5-6 month kitten. 5 day fever and low red blood cell count

[Kiibee]

First time here so sorry it's long, or I don't make sense :p

Kii began acting strange a week ago today. Sleeping a lot, which isn't her thing at all. Then on Friday her balance was way off, she wouldn't jump up on anything, and if she tried she fell backwards, or on her shoulders.

Called the vet they told me to bring her in that day. They took her temp, it was around 102. Blood test came back with Liver enzymes in the 160's and a low white blood cell count. They sent us home with Clindamycin to give her every 12 hours. They also injected fluids to hydrate her a bit incase she needed it.

She has been eating, drinking, and going to the bathroom just fine. Besides the fact that she always wanted to be next to the heater. So I moved her food and water next to her, she was very pleased with that and finished her food.

On Monday she still wasn't looking too good. She'd just lay around all day with her eyes barley open watching everything going on around her. She was still eating, drinking and going to the bathroom okay. No vomiting, no diarrhea. Her third eye was showing a little more, her fur wasn't as soft or fluffy since she wasn't bathing as much.

Back to the vet we went. Fever of 105, I can't remember what they said about her ATL (? liver enzymes) They wanted her to stay the night so they can get her on fluids and another blood test. Gave her antibiotics to help with the fever, changed her diet to a bland one.

Tuesday; Her fever went down to 103, they wanted her to gain some energy back and said they'd call me later to confirm if she could come home. Around 4 they called and said her fever was back up to 105 and her red blood cell count has dropped, so they wanted her to stay the night again. She's still eating, drinking, normal bathroom use, besides slightly loose stool (due to the antibiotics) No vomiting.

Wednesday; Her fever lowered a bit tuesday night but was back up to 105 Wed. afternoon. Vet did a test for mycroplasma, she was negative, but she said it doesn't always show, so she went ahead and switched her antibiotics to help with that, incase she did have it. Poor Kii is laying on a ice back they gave her and is purring and friendly but still weak. Later in the day they called to say her fever is 101 but her RBC count has dropped a little more. Another night at the vet

Today(Thursday) Her fever is gone, her RBC count dropped to 18 but then was staying at 22. (I was too nervous to have her come home so she stayed the night again) Her ALT were normal. Still eating, drinking and using the bathroom normally. Urinalysis was normal.

She's been tested for FeLV and FIV, tested negative. This was about a month and a half ago when she was getting spayed, they said everything looked perfect. I was worried cause she was a stray and I didn't know anything about her, as far as I know she hasn't been vaccinated for anything since she was so small when she found me. I was getting ready to get her vaccines done when this happened She's been a very bright, playful kitty. Has the biggest personality I have ever seen in a cat (she learned how to high-five)
Recent changes in the house: Use of a vent-less natural gas heater (I hate it!) I did some reading and she did have CO poisoning symptoms, but the vet said she didn't see anything that related, but was still waiting on a call from another Vet for more information about that. Meanwhile I had the gas company come out and test it, there was a very small leak, he said it wouldn't have been enough to hurt us, but Kii lays next to that heater whenever she naps. I only have it on from 6pm until I go to bed..

We also have another cat, Gus, He's been here for about 2 months now. I'm taking him in in the morning for a check up, just incase. He'd had vaccines, although I don't know his history for FeLV or FIV.

I googled Fever for 5 days, and low red blood cell count and came across the story of Logan from early last year, my heart goes out to his family. It scared me enough to post my rant about what's going on with my little Kiibee monster. I get to see her tomorrow, Gus too. And if her RBC count stay at where it is or increases, she gets to come home, I'm very nervous about it, but happy to have my alarm clock back. I miss her so much.


http://razzi.me/photos/344413-kii-gus

Kii (top) and Gus

[Traci]

You're saying she did NOT receive vaccines last week, only that you were getting those scheduled, correct?

Can you please tell me what "test" the vet performed to rule out mycoplasma? Generally, only a blood smear can be done in the clinic, but the mycoplasma testing requires a blood sample (plus the blood smear slide if possible), that sample must be sent to an outside lab for confirmation - usually takes 4-6 days. Whenever hemobartonella is suspect (Feline Mycoplasma), it is prudent to also test for other immunological/viral diseases with the same sample (like FELV/FIV, tick disease, other immunology).

Even though she was tested for FELV/FIV, it might be wise to test again, just to be certain. This can be done quickly in the clinic with results in 10 minutes - a combo FELV/FIV snap test is all that is needed.

Do you know if her urine was tested for any sign of infection? Generally, the WBC would increase rather than decrease, concerning many bacterial infections, but it's worth getting a urinalysis done.

The liver enzymes, particularly the ALT can alter during any type of illness, in Kii's case, most likely due to dehydration, possible infection. ALT can also change due to stress.

I would strongly advise getting the hemobartonella testing done (via outside lab), because even if the vet couldn't see it on a slide at that time, it may be developing, and it requires sometimes up to a month to treat on tetracycline drugs (example, doxycycline). The sudden fever could be indicative of that.

The antibiotics are probably helping to regulate her temperature and keeping it close to normal now, but her temp should be taken every day until there is a known cause or source of the fever/infection etc. If a temp rises too fast too soon, it's very serious and requires immediate veterinary attention. If you're able to take her temp at home, then record it once or twice a day (ask your vet to show you how to take her temp - don't stress her but it should be taken AT LEAST once a day). If her temp rises to 104 or beyond, call the vet IMMEDIATELY.

There is a high chance this may be hemobartonella, so please get the testing done, and treat AS IF it were. Hopefully that is what your vet is planning.

If hemobartonella testing comes back negative, I would seriously consider testing for FIP. Not trying to scare you, but if the source of the fever and malaise cannot be determined, then testing for FIP would possibly be a next step.

The fact Kii is responding to antibiotics now is good news. The fact that she has continued to eat, drink and eliminate normally is also good news. Keep doing what you're doing to keep her eating and drinking, pay particular attention to her water intake, you don't want her getting dehydrated again. Provide another dish of water in the home, or whatever it takes to keep her drinking.

Hoping for the best, hang in there, ask the vet about specific hemobartonella testing and take it from there. Please post back when you know more.

[Kiibee]

She hasn't had any vaccines. She was spayed late November and was tested for FeLV and FIV, they were negative. I asked for them to test that again earlier this week and she said it was still negative.

For the mycoplasma, she said she did a blood smear, didn't see what she was looking for, and did it again later on. I don't see anything on my bill that says she sent it out. She told me, that with advice from another Vet that she's going to give her the antibiotics for mycoplasma. They sent me home with Fortiflora to give her once daily after the medication. Prednisolone 5mg, to give her twice daily, and Doxycycline 100mg 1/3 tablet to give her twice daily. They said to bring her in in a week to run another blood test.

On my bill, it doesn't say anything about an urinalysis, but I remember her telling me earlier in the week that she did that, and it looked good and normal.

Would they be able to send in a sample from what they already have? or when she goes back in in a week should I ask to have it sent out then? They were very helpful, called a couple times a day to update me. But when it came time to leave no one gave me instructions on her medication, even though it says it on the bottle, and they closed out her account, so when I go back in I'll have to pay in full that day for whatever she needs done.

As for her temperature I do plan on taking that daily, the Vet said she was going to show me how, but I guess there was lack of communication between her and the nurse. So I'll go back in there later today and ask when I go to make a payment.

They vet and I are both trying to keep FIP out of our minds given the fact that her symptoms closely relate to other problems. She's been eating fine, when she got home just a couple hours ago, after her cleaning she was begging for food. I have water near her but I don't know if she drank yet. Should I give her a few drops of water every now and then? Just so I KNOW she is getting some?

Is "Referral Labwork" outside lab work by any chance? It says PCV was done 4 times. I'll ask when I go in soon.

Also her RBC count dropped down to 20 from 22 yesterday. this makes me nervous because she won't be tested again for a week, I know to look for weakness, bruising, and bleeding from where they took her blood, and her nose, but is there anything else that I would be able to notice if it drops lower? I'll probably have them do it sooner.

[k9Karen]

I hope your sweet kitty is well soon. I'm not a cat expert (Traci gets that designation), but I do understand most blood tests (I've worked in a human medical lab for over 35 years and have a degree in medical technology, which is now called "clinical laboratory science". "Referal lab" should mean blood (or possibly urine) tests were sent out to a reference lab. Please ask your vet what tests were sent and what the results were.

[Kiibee]

I definitely will ask her what they were, it says PCV (pack cell volume).

How do you split pills? into thirds, I'm surprised they weren't already

[Traci]

First, please call or talk to the vet immediately today about the medications and dosages - I'm rather appalled that no one took the time to go over them with you - the vet should have at least CALLED you to discuss the doses and how to score them (break them) - he should have scored them FOR you.

You can either take the tablets back to the clinic and ask them to score them for you, or see if they will sell you a pill splitter - or if the vet tells you to break those tablets at home, run to your local drug store or pharmacy and pick up a pill splitter - (like this one ). Be absolutely sure you understand those doses and how they are divided when you split the tablets.

The medications being given to Kii are typical for treating mycoplasma, but I would ask the vet if the prednisolone dose isn't a bit too high for Kii, given her age and weight - while it is common to dose with prednisolone at a rather high dose for some very serious conditions, I'd ask about this dose in particular. Remember, with pred, you will have to TAPER it to a lower dose over the course of a couple weeks or so, you cannot simply cease giving it because ceasing it entirely can cause some side effects. Your vet should be discussing that with you and scheduling the doses as he re-evaluates her condition (preferrably each week until a followup test shows she is recovering).

Yes, definitely ask about testing for the hemobartonella via outside lab - ask about a full immunology panel (that includes hemobartonella, Coombs, FELV, tick disease etc) - and yes, referral lab means an outside lab - typically, we use a lab called Antech or another lab that does very specific bloodwork/testing for animal species.

I stress this panel because even though the snap tests done in the clinic are, for the most part, accurate, they are not always 100% - meaning that timing, age of the cat, some bad batches of tests etc can all affect results. When the FELV test for example, is done via lab, it is more specific and garners more accurate results especially when snap tests have been done prior - it is just a good safeguard when the patient is ill and a source or cause cannot immediately be identified.

I doubt they took enough blood, nor preserved it, for sending a sample to the lab - so it would require a new sample.

No, do not give her water via dropper or syringe - that she is eating normally, urinating normally, and has a good appetite indicates she also is drinking appropriately. By forcing water orally, one could always run the risk of aspiration in the lungs. Only in times of severe illness or when the patient is too weak to eat/drink on their own should forcing food or water be necessary, and even then, must be done slowly and carefully, giving the patient a chance to swallow each drop at a time.

The PCV should be done weekly during treatment, or more frequently in the event of fever or other symptoms of progressing illness. In cases of immunological distress or illness, it can take some time to get the PCV count to normal levels - usually only a week or so, but pay attention to any other symptoms such as: lethargy, weakness, refusal to eat or drink, pale or white or yellow tint coloring of gums, inside ears, under eyelids and the fleshy part of the nose. In that event, it would be an emergency where the vet would get the patient back on IV fluids, other medications etc.

Be sure to ask the vet how to take Kii's temp - otherwise, you can see here for instructions - please be careful and gentle, she doesn't need added stress right now - if you have someone with you at home, it's helpful to have the other person gently hold kitty while you take the temp. Also, NEVER EVER use a mercury thermometer - when you're at the drugstore or pharmacy, when picking up the pill splitter, pick up a digital thermometer as well, try to check it before purchase because they have cell batteries in them and they have to be fresh (you can also ask the store staff for an extra battery).

Please update us when you know more - hang in there!