Hello Group:
I just got back from the vet where my 11 month old cat "Arlo" was given a blood transfusion and a battery of tests. The prognosis is not good..PROBALLY FelV ...so I wanted to get some feedback from the group ....if there is anything else I can try if the meds I am giving don't work -- I am all ears....I really want my little guy to make it. His PCV/TS (on presentation) was 7%/8.0 g/dL His PCV/TS (AFTER THE TRANSFUSION) IT was . : 10%/6.6 g/dL. He came back negative for FelV/FIV , his kidneys are fine, so is his white blood cell count. But the Vet believes that he does have FelV, it's just hiding out in the bone marrow. They have given me meds to treat him for IMHA and Hemobart but nothing specifically for FelV. What about interferon?
What about Immuno regulin?
Please help me sort this out. I am bringing him back to the vet on Monday or Tuesday and would like to have a plan or at least more info then I have now.
Here's the summary of the Vets prognosis: "Presentation: On presentation, Arlo was quiet, but alert and responsive. MM - Pale, CRT - unable to get. Heart Rate - 200 bpm, Resp Rate - 50 bpm, Temp - 99.8 F, Blood pressure - 115 mmHg. Arlo was tachycardic with a graqe IIIIVI heart murmur was auscultated. Lungs auscltated clear and eupneic. His pulses were fair and urine was staining his perineum. The remainder of his physical exam was within normal limits.
Because of the mild clinical signs relative to the severity of the
anemia, this anemia is most likely chronic in nature. The CBC results and reticulocyte count reveal that the. anemia is non-regenerative. Even though the FelV/FIV test was negative, this doesn't rule out FelV as a cause of the chronic non-regenerative anemia. Other causes of a chronic anemia include red blood cell parasites such as hemobartonella (typically regenerative). We highly recommend that a bone marrow aspirate and cytology be performed in order to definitively rule out FeIV. As this was not an option (for financial reasons), we plan to treat for a potential hemobartonella infection with Doxycycline (an antibiotic). There is no effective treatment for Feline Leukemia Virus. Another potential cause of the anemia is IMHA (immune-mediated hemolytic anemia) which results when the body attacks its own red blood cells (RBCs). This is a less likely differential as bloodwork results usually show a regenerative response in spite of the destruction of red blood cells. Additionally, bilirubin levels are commonly increased with this syndrome. The hemolysis is also usually evident when performing the PCV/TS. There was no evidence of hemolysis at this time. Treatment of IMHA involves steroid therapy to suppress the immune systein and prevent its attack on the RBCs. If Arlo does have hemobartonellosis, steroid therapy could .potentially make it worse. . While the heart murmur is most likely secondary. to the anemia, a primary cardiac cause cannot be ruled out without chest radiographs +1- echocardiogram. The murmur improved after administering the blood transfusion. Chest and abdominal x-rays would also help to evaluate for lymph node enlargement and/or organ enlargement (common in feline leukemia virus). . Discharge Instructions: Please schedule a recheck appointment either through your regular veterinarian or through the medicine service at FA VS in 2-3 days to evaluate his response to therapy. This may entail performing repeat bloodwork to evaluate the anemia. If he becomes acutely much more lethargic or depressed or inappetant and his gums appear pale, please bring him back immediately as he may require another blood transfusion. 1. Doxycycline (Vibramycin) (5 mglml solution): Please give 6 ml by mouth once daily for the next 8 days. A dose was already given intravenously today. 2. BaytriI (68 mg tablet): Please give 'l4 tablet by mouth once daily for 14 days. 3. Prednisone (5 mg tablet): Please give 1 tablet by mouth twice daily indefinitely. Response to therapy will be re-evaluated. If IMHA is the cause of the anemia, Arlo will require long term steroid therapy." Please if there is anything that the Vet missed or that I can try I would be so grateful. Chris |
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