Expert: Jana Connell RVT, CVT - 8/3/2010

Question
My 3 year old male cat has had a yet-unexplained persistent anemia. He's been under the care of a Vet for the last 7 weeks. Here's a rundown of what's happened so far:
• 7 Weeks ago - He was having a problem with one of his ears, constantly batting at them. Looked very dirty. Also, was overgrooming himself. We had bloodwork run because it was also his annual, which his RBC came back at 19 indicating anemia. Everything presented fine. Vet suspected infection, prescribed an antibiotic (pink liquid - zythromicin?), and told us to come back in 10 days.
• 6 Weeks ago - no response, vet ran additional test which indicated nonregenerative anemia. Is posistive for coronavirus (multicat household) and feared FIP. Prescribed doxycycline and prednisone for 3 weeks.
• 4.5 Weeks ago - RBC still at 19, but vet was encouraged that test now showed he was producing large amounts of immature red blood cells. Expected improvement upon next test
• 3 Weeks ago - RBC raised to 25 , still slightly anemic (vet indicated normal is 29, although I've read online that it's 25 -4 45), refilled prescriptions.
• Today - RBC still at 25, test showed an elevated lymphocyte count. Vet said that this could indicate lymphoma or persistent virus, and that we either should double his predisone dose to 10mg per day, or get a bone marrow biopsy. We decided to do the latter. I also read that use corticosteriods can cause increased white blood cell count, as can stress when taking a blood sample.  

All other tests have been normal throughout process. Is positive for coronvirus but has no other indications of FIP. No FELV or FIV. Since his first visit, he's gained 1.25 pounds and his appetite and water consumption are normal. He shows no signs of illness and is one of our more active cats.

I feel like we may be missing something. I realize you're not a Vet, but was wondering if there's anything we may not be considering.  We'd like to get a 2nd opinion, but have already spent well over 1000 dollars trying to treat/diagnose our little guy.  Is it possible that a cat can just normally have a low RBC count?  Thanks ahead of time!

Answer
Thank you for taking the time to read my profile Bryan. Not many do!
I think a second opinion is a good thing, but let me ask you this: did your vet check the cat for hemobartonella infection? In our practice we have seen cats from a particular area in the county that get this infection, which is from a mycoplasma bacteria. The symptoms are very much the same as leukemia and anemia except for one thing- the cat is very active still. Here is some information on the disease:
http://vetmedicine.about.com/od/diseasesandconditions/f/FAQ_FIAhemobart.htm

Now having said that, there is also the chance that he is eating lizards and lizards have all kinds of stuff in them that causes anemia, B-vitamin malabsorption etc. Some species are fatal to cats.

I know that the vet gave him antibiotics, but maybe it's time for a different one and some tonic to build up his blood. We use Val Tonic, which most vets carry.

While it is true that a cat can have a latent FELV or FIV, FIP and those other two usually will show up on testing. They can always send out for a different type of test than what can be done in house but the results are usually the same.

I wouldn't put too much store into the elevated lymphocyte count unless it become persistent as well. The pred could be causing that.

You might want to call around and since you have all his labs maybe someone else might come up with something no one has thought of. Having his labs will save you a lot of money on a second opinion.

I hope you can find his problem soon, poor little guy. Please let me know if you do find out what it is.
My thoughts will be with you and your little guy.