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<p class="MsoNormal">Hi Deborah<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">The CBC results are unusual. There is some anemia going on, and there is the low white cell count. There is also an elevated monocyte count.
<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Most people are aware that white cells go up with an infection, but they can also go quite low with an infection – often if there is a focal area of inflammation/infection and white cells are moving out of the circulatory system to go to
the site of infection in the tissues. My worry is that there ma be a source of infection somewhere. Monocytes can be elevated with a chronic infection as well.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">If it were my cat, I think I might ask the vets to give more in the way of antibiotics, with a broad enough spectrum to cover Gram positive and Gram negative organisms. I think I might insist on using Doxycycline along with another antibiotic,
because the Doxycycline also has an effect on some more unusual organisms like some parasites and some viruses even. I think I would also try the Winstrol if it were me. Winstrol has an excellent enhancing effect on appetite, and may also help with the anemia.
I myself wouldn’t be that worried about the prednisone/prednisolone but it probably wouldn’t hurt to hold off on that one and see if you get some improvement on the Doxycycline/Other Antibiotic/Winstrol combination.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Amani<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><b>From:</b> Felvtalk <felvtalk-bounces@felineleukemia.org> <b>
On Behalf Of </b>Deborah Whorley<br>
<b>Sent:</b> July 25, 2019 2:59 AM<br>
<b>To:</b> felvtalk@felineleukemia.org<br>
<b>Subject:</b> [Felvtalk] Chablis - seeking advise about giving Pred/Doxy/Winstrol with low WBC<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">Hi - one of my FeLV+ cats, Chablis (F, 5 yrs), has been dealing with constipation since Jan of this year. Last week she stopped eating like she does when she is
“backed up” but 100 cc SQ fluids didn’t resolve the issue as it normally does. She also started wheezing Sat eve. I ended up with her in the emergency clinic on Sun and to my surprise her CBC was terrible (see below). Radiograph revealed no constipation or
obvious masses in lungs/abdomen. ER vet, and my vet the next day, reluctant to give pred due to low WBC. Treating dehydration and inappetance with SQ fluids and mertazapine. ER vet also gave Convenia "just in case”. Going back on Fri to my vet for another
CBC. Have been following this group for several years and want to try Amani’s treatment protocol, but does low WBC contraindicate giving prepnisolone and/or Winstrol? Thanks in advance for any advise. - Deb</span><o:p></o:p></p>
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<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">CBC (21Jul2019) <o:p></o:p></span></p>
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<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">NOTE: they did not repeat the analysis which, in hindsight, I should have insisted upon<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">Test <span class="apple-tab-span">
</span>Result <span class="apple-tab-span"> </span>Flag <span class="apple-tab-span">
</span>Normal Range <span class="apple-tab-span"> </span>Measure<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">RBC <span class="apple-tab-span">
</span>5.11 <span class="apple-tab-span"> </span> L <span class="apple-tab-span">
</span> 5.65 8.87 <span class="apple-tab-span"> </span> M/μL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">HCT <span class="apple-tab-span">
</span>24.4 <span class="apple-tab-span"> </span>L <span class="apple-tab-span">
</span> 37.3 61.7 <span class="apple-tab-span"> </span>
%<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">HGB <span class="apple-tab-span">
</span>7.8 <span class="apple-tab-span"> </span>L <span class="apple-tab-span">
</span> 13.1 20.5 <span class="apple-tab-span"> </span>
g/dL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">MCV <span class="apple-tab-span">
</span>47.7 <span class="apple-tab-span"> </span>L <span class="apple-tab-span">
</span> 61.6 73.5 <span class="apple-tab-span"> </span>
fL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">MCH <span class="apple-tab-span">
</span>15.3 <span class="apple-tab-span"> </span>L <span class="apple-tab-span">
</span> 21.2 25.9 <span class="apple-tab-span"> </span>
pg<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">MCHC <span class="apple-tab-span">
</span>32.0 <span class="apple-tab-span"> </span> 32.0 37.9 <span class="apple-tab-span">
</span> g/dL<o:p></o:p></span></p>
</div>
</div>
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<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">RDW <span class="apple-tab-span">
</span>23.6 <span class="apple-tab-span"> </span>H <span class="apple-tab-span">
</span> 13.6 21.7 <span class="apple-tab-span"> </span>
%<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">%RETIC <span class="apple-tab-span">
</span>0.2 <span class="apple-tab-span">
</span> %<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">RETIC <span class="apple-tab-span">
</span>8.7 <span class="apple-tab-span"> </span>L <span class="apple-tab-span">
</span> 10.0 110.0 <span class="apple-tab-span"> </span> K/μL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif"><o:p> </o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">WBC <span class="apple-tab-span">
</span>* 2.39 <span class="apple-tab-span"> </span> 5.05 16.76 <span class="apple-tab-span">
</span> K/μL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">%NEU <span class="apple-tab-span">
</span>* 32.6 <span class="apple-tab-span">
</span> %<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">%LYM <span class="apple-tab-span">
</span>* 36.8 <span class="apple-tab-span">
</span> %<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">%MONO * 28.5 <span class="apple-tab-span">
</span> %<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">%EOS <span class="apple-tab-span">
</span>* 0.4 <span class="apple-tab-span">
</span> %<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">%BASO <span class="apple-tab-span">
</span>* 1.7 <span class="apple-tab-span">
</span> %<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">NEU <span class="apple-tab-span">
</span>--.-- <span class="apple-tab-span"> </span>2.95 11.64 <span class="apple-tab-span">
</span> K/μL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">BAND <span class="apple-tab-span">
</span>* Suspected<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">LYM <span class="apple-tab-span">
</span>* 0.88 <span class="apple-tab-span"> </span> 1.05 5.10 K/μL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">MONO <span class="apple-tab-span">
</span>* 0.68 <span class="apple-tab-span"> </span> <a href="x-apple-data-detectors://9"><span style="color:black">0.16 1.12</span></a> <span class="apple-tab-span">
</span> K/μL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">EOS <span class="apple-tab-span">
</span>* 0.01 <span class="apple-tab-span"> </span> 0.06 1.23 <span class="apple-tab-span">
</span> K/μL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">BASO <span class="apple-tab-span">
</span>* 0.04 <span class="apple-tab-span"> </span> 0.00 0.10 <span class="apple-tab-span">
</span> K/μL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">nRBC <span class="apple-tab-span">
</span>* Suspected<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">PLT <span class="apple-tab-span">
</span>* 182 <span class="apple-tab-span"> </span> 148 484 <span class="apple-tab-span">
</span> K/μL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">MPV <span class="apple-tab-span">
</span>17.6 <span class="apple-tab-span"> </span>H <span class="apple-tab-span">
</span> 8.7 13.2 <span class="apple-tab-span"> </span> fL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">PDW <span class="apple-tab-span">
</span>--.-- <span class="apple-tab-span"> </span>9.1 19.4 <span class="apple-tab-span">
</span> fL<o:p></o:p></span></p>
</div>
<div>
<p class="MsoNormal"><span style="font-size:13.0pt;font-family:"UICTFontTextStyleTallBody",serif">PCT <span class="apple-tab-span">
</span>0.32<span class="apple-tab-span"> </span>0.14 0.46 <span class="apple-tab-span">
</span> %<o:p></o:p></span></p>
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