Wendy

I was going to comment on that issue earlier, but I thought you had already 
gone ahead with the bone marrow testing. I am not sure there is any other 
treatment, regardless of the outcome of the testing. I personally agree with 
you that I probably would choose not to put my cat through bone marrow testing, 
when it really can't affect the outcome. I am glad to hear that he is feeling 
better after the two transfusions. Use the Doxy-Pred-Winstrol combination now, 
and hopefully, your kitten's haematocrit doesn't end up falling after the 
temporary boost from the blood transfusion. The life span of a red blood cell 
is 120 days (at least in humans), and the blood transfusions will have red 
cells at different stages of their life spans, so you probably already know 
that the effect of the transfusions will probably only last 3 months or so. 
Hopefully by then the Winstrol would have kicked in to assist the bone marrow 
in producing red cells.

Amani

From: Felvtalk <felvtalk-boun...@felineleukemia.org> On Behalf Of Wendy
Sent: September 19, 2019 10:41 PM
To: felvtalk@felineleukemia.org
Subject: [Felvtalk] Bone Marrow Testing for FELV positive Cat?

Hello, Thank you all for your replies earlier today.  Our cats' red count is 
coming back after 2 blood transfusions, and we started doxy today.  He is 
eating, drinking, purring, has much better energy, is back to talking, etc.  We 
are awaiting results that we should have tomorrow morning on the test of his 
lymphocytes using blood that was drawn before the blood transfusions.  If the 
test comes back showing that the lymphocytes contain cancer cells, then we have 
our answer.  If the test comes back showing that the lymphocytes do not contain 
cancer cells, then it has been suggested that we do bone marrow testing asap 
tomorrow afternoon.  My understanding is that the bone marrow test would likely 
either show that he has myelodysplasia or cancer in his bone marrow.  My 
question is: Would the suggested treatment of Doxy + Pred + Winstrol change if 
we find out that our cat has myelodysplasia vs if he has cancer in his bone 
marrow?  If the treatment is the same, then I question putting our cat at the 
risk of anesthesia, lowering his red count, infection, etc.  The plan is to 
start our cat on Doxy + Pred + Winstrol tomorrow afternoon, and we are being 
told that if we want to test his bone marrow we need to do it tomorrow morning 
before we start giving him steroids.  In addition, his chest x-ray today was 
clean, and his abdominal ultrasound showed a slightly enlarge spleen and either 
a few slightly enlarged lymph nodes or possibly a few small satellite spleens, 
all of which seems can be expected with the anemia and / or infection, and 
therefore was not cause for concern.

Following are the background facts, which I also posted this morning:  Our FELV 
positive neutered male cat approximately 1 and ½ years old has gotten very sick 
suddenly. He is a house cat, and he was neutered in May of 2019.  A few days 
ago, he became lethargic and lost interest in eating.  We had his blood drawn 
yesterday and he had iv fluids yesterday, and today we were told he needed a 
blood transfusion (or two) and more iv fluids, and then a bone marrow test 
tomorrow.  We were told that the first blood transfusion today was not very 
effective because he got so many iv fluids at the same time, so now they are 
going to give him another transfusion.  As background, we rescued him as a 
stray from Barbados in October 2018 when he was about 6 months old, and he has 
been healthy, active, happy and gaining weight, despite being FELV positive.  
Since October 2018, we cured him of giardia and bartonella henselae.  On 
12/31/2018, he tested positive for the ELISA and IFA, although his blood work 
was in normal ranges at that time.  In 03/2019, we started giving him 1 t-cyte 
shot once per month, and we started giving him 1ml of interferon per days for 7 
days on and then 7 days off, repeated.  We have continued the interferon and 
t-cyte in this manner ever since 03/2019.  Just yesterday, here are the results 
of his blood work:
Tests                             Results                Ref. Range
Total Protein                  6.1                      5.2- 8.8 g/dL
Albumin                         3.5                       2.5- 3.9 g/dl
Globulin                         2.6                       2.3- 5.3 g/dL
A/G Ratio                      1.3                        0.35- 1.5
AST (SGOT)                  106 (HIGH)           10-100 IU/L
ALT (SGPT)                   39                        10- 100  IU/L
Alk Phosphatase            40                        6- 102  IU/L
GGT                              1                            1- 10 IU/L
Total Bilirubin               0.1                       0.1- 0.4 mg/dL
BUN                             15                        14- 36 mg/dl
Creatinine                      0.9                       0.6- 2.4 mg/dl
BUN/Creatinine Ratio   17                         4-33
Phosphorus                    4.4                       2.4- 8.2 mg/dl
Glucose                        178 (HIGH)             64 - 170 mg/dL
Calcium                         9.3                    8.2- 10 .8  mg/dL
Magnesium                    2.0                       1.5- 2.5 mEq/L
Sodium                         153                      145-158 mEq/L
Potassium                      4.6                       3.4- 5.6 mEq/L
NAIK Ratio                     33                        32-41
Chloride                    121                      104-128 mEq/L
Cholesterol                    94                        75- 220 mg/dl
Triglyceride                    108                      25-160 mg/dl
Amylase                       611                          100-1200 IU/L
PrecisionPSL(tm)              10                         8- 26 U/L Acute 
pancreatitis is unlikely. Chronic pancreatitis is not excluded.
CPK                         711 (HIGH)                  56-529 IU/L
WBC                             20.5 (HIGH)        3.5- 16.0 10'/µL
Corrected for NRBCs
ABC                              2.5 (LOW)            5.92-9.93 10°/µ L
HGB                           4.5 (LOW)            9.3- 15 .9 g/dL
HCT                                                           29-48 % '
The hematocrit in th 27. (Normal range 29-48). A recent study has indicated 
that >23% of anemic cats are infected with one or more species of hemoplasma 
and several studies confirm that PCR is significantly more sensitive in 
detecting hemoplasma.
MCV                              57                        37-61 fl
MCH                             18.2                     11-21 pg
MCHC                          32                        30-38 g/dl
Poikilocytosis                 Slight
NRBC                           9(HIGH)                0-1/100 WBC
Blood Parasites                       None Seen RBC Comment
Rouleaux Moderate
Platelet Count             78 (LOW)            200-500 10'/µL
Platelet count reflects the minimum number due to platelet clumping.
Platelet Estimate            Adequate
Differential                    Absolute      o/o
Neutrophils (LOW)        1640             8      2500 - 8500 /µL
Bands                                                 0
Lymphocytes (HIGH)   17630            86    1200 - 8000 /µL
Monocytes (HIGH)        1025                5     0-600 /µ L
Eosinophils                    0                      0      0-1000 /µ L
Basophils (HIGH)         205                  1      0- 150  /µL
FREE T4 BY EQU ILIBRIUM D IALYS IS (Pending)
UR INALYSIS- C OMPL ETE
Collection Method Cystocentesis
0.8- 4.0  µ g/dl
Color Appearance Specific Gravity pH
DARK YELLOW TURBID
1.056                                                  1.015- 1.060
7.0                                                      5.5- 7.0
Protein                    2+ (HIGH)        NEGATIVE
Glucose-Strip        NEGATIVE        NEGATIVE
Ketones                 NEGATIVE        NEGATIVE
Bilirubin                 NEGATIVE        NEGATIVE
Occult Blood        NEGATIVE          NEGATIVE
WBC                      NONE                0-3 HPF
RBC                       NONE                0-3 HPF
Casts             NONE SEEN             Hyaline 0-3 LPF
Crystals         NONE SEEN             HPF
Bacteria Epithelial Cells    NONE SEEN NONE SEEN                                
                                   None Seen                                    
                                  HPF HPF
Fat Droplets                                                                    
  >50                                                                           
                                                                        HPF
RETICULOCYTE COUNT REFLEX
Reticulocyte Total Abso lute Ret iculocytes
0.6                         0-1                  %
15000                  <45,000               JµL
Would you please let us know what we can do to help our cat?
Thank you again, Wendy

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