoms if he had a complete blockage.
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Customer reply replied 4 years ago
Ok I guess that rules blockage out. I am trying to think if anything other than cancer :(. If the steroids bring a little appetite and has more energy would you recommend another round or is it really one round and that's it? I'm just curious how long I can sustain him on these pills. I know he has to eat in order to survive. Also, if he's still not drinking on his own do you recommend another I.V. bag of fluids to inject? The vet gave us one bag that is good for like 4 days.

I sort of feel like I'm temporarily holding off his death this way I'm just not ready to let him go :(
If the steroids are helping and he is eating and feeling well, I would definitely continue them until he no longer is doing well. If your vet put him on a pretty high dose (like 5 mg twice a day), if things are going well after 2 weeks, I might try decreasing to 1 tablet per day. But I'm not sure I would stop them completely, unless he seems 100% back to his old self after a month of taking them.

Giving SQ fluids at home can be helpful and I don't consider it to be "going above and beyond." I would probably give him 100 ml daily or 150-200 ml every other day.
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Customer reply replied 4 years ago
Ok thank you. Hopefully he wants to eat again. I am going to get some wet food for him. I read wellness brand is good, do you recommend anything else?
If he is underweight, I would get some Prescription Diet A/D from your Vet or Iams Veterinary Diet Max Calorie--both are calorie dense (the Iams is the most) and will help get weight on him.

Otherwise, Wellness is fine. I like EVO, I feed my cats Science Diet canned and dry. Really, whatever he will eat that isn't really cheap food (no Friskies or Cozy Kitten!)
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Customer reply replied 4 years ago
Thanks. I ended up with wellness wet. He lapped up the gravy and ate 10 treats. He has gone to his water bowl 3 times and drank a good amount of water. We are having a hard time giving him his pill though. We can hardly pry open his mouth and then he spits it out before we know it. Next week we are on vacation and one person will be giving the pill. Is there any way you suggest we give it to him? Crush it maybe and put it in an eye dropper?
You can certainly crush the pill up and either squirt it in his mouth or mix it with the gravy. By next week he may be eating much better and the pill (or crushed pill) can be better hid in canned food.

You can also get it compounded into a liquid--your vet should know some compounding pharmacies or you can call around to pharmacists in your area and see if they can make it in a chicken or beef flavor.
Dr. Scarlett
Dr. Scarlett, Cat Veterinarian
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Hi Melissa,

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

Dr. Scarlett
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Customer reply replied 4 years ago
Hi Dr. Scarlett

Well, Moose was eating a bit of dry food on his own here and there and treats. He has been drinking water once or twice a day and he seemed to be drinking a lot. Today though, he only ate a little food this morning and hasn't drank anything. So it seems like some regression. We've been giving the steroid but having a hard time because he doesn't want to sit for it. He was still alert and rolling on his back to get scratched. He'll sit in the window and his tail moves when he sees a bird. He hasn't lost it completely, but I don't see him bouncing back much. It's upsetting because it appeared to have come out of nowhere. Ill see how the next couple days and have to make a decision from there.
Thanks for the update; sorry it isn't better news.

Does Moose like canned food at all? Sometimes tuna or meat baby food will get them to eat a little.

Poor guy, wish we had a diagnosis!
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Customer reply replied 4 years ago
Ill give those a try. He literally at some wellness tuna, treats and water. So that's something! He was more drawn to the dry food. I picked up Orijen and he seems to like it. I hold my breath when he goes to the food an water bowl because I just want him to stay and eat! He's on his own schedule with that. Ill let you know how the next couple days are.
Sounds good. I'll keep my fingers crossed for you both!
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