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miw_bast

cats - non regenerative anemia

miw-bast
15 years ago

My 10 month old cat was diagnosed on Friday with severe non regenerative anemia, though a cause has not yet been found. Feline leukemia and FIV tests have already come back negative and she is fully vaccinated. She returns to the vet on Monday morning for further tests and a blood transfusion.

Because I'm not overly confidant about my vet, and his repeated comment that "this is the most exciting thing to happen in my career, such a young cat suffering so severly from anemia" is not in the least reassuring or comforting, I thought I'd see if anyone else has had a cat experience this type of anemia.....or if anyone knows likely causes? I want to ensure I know all the possibilities to make sure she is tested for everything so this can be dealt with.

My thanks!

Tina

Comments (78)

  • jaydep
    9 years ago

    hi all
    been reading your posts and feel a little worried now as my 2yr old female has been in the vets 3 days now and i don't think its looking good she is really anaemic and she had test done, she was negative on her FIV which is a good thing but her RBC was 4.
    just waiting to here from the vets as they want to speak to me so i think its going to be a blood transfusion as she mentioned it as a last resort but thingers crossed!

  • dave_hurd
    9 years ago

    hello everyone,

    reading your posts,many are heartbreaking. I had to put my dear Sarah to sleep on Oct 30, 2104 and am still crying once or twice a day and this background of sadness is ever present. Not sure if I will ever get over losing her this way. she was only four and got Mycoplasma blood parasite, which was my fault because I was not using Revolution on her and was using some essential oils.I though would be better for her than the meds. I didn't know if you didn't see fleas, that they could still be there. Also felt a few ticks on her and it breaks my heart that I could be so stupid to let her outside without a tick collar on in the Spring..anyway the Vet said the Mycoplasma could be easily cured with doxycycline. She didn't respond to the antibiotics and Vet said her anemia was Non-regenerative and she kept getting weaker and weaker. So heartbreaking, remembering how she used to run SO FAST!!
    Her hematocrit went from 20 back to 22 after I used the Revolution and poor baby had the fleas and ticks stop biting her. I will NEVER forgive myself as I loved her SO dearly. Anyway her hematocrit went down to 15 and the last time I took her to Animal Hospital she was so weak, that when I opened the carrier she just layed there. I am crying as I write this. Anyway she tested negative for FeLV and FIV as many of you have said your poor cats did as well. I didn't like what "Izrddr" said in his post above.
    I thought that if a cat had the virus in bone marrow that if cat got sick, the virus would again be in blood stream and cat would test positive. He said "many" cats tested negative and still had virus. I really doubt that. I was feeling guilty for feeding a stray cat that bit my Sarah in Sept. 2012. I thought that I attracted the thing that gave her FeLV. But when she tested negative, I felt less guilty, although still devastated. Then i read his post and now I a may still be guilty of indirectly causing death of a cat that meant everything to me.

  • lzrddr
    9 years ago

    I am sorry to hear about your beloved pet… it is very sad when these pets get ill for no apparent reason and we cannot find the answers.

    I do not, however, think you read my post well. I said I have had 'several' cases in which my patients had Felv virus recovered in bone marrow (two of three on post mortem sadly) that did NOT test positive in their blood… but certainly not 'many' cases. I have not seen but 3 cases ever my self in which the kitty had Felv in the bone marrow but every time we tested (and some we tested 2-3x) the blood for Felv it was negative. Very frustrating. One cat was positively diagnosed by the specialists before it passed away, but it did not help the end result obviously. But in a way, all felt a bit better as Felv is basically an incurable virus, so at least we (me and owners) did all we could.

    Some kittens have Felv before you even get them (some are even born with the virus) so there is little you can do to avoid it in those cases… though keeping them indoors is virtually 100% effective as long as they weren't born with the virus (or got it as tiny kitten before you got her).

    There may be other viruses we have not discovered yet that could be the root of the problem, too. Felv virus was only discovered about 30 years ago, and FIV nearly the same. We are discovering new viruses every 10-30 years.

  • dave_hurd
    9 years ago

    yes, sorry, i am just devastated by being the cause of something I was responsible for their care and I FAILED to do the basic thing of keeping her immune system stress free.. I mean to keep her free of fleas and ticks is just BASIC care that I did wrong thing and the Mycoplasma she got , i believe , stressed her and brought out the killer disease, I am pasting something that tells me that this is most likely the case. NEVER FORGIVE MYSELF.

    When Office Tests For Feline Leukemia Are Negative, Can I be Certain

    That My Cat Is Safe ?

    When the test is negative, your cat does not have the feline leukemia

    virus in its complete form. But there is some evidence that portions of

    the virus might linger in cats that have successfully conquered FeLV

    exposure (remember that most cats overcome the feline leukemia virus).

    There are veterinarians who think that certain diseases are more common

    in cats because of portions of the FLV virus that remain locked deep

    within the genes of their body. (ref). The veterinarian who has spent

    the most time studying the dynamics of feline leukemia is Dr. Niels

    Pedersen. He explained it in this way:

    "After primary infection there is a brief and often non-detectable

    viremic stage where the replicating virus can be found all over the

    body. The cats then build up immunity and this replicating stage

    ceases. However, during the course of this replicative stage of

    infection the genetic material of the virus is inserted randomly in many

    places in the chromosomes of the cat. This genetic material can be

    reactivated in some cases by stress and other factors, but after a few

    months the inserted FeLV genetic material becomes more and more

    fragmented and reactivation becomes impossible in most cats. However,

    the insertion of this viral genetic material (and later, pieces of viral

    genetic material) can alter the cat's normal genes in such a manner as

    to cause disease later in life. This is usually in the form of a

    several fold increase in blood and lymph node cancers. The importance

    of this event to cats is largely unknown, "

  • lzrddr
    9 years ago

    if a cat tests negative in the blood for Felv, they are not spreading it, so other cats are safe around that cat (at least during the time the blood is clear of the virus in the circulation… however that situation can change suddenly if the infected cat is stressed or something changes in its system… most of these bone-marrow-infected cats are ill and do not survive long, though.). Even cats that are positive for the virus in the blood but have a negative IFA test are not shedders of the virus (and most of those cats may be currently in perfect health, though still long term survival is unlikely).

    The virus, as bad as it is, is super wimpy once outside the body, so it does not live for but a very short time in the environment. If you have other cats that are currently testing negative and the sick cat is gone, there is no danger. That is assuming of course that cat died of Felv… we do not know what your pet died of other than a non-regenerative anemia.. could have been a form of cancer of the bone marrow (never know without a biopsy of the marrow) in which case there was never any danger to begin with.

    Felv used to a be a really common infection in cats… saw a case a week back in the 1990s, but now I see maybe one case a year… it is almost 'gone' from the cat world, at least in the US. I doubt it will ever truly be gone, but it certainly has become far less of a scourge than it used to be… not sure if that is due to the vaccines, or due to some natural population waxing and waning… could become more of a problem in the future again… who knows.

  • stephiepoopy
    9 years ago

    Hi everyone,

    For those of you would had cats that received blood transfusions, do you recall how much it cost? My cat needs a transfusion soon (PCV 16%) and the estimate which we received from an emergency hospital was in the $1800-2200 range, which includes the cost of the transfusion, medication, and all bloodwork. I don't know if this is normal or maybe higher than normal because it is at an emergency hospital? We are able to take him to our regular vet today to see if they can refer him to a specialty hospital with hopefully lower prices, but I am interested in what price ranges other owners have encountered too. Thank you!

  • nej917
    9 years ago

    Stephiepoopy,

    That estimate sounds about right, unfortunately. My felv+ kitty just had two transfusions, on separate occasions, performed at an emergency and specialty hospital. They kept him for 24 hr. observation, prescribed meds, ran blood diagnostics. He had an internal medicine specialist overseeing his care. I imagine a regular vet hospital wouldn't charge nearly as much.

  • mainecoonmama
    9 years ago
    last modified: 9 years ago

    Please speak to your vets about either: Feline Hemotrophic Mycoplasmosis (AKA: Infectious Anemia) and Feline Hypertrophic Cardiomyopathy. We lost our beloved Baby Gray due to the hemotropic mycoplasmosis. The doctor's couldn't figure out how she contracted it as none of our babies go outside nor had any fleas, etc. It came on so very quickly. She was literally active & just fine and then went and laid down in my closet and didn't want to come out. I offered her a treat Which is NOT LIKE HER. I knew at that moment something was VERY wrong. Ultimately, she had 4 blood transfusions (total). They were 333 each at a local Blue Pearl Animal hospital, but an extra 85 extra for the port). They were 485 a piece at a local VCA animal hospital. Make sure they type your baby, too. Both of the hospitals are nation wide, too. Unfortunately, it spread to our other babies. We used Atopica. It works very quickly. SOME vets will charge you 200 just for the med, but you can find it for 45 on line. You'd need to overnight it though. They were also placed on Doxy for 21 days along with Prednislone. Not regular pred cuz the Prednislone bypasses the liver (so to speak). Blue Buffalo no grain food is good, too. Make sure you're not feeding your babies an only dry cat food diet. When they get ill you'll desperately need them to be use to wet food. Might I also suggest Trupanion Pet Insurance. We carry it now, but it would have saved us thousands.

    http://www.peteducation.com/article.cfm?c=1+2133&aid=292

    PS: You must follow the doxy with fluid to flush the throat or it can cause strictures.

  • mainecoonmama
    9 years ago

    Oh, I forgot to mention that with with the mycoplasmosis... it may NOT show up in a blood test. All that means is that the cooties weren't in that tiny sample. Baby Gray was checked three times in 24 hours and it showed in the second test but not the others. My other babies, that now have it as well, have to take the doxy/pred every so often when they flare. Observation and immediate medical care are a must.


  • izawright360
    8 years ago

    Hello everyone. I am right in the middle of going through the same experience as all of you with my cat Sherman. He is 1.5 yrs old, was taken to the vet on Monday bc he had experienced rapid weight loss and lack of energy with in one week, he was also peeing on the front door, which he normally never would have done. Upon arrival at the vet the doctor said that Sherman appeared extremely anemic and he suspected he had leukemia or aids, his RBC came back at 7%, the vet said he didn't think he would live and needed a blood transfusion. Sherman tested negative for leukemia and aids, and did not have any parasites in his blood. After his blood transfusion his RBC went up to 12%, I then transported him to a specialty vet hospital where he spent the night in the ER getting more tests ran and another blood transfusion. Sherman tested negative for every virus and cancer, I opted not to get a bone marrow biopsy because if he was indeed terminal like the vet was saying I wanted him to spend his days at home instead of getting poked by strangers. I brought Sherman home from the hospital on Wednesday, his RBC was 17% after his second transfusion. Since being home I have been feeding him small amounts of wet food mixed with plenty of water every two hrs, he takes prednisone every twelve hrs with a multi vitamin treat and lysine treat, I have also been mixing Bentonite clay in with his food, which is full of minerals and iron and will remove toxins from his body. He has gained his weight back and appears to have his energy back, his respiratory rate and heart rate are staying with in normal range. Yesterday he had a blood draw and his RBC had increased by 1%, a small increase, but it shows that as the transfusions are wearing off, his body is starting to produce some red blood cells of its own. I personally think that his almost fatal anemia was caused by a reaction to the flea medication "Revolution." The first time i gave it to him he stopped sleeping in our bed at night and was sleeping more during the day, a month later when i was instructed to give him another dose, is when he almost died, i gave him the treatment and with in a week is when he was at the vet almost dead. The time line of the application and start of symptoms seem to line up way to close for it to just be a coincidence.

    I am continuing the prednisone that the vet prescribed but am also giving additional nature supplements such as BENTONITE CLAY multiple times a day, and today starting him on premium fish oils called VITAL PET LIPIDS, an immune support called CELLOQUENT all found on www.vitalityscience.com, a wonderful site that sells supplements designed to help animals with cancer or other serious health issues. I also ordered another product today, http://www.holisticanimalmedicines.com/store/blood_tonic_homeopathic.html?HAMPLsid=868228297f6a77a5e5a5d758e80b2d4d,

    It is a homeopathic support for blood diseases.

    As of today Sherman appears to be recovering, eating, drinking, using cat box, running around house with energy, and sleeping in our bed again. Will post update as his journey continues

  • nej917
    8 years ago

    @mainecoonmama: Thank you for sharing that! I thought a negative myco test was conclusive. I'll be looking into a PCR for my anemic kitty asap.

    @izawright360: If you're interested in natural remedies, a holistic vet can be an invaluable partner in treating this disease. And definitely discuss Cyclosporine with your vet, as I've found it more effective than Prednisolone alone.

  • izawright360
    8 years ago

    just an update: today my cats blood work came back completely normal. He's still on the prednisone and two supplements from www.vitalityscience.com, the fish oils and the celloquent

  • nej917
    8 years ago

    @izawright360 Glad to hear your kitty is doing so much better! To think this disease used to be considered a death sentence, and many vets still believe it is. I'm ecstatic that we're proving them wrong!

    Update on my boy: Mycoplasma PCR was negative. He has Primary IMHA "at the bone marrow level" (RBCs are attacked before making it out of the marrow). Most recent blood work: 100% normal! HCT of 44% and everything else is excellent. He's on 10 mg. of prednisolone (compounded into capsule form) and 25 mg. of cyclosporine daily. He also takes Standard Process Feline Immune System Support, and I did notice a huge improvement shortly after starting it. He also gets a Canna-Pet Cat every day (helps with side-effects from the cyclo), tiny bit of Jarrow B-Right, tiny bit of ImmPower (AHCC), and probiotics: Renew Life Ultimate Flora (around 1/8 capsule), 1/2 cap. Jarrow S. Boulardii + MOS 2x a day, and 1 Tablespoon A+ Answers Raw Goat's Milk Formula 2x daily. The probiotics are to help counteract digestive side-effects from the cyclo (harsh stuff!). There's also a weekly B12 injection.

    V. important: always separate supplements and meds by at least 2 hours.

    I hope someone will find this info helpful. Good thoughts to all!



  • netc777
    8 years ago

    Help! My 3 yr old male cat, who we just adopted as a feral cat who showed up in our neighborhood, has developed the same symptoms as the kitties discussed here. And like most of these kitties, he has tested negative (twice) for leukemia, histoplasmosis, blood parasites and other things. He has been on 50mg of doxycycline for 5 days (which I think is twice the dose he should be getting based on an article I read by an Ohio State Univ DVM, oncologist and professor). At my request, we are now adding prednisolone.

    Could you you all please tell me the *specific* doses of doxycycline and prednisone/prednisolone your cats' vets have your babies on? It will help me to determine how much of each to give to my Don Pablo. He is 14#. I am thinking 25mg of doxy once a day (half of what he is currently getting) and 5mg of prednisolone twice a day to start.

    For those of you whose kitties have thankfully survived and are on a maintenance dose of prednisolone, I would love to hear what that maintenance dose is, as well.

    Thank you so very much! I am desperately trying to save my kitty! His last HCT was 22% and the lab indicated it was non-regen anemia. He had a fever of 104.9, too, initially, and it spiked lower and back to 104 for a few days after hospitalization began, but that has pretty well subsided now. Still, he will not eat on his own so I am syringe feeding Royal Canin Recovery RS and alternating at times with Hill's a/d. He is also getting 1ml of NutriVed (generic Pet Tinic), weekly B12 injections, twice weekly subQ fluids (because he is not drinking on his own--getting his water via syringes canned food). I also give Zofran to help with nausea, but it doesn't seem to help. (And Cerenia made him super sleepy.) I wonder if he is getting too much doxycycline and that is causing upset stomach. I am considering a small bit of Culturelle.

  • nej917
    8 years ago

    @netcatzpj Doxy is indicated for mycoplasma infection and usually given "just in case". It may not resolve the anemia if myco isn't present. I would trust the vet to know the correct dosage for your cat's weight. It will either work or not, and some cats have needed to take it for a month or so before seeing progress. I think it's always a gamble risking side-effects and antibiotic resistance for possibly zero pay-off, so I would recommend a mycoplasma PCR test if you can afford it (my cat's test was a little over $100). The regular myco test is unreliable. Cheaper, but worthless if no myco is present in the blood sample.

    Definitely use a probiotic while on the doxy. All the antibiotics mess with intestinal flora.

    22% HCT isn't actually that bad, so please try not to worry overly much at this point. My boy's HCT was 12% when we started this battle and it's gradually increased, with minor fluctuations, over the past few months to 44%. Prednisolone is a good start, but adding cyclosporine is even better. They work synergistically and the combination is what current literature and internal medicine vets are recommending as a first-line treatment . Cyclo can always be tapered down at a later date.

    If you decide to go that route, cyclosporine comes in a softgel form that some pharmacies carry in cat-size doses. You don't necessarily have to use the horrible-tasting suspension.

    I've used Canna-Pet in two sick cats, including the one with IMHA, and it does wonders for appetite. Can't recommend it enough. (No affiliation, just very happy with the results.) Anemia has a dramatic effect on appetite- that's just the nature of the disease.

    Maybe also consider adding Standard Process Feline Immune System Support. My boy's holistic vet prescribed it and it got rid of the fevers immediately. I also have to credit it with helping balance immune function. I don't believe HCT would've improved so dramatically without it.

    Best wishes!

  • netc777
    8 years ago

    Nej917,

    Thank you so much for replying to my post!!! Very helpful! I have already ordered the SP after reading your earlier post. And I will order some CannaPet today, which I am familiar with. I had previously ordered a few capsules for an inappetent CKD cat, but chickened out on giving it!

    Two questions:

    1) How is this PCR test performed? Is it a regular blood draw that is sent off, or does the sample have to be taken from the cat in a special manner?

    2) My understanding is that cyclosporine is a chemo drug. Is it used only if mycoplasma or leukemia is confirmed? Due to its toxic nature, I am very hesitant to ask for it unless either of those illnesses are confirmed in my cat, or his anemia greatly worsens.

    I started 5 mg prednisolone last night (BID dosing starting today), and he has already shown improvement. He ate some on his own during the night and this morning was head butting, vocal with a strong (vs his recent weak, "I'm sick") meow, and ate half a pouch of Weruva! I pray it continues.

    Many thanks again.


  • AzarNoush NZ
    7 years ago
    last modified: 7 years ago

    Hello All,

    is there anyone here have experienced Ups and down in the PCV test? To be more clear the very first day we took my 3 year old Persian cat to Dr was 17th May and he was at 8%.

    During 2blood transfusion he went up to 14% but dropped again to10% and he sayed at 10 till 1st of Aptil. 1st of April he was 18% and the immature blood cells (reticulous?!!)where so high that dr told me the medicine ( Atopica + predisonolone) are responding great.

    Unfortunaetly today after 11 days he dropped at 15% and immature red cells are really low too. Any one experienced something similar?! Is there any hope he goes up again?

  • nej917
    7 years ago

    My boy was on quite a roller coaster for the first several months of treatment. From what I understand, it's not uncommon for cats to have ups and downs in the beginning. The PCV test has a 2% margin of error, so it's possible his real number is 17%. I never worried unless it dropped by several % pts.

    The thing to watch for is steroid resistance, which can occur in some IMHA cats. My boy was on Prednisone, became resistant, we switched to Prednisolone, he became resistant, we switched to Depo Medrol and he's been stable ever since, give or take a few % pts. He stays near 32% these days.

    I should mention that meds alone haven't been enough. He gets 2 Classic Transfer Factor capsules daily, 1 ChlorOxygen most days, and 1 Life Extension Reishi Extract capsule most days (high triterpene content, which is important) mixed with Pet Ultimates Probiotics for Cats, tiny amount of Vitamin C powder (helps medicinal mushrooms get absorbed) in 6 ml. of A+ Raw Goat's Milk Formula. The probiotics and goat's milk are digestive aids that help counteract a GI sensitivity to Cyclosporine (he takes the generic human form instead of the veterinary brand name, Atopica).

    Best wishes to you and your kitty! It sounds like he's making progress.

  • AzarNoush NZ
    7 years ago

    Thank you for your compelete response my friend. He did progress in the begining and they have said bone marrow is waking up but reticulocytes are low again which apparently is not a good sign. Also they have told me dont give him anything except medication and cat food, dont do any supplements cause all the tests were negetive so they dont know if the body itself is killing Red cells and they dont want to strenghten that.

    In any case I will b back to check his PCV in a week and I will show dr these supplements that you said.

    thanks again.

  • nej917
    7 years ago

    You're very welcome! The supplements I suggested are "immunomodulators". They balance, not stimulate. A holistic vet could give you more advice on that subject :-) If you're interested, here's a site for finding one: http://www.ahvma.org/


  • AzarNoush NZ
    7 years ago

    thank you .I will def ask the doctor. Can you tell me more in detail about your cat? how long did it take to be stable? how much doses of medication he start with and what is the doses now? what do you exactly mean by roller coaster, can you give me the numbers of PCV if you remember? and did you ever checked the reticulocytes ? Dr told me normal cat is 40,000 and if the medication response it is supposed to go really high. the 1st of April CBC test said it is 400,000 and they said it is a miracle. but the recent one shows it is only 34,000 which is even less than a normal cat. I am super worried can you please share your experience with me.

  • madismom5
    7 years ago

    Get a second opinion

  • AzarNoush NZ
    7 years ago
    last modified: 7 years ago

    I did talk with 3 different Dr. , 3 different Hospital.and this is what bother me the most . they dont know why this happend as all the tests were negative. they dont know where all the 400,00 reticulocytes disappeared? I just go there weekly to give me a PCV number at this point . no other help.

  • AzarNoush NZ
    7 years ago

    Hi ,

    my cat was at PCV 20% last week , today he is at 10%!!!!.CLast week he was at 67,000 reticulocyte, we are still waiting for the CBC test result of today. since last week no change in his medication or food or anything and unfortunately they cant go higher in dosage as he gets 2 predisolone every 12 hour plus 0.35 ml Atopica every 12 hour which is the maximum for a cat.

    does anyone experienced such a dramatic drop? please share your experience with me and please please pray for my cat :,(

  • jameszcurtis
    7 years ago

    My boy cat was 4 at the time, appetite decreased, gums pale. Took him in severely anemic had a blood transfusion. Had tested negative for leukemia/fiv. After transfusion still was my doing well. They did an exploratory surgery to see if there was a tumor ect, ended up finding pus. Sent samples out. At the time there wasn't definitive positive or negative but turned out he had fip. Feline infectious peritonitis. I had never heard of it . It is similar symptoms as fiv and leukemia. There is no cure. Ended up having to python to sleep. This was 6 years ago, maybe they have better testing now. The vet did say usually if they have fip, it'll take them b4 they're 2.

  • jameszcurtis
    7 years ago

    I adopted a leukemia positive cat. She's 3 and anemic. On doxecyclin and prednisone. Not getting any improvement. Soo nonregenrative cells. I did find a sight on t-cyte injections for immune suppressed cats. Suppose to stimulate they're immune systems. Possibly to stimulate Rbc production. She's at %15 hematocrit so may not have started these early enough but worth a shot

  • Tori Adamache
    7 years ago

    Hi all. I have a very sick kitty. 9 months. Severe anemia. High blood proteins. Normal white cell counts. All tests negative for leukemia. Diarrhea and then energy decline. Over a few weeks. Weight loss became very apparent in the last week or so. Appetite stopped mid week. Great vet. Consulting with internist. He did have a bad UTI. Largest concern is the anemia. FIV has not been ruled out but set aside as bloodwork and symptoms lack some alignment. Focused on anemia and other causes first. Question 1. What are transfusions costing and how often do your babies need them? Question 2. He is in doxycycline and prednisone. What else can I be doing to help with the anemia? Anything???

  • lisa_fla
    7 years ago

    I bought aranesp (rx $152) from Walgreens for my anemic cat with kidney disease. That would last for almost 3 months. It worked almost immediately. Vitamin B12 may help. Post your labs over on the felinee yahoo group for cats with anemia.

  • Lauren S.
    7 years ago

    Hi everyone. It breaks my hear to see so many kitties going through something so terrible, but also gives me a bit of hope that my cat isn't alone and there might be a solution out there. My 9 month old baby was diagnosed 3 weeks ago with severe anemia and a grade 5 heart murmur. I first noticed something was off when he was licking everything (the walls, coffee table, my iron) and within 5 days he was extremely weak and wobbly. We brought him to the vet to find that his red blood count was at a 9. After 3 doses of prednisolone, I woke up to vomit and loose stool, and my cat would not eat. He stayed at the animal hospital for several nights for a blood transfusion and a variety of tests, and no identifiable cause was found for the anemia. For those wondering, in NJ a blood transfusion cost about $500. The overall hospital stay, including tests for his heart, was about $3200. In additional to the anemia, my cat was diagnosed with a progressive heart condition (HCM), which makes taking a steriod for the anemia very risky as it can contribute to heart failure. His count was at 15 after the transfusion, and fluctuated between 11-18 during his stay.

    The vet recommended the bone marrow and spline aspirate, but did not sound hopeful that we would get an answer. I opted out of any additional invasive tests and took my cat home, where he was good for about 2 weeks. At our most recent vet visit, his red blood count is back down to 10. This vet is preferring not to go through with another transfusion as there could be implications of that (building antibodies/resistance, complications). So we are now trying Epogen injections 3x/week and she gave him an iron injection. The vet recommended Hi-Vite drops, which are high in vitamins and iron. I've read a lot of reviews about these drops and it looks like they have helped a lot of sick cats. The cost is low and you can purchase it without a prescription. It is not easy to administer as it's a liquid and has a strong odor, but might be worth it if it works. His spirits are good and he is social and eating well..just seems weak and tired. I hope this information can be helpful to someone!

  • nej917
    7 years ago

    Lauren S., So sorry to hear that your kitty is dealing with this disease :-( I'm glad your vet was open to trying Epogen- I've heard it can assist in getting IMHA cats over a crisis. I did want to mention that many cats do just fine with multiple transfusions. My boy didn't respond that well to his first two, but did exceptionally well with his third. He's one of the unlucky IMHA cats who doesn't respond that well to steroid therapy or cyclosporine, so we've dealt with a few serious relapses over the past couple of years. Speaking of, you should definitely try cyclosporine. It's a first-line treatment for IMHA in cats.

    Just passing this info along in case anyone reading this thread has a treatment-resistant cat. My boy has now seen four internists, at two different specialty hospitals, he's had a bone marrow aspiration/biopsy to rule out FeLV (it was negative), and the latest verdict is that he needs a bone marrow aspiration for FIV and Leukemia (the cancer, not to be confused with FeLV) performed at a university hospital. I don't live close to one, so am planning (and saving up for) a trip to Ohio State University in the spring. Some diseases that cause IMHA can end up "trapped" in the bone marrow and so are impossible to diagnose without that aspiration/biopsy.

    Following a severe relapse and transfusion a couple of months ago (his HCT was 12%, then settled at 25% post-transfusion), our vet decided to pull out the big guns and he's been on an every third day regimen of Chlorambucil (brand name Leukeran) with a once a day dose of Prednisolone. His HCT was 39% on the most recent CBC. I hope everyone will keep in mind that Leukeran/Chlorambucil is a good option for IMHA cats that aren't responding to traditional therapy.

    About the vitamin drops, be warned that excessive vitamins can worsen existing disease. IMHA cats don't need extra B vitamins or iron because they aren't deficient in them and supplementation doesn't help the anemia. If you're concerned your kitty might have a deficiency, your vet can test for it.

    One more thing: Aranesp is safer than Epogen for long-term use. These drugs also come with risks, so please do some research and watch out for potentially life-threatening side-effects.

    Best wishes!

  • nej917
    7 years ago

    Forgot to mention that I hope your kitty had all the standard tests for infectious diseases (pathogen panel), FIV, FeLV. Most will treat with doxycycline in case of a mycoplasma infection, but you can opt for a mycoplasma PCR test- you definitely need to either rule it out or preemptively treat it since it's one of the most common causes of IMHA in cats.

  • nej917
    7 years ago

    One more comment: I don't know if your cat can handle any steroids, but Depo-Medrol is one of the best for IMHA and worth trying if it won't hurt his heart condition.

  • Lauren S.
    7 years ago

    ne917, Thank you so, so much for the information. You are a saint for doing so much for your cat. We did complete all of the standard tests to rule out infectious diseases, all were negative; the vet prescribed the doxy for approx 5 weeks anyway. I guess our biggest issue is that he hasn't actually been diagnosed as immune deficient..we have gone to 3 vets so far and no identifiable cause has been found, so they are just trying different treatment methods to see if any are effective. It is comforting to see that many cats have gone through several infusions before responding favorably. I have an appointment at the end of the week to check his levels again to see if the current meds are working- if not, another transfusion may be warranted. Thank you for the suggestion of depomedrol and aranesp, I will definitely keep those in mind. I am hopeful as it seems like he has eaten more the past 2 days than he has in weeks, and seems to be a bit more alert and playful. I will post more if/when I find out more info so that others might benefit from this experience as well. :)

  • nej917
    7 years ago

    Lauren S., Did your vet tell you what his reticulocyte count is? If it's abnormally low, that means his immune system is destroying red blood cells or the marrow is failing to produce an adequate supply. Vets usually only prescribe immunosuppressants like Prednisolone if they believe the anemia is primary or secondary IMHA, so it sounds like that's probably the case with your kitty. Testing at this point would be to rule out causes of secondary IMHA. Primary IMHA is extremely rare.

    Iron supplementation is a really bad idea if he hasn't been tested for an iron deficiency beforehand. I would insist on that.

    I'm wondering why your vet, knowing steroids are risky, hasn't opted for a different immunosuppressant like cyclosporine. Unfortunately, most regular vets just aren't that knowledgeable about IMHA and all the tests and treatments available. My boy didn't get the treatment he needed until he saw an internal medicine vet. Emergency and Specialty Hospitals are usually where they're found.

    You might also want to look into joining the Yahoo Group "For Cats & Dogs with Anemia". There are a lot of knowledgeable and supportive people there :-)

  • suki1960
    7 years ago

    Hi my daughter has just had her 8 month old kitten put down as her bone marrow was not producing anything it was all very sad as she had so many tests and all came back negative but we just couldn't understand the blood clotting and the low blood cells her pallet was clotting to so we dicided on a bone marrow cheak while she was under and the vet hospital told us the bad new nothing could be done for her it was a very rare case the best thing was to put her down while she was under

  • cole82709
    7 years ago

    Wow I am so glad I am not the only one. In November I had to take my 7 month old kitten to an emergency hospital she wasn't acting right at all. She peed at the front door pick picked her up and she froze. The night before I notice she was hiding upstairs which wasn't like her. Once I got her to the ER they told me she shouldn't even be alive her tests show no life. Her breathing was very shallow they could hear a heart murmur and her heart was very sluggish. X rays showed nothing but her blood was at 5%. They called another hospital that did blood transfusion because she needed one right away. We drove 20 min there the vet at the ER didn't really thing she was going to make the ride he thought she was going to die before we got there but I had hope. Once we got there their ultrasound machine wasn't working and they didn't do blood transfusions there they do them at their other hospital which was another 45 min away. So we get in the car and drive there. Once we get there we waited forever. I expressed how the doctor from the other vet doesn't think she is goin to live long but they gave her a shot in case it was a blood born parasite. We gave them all the test results from the ER. Once my kitten Mya went back they told us they wanted to keep her at least over night to do some testing. Long story short she spent 3 nights in intensive care unit with infectious disease. They kept me up to date. She had 3 blood transfusions. He blood came up to 18 then the next day dropped back Down to 14. All of the test for feline aids etc came back negative as they did when o first got her and had her tested. Which I always do before bringing a cat on my house since I had 3 others cats. Then they called and wanted to take a piece of her bone marrow to test that. So we did and there was no cancer or anything bone marrow was great. So all test came back negative. They gave her her last transfusion the night we picked her up. She was on doxicycline and prednisone for 4 weeks after she came home. Now she is still one the prednisone. Every 3 weeks o take her to my vet to get her blood levels checked and so far she is now up to 39%. That hospital bill alone cost me $4000.00. But it was worth it. She fought he little heart out. And doing great now. But unfortunately they can't figure out what the underlying cause of all this is. I wish I had an answer

  • cole82709
    7 years ago

  • chrissyhubbard89
    7 years ago

    Thanks for this thread! LaurenS what is the update on your cat?? My cat has almost the exact same situation... we are desperate for any help from people with the same case that had some success.

  • chrissyhubbard89
    7 years ago
    last modified: 7 years ago

    @Lauren S. what is the update on your cat? Mine is going through the exact same thing right now..

  • chrissyhubbard89
    7 years ago

    @miw-bast what ended up happening with mouse? My 9m old kitten has the same situation! looking for some guidance.. he's on steroids now but curious how much mouse was on until it started working after 2-3 weeks. Also I read a little about combining cyclosporine with the steroid.. wondering if you did this? Thanks!

  • chrissyhubbard89
    7 years ago

    @cole82709 im so sorry about your kitty. Mine is 9 months old and the same thing is happening. He's had two transfusions so far- was at 14 and now at 11%. He's been on predestrone as well for 3 weeks now and i don't know if it's working because he has now lost his appetite and I can hear him having trouble breathing lately. Does your cat still have an appetite? Do you notice the steroid helping?

  • Karen Redding
    7 years ago

    Happy to have found this forum. Our 3yo Ragdoll just transfused last night. Hematocrit now up to 19% post transfusion and holding. Having a bone marrow aspirate this afternoon. Hoping for some answers but thus far am hearing nonregenerative anemia since his reticulocytes were very low. Hopefully the bone marrow will reveal primary or secondary IMHA. Thank you to everyone posting here as I have learned there are more options available which is giving us hope. Will keep everyone posted.


  • hypurchick
    6 years ago

    Going through this right now ( or so we think) . My 10 yr old girl was losing weight.. but still doing well. Found her staring at the wall last Tuesday and lethargic. Separated her from the other animals in the house to monitor closely. Ate wet food. By the am she had vomited. Took her to the vet Wednesday. Ran blood work and only showed her glucose was elevated and bilirubin was high. Slightly jaundiced... but all other liver enzymes were a little high.. but nothing significant

    Vet said that all the blood work never led him towards one diagnosis or another

    Decided together to shot gun treated for infection and recheck progress the next day. She got a shot of Convenia and was put on cerenia..doxy and a pain killer. Subcu fluids . Took her home. Next day she ate a small amount. No urine output in 48 hrs at this point

    At the recheck.. he was happy with how she had perked up and kept the water weight on. Took her home. Appetite was back full tilt. Ate 3 cans of wet food and wasn't going to slow down. He sent me home with all the meds previously discussed and subcu fluids to administer myself. Started on an appetite stimulant ( mirtazipine). Started peeing. Friday was like a new cat! Saturday night she crashed and was right back to point A.. but worse. Would not eat and still won't drink. I worked a night shift.. came home Sunday am and she was so bad that after a few hours of sleep. We went to emerge


    They really did blood work as we figured it was l fatty liver . Did an ultrasound and started on IV as she was dehydrated again. Vet called back after doing the blood work and said she ran a CBC with the liver panels and her RBC had dropped form 30% to 15% in the few days. Leading her to believe that she has IMHA and that her bone marrow is not able to produce RBC


    I don't think I'll go into invasive testing. She said she would start treatment with steroids and see if there is any response. I have never seen an animal go from near death to brand new and then crash so hard again. Part of me wonders if maybe the liver was her initial problem. And the this is now a reaction to one of the meds she was put on. We rechecked again for feline leukemia etc and all tests are negative. No known cause.. but she is guessing that it could be an underlying cancer.


    Seems to be some debate on the antibiotics Convenia... hoping to do some more reading on that. Keep Pixie in your thoughts! She is fighting. She's a tough one .

  • chrissyhubbard89
    6 years ago

    my cat was very young when his anemia started (he's only 10 months) but nothing worked until we combined cyclosporine with steroid. He's also on hi-vite and heart meds as his anemia seemed to have caused heart issues. Good luck with everything... I know the feeling. If only animals could speak to us and tell us when things make them feel better! Don't give up.

  • hypurchick
    6 years ago

    RBC dropped to 10% . She looked miserable and I just decided to euthanize. We fought. She fought. I truly felt even with a blood transfusion that we wouldn't solve the problems that were piling up. Spoke to a friend who is a vet and he suggested that there is probably lymphoma. Regular vet clinic .. the vet felt that maybe this wasn't auto immune and was secondary to cancer

    I still question the usage of Convenia. She was going anemic when problems started.. I just wonder if this with the drug kind of pushed everything into overdrive .


    Rip my beautiful girl

  • Deb T
    6 years ago

    Wow, I came across this thread on Google and saw the first post so many years ago and it's sad to see it's still a current thread today. There is hope. I wanted to share that one of our cats has primary IMHA for 2 years now. He is on Atopica and prednisolone and is doing well.

    He has had several relapses over the years when we're not diligent about daily meds. We're now good at pilling, so he's been stable for awhile. He is overweight and eats like an elephant, so whenever it seems he's not eating much, I know to check his ears and gums (they're very pale when he's relapsing) and monitor how much he poops and take him to the vet for CBCs. We boost the pred and he recovers pretty fast.

    We don't entirely know why IMHA happened, but the first bout of anemia happened within 2 weeks of annual vaccinations at age 7. He had in previous years sometimes had reactions to vaccinations like bad diarrhea afterwards. He is now no longer vaccinated.

    One challenge has been care when we're traveling. We found a cat sitter who is a former vet tech and can administer meds. It's more costly than having the neighborhood teens check on the cats, but the key for us has been to give consistent daily medication. Our big boy is now 9 and we look forward to a 10th birthday next year!

    Mostly I'd say, know your cat, watch how much they eat and poop, and if you see a significant decrease, take them to the vet very quickly.

  • kellyewinkler
    6 years ago

    My 7mo kitten Finley was taken to the vet this past Saturday after he had not been eating for a few days and for being generally lethargic. We did a blood test and found out his hematocrit was at 5%. Thankfully I was able to get him in for a blood transfusion maybe an hour later at an animal emergency hospital about 30 minutes away. He ended up staying at the hospital overnight for monitoring. They took 3 additional PCV tests; the first came back 14%, then 16%, and finally 15%. Since he was stable, I was able to bring him home that night. Brought him in to the vet the next day for another test, and thankfully he was still sitting at 15%. He seems to have stabilized, but both the emergency vet and regular vet think it is Hereditary Pure Red Cell Aplasia, since it appears his bone marrow is not responding to low hematocrit levels. He tested negative for both FIV and FeLV (blood test, not bone marrow, so can't be completely ruled out). He is a full-time indoor cat, up-to-date on all his vaccines.

    He is due for another appointment this Thursday to test again. The vet says he is doing research on what all we can do for him in the meantime. I called him this morning and he said that iron supplements will most likely be prescribed. I read through this forum and saw many referencing the steroids Prednisone and Doxycycline. Is this something that would help Finley?

    He is now eating wet food in the morning and evening as meals, with Blue Buffalo dry kitten food throughout the day. His appetite is back and in full force; he's eating everything I put in front of him! His personality has also come back which I am so grateful to see. Now I am just concerned he will relapse and need another transfusion. It won't break the bank, but it is definitely not something I can sustain for the rest of his life (the last trip to the hospital was almost $1000). Asking suggestions for next steps (tests, supplements, medications, anything)! I am very desperate; he is my perfect little floofball, and I would be devastated to lose him.

  • chrissyhubbard89
    6 years ago

    @deb T glad to hear your cat is stable. Our cat was diagnosed with IMHA at 9 months old... he also had issues after being vaccinated and neutered. We are believing more and more on our own that either the vaccination or flea medication set off his auto-immune disease.


    Pred & atopica combo seems to be what works. We tried taking him off prednisolone and he relapsed and is currently at 18%. We are now back on it and working on getting him back up.

    @kellyewinkler I would be prepared to save up! We spend about $200 a month on medications for our cat with IMHA. Vaccinations we think is what triggered his IMHA so beware of getting those. Obviously it's so hard when we don't know the cause. Does your vet suspect IMHA at all? If so, as stated above and in other comments on this thread the combo of atopica and pred. really works although overtime has its' own side effects.

  • kellyewinkler
    6 years ago

    @chrissyhubbard89 $200 is doable! We haven't discussed IMHA, but I will bring that up on Thursday. I suspect Finley was always slightly anemic, but the neutering he got done a little over a month ago might have stressed him enough for it to go into overdrive. It's so relieving to hear of other people going through the same thing I as am and reading success stories. Thank you for your advice!

  • suchaturi
    6 years ago

    I had an FIV positive cat who became extremely anemic. He couldn't lift his head and I thought it was the end for this guy, even though he was only five or six at the time. However, I gave him a supplement I had been taking myself called Biosuperfood. It is a particular type of blue green algae, and I believe the cell wall is removed which significantly improves the body's ability to absorb it. Amazingly, he got up and very slowly walked into the other room only ten minutes after I put some in his mouth. He hadn't moved for 4 days. It was a long slow uphill climb that took four to six weeks but this cat, named Thomas, slowly regained his strength. He lived several more years and died from a freak accident falling off a kitchen counter when he was 14 years old. He stayed on the Biosuperfood the rest of his life but the form for animals is called Biopreparation. The formulation of Biopreparation is more geared towards the faster digestive track of the animals.