# Not eating and anemic...



## Meli1973 (Nov 15, 2012)

We have a 13yo male neutered tabby. Over the last couple of months he has lost a bit of weight and has lost interest in his morning food although he would eat well at night. Last week I gave him a dose of Capstar as the vet recommended dosing all 3 of our cats after we had flea-bombed the house and used Advocate on them to try to rid them of fleas entirely. The next day he stopped eating altogether and did not move off the couch for over 24 hours. He has also stopped grooming. 

After 2 days of him not eating and hardly moving I took him to the vet. She kept him for about 36 hours in which time she did blood-tests, re-hydrated him and force fed him. His blood tests came back normal except for he is slightly anemic. She gave him a worm treatment as this is a common cause of anemia. As he was clearly distressed being at the vets we brought him home with a week's supply of Microlone (steroid) to try to encourage his appetite. We are now 4 doses into the steroid but I'm not seeing a noticeable difference in his appetite. I've tried every type of food I can think of that he normally loves but he's just not interested. He might be eating a tablespoon of food per day. Still not grooming himself but he loves it when I brush him.

How quickly should a steroid work? Should we have seen an improvement by now or does it take longer to act? 

If it's not worms that have caused the anemia I'm worried its Feline Leukemia or another type of cancer. Am I over-reacting?:001_unsure:


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## Ianthi (Oct 21, 2008)

Anaemia can have several inciting causes, one of which is chronic illness for instance which resolves once the concurrent illness is resolved. Another is infection where the body sequesters iron (because bacteria thrive on this) which is necessary for making red blood cells. There are lots more and in older debilitated animals even fleas can be a contributor! The actual blood tests can help pinpoint it's actual origin. An anaemia profile will tell you even more!

I think it's important to discover exactly why your cat is anaemic in the first place. As you've mentioned worms can be a factor so I wonder why the vet thought this? Steroids IME work fairly quickly in terms of appetite and general activity.

How was he on physical examination? Any discomfort? What's his history?

I think you need to take him back now especially with the poor appetite. He must have lost weight for one thing!


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## Meli1973 (Nov 15, 2012)

Thanks for your reply. He has no history of illness at all - even the vet commented that his blood tests were very clear except for the anemia. He used to get into fights when he was younger and he's be on antibiotics for a few scratch injuries that became infected but the last time this happened would have been more than 5 years ago. Really we've been extremely lucky to have had a very healthy cat in terms of illness. 

I will speak to the vet today and see what she suggests.


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## Meli1973 (Nov 15, 2012)

Good news - the test for Feline Leukemia and Feline AIDS is negative. Still not eating or drinking very much at all but he has gained 40grams this week and was more animated at the vets today than he has been all week. 

The vet is going to run his bloods again to see if there is a difference between the ones she took last week. 

Fingers crossed they turn up something!


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## Meli1973 (Nov 15, 2012)

Bad news tonight. Our little guy has a lower red blood count than last week and he has not eaten much at all today. His PCV is now down a further 5% to 23.

The vet has prescribed increasing his steroid dose and also an antibiotic paste. She can find no underlying reason in his bloods for the anemia. She suspects cancer. I wonder if it's a toxin or an allergic reaction to something in the Capstar that has started this downward spiral.

If he doesn't improve in the next 10 days we will be facing having him put to sleep. We rescued this little guy from a bag of dead kittens someone had dumped near the railway line near our house, 13 years ago. He is part of our family and I'm just so sad to see him so unwell. I can't believe it's happened so quickly. 

Fingers crossed that he responds to the medication soon.


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## denflo (Apr 29, 2011)

Has the vet suggested doing any ultra sounds on him? If it is a tumour, then this should show up on a US. Has he been sick or had diarrhea recently?


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## Ianthi (Oct 21, 2008)

Meli1973 said:


> Bad news tonight. Our little guy has a lower red blood count than last week and he has not eaten much at all today. His PCV is now down a further 5% to 23.
> 
> The vet has prescribed increasing his steroid dose and also an antibiotic paste. She can find no underlying reason in his bloods for the anemia. She suspects cancer. I wonder if it's a toxin or an allergic reaction to something in the Capstar that has started this downward spiral.
> 
> ...


Right, who has suggested putting him to sleep? The vet? Ridiculous in my view. A PCV of 23% isn't that bad at all - I've seen cats with ones much worse than this who, once the inciting cause has been found (and believe me there ALWAYS is one) and once successfully treated, have been pulled back from the brink ! The reason for the decline and your vet's apparent inability to find the cause conern me far more than the actual numbers. in fact, the latter would worry me more. Any vet worth their salt should be able to do this! Frankly, if you remain with this vet he risks being PTS owing to sheer lack of effort!

So, two options-request the vet as a matter of urgency ( I'm suggesting this because the lab may have some blood left over so could save time and money) to do an Anaemia Profile which is a special test aimed at finding the cause. This is always run at an outside lab. If you have copies of the other tests meanwhile, I can have a look for you. Changing vets or seeing a different one at the practice is another option. You do need to pin this down fast though before it declines further with the added risk of more complications!

Based on the fact he's not eating, which suggests an underlying illness such as inflammation, I would _suspect_ this to be a chronic illness anaemia though it may also be due to a combination of factors. In some instances it can even be due to a blood parasite, which is easily treated with antibiotics.

I also wonder if it might be worth testing for something like pancreatitis as anaemia can be one of the symptoms-the inappetence might just well be caused by this. In any case, you could enquire about a test now though, just to rule it out! B12 injections can also help with anaemia so I'd ask about these as well.

.


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## Meli1973 (Nov 15, 2012)

Thanks for the replies and support  

I don't think the vet is suggesting PTS because she doesn't care or indeed is lacking in effort. I think she just wanted us to prepare ourselves should we not see an improvement and we don't want to go down the path of invasive/distressing tests for a condition we will not be able to afford to treat. She has prescribed the antibiotic for the blood parasite and she's also told us about the referral hospital she uses to test and treat for cancer and the potential costs involved should we take that route. On top of which one of our other cats has just had to have his leg amputated so she's conscious of the fact that in the last 6 weeks we've spent over $2000 on our cats and we are now approaching a point where extensive and expensive treatment is not something we're in a position to afford.

This morning at 5am our little guy was hungry and ate a tiny bit of breakfast (tinned food) and drank some water. He ate a bit more at about 8am (ham and unsalted butter - a tip I picked up from someone else's site about cats who aren't eating). He's had a 2nd dose of the antibiotic paste and is on the 2nd day with the double dose of steroid. I also watched him groom himself just a little bit (not a big clean but the first time in a week he's bothered to lick his fur). These are positive signs although it's early days. I'll keep you posted.


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## Sled dog hotel (Aug 11, 2010)

Ianthi said:


> Right, who has suggested putting him to sleep? The vet? Ridiculous in my view. A PCV of 23% isn't that bad at all - I've seen cats with ones much worse than this who, once the inciting cause has been found (and believe me there ALWAYS is one) and once successfully treated, have been pulled back from the brink ! The reason for the decline and your vet's apparent inability to find the cause conern me far more than the actual numbers. in fact, the latter would worry me more. Any vet worth their salt should be able to do this! Frankly, if you remain with this vet he risks being PTS owing to sheer lack of effort!
> 
> So, two options-request the vet as a matter of urgency ( I'm suggesting this because the lab may have some blood left over so could save time and money) to do an Anaemia Profile which is a special test aimed at finding the cause. This is always run at an outside lab. If you have copies of the other tests meanwhile, I can have a look for you. Changing vets or seeing a different one at the practice is another option. You do need to pin this down fast though before it declines further with the added risk of more complications!
> 
> ...


Just a thought but is immune mediated hemolytic anemia or auto immune hemolytic anemia a possibility? I think you can get primary where the body produces antibodies against its own red blood cells and also a secondary version caused by things or started off by toxins and medications vaccinations and allsorts. Although I think there can even be an idiopathic cause (just unknown)

The only reason I ask is that I noticed he seemed to pick up on steroids and steroids are usually used with IMHA to supress the bodies immune response to stop it attacking the blood cells.

Amongst other tests there is something called a coombs test that is usually part of the diagnosis. Just thought I would mention it in case you think it could be a possible.


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## Ianthi (Oct 21, 2008)

Yes, it could be Sled Dog, however it tends to be more common in dogs than cats. Additionally, it would need an immunosuppressive steroids dose for treatment and the kitty's reaction sounds normal to me. That's why I was suggesting the Anaemia Profile which could include a Coombs. I'm just concerned at why this vet isn't able to pinpoint an actual cause(s) and although numerous-it's not that difficult.

(PS I meant to to reply to your last post about the HT bit snowed under since but will do!)


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## Ianthi (Oct 21, 2008)

Meli1973 said:


> Thanks for the replies and support
> 
> I don't think the vet is suggesting PTS because she doesn't care or indeed is lacking in effort. I think she just wanted us to prepare ourselves should we not see an improvement and we don't want to go down the path of invasive/distressing tests for a condition we will not be able to afford to treat. She has prescribed the antibiotic for the blood parasite and she's also told us about the referral hospital she uses to test and treat for cancer and the potential costs involved should we take that route. On top of which one of our other cats has just had to have his leg amputated so she's conscious of the fact that in the last 6 weeks we've spent over $2000 on our cats and we are now approaching a point where extensive and expensive treatment is not something we're in a position to afford.
> 
> This morning at 5am our little guy was hungry and ate a tiny bit of breakfast (tinned food) and drank some water. He ate a bit more at about 8am (ham and unsalted butter - a tip I picked up from someone else's site about cats who aren't eating). He's had a 2nd dose of the antibiotic paste and is on the 2nd day with the double dose of steroid. I also watched him groom himself just a little bit (not a big clean but the first time in a week he's bothered to lick his fur). These are positive signs although it's early days. I'll keep you posted.


So on what grounds does she suspect cancer then? Any abnormalities ( lumps, intestinal thickening etc ) on physical exam? Were the bloodtests completely normal? A suspicion like this shouldn't preclude her looking more thoroughly for the cause of the anaemia though. Do you think he's in any pain? If so painkilers might help a lot! You do need a definitive diagnosis regardless though - otherwise it only amounts to 'tinkering' around with valuable treatment time being lost!

I'm glad to hear he's picking up for you-fingers crossed it continues. Sorry to hear about your other cat as well.


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## Meli1973 (Nov 15, 2012)

Sad news I'm afraid, Little Man passed away last night. I really thought he was improving and responding to the drugs, he was eating of his own volition and was responsive to us, but yesterday morning he took a turn for the worse and we found him struggling to breath and move when we got up. I spoke with the vet and we monitored him all day - I was syringe hydrating him all day but he just got worse and worse. In the end we chose to end his suffering rather than hope he would pass away quietly on his own - I felt he was in too much pain for me to consider letting him continue.

We plan to bury him at home tonight and plant a beautiful rose just for him.

Thank you for all your advice and support.


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## Sled dog hotel (Aug 11, 2010)

I am so sorry for your loss, thoughts are with you.
RIP little Man x


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## denflo (Apr 29, 2011)

I'm so sorry to read this, but you must reassure yourselves that you did absolutely the right thing for him at the time when he needed you to the most - easier said than done, I know. 

RIP little boy


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