Can someone interpret? (lab results)

[MA]

Recent rescue, a year old tom (due to be neutered next week) Cyrus arrived extremely dehydrated, hanging head over water bowl unable to drink, refusing food. No diarrhea, no vomiting. Rushed to the vet- received the lab results but can't make heads or tails about what it means. Vet is out of town currently on farm calls-

CK- 63
GGT-8
Glucose-60
Calcium-7.9
WBC-19.2
MCV-39
Lymphocytes-17
Monocytes-10
Eosinphil- 0

Reactive lymphocytes present. Neutrophils appear slightly toxic
Blood count and platelet evaluation affected by presence of clot in tube

Absolute Neutrophil Band- 576
Absolute Monocyte- 1920

Findings suggest an acute and overwhelming tissue demand for phagocytes (both neutrolphils and monocytes) as could occur with inflammation or infection.

Ok, so this kitten has an inflammation or infection- I have an appointment to take him back Friday to the vet. He is eating better and drinking now without having to have subcu's. But I can tell he is still feeling punky. This guy was owner abandoned when they got evicted, they left all their animals behind. He has a neuter appointment soon and I would like him to be healthy before they put him under.

Thank you-

[Traci]

It could be that everything is out of whack due to severe dehydration and malnutrition (prolonged starvation, particularly if abandoned and food/water sources scarce). There could still be an infection, like bacterial or viral in nature, since kitty is immunocompromised. Does he have any respiratory symptoms? Does he have any skin sores? Muscle problems?

Was a fever ever noted, and did the vet check his temp???

I would advise repeating CBC next week (or tomorrow if you mean his next appointment is tomorrow) - Ask vet to consider glucose as well. (has this kitten been tested for FELV/FIV?) Did vet rule out distemper? Any other of the pets sick, as in viral? Or, are they sick with dehydration and malnourished as well? How long exactly was this kitty and the other pets abandoned, without food/water etc???

Did the vet put kitty on antibiotics for now?
When is the vet going to be available and why didn't he go over this with you? Do you have another vet you can utilize?

No, do not neuter this cat under any circumstances until he has cleared any infection, gained weight and is in overall excellent health, this will not happen in one week. Postpone the neuter appointment, and recheck this kitty within one week of the last vet visit, or sooner if symptoms worsen or new symptoms develop (or tomorrow if that's what your post indicated). May have to wait up to a month or so to reschedule a neuter.

[MA]

Thanks Traci- the bloodwork was run because my fear was distemper. I had an outbreak late last year. First time I have had this hit and it was ugly. I have since boarded up the kitten room and we use it for storage after I scrubbed the heck out of it and tossed everything movable in the burn pile. The kitten had been ill for two days so the vet didn't think it was distemper. I did ask for a snap test- even though I know it can test a false positive, but the vet vetoed me and said the bloodwork would show better if it was distemper.

Cyrus was tested for all the diseases as well and came up negative. His skin is so tough- it took the vet six times of sticking to get blood! That is the first time I have ever seen this vet struggle so.

Cyrus is eating and drinking. The only visible signs that he doesn't feel well is a tiny bit of drainage from his eyes- barely gets the tip of a q-tip wet. it is his demeanor that shows me he isn't well. No fever, not lethargic-no skin sores, no muscle tremors or weakness.

My vet is on the coast doing his farm calls today and tomorrow. I am sure he will call me as soon as he can. I will reschedule his neuter, but I still have four to take in anyway.

A cat I got just last week makes me weep. She has been to the vet twice but she was in deplorable shape and almost dead when I went to fetch her. She is an orange girl and about 13 years old. Some *beep* four-pawed declawed her! She was pencil thin and even though short haired, she had a massive mat all the way along her back. She is slowly gaining weight, and now is able to actually walk a bit. But my heart cries everytime I see her. I have her on liquid vitamins. I call her Torah and she will be with us from here on in. I shaved her mat off and underneath you can see her backbone and ribs. I just want to hit the person responsible for doing this to this lovely girl!

Thanks again Traci, I will ask the blood tests to be repeated. Is it normal for the blood to clot in the tube?

[Traci]

Well, my guess would be they let the blood sit for just a few minutes longer than it should have before centrifuging. One is supposed to invert the sample first to prevent clotting, then test right away. If there was a clot in the sample it was probably mishandled. This is another good reason to repeat the CBC, for accuracy.

The good news is that the toxic neutrophils are only slight, which could indicate bacterial infection or inflammation somewhere (where remains to be determined). "Reactive" lymphocytes might indicate a lymph node reaction, responding to an infection. The bands are a bit high but that could be due to the body's natural defenses attempting to produce from the bone marrow to compensate (i.e., fighting a lingering infection). If this were my cat, I would of course repeat the CBC within a week of the last one to determine accuracy and to monitor any significant changes. IF there are any significant changes, especially if the neutrophils change to more toxic or in high numbers, PCV or platelets are significantly low, seriously consider testing for immune-mediated problems. Hopefully, it won't come to that.

Did the vet suggest parasitic infection? Did the vet suggest a fecal exam?

By his demeanor, what exactly do you mean? Is he perhaps just overly stressed? Are you checking his temp daily, checking his mucous membranes (gums), is his skin normal colored and not pale/white/bruised?

When you said he was tested for all the diseases, do you in fact mean he was tested with the snap FELV/FIV combo? Please make sure that was done or is done at the next appointment.

Can you keep me updated on this kitty please?

As for the 13-year-old, as soon as you can afford to, please consider a senior blood profile for her, at the very least, check kidney function and a thyroid panel. The extreme weight loss is concerning and could be due to any hidden or unchecked organ disfunction. Glad to hear she is gaining weight but do keep a very close eye on her.

Thanks for taking these two into your heart and home! Keep me updated.

[MA]

Yes to the testing on Cyrus. All was done. He just feels punky. I can see it in his movements and how he reacts with me when we are sharing time together. He doesnt want to eat this morning at all or drink. I am taking his temp regularly. No spikes, no sub-normal temps.

As for Torah, she was so flea-ridden that she had nothing left to give. I changed her bath water, when I finally did give her a bath (after the vet flea-treated her) He didn't want to, given her depleted condition, but the fleas were huge and so bad Traci! Honestly, I have only seen this one other time with my one kitten when he arrived here- Hurricane Charlie. Who is thriving wonderfully now. But anyway with Torah, her bath water had to be changed 6 times due to the flea dirt and blood!

Once she is strong enough- I will take her in for a senior panel. My vet, bless his heart is treating both of these for free. He is even doing the neuter on Cyrus at no charge. Torah needs a dental badly, but again, she is to compromised still for any type of procedure.

I had stepped out of rescue. Even announced it at the clinic months ago the last time I was there (before these two came into the picture) The distemper was nasty and quick and it took no prisoners of the litter of kittens. Do you see anything in the blood work Traci that points to distemper?

[Traci]

If distemper, I think he would be showing obvious signs by now, and given his history, it sounds more like he is simply trying to compensate for stress, malnutrition, hydration. But, the important thing is the vet attempts to find the source of infection, and that the CBC is repeated for accuracy or any changes. When the bloodwork is altered due to mishandling of the sample, this is not good. A new CBC should be more accurate and include the PCV and platelets which can tell you more.

GI infection, parasitic infection (intestinal worms), some type of older wound possibly, oral infection etc are all things the vet should focus on. Do you know if this kitty was kept strictly indoors before? If you know if he was allowed outdoors, then of course, the possibilities increase for types of infection (fleas, parasites, heartworm etc). Again, knowing his history would be a big help in terms of environment etc but I understand if that's not possible.

Is Cyrus' appointment today?

[MA]

Yes the appointment was today. He is on Clavamox and his appetite has returned (catnip helped) The vet is calling this a low-grade infection and wants to sit and wait and see if the antibiotic works.

[MA]

Traci, Cyrus is eating now like there is no tomorrow. He is drinking on his own and interacting with the toys in the bedroom. Whatever he had, the clavamox seems to be helping him out.

Torah is getting stronger, she still sleeps pretty hard, but I suspect she was outdoors a very long time. She also is peeing like a racehorse (suspect diabetes) as she drinks tons of water. I am giving her one more week to be a bit stronger and have more meat on her before taking her in for bloodwork. I didn't even think she would survive when I got her. I am so glad that so far she is fighting to stay here.

[Traci]

For Torah, test for diabetes (both blood and urine glucose) as well as kidney enzymes (best to test completely, like full blood profile including thyroid level).

Don't necessarily assume she is going to feel better in a week and don't let that deter you from getting her in sooner....if this is diabetes for example, the condition can worsen drastically in a matter of hours if hypoglycemic (weakness/incoordination/stumbling the most obvious signs). Getting her in immediately will benefit most by showing what level the glucose truly is and getting treatment started immediately.

I'm glad to hear Cyrus is feeling so much better!

[MA]

Traci, Torah has passed. The vet said her systems were shutting down. I won't go into the details. She was given a last moment of dignity in the end. Thanks for your help-