Sally, Not a good report, but not entirely without hope either. Do you happen to know the specific numbers on the CBCs? Get a copy of the reports. Read them carefully - vets miss things sometimes and don't always remember to convey all the information they have when they meet with you. It happens, not intentionally or maliciously.
Here is specifically what I would like to know: 1. Reticulocyte count for each CBC you had done- if this number is increasing (I would like to see by way of thousands or tens of thousands) than you are certainly on the right path and need only wait until those cells become mature enough to replenish the RBCs in the peripheral blood. A regenerating anemia is defined as a reticulocyte count greater than 15,000 (for most labs). An exact number and change in numbers over time would give me a better idea of what is going on in his bone marrow. Understand that it takes time for these cells to mature before they become fully functional for his needs - in the meantime a blood transfusion could be necessary. 2.Hematocrit - most vets will transfuse around 18 or 19. If this is his first transfusion and he has a hematocrit around 14-15, I would not hesitate to transfuse. In general the first transfusion is kind of a freebee. They generally do not have a reaction until subsequent transfusions. Your vet, however, should make sure that the transfused blood is a match for Lukey. You can do a type and cross or a full panel (~$100.00). If she is uncomfortable about this I would go to an emergency vet or someone who feels comfortable doing them. It should be a slow transfusion and he should be monitored for any signs of a reaction. If there is, you simply stop the transfusion. It is a risk/benefit analysis. In my opinion, a hematocrit of 15 is certainly worth transfusing. I would not hesitate - not even one day. Again, I would like to see the numbers. 3. Lymphocytes - this number should be increasing as a sign of stimulated immune response (a sign the LTCI is working)- I would like to know all results from the first to the last blood draws. 4. Platlets - an increase in these also suggests a stimulated bone marrow indicating the LTCI is working. Autumn had a hematocrit of 10, I believe, when I brought her in for the first visit. She had a hematocrit of 4 when I transfused her. I would not recommend waiting this long. She was dying, a matter of hours and she would have died. Do not wait until this point. Here's the concept. Mature RBCs live about 2 1/2 to 3 months in most cats, at the end of that time, the spleen destroys the old cells in anticipation of new ones. It is likely that Lukey has had a suppressed production of RBCs for quite some time and now the old RBCs are being destroyed. If his bone marrow sort of woke up after the LTCI injection, it takes weeks for the bone marrow to generate the cells and then more time for them to mature. So in the cycle of normal bone marrow production of RBCs and destruction by the spleen, Lukey's cycle was interrupted and now weeks later when the old RBCs are dying there aren't any new mature ones to take their place. If there is evidence that the bone marrow is waking up (increased reticulocyte count, lymphocyte count and platelet count) what you need to do is provide supportive care until those cells can mature and do their job. This may very well include a transfusion. I would not fear the transfusion because of a reaction if he is that severely anemic. Everyday his old cells are dying. It is a race between new maturing RBCs and destruction of the old ones. The statement that Lukey has a regenerative anemia is very promising. Right now is a very difficult time for you and for him as he is in the lull between the suppressing effects of Felv+ and the hopefully productive effects of LTCI. You are seeing a clinically diminishing status but his lab work suggests improvement. I would rely on the labs and take heart in the promising numbers. If you give me the numbers I can tell you how happy or not happy I would be with the presence of and rate of improvement. Take heart knowing that the clnical improvement will be slow and delayed from the lab tests. What you see improving in lab values you should see reflected in clinical improvement with time. Be patient but don't hesitate to transfuse if necessary. This is my opinion and how I would evaluate and proceed with an animal of my own. There is never a guarantee, but I will pray for you and for him. If there is anything more I can do, please don't hesitate to ask. Jenny On 9/25/09, Tower Laboratories Corporation <sa...@towerlaboratories.com> wrote: > > Hi, Jenny and all, > > Lukey is not doing well. He has become much more anemic > while we've been waiting on the LTCI to work. The good news > is that though his lymphocytes are way down, his RBCs appear > to be regenerating somewhat, so there is still hope if we > can keep him from crashing from the anemia. > > I'm wondering if you can tell me what Autumn's numbers were > when it was decided that a transfusion was necessary? My > vet has advised against it because of the risk, though I > don't want to wait too long if that is what it will take to > save him while the LTCI continues to work on his RBCs. The > vet is putting in a nasogastric feeding tube because he > continues to fight us on the syringe feeding and is now bone > thin. He is also getting intravenous fluids and high doses > of vitamin C. He doesn't seem to be struggling to breathe, > though, and is still fairly alert, though his gums are white > and he is clearly not well. > > Thanks for your concern, and we sure could use some prayers > for our Lukey boy . . . we're so worried > > Sally > > > -----Original Message----- > > From: felvtalk-boun...@felineleukemia.org > [mailto:felvtalk- > > boun...@felineleukemia.org] On Behalf Of jbero tds.net > > Sent: Friday, September 25, 2009 11:47 AM > > To: felvtalk@felineleukemia.org > > Subject: Re: [Felvtalk] FW: Q re Staph Protein A > > > > Hey everyone, > > > > I haven't been following the emails concerning strep A. > but I > > actually > > looked into this when trying to figure out what to do with > Autumn. > > There > > were a few studies out there but they were done about a > decade > > or more ago, > > mostly by a vet in Texas. I called his lab to speak with > him. > > Unfortunately he was no longer practicing there, but I > spoke with > > a > > colleague of his who suggested the results weren't as > promising > > as was > > hoped, there were some negative side effects and they had > > stopped > > investigating it. > > > > I don't remember the exact details but I thought it was > less > > promising than > > LTCI. If I get a chance later today I will do a > literature search and > > try > > to find the paper. I'll forward whatever I find. > > > > Also, a quick update on Autumn. Tomorrow I will get a CBC > on > > her and let > > you all know. Her energy is up and she's getting > mischievous > > again. She's > > slowing gaining weight back - the bones are less prominent > > again. She > > continues to do well. I know it may not be the cure all > for felv but > > I feel > > there is at least some hope of treatment. Sally I hope > Lukey is > > improving. > > > > Jenny > > > > > > On 9/23/09, mitchell <hhur...@gmail.com> wrote: > > > > > > Approved by the United States Department of Agriculture > > > > > > On Wed, Sep 23, 2009 at 9:54 AM, MaryChristine > > <twelvehousec...@gmail.com > > > >wrote: > > > > > > > approved by whom, i keep asking. and it's not a > treatment, > > it's a > > > > "treatment > > > > aid." that's all they're allowed by law to call it. > > > > > > > > > > > > > > > > On Tue, Sep 22, 2009 at 11:47 AM, mitchell > > <hhur...@gmail.com> wrote: > > > > > > > > > I don't know much about this product, but I do know > that > > there is an > > > > > approved treatment for FeLV. That is LTCI. It can > be > > obtained easily. > > > > > > > > > > > > > > > > > > > > > > -- > > > > > > > > > Spay & Neuter Your Neighbors! > > > > Maybe That'll Make The Difference.... > > > > > > > > MaryChristine > > > > Special-Needs Coordinator, Purebred Cat Breed Rescue ( > > > www.purebredcats.org > > > > ) > > > > Member, SCAT (Special-Cat Action Team) > > > > _______________________________________________ > > > > Felvtalk mailing list > > > > Felvtalk@felineleukemia.org > > > > > > > http://felineleukemia.org/mailman/listinfo/felvtalk_felinele > ukemia.o > > rg > > > > > > > _______________________________________________ > > > Felvtalk mailing list > > > Felvtalk@felineleukemia.org > > > > > > http://felineleukemia.org/mailman/listinfo/felvtalk_felinele > ukemia.o > > rg > > > > > _______________________________________________ > > Felvtalk mailing list > > Felvtalk@felineleukemia.org > > > http://felineleukemia.org/mailman/listinfo/felvtalk_felinele > ukemia.o > > rg > > > > _______________________________________________ > Felvtalk mailing list > Felvtalk@felineleukemia.org > http://felineleukemia.org/mailman/listinfo/felvtalk_felineleukemia.org > _______________________________________________ Felvtalk mailing list Felvtalk@felineleukemia.org http://felineleukemia.org/mailman/listinfo/felvtalk_felineleukemia.org
