Please help me with my cat's blood results

[brogueish]

I took my lovely 4 year old rescue girl to the vets on Monday bc she's had some regurgitating and vomiting. She came to us in mid-December, so it's been a few months. I experienced vomiting/regurgitating in a previous cat when she would be a bit sick before breakfast (overly hungry) and then bolt her food and regurgitate it barely chewed. I took previous cat to the vets and was told some cats are just a bit sicky! She was ok otherwise.

Honestly I wasn't that concerned about current cat bc otherwise she's ok, but I was worried that there may be a stuck furball or something like that. The vet did not think that was the case.

The vet recommended bloodwork, which cost £200, and on the basis of that is now recommending further investigations (scans and bloods) totalling another £300. The money is not the issue here, but I am really reluctant to put my lovely cat through unnecessary trips to the vet and blood draws etc. She has been her normal self, playing, eating, etc. I would prefer to take a conservative, watch and wait approach, but the vet was keen to get the scan done this week. We've split her meals into more frequent smaller feeds and so far so good.

Looking at the bloods, there are a few areas outside of normal range:
Haemoglobin 167 (80-150)
Haematocrit/PCV 0.513 (0.24-0.46)
White blood cells 4.5 (5-15)
Lymphocytes 1.08 (1.5-6.5)
Platelet count 48 (230-680) - there's a note that platelets were clumped and could not be manually counted

What would you do? I definitely don't want to withold treatment, but she seems ok in herself and I don't want to upset her if it's not necessary.

In this situation, and with the vet recommending it, I'd personally definitely get more tests for my cat. The low platelets would worry me, not that I have any expertise in that area!

No help with the bloods, but our cat goes through spells of puking - mainly overnight so maybe it is because she is hungry/too long between meals. Generally it’s like a mouthful and some grass/hair.

We’ve had her to the vet umpteen times and they have never been overly concerned as she’s well in herself, not off food or losing weight. One time last summer she was sick multiple times in a day and did seem off-colour so I rang and took her in that afternoon (by the time of the appointment she was fine, of course). She was given a jab and told to bring her back if she was sick in 24h which she wasn’t.

I totally get not wanting to stress her with vet visits - ours absolutely hates it and finds it so distressing. We’re booked in for boosters next week and she’s been going through a sicky spell again this week, so DP is going to ask them to check her over then to double up.

Thanks, it’s good to hear other thoughts.

@Judystilldreamsofhorses thats pretty much exactly what we’ve experienced too. I’ve not seen this particular vet before though.

I’m just worried that if it is nothing, how far will the investigations go. Doing a biopsy has already been mentioned. This practice has tended not to rush into invasive tests so it’s taken me back a bit, especially as she seems so well in herself.

What did you decide to do, OP?

Well, after several long chats with DH, we've decided to watch and wait. She seems absolutely fine in herself today, nothing at all to note. I've not taken her in for a scan today or booked another appointment, but of course I will if anything changes. I think we both felt that it's really hard to prove that nothing's wrong and the thought of a biopsy to "get to the bottom of" (maybe) nothing really wouldn't be in her best interests.

One thing that the vet mentioned and then seemed to step away from was the possibility of giardia, which is apparently really common in cats coming from rescues. So I'm going to get the panacur and do that as a precaution anyway.

Thanks for following up. I hope we've made the right decision, I definitely feel more comfortable with it.

That sounds like a good plan - and you can ring in if you are concerned.

I am now paranoid our vet hasn’t been thorough enough and has missed something! We last had her in at Christmas and the vet said to keep her in for a week then bring her back for a further check. She was still sick a couple of times in the week in, and demented with not being allowed out. On the return visit the vet said she was happy with her, no concerns, and didn’t want to see her again. Over the year we saw three different vets in our surgery and presumably they are all competent but I get so anxious!

Just out of curiosity what food are you feeding

@Judystilldreamsofhorses Honestly I wouldn't worry. Like you, we've seen so many different vets over 2 cats with the same symptoms and this is the first time we've ever been advised to even have bloods taken. I appreciate the thoroughness but also it seems so vastly different to previous advice, I'm not sure!

@IsEveryUserNameBloodyTaken Good question. She (and previous cat) were on James Wellbeloved dry (grain-free or hairball) in the morning plus a pouch of wet in the evening (James Wellbeloved again or Nood from Tesco, always chicken or turkey). However, I've looked again at the JW dry ingredients and ditched that in favour of Lily's Kitchen dry, but have been giving her mainly wet stuff this week. Did you have any thoughts or suggestions on this? I'm really keen to have her on decent stuff.

@IsEveryUserNameBloodyTaken i’ll chip in here too! We were on Felix in gravy which was what she had always had from when we adopted her, and she wouldn’t take anything else. Dry was Iams.

Last year I read about Felix making cats ill, and transitioned her onto Sheba. She was very, very rarely sick before then, maybe twice in six years. We then switched to hairball Royal Canin, but the vet at Christmas said the switch in food might have triggered the puking. That makes sense time-wise. So now she has a mix of Felix and RC, with RC dry in a puzzle feeder because she’s a guzzler and not a grazer.

We have that hairball paste from the vet too, but she goes in phases with loving it and treating it like poison.

I’m reluctant to chop and change but equally want her to have a happy tummy!

@Judystilldreamsofhorses That's interesting - our current and last cats were also guzzlers. Both came from multicat homes/rescues, which apparently makes them more likely to gorge because they've learnt to be in competition for food. We are using a slow feeder for the dry food now, which has definitely put a stop to the regurgitated kibbles.

@brogueish we adopted ours direct from a family where she was being terrorised by their toddler (just a typical boisterous wee boy, but she is a nervous soul and was really stressed). No multi-cat situation, she is just a greedy madam!

I often look after my neighbour’s cat and dog, and it amazes me that her cat will daintily lick the jelly/gravy from his food when I put it out, then saunter off and come back to it in a few hours. I would be VERY worried if ours didn’t lick the plate absolutely clean in five minutes flat!

Here she is, werking for her dinner!

Oh she's lovely!

I don't understand the bloods but if by any chance she's a ginger it's very common.

This is my girl, she’s a spotty cat ☺️

She is a bit ginger (see above!). Thanks, that's interesting to know.

@brogueish I think what is more of concern than the abnormal results ( which really show minor dehydration - you have platelet clumps so that makes those concerns smaller) is that there is no explanation for the vomiting. I would guess they are suggesting ultrasound to look at the causes of vomiting that don't show up on blood tests like cancers, some pancreatitis and some other things.
Intestinal lymphoma is relatively common in cats and can often be controlled for many years with oral chemotherapy once every couple of weeks. I have had patients live years on these treatment regiemes.

@Lonecatwithkitten Thanks for your post, that's definitely food for thought. I wonder if that's why the vet mentioned a biopsy too :(

The approach DH and I have agreed is to watch, and if she has vomiting again to take her back. Would you think it better to take her back for the scan straight away then? I'm genuinely trying to act in her best interests here, not just withold investigations on principle.

I’m really as lost as you on finding suitable food after chopping and changing over the years.I know one of mine was being sick a lot and stopped when I changed food but it’s none of the brands you have mentioned.

How are you doing @brogueish ? We brought our cat for her boosters today and got a full checkup at the same time. Based on this thread I pushed for answers re the vomiting. Physically she is well, no weight loss, heart/lungs good, teeth fine, the vet gave her tummy a good prodding much to her displeasure, and said she was “very lively in herself” (shouting her head off and trying to escape!) so she had no real concerns.

She thinks it might be a kind of cat acid reflux, so we got an anti sickness injection and then a course of omenprazole to try. if no improvement then we have to bring her back for bloods, and an X ray.

Thanks for checking back @Judystilldreamsofhorses 😊

Your vet sounds sensible tbh. How are you feeling about it? I’m really sorry if this thread has worried you unduly. It’s really positive that they’ve found no other causes for concern. How often is yours being sick now, and is it actual vomiting or regurgitating food?

So, here she’s now had various blood tests and an ultrasound scan - we’re at £500 now and completely none the wiser. Lots of things have been ruled out (pancreatis, leukaemia, feline AIDS, other stuff I think), but vet says that the next step is a biopsy under GA to potentially diagnose irritable bowel, which as I understand is managed by diet anyway. A biopsy sounds highly invasive and I’m not keen.

I’m not really sure what to make of it if I’m honest. She can be sick if she’s not eaten for a while, and if we accidentally give her too much at breakfast she regurgitates it pretty much straight away. So I’m feeding her little and often, basically. Luckily I wfh 😂

@IsEveryUserNameBloodyTaken it feels like such trial and error! What food did you switch from and to? My girl is now only having Scrumbles wet food to soothe her (possibly) irritable bowel, it’s not having much impact yet though… 🙃

@brogueish I agree our vet seems sensible! It was the same woman DP saw at Christmas with her so that worked out well. We had no sick after the injection which was great as they said it acts as a “diagnostic” (?) as well as an anti-emetic. I was literally counting down to 4.30 today when the 24h was up. An acid reflux type situ actually makes sense to me as a human reflux-er. She seems to be sick mainly overnight when she’s had a big gap between meals, and it’s more what I would call “spit up” than actual vomit, like a pool of grass and hair in a bit of brown-y liquid, like a mouthful.

The other thing the vet said was to feed her later at night, so she had a surprise midnight feast!

It’s good news that your vet has ruled out all of these things. Have they given any advice on food? I ordered a trial box of “Untamed” which was £8 - they tried to tie me into a subscription straight up but I cancelled that. I did as they suggested in the bumph and put a little bit with her usual food tonight. They said it would encourage her to sniff it, but she wolfed it down, including actual visible shrimps which I couldn’t even look at!

Yes we’ve been giving this one a midnight feast too, she is delighted! What you describe is really similar to what we have too.

Let me know how you get on with the Untamed food. The vet only specifically suggested royal canin GI to me, which is what they they sell. The ingredients on the wet food I’m currently giving her is literally chicken, chicken liver, oil, minerals and slippery elm, which feels to me as close to basic as possible. The vet did suggest that a single protein would be better (e.g. chicken or white fish).

Hopefully both our cats’ tummies will settle soon!

We’ve ordered a timed feeder thing so we will see how that goes. Usually there’s at least one day she’s home alone all day while we’re both in work with no-one to give her lunch. Pre lockdown this was the norm every day, but she was such a nuisance begging for food when we had lunch that we started splitting her meals.