Case Spotlight – Young Anemic Cat
“Teddy” – 1 and ½ year old MN DSH –
Cindy Stubbs, DVM, DACVIM (Small Animal Internal Medicine)
Owner reports lethargic, not as playful as normal, appetite decreased. PCR panel pending.
Cat one of three from a litter raised by owner. Littermates still in same household and are clinically normal with normal blood work. This pet reported to be quieter than the rest.
Never tested for FeLV/FIV. Was exposed to a FeLV positive cat in same house but separated.
Inside only cat.
On Revolution for flea control. No history of exposure to fleas and ticks.
Pet looks fine on exam – normal weight and appearance. No overt abnormalities.
Blood work shows significant anemia with little to no regeneration. Path review still pending.
Anemia – suspect infectious disease as underlying cause (Feline Leukemia virus most likely), immune-disease also a consideration. Could have had an infectious disease that sparked an immune component to anemia.
(1) Check FeLV/FIV status on peripheral blood of this cat and other cats in the household.
(2) If negative, consider bone marrow aspirate or core biopsy. Perform CBC at time of bone marrow sampling so lab can compare. Perform Feline Leukemia IFA or PCR on the bone marrow sample (National Veterinary Labs recommended).
(3) Consider empirical treatment with doxycycline 5 mg/kg every 12 hours or 10 mg/kg once daily (follow with food or water to prevent esophageal issues) and/or prednisolone 5-10 mg/cat daily. Prednisolone preferred in feline patients as it is the active form of prednisone. Cats can make the conversion of prednisone to prednisolone in their liver but it is not reliable.
(4) Based on exam, pet has been anemic for some time and has adjusted to the anemia. A blood transfusion is not indicated at this time.
Follow-up telephone discussion: “Teddy” tested positive for both FeLV and FIV. The littermates were negative. Since the owner wishes to keep all the cats together, it will be important to stress the need for continued vaccination for FeLV and advise owner of the efficacy of the vaccines.
I recommend treatment for “Teddy” consist of doxycycline 10 mg/kg once daily for 3 weeks and possibly prednisolone 5 mg daily for 3 weeks. Reassess the PCV after that period of time to determine if there is a response to therapy. If the red blood cell count improves, the medications may have to be continued long term to maintain the PCV.
Pet should be handled as an immunosuppressed patient, with every cough or sneeze treated in a more aggressive manner. His long-term prognosis is quite guarded especially with the development of the apparent non-regenerative anemia. However, if the anemia does improve there is a chance he might do well for a longer period of time.
Anti-viral therapy has been met with questionable efficacy and I do not routinely recommend their use.