Pam’s cat Emily

[Pam]

Thanks Vally,

Yes, it is sad and frustrating.

Pam

[Pam]

Linda,

I will be contacting you. Thanks for the offer. I’ve been flying by the seat of my pants this last week, so my mind has been crazy.

Pam

[admin]

Hi Pam
Just a quick note to say I have been thinking about you & Emily – how is she doing? Any news on the medications?
Love Sheena xxxxx

[Pam]

Sheena, Each day is a little different. Emily looks good, but I think perhaps the Mirtazapine pill that I give every 3rd day causes some effect that may make her more restless one day, or more calm another etc. I took Emily for a recheck today and her PCV was 22.7 and temp 102.6 , weight 12 pounds. This was about the same as last week.

There are some days when I’m pleased that she eats frequently and other days when she doesn’t eat as much. She is on the Mirtazapine as an appetite stimulant.

In your other post you had mentioned Dr. Holland and ehrlichiosis with your dog Worzel. Emily had a full disease panel done and it all came back negative. She has never had a PCR done. I don’t know how Dr. Holland could help me in that Emily has already had a lot of tests. If tests come back negative then what?

My regular vet wants me to keep Emily on 5 mg of prednisolone and bring her in every week for a PCV check. If her PCV were to go down then she says she’d then think about trying Chlorambucil with Pred. I just don’t know what to think. Something must be preventing her from rebuilding red blood. It’s been two weeks since the splenectomy.

Pam

[Vally]

Pam have you thought about contacting Dr Jean Dodds? I ran through everything here quickly and can’t see a reference to her.

She’s wonderful with our dogs, but she is not exclusively dog at all.

There is an Online Consultation form you can complete and get off to her:
https://labordatenbank.com/cake/hemopet/onlineorders/hemopet_add

I would include a copy of everything you have and do a consult with her. She does a premium consult for $175.00 where you can attach information and there is no limit to text. Once she responds, and she does very quickly, if you have further questions, you just email her back, so the consult fee is really very reasonable. I like to warn people she answers questions very simply, she doesn’t use a lot of words, so don’t be offended if she answers with a simple Yes and No. Be assured, she is a very compassionate and lovely lady and a brilliant Dr. When attaching, it’s also better to scan everything onto 1 document, as once you upload a second attachment, the first one drops off.

You may have already done this and I’ve missed it, but if not, I really recommend you run it all past her. She really is very clever and has helped so many of us.

My best
Vally & Bingo

[admin]

Oh Pam, this is crazy for you. I’m so sorry. I did not consult Dr Holland – my specialist & local vets here in France treated Worzel for Ehrlichiosis because we all thought his symptoms pointed strongly to that – we only had one blood test & it was negative – but I was already pretty sure that was what he had from my own research. I like a vet who uses their instinct & gets on with treatment quickly. The specialist told me that 4 out of 5 blood tests for Ehrlichia come back negative in his experience, so we could not afford to mess around & we immediately started antibiotic treatment – 5 weeks of high dose doxycycline. All the symptoms disappeared of course & you already know his bone marrow started producing baby reds after about 10-14 days on the azathioprine. I believe azathioprine is toxic to cats, so that’s no good to you – the chlorambucil looks like the best alternative.

I think Patrice suggested Dr Holland as Dr Dodds has worked with her & she is an infectious disease expert – I think she has a good reputation & I would contact her & just ask her advice as to what to do next. PCR test requests are specific I believe, so you would need to ask which diseases to look for. If they all come back negative, you can then assume this is “idiopathic” i.e. we just don’t know what triggered it with today’s science. Mary has been keeping us updated of course, bless her. I expect she’s passed our ideas on to you.

I’m glad to hear Emily is coping without her spleen & the Mirtazapine is helping. I am taking a guess that any infection would get worse without a spleen – but that is based on human experience & I can’t be 100% sure of this. I am strongly of the opinion that you should start the chlorambucil – you have to try something as she can’t stay at a PCV of 22 – it’s worth doing, I think. How do you feel about pushing your vet to start it? I would if I were you.

I really feel for you Pam. So frustrating for you. We have a lot of “idiopathic” cases on here you know. The treatment is the same, regardless.

Love Sheena xxxxx

[admin]

Hi Pam

Thank you for updating us on Emily’s check up. So very frustrating that there is no change. I hope she’s still healing up ok from her surgery? Did she go back to the specialist or are you planning to stick with your regular vet? If so, Dr Dodds can work with the regular vet if that’s ok with you and them (Vally – thank you for your post – Pam has been in contact with Dr Dodds).

I’m concerned that the 5mg pred doesn’t seem to be boosting Emily’s PCV, and wonder if either a larger dose of pred and/or starting Chlorambucil might help. Does anyone have any thoughts on B12 and/or thyroxine? I’m just trying to think of other things that might give her a kickstart. Of course it is so difficult to know without having a diagnosis.

I think it would be worth contacting Dr Holland just to see what she advises, and whether she thinks there could still be an infectious cause even though the tests so far have been negative. Have they ruled out IBD? Do you know how her platelets and neutrophils are now?

Happy to know she is still tolerating the Mirtazapine and that it seems to be helping her eat more. I’m so sorry this is still ongoing with no answers. You are doing an amazing job with looking after Emily and I hope you are looking after yourself too.

Best wishes,

Mary and Mable x

[admin]

I am so sorry you are going through all this still. You really have been though it and so has poor little Emily.

Pam, I have used Dr. Holland for Sadie when she first came down with the AIHA in 2013 and we were trying to figure things out. Dr. Cynthia Holland is with ProtaTek Reference Laboratory. Her e-mail address is cholland@protatek.com – website is: http://protatek.com – the phone number is 480-545-8499. She will be glad to speak with your vet too, she’s VERY nice and all that she does is amazing.

I had the vet draw Sadie’s blood, packed in ice and sent overnight to the Chandler, AZ address. You will need to send 1cc blood serum (they may have to draw 2cc of blood to get the 1cc of serum). Include the Requisition Form with desired test to preform and a check (I spent $82.00, not bad at all). She’ll want Emily’s history faxed to her (call them first for a heads-up it’s being faxed). The fax number is 480-545-8499.

I would talk with or e-mail Dr. Holland first, she will tell you exactly what to do (there is a form on line too, a Requisition Form, that needs to go with the blood sample and check). I did the Enrlichia canis, A. phagocytophilum (E. equi), Rickettsia rickettsia and Borelia burgdorferi Lyme IFA tests. They were all negative, but I sure felt better doing it and it put my mind at rest for tick borne disease(s).

I would also encourage you to contact Dr. Dodds. She is incredible and her knowledge and her heart are incredible.

Please keep us posted as to Emily’s help. If you need a sounding board, you have my phone number (and e-mail, I hope).

Love and behind the ear scratches for Emily (and you, minus the scratches),

Linda and Sadie

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