Pam’s cat Emily

Keymaster

Hello Pam & Emily

Emily – you are a beautiful girl with the prettiest eyes.

I am so pleased you’ve found us & I hope we can help you through this illness. A huge welcome from us all. I “met” Mary through a mutual friend – it’s a small world! Mary has e-mailed us the tests & reports. I admit I am no expert on cats, so we will all be learning as we go. Mary says giving medications to cats can be quite a dangerous business, so I really feel for you trying to find a way of getting the drugs into her. I used a nice piece of smelly stinky Toulouse sausage to start with, but Worzel now just opens his mouth out of habit & I pop them in the back of his throat!

I know Patrice is helping too – she really is the expert on the spleen, as her dog Chance had his removed, leading to the discovery that Chance had bone marrow failure.

My gut instinct on this is also that Emily could have an infectious disease & would urge you to contact Dr Holland, as Patrice suggested. My dog Worzel had ehrlichiosis – we are 99% sure of that – even though a blood test was negative. He could have had this evil disease hiding away in his bone marrow for months or even years, without having any symptoms – and if it wasn’t in his bloodstream, I imagine the blood test would of course be negative. Gradually, he went downhill, slowly & horribly – I cannot count how many times I took him to the vets & said I knew there was something wrong. Stupidly, even though the vets said he was fine, I let him have a vaccination & things got even worse – he became anaemic. Not much appetite, losing weight rapidly, really miserable. We started him on prednisolone for a couple of weeks & then things really went from bad to worse – loads of strange symptoms, but NO temperature, then a few days later, a raging temperature, diarrhoea, stopped eating completely. So we started him on high dose long term doxycycline (5 week course) & found a great specialist who was totally convinced that ehrlichia had triggered his bone marrow failure. Does this story sound familiar to you at all? If so, an infectious disease seems likely. The moral of the story for me was the prednisolone will allow any infection to really take a hold on them, so strong antibiotics for many weeks are often necessary. Also, if the diagnosis is definitely IMHA or bone marrow failure, a second immuno-suppressant is the only way to get that bone marrow working properly again. At this stage, I know it is not certain Emily has IMHA (and I am not sure either), but something is affecting all the cell lines in her blood – all are just below the normal levels. This buys you time, thank goodness, but I know you are really desperate to find out what on earth is the matter.

I think most vets jump on the cancer idea to be on the safe side – quite understandable & it is necessary to rule out these things. Again many of us have heard that cancer word mentioned but it mostly turns out to be immune-mediated disease.

Reading your post above, we very often see enlarged spleens in dogs with this disease because the poor old spleen had to work very hard to keep up with cleaning up the damaged cells & other debris from the bloodstream. Macrophages are a type of phagocyte which are cells that clean up unwanted bits & pieces such as bacteria, dead cells & pathogens, so they are probably working overtime too – many of them would be needed to cope with that cleaning up operation. Macrophages start life off as monocytes & differentiate, or turn into macrophages. I have never come across them being mentioned as “significant” in a spleen sample myself – I’m sure they should be present & am wondering why this has been flagged up. They are absolutely essential & are supposed to be there (in certain areas) for sure. They play a vital role in “innate and acquired immune defence mechanisms response”. Maybe this is an indicator of underlying, rumbling infection? I don’t know for certain.

If this is something infectious that has not yet led to IMHA, the prednisone will make things worse without the correct antibiotic treatment. If it’s IMHA/bone marrow failure, prednisone is not enough to suppress the over-active out of control immune system adequately. Stating the obvious from me then! I can see exactly why your vets are uncertain, but they will get to the bottom of this with the right help. It’s a matter of getting the experts involved – & I know you are determined to get her better.

Please keep firing thoughts & questions at us – we’ll do our best to help.

Love Sheena, Worzel & Ollie xxxxx

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