# My cat has severe anemia



## LadyDayne (Aug 21, 2013)

I want so badly to save his life but I am running out of options and ideas. We've been going to our main vet for 6 months and have gotten a few second opinions as well. Now I am trying to reach out to others that may have dealt with this issue themselves. 

He was a feral kitten born under my house from a very shy young feral mother. Right now Ash is about 4 years old. I've had him indoors since he was 6 weeks old. I've also got his brother from the same litter who has no problems at all. We also have an older cat that is fine, and two dogs that are fine.

It started about 6 months ago when he started to lose his appetite. He has always eaten away from the other cats and likes to eat when they are done so I didn't really notice at first that he wasn't eating as much. But what I did notice was me pour food or setting out wet food and him just walking away and never going back to eat. My other cats were getting fatter and he was getting skinnier. 

Then the vomiting started. It was every few days at first, then before I knew it he was vomiting in groups of threes, about 4 or 5 times a day. One morning he vomited blood. I had him at the vet that afternoon. He was dehydrated and had high blood pressure and was admitted. He stayed at the vet for 4 days on IV and eating A/D canned food. They ran all kinds of blood tests and other assorted tests (ultrasounds, xrays, etc) and everything came back fine.

What the vet noticed was his white gums around his teeth. His red blood cell count was almost non existant and his white blood cell count was very high. I assumed the worst. More lab work, more blood taken, and everything still comes back fine.

No cancers, no luekemia, no fiv or aids, kidneys and liver function normal, etc. For some reason immune system decided that his red blood cells were invaders and started to attack them and kill them off. He replenishes them but not as fast as they get destroyed.

He went on a mixture of cerenia for vomiting, prednisone steroids to supress his immune system, and pepcid ac to reduce the acids in his stomach. 

After 3 weeks of this he seemed to be doing great. He went from 11lbs to 5lbs in a month, then back up to 9 lbs after the 3 weeks. His blood work came back great with high red blood cell count and low white. We started to wean him off of the steroids.

Everything came back with a roaring vengence. The vomiting, the no eating, the weight loss, depression, etc. We have been struggling for months with this and it's all I can do everyday to sit with him and beg him to eat something. All he will eat is canned prescription a/d from the vet. In the past two days he has eaten about half a can.

He is so skinny and I am just so worried. A lot of people have told me just to have him put down but I am not ready to give up on my cat yet.

Does anyone have any ideas at all?? We have tried so many things. He won't eat kibble at all, or cat treats no matter if they are soft or hard. He won't eat tuna or sardines, he won't eat cheese or eggs, he won't eat any people food at all, he will lick the juice up from most canned foods but leave all the meat there, he won't drink the kitten formulas or eat baby foods...

I was thinking maybe a different steroid combo?? My vet just went on a two week vacation and I am out of people to talk to.

Thanks in advance!!!


Edit: We did a raw diet for his first two years since our dogs were already on one but he even refuses that too.


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## Stryker (Apr 2, 2007)

Hi LadyDayne and welcome to the forum !

You certainly have had a journey with this little one. He is so very fortunate to have you as his guardian.

Anemia can be one of the most frustrating conditions to deal with...the sense of powerlessness can be overwhelming...and, I say that from personal experience. And now, whatever help you might have had.....has just walked away to holiday and this cat is wasting away.


There are two things that must be done immediately


You have to begin assist-feeding. You don't seem aware of a potentially fatal liver condition that can develop in cats who do not consume their required caloric intake for an extended period of time. Your Vet should have cautioned you about this and provided both information and instruction about it. The fact that he lost six pounds - 1/2 his body weight - in the space of a month, is, IMO, an indictment of the attending Veterinarian. More info below on assist-feeding.
You need to find a competent feline Vet as quickly as possible. If you are near a Veterinary College, it should be your first choice. You can look at this site if you're unsure AAVMC Contact Map If distance excludes that option, perhaps you can look for a cat-only clinic nearby. If you can't find one, you can use this site's link (don't check the red bar at the bottom) Find a Feline Practitioner | American Association of Feline Practitioners
About the need to assist-feed...here's what can and does happen to cats with reduced food intake or inappetence: Hepatic Lipidosis

If he's eating small amounts on his own, then walking away, I doubt that any of the usual "tricks" or enticements are going to work (and you've tried lots!). I think the only way to increase his intake will be to syringe-feed.

Here's a pretty good video that covers what this is all about:



 
There's lots of info on this page AssistFeed.com: Advice to help a sick cat who will not eat

Syringe feeding, itself, is usually very stressful for any cat - at least, at first. you are going to have a much easier time of this if you get into the mindset of assist-feeding...you're helping, NOT forcing - this may seem trivial but, believe me, it can make all the difference - for you, and, for Kitty.

Cats who are stressed and struggling can easily breathe in (aspirate) liquid food. You must be extremely careful that he does not aspirate...if that happens, there's a great risk for another serious condition (aspiration pneumonia). So, little drops at a time, put into the sides of his mouth, he swallows, put in a few more drops. You should NEVER squirt/put anything straight down a cat's throat.

Here are a few more thoughts:


use a very small syringe, one that fits easily in your hand (3-6ml) - available from the Vet
show the syringe to the cat, allowing the cat to desensitize to it
practice first, away from the cat, so that you "learn" how to make small drops of food come out...not even squirts, just drops
put some of the food on the tip of the syringe, allow the cat to smell it
insert the syringe into the side of his mouth and put a few drops of food inside
a cat never takes a large quantity of liquid into its mouth, only the tiny amount that adheres to its tongue...mimic that, and your cat will be less stressed
Most people will use this Rx food sold only by Vets: a/d® Canine/Feline Critical Care - Canned It's made to flow through a syringe and is high in calories. You could also use a food he is accustomed to, if you blend it smooth enough to go through the syringe.


About the anemia: It's hard to know where to start, not knowing your own understanding of it. A Vet friend of mine once gave me this:


> we really need to find the underlying cause of the anemia. Anemia can be caused from three main etiologies: 1) Blood loss, 2) Blood cell destruction and 3) lack of production.
> 
> It sounds like we can rule out blood loss. Blood destruction can occur as an immune mediated source like IMHA (Immune Mediated Hemolytic Anemia) but is rare in cats, from onion or garlic toxicity, drug reactions, blood borne parasites, or sepsis.
> 
> ...


Just as in the example he was quoting, blood loss would presumably have been ruled out in your cat. That leaves two possible causes, an immune system issue where it is attacking itself, and a blood borne pathogen (again, presuming garlic, drugs and infection (sepsis) have been ruled out).

Identifying the cause takes determined, methodical detective work. "Ordinary"/standard blood tests help but are not, by themselves, going to identify the origin. A competent Vet accompanied by a competent lab pathologist can isolate the cause. Here is a presentation given by a renowned pathologist and his summary of that job:


> Anemia is the result of only a few processes and when these processes are considered, a series of diagnostic steps may be set in motion, often revealing the underlying cause.
> 
> WSAVA 2001 - Feline Anemia: Practical Investigation and Management


Some reading if you want/need
Anemia 101 Anemia in Cats
Advanced 1 Hemolytic Anemia in Cats
Advanced 2 Feline Infectious Anemia (Hemobartonellosis)

Because anemia is so difficult to deal with from our perspective and, because diagnosing and treating seems to challenge many Vets, there has been a specialized online group of people with anemic cats at work for the past thirteen years. If I were again dealing with anemia, I'd be a member of this group. A word of advice, I have 'heard' that some members there can be quite strident (not surprising, because anemia requires action, not watching) and so, being forewarned and having a bit of a 'thick skin', you should be fine there. The group is here: Feline_Anemia : For Cats & Dogs with Anemia Just click the blue "Join This Group" button and, if you don't already have a Yahoo account, get one, it gives you complete access to files and documents from that group.

Bottom line - three, actually


you MUST feed him now
you MUST find a competent Vet ASAP
watch him like a hawk...he's very fragile...any deterioration, off to the ER
Hope some of this helps - and I hope you'll keep us up to date.

Thinking of you!


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## LadyDayne (Aug 21, 2013)

Thank you so much Stryker! Some of this I did know but some I did not. I'm going to look into that group with my thick skin on lol. I think assist feeding is going to be a good option. Earlier today in my searchings online I read about finding a vet school to take him to, I think there may be one in Chico, CA which is about 45 minutes North of me, and Sacramento is about 45 minutes South of me, so I'm sure i can track one down. The liver issue is something that has worried me from the get-go. Here is Ash yesterday.


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## LadyDayne (Aug 21, 2013)

So I think I'm going to call the US Davis Vet School and make him an appointment. I've been denied for care credit 3 times this year, I don't have a credit card or any wealthy friends to borrow from. I already give other family members money to help them with their needs so there is no family to borrow from. I've put over $1,000 in just blood and lab work into this issue and even more on hospital stays, iv fluids, prescription canned foods, medications, etc. Right now my income is just tapped out. In October I'm starting a 3rd part time job (to go along with my current full time and 2nd part time), and I also go to school two days a week. I am willing to do ANYTHING to save my cat, we have a for sale sign on the car outside. I spend a few hundred each month with the vets.

That video is amazing and I'm really encouraged to give it a try! I went by a pharmacy early this morning after work and the pharmacist gave me a free syringe for feeding (Walgreens for some brownie points). 

I'll get some blood work at US Davis and do the assist feeding and let you know where we go from there.


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## LadyDayne (Aug 21, 2013)

After the first attempt at assisted feeding with 2 ml of water, pretty sure the cat is plotting my demise. It went well overall though. I went with the small bit of water first because it was pill time and they've been getting stuck in his throat lately, and he took like 3 small nibbles of A/D right before the pill. He just walked into the kitchen as I type this which is cat code word for 'i'm hungry' so I'm going to go see what he'll do then go for the syringe.


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## Stryker (Apr 2, 2007)

> ... it was pill time and they've been getting stuck in his throat lately


THAT is something to guard against....no dry swallowing for cats...we should always use a 'chaser' to prevent damage to the esopgagus:


> "Last year, I was prescribed clindamycin...and was instructed to take each capsule with a full glass of water. One night, being lazy, I took the capsule with just a gulp of water. What ensued was the worst case of heartburn/esophagitis I have ever had. At first, the pain was so intense I thought I was having a heart attack. This cured me of ever pilling a cat without a water or food chaser."
> 
> Pilling Cats and Erosive Esophagitis by Lisa A. Pierson, DVM


Dr. Pierson also quotes from a shocking study:


> Study design:
> 30 cats were used. Fluoroscopy was used to evaluate the pill/capsule passage at 30, 60, 90, 120, 180, 300 seconds.
> 
> Study results:
> ...


Anyways, maybe overkill....but, a while back, for me it was "Well, who knew?"


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## LadyDayne (Aug 21, 2013)

Wow that is some great information! Generally he gets the pill with a popper and he either gets it down or spits it out. He's been making those gagging motions after a pill and randomly throughout the day from time to time. I bet he's had a share of them stick and never make it to his stomach  That makes me feel awful, but now I know and will always give water with a pill. Poor baby 

On another note I did two full syringes of A/D food today and he took it like a champ. I'm sure his weakness had a lot to do with it but believe me when I say this cat has a lot of fight in him lol. I didn't have to wrap him in a towel or even clean up a mess. We went real slow and he was able to take 1 ml at a time of food. There wasn't even a mess on his face to wipe up, and I had all these wet towels ready LOL.


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## LadyDayne (Aug 21, 2013)

I just got off the phone with my vet's stand in vet who seemed extremely knowledgeable in this issue and she wants to do a blood test and medication change today. I am feeling good as she seemed to really know what she was talking about and is currently working with a cat at her clinic in Chico who has been dealing with this for 3 years, which did give me a bit of a twinge. 

She was excited about the syringe feeding and she also stressed the water after a pill so they make it to his stomach, she brought that one up on her own. So we're going in today to get the blood work and order new medicine.


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## Stryker (Apr 2, 2007)

Perhaps show her that WSAVA piece with Dr. Feldman's recommendations/protocols....I would ask her to set out the path she plans to take to track down the cause....the steps, which pathology lab, etc....the real nitty-gritty............lest you, too, find yourself nowhere better off 3 years from now. Temporary solutions wouldn't cut it for me.

I was cheering to hear that you're near UC Davis.......all the Vet schools have small animal hospitals which are the entry points for access to a whole realm of Board Certified Specialists who teach and become involved in cases. That would be choice of route. Anyways, be careful with this one!


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## Mitts & Tess (Sep 4, 2004)

stryker I didn't know that about a pill. I'm always going to administer fluids for adult cats from now on. sometimes I put baby food ham syringed in to take away any after taste. fluids sound more necessary.


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## LadyDayne (Aug 21, 2013)

Syringe feeding is awesome, Ash is taking to it very well. He has started to eat on his own several times a day now, even running to the kitchen and begging for food. Unfortunately UC Davis wanted nearly 4 times the amount of money to run a red blood cell count that my normal vet does, and they wanted a huge deposit on a procedure they said they wouldn't do until we had 3 sets of blood work done... ugh, over $1000 for something my normal vet did for $300. So we went back again to my vets temp again and did the blood work, still waiting on results but the initial check up looked better than it has. Instead of pure white there is a little pink in his mouth now, and he is getting more energy. We are switching him to prednisolone (sp) instead of prednisone and also putting him doxycycling (sp). Both in liquid forms instead of pills with some vanilla flavoring to make it a bit easier to take. Those meds are being shipped to me so it'll be 4 business days until I start his new meds. So far things are looking better though.


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## 10cats2dogs (Jun 16, 2013)

I sure hope things are looking up for Ash!
Keep us posted on his progress!


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## LadyDayne (Aug 21, 2013)

Well here is an update, we added liquid maalox into his medicine regime and that has been a turning point for him. Now he is eating small amounts of food all day and night, slowly getting his energy back which I am trying my best not to let him use up, and even grooming a few times a day and getting really affectionate again. He's not throwing up most of the time, sometimes 4 or 5 days between vomiting. He is still very thin and right now my major concern is getting his weight back on him properly. At this point he is willing eating canned food and kibbles. I don't want to let him overeat but he seems to have a strong appetite again so it's hard to not let him just pig out. 

One major problem I'm still having is that he is eating cat litter. Within minutes of eating cat litter he throws up. I know this is because he is emaciated from not eating properly, but it's really bothering me!


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## 10cats2dogs (Jun 16, 2013)

They're small steps...but still steps in the right direction, good for you for hanging in there with Ash...
Since he seems determined to eat kitty litter, make sure its non-clumping kind!!
The only thing you can do feeding wise, is to feed him more often, you may already doing that...
I hope more folks will give some feedback for you to! Hang in there.


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## laurief (Jun 22, 2008)

Litter eating is a common symptom of anemia in cats, so I would suspect that he is still somewhat anemic. The strong appetite is a wonderful improvement, though, so he must be feeling stronger.

Is he getting regular B12 injections to help support red blood cell development?


Laurie


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## Mitts & Tess (Sep 4, 2004)

Hope your not using clumping litter.


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## Valentine's Heart (Mar 18, 2011)

I am so sorry for what you are going through. This sounds like what happened to my Fernando. He was 2 and I took him to specialists. Nothing could be done. And they couldn't figure out why his red bloods cells were low. He was negative for all the fatal diseases. He had three transfusions and then I had to make the awful decision to let him go. If the red blood cell count doesn't go up, there isn't anything that you can do. At least there wasn't for me. I'm so sad to here this. My Fernando also was a feral kitten born to an malnourished mother. My heart goes out to you.


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## LadyDayne (Aug 21, 2013)

Nobody has ever suggested b12 shots! I will ask the vet on Thursday when I go back in to refill some meds.


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## laurief (Jun 22, 2008)

I suggest you read this link:

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - All About Anaemia

The link refers to the type of anemia commonly occurring in cats with kidney disease, so all of the information may not apply to your cat's type or source of anemia. It may, however, give you some additional information and treatment ideas to discuss with your vet.

Laurie


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