Archive for November, 2009

Info on hermobartonellosis and the importance of following your instincts…a must read if you have cats!

Monday, November 23rd, 2009

About seven weeks ago I noticed that our cat Longtail seemed to be drinking a bit more water than normal. It was very minimal and it was hot out but something told me it was time to get this 12 year old boy a senior blood panel to make sure his kidneys were functioning properly.  Longtail is extremely shy so I decided to take him to the closest vet possible to limit his time in the car. When we got the results of the blood work I almost had a heart attack. Although his kidney values were normal his white blood cell count was dangerously low (1.8 when normal is 3.5-16). and his red blood count was low too (HGB was 8.3 on scale of 9.3-15.9 and HCT was 25 on scale of normal being 29-48). I panicked and immediately called the vet. Longtail was not showing any symptoms so the vet brushed off my concern and blamed his white cell count on the fact that Longtail had Pan Leukopenia 2 years ago. This did not make sense to me since his blood work after the pan leuk had confirmed that his white blood cell count had returned to normal. I faxed his blood work to another vet for a second opinion. The other vet told me to rule out FVI, FeLV (feline leukemia) and to posibly do a bone marrow aspirate. I brought Longtail back in and had him checked for FIV and FeLV and both were negative. I decided I did not want to put him through a bone marrow aspirate. An amazing holistic practitioner I work with told me to take him in and do a reticulocyte count to make sure his body is actually making red blood cells. This came back normal as well. No one could tell me what was going on but I KNEW in my heart that a low white blood cell count can be deadly for a cat (this is how they fight off infection and sickness). I started Longtail on Chinese herbs that were recommended by the holistic practitioner to try and boost his blood cell count.

This last Thursday (seven weeks after the first blood panel was done) I took him in for a follow up to see how his blood looked. The results came back even more devastating…his white blood count was now down to 1.5. Again, not even a call from the vet who took the blood…no concern at all that something major was wrong. However, I emailed these results to 2 people…one was the holistic pracrtioner (who by the way is not a vet) and a friend who is a research scientist and one of the smartest people on this planet (also not a vet). Both contacted me right away and said “get him checked for hemobartonellosis (also known as hemobartonella, hemofelis mycoplasma and ricketsial infection). Hemobart is a blood parasite usually contracted through fleas or ticks.
The tricky part was finding a vet who actually knew how to do this test and what to look for. Clearly two vets had already failed Longtail in not even thinking about this as a diagnosis.  Many veterinarians routinely test for the disease by sending blood samples to an outside laboratory.  The laboratory will almost always return the following statement:  “No organisms found.”  What that means is that they’ve examined the blood sample under a microscope at a magnification of 1000 and saw no parasites attached or near the red blood cells.  The reason that they don’t see any organisms is that the preservative used to protect the blood sample from coagulating during shipment washes away all of the organisms!  The only correct procedure for testing for the organism, optically, is to take blood directly from the animal and prepare a slide immediately and examine it at the hospital using a diffraction limited (i.e. really good) microscope.  A few texts on hematology make a point of emphasizing the correct procedure, but unfortunately most veterinarians aren’t informed.  Sometimes, the doctor will request a reverse-polymerase-chain reaction (PCR) test to determine if the organism is present in the animal’s  (cats or dogs) blood.  The problem with PCR testing is that it is so sensitive that it will return a positive result even if the animal has a non-clinically significant infection.  A negative result can be used as a “rule-out”, however.  Optical examination and verification is the gold standard for diagnosis of this kind of disease.

We rushed off to Jansen Animal Hospital in Torrance…this is an INCREDIBLE hospital that our scientist friend told us about. They have an internal lab and they know how to diagnose hermobart. Sure enough…five mins after taking blood they confirmed that Longtail had hemobart.

Finally a diagnosis! Something that can be cured if caught early enough! What a relief.

There are many things about hemobart that we learned through this experience that I want to pass on to all people who live with cats. Here it is in a summary:

* This parasite attacks the red blood cells and basically kills them. The white cell count can go down because the white cells start fighting off the red cells. So essentially it is like the cats body is fighting against itself.

* If left untreated this could kill your cat. However, if you catch it it is 100% curable. Many times cats will show symptoms such as lethargy (so hard to diagnose since cats sleep 18 hours a day anyway!), lack of appetite, pale gums due to the anemia (low red cell count) and can even have labored breathing and heart failure. However, there are many, many cats like Longtail who do not show any symptoms until it is very advanced.

* Longtail received a shot of steroids which helps the white blood cells and is taking Orbax for a week. At the end of the meds we will have his blood retested to make sure all organisms are gone. In addition, all our other cats are being treated as well.

* Even though our cats are strictly indoor cats they ended up with fleas this past summer and that is most how he got hemobart. Because it is passed from animal to animal through flea bites, all our cats are being treated. however, it is highly unusaly for dogs to get it so our dog is not being treated.

* It is more common in cats than dogs.  

* If your cats end up with fleas you may want to check their red and white blood cell count.

The most important thing I learned through this experience is to trust your instincts. I KNEW his blood work was a sign that something was wrong. I KNEW that both vets could not figre out what was going on so I continued to search out answers. Lastly, I KNEW that if I did not find out what was going on we would lose our sweet boy. The reality is that I could have come home one day and found all my cats dead or in heart failure. I am forever thankful to my friend Jim, the scientist and to Kim the holistic practitioner for figuring out what was going on with Longtail. I am so relieved to now have a animal hospital that does not just brush off abnormal test results. In fact, Jansen Animal Hospital told me that because Longtail had no clinical symptoms… the FIRST test they would have done 7 weeks ago would have been for hemobart. THAT is a good vet…