Expert: Jessica - 7/29/2010

Question
hi Jessica,
my cat ( about 8 yrs old) has not been eating for a week now. took her to the vet and did some blood test. her white blood cells are low(first test 4.8)5 days later(4.1). all the other results were normal. did a FIV and FELV test and that was negative too. did an x-ray as well. other than gas in her stomach everything else was fine. She has no appetite, although she tends to go to her food bowl sniffs the food then walks away without eating. She is not dehydrated as she does drink water. Been force feeding her and the vet has give her some antibiotics, folic and vit b12 tablets. Please let me know what i can do as i feel so frustrated as the vet has not given me any answer to what it could possibly be. She did say that we could give her the jabs kimotherapy patients get before going for kimo to increase their white blood cells. Is that advisable? Would really appreciate it if you could tell me what we should do next. Thank You

Answer
Hi Lavinia,

I'm glad she tested negative for FIV and FeLV.  Some other things to be concerned about are cancer, panleukopenia (feline distemper), feline infectious peritonitis and possibly an autoimmune disease.  

If your cat is vaccinated against panleukopenia, then you can almost certainly rule this out - the vaccine is nearly 100% effective.  If not, I would be suspicious.  Your vet may have reasons based on the blood tests why she would not suspect this disease, but the main symptoms are nausea and anorexia, and the major finding on blood tests is a low white blood cell count, which will usually drop to an almost undetectable level as the disease progresses.  Because this is a viral illness, it can’t be cured, but the cat should be kept in the hospital with IV fluids and antibiotics to protect her against bacterial infections.  The disease is very dangerous and can take the lives of as many as 70% of its adult victims without prompt treatment.  White blood cell count does not tend to respond to filgrastim (the injection to boost white blood cells) if it’s caused by panleuk.

Cancer would be another large concern, as the bone marrow is often affected in later stages of lymphoma, which results in a low white blood cell count.  Additionally, depending on the location of the cancer, it can cause gas to build up as a byproduct of the activity of the cells.  When there is an abnormal amount of gas in the belly, sometimes it can mean inflammation, sometimes it can mean the presence of cancer in the gastrointestinal tract.  An ultrasound is often the best way to detect abnormalities that would suggest the presence of cancer.  Her white blood cell count may respond to filgrastim if cancer is the cause of her problems, but her anorexia would remain a concern.  An appetite stimulant such as mirtazepine or an anti-nausea medication like Cerenia might help.

Feline infectious peritonitis (FIP) is a disease initially introduced by a corona virus, which tends to cause mild diarrhea.  In some cats, the virus mutates and moves outside the intestines, into the lining of the abdomen, called the peritoneum.  The immune system overreacts to the presence of the virus so much that it causes body-wide inflammation, causing the condition known as FIP.  The condition is deadly in almost 100% of cases.  One of the findings on blood tests in the end stages is a low white blood cell count.  Often, you will see high globulin levels and low albumin levels, too.  There is no great test for FIP, but your vet can run a corona virus titer test to see if your cat has been exposed to the group of viruses that can cause FIP.  The problem is that most cats will test positive for exposure, and this does not mean they have the disease.  Your cat also is not in a high-risk category (kittens under a year old, cats over 15, or cats with FIV/FeLV).  If the vet does suspect FIP, however, she might start her on some prednisone to suppress the immune response that’s causing the symptoms, and perhaps an antibiotic.

Finally, auto-immune disease could cause some cats’ immune systems to attack their own white blood cells.  The exact cause of this is rarely found.  Normally there would be an indication of this kind of activity on her blood tests, such as a high eosinophil count.  An immunosuppressant drug is the treatment, such as prednisone, and this can be beneficial if she’s suffering from cancer or FIP, but dangerous if she’s suffering from panleuk.

I hope she improves soon!

Jessica