Sick kitty all of a sudden June 3rd

Did some poking around, yes, cats can get it:

http://www.petplace.com/cats/ehrlichiosis-in-cats/page1.aspx

Ehrlichiosis is an uncommon tick-born disease of cats that is caused by one of several rickettsial organisms that belong to the genus, Ehrlichia. Ehrlichia canis (E. canis) and Ehrlichia risticii (E. risticii) are believed to be the primary causative agents in the cat.

Rickettsia are small microscopic organisms that are different from both bacteria and viruses. They enter various cells of the body and behave as tiny parasites, eventually killing the cell. Ehrlichiosis has been detected in cats in the United States, Europe, South America, Africa, and the Far East.

How cats acquire the disease is not well understood. Ticks have been identified on some infected cats. Although the pattern of development of the disease in cats is not well known, it is believed to be similar to ehrlichiosis in dogs.

What to Watch For

Lethargy, depression
Anorexia (decreased appetite), weight loss
Vomiting and diarrhea
Fever
Pale mucous membranes from anemia
Breathing difficulty
Swollen glands (enlarged lymph nodes)
Swollen and inflamed joints
Discharge from the eyes and inflammation inside the eyes

Diagnosis

A complete blood count (CBC), platelet count, biochemical profile, and urinalysis are indicated for all suspect cases. Abnormal findings may include anemia, which is a low platelet count and low counts for some or all of the white blood cells. Platelets are small particles in the blood responsible for initiating a blood clot. Other findings may include elevated protein levels in the blood, evidence of the presence of another blood parasite, Haemobartonella felis, and evidence of lymphosarcoma, a cancer of white blood cells.

Although rarely seen, the presence of organisms within the white blood cells is diagnostic for ehrlichiosis. {That was the case with Sebastian; the blood tests did NOT show anything, but the course of prescribed treatment did the trick.}

Screening chest and abdominal radiographs (X-rays) may be performed. Although within normal limits in many cases, they may reveal an enlarged liver or spleen. They also help to rule out other diseases that produce similar clinical signs.

A bone marrow aspirate may be recommended. Examination of the bone marrow helps to determine why certain blood cells are decreased in the blood count, and provides information on whether the bone marrow is healthy enough to recover. Evidence of lymphosarcoma may also be found in the bone marrow.

Serologic testing detects various antibodies produced by the body against Ehrlichia. Sometimes these antibodies are detected in cats, yet they do not always correlate well with the presence of active infection in cats.

Ehrlichia polymerase chain reaction (PCR) is a test that is capable of detecting the presence of extremely small amounts of the parasite. Some cats that are negative on serologic testing may be positive with the PCR test. A positive PCR test usually confirms the diagnosis.

Confirmation of the disease in cats may also require culturing of the organisms from a blood sample. {Ordinarily, you don't really have time to do all these tests... just give 'em the darn doxycycline and if it works, then you know.}

Treatment

Depending on the severity of clinical signs, treatment options may include out patient care or may necessitate hospitalization. Antibiotic therapy is the mainstay of treatment for ehrlichiosis in cats. In severely ill patients, intravenous fluid therapy, blood transfusions, and other forms of intensive support may be indicated.

The most common antibiotics used to treat ehrlichiosis belong to the tetracycline family of drugs. They include doxycycline, tetracycline, oxytetracycline, and minocycline. These antibiotics have the greatest efficacy against Ehrlichia, and the fewest side effects. Presently, doxycycline is the preferred drug to use for ehrlichiosis because it is well tolerated in cats. Tetracycline and oxytetracycline may cause anorexia, fever and lethargy in some cats.

Home Care and Prevention

At home, be sure to administer all medication exactly as prescribed and return for follow-up testing as directed by your veterinarian. Most antibiotics are given for at least two to three weeks for this disease. Prognosis is excellent if the disease is caught early. Most cats show improvement within 72 hours of starting the antibiotics. The prognosis for severely ill cats, or for cats with accompanying feline hemotropic mycoplasmosis and lymphosarcoma is poor. {You really have to give the doxycycline for about 3 to 6 months to prevent the disease going latent and reemerging as leukemia.}

Although the method of transmission of ehrlichiosis in cats is unknown, prevention of tick and flea infestation is recommended. Tick and flea infestation can be prevented by spot-on medications that are applied to the skin, and with sprays or powders. Cats are highly susceptible to insecticides that prevent fleas and ticks. Products designed for use in dogs may be severely toxic to cats, and may result in seizures, collapse, coma, and death. It is important to obtain tick and flea preventive medications from your veterinarian, and to make sure the product labeled as being safe for use in cats.
 
Supposedly the first case of cat Erlichiosis in 1999:

http://www.ncbi.nlm.nih.gov/pubmed/10092038

J Small Anim Pract. 1999 Jan;40(1):20-4.
Feline granulocytic ehrlichiosis--a report of a new clinical entity and characterisation of the infectious agent.
Bjöersdorff A, Svendenius L, Owens JH, Massung RF.
Source

Department of Clinical Microbiology, Kalmar County Hospital, Sweden.
Abstract

A 14-month-old shorthaired cat was presented to the Animal Hospital in Skara, Sweden, with a two-day history of lethargy, anorexia and tachypnoea. Clinical examination and laboratory investigations revealed fever, dehydration, tick infestation, neutrophilia with left shift, lymphopenia, hyperglycaemia and intracytoplasmic neutrophilic Ehrlichia inclusions. After treatment with intravenous doxycycline and lactated Ringer's solution the temperature returned to normal. Oral treatment with doxycycline continued for 20 days. The ehrlichiosis diagnosis was confirmed by serology, polymerase chain reaction and DNA sequencing. No relapse was observed during the eight-month follow-up period. The granulocytotropic Ehrlichia strain found in the cat was later characterised by analysis of the 16S rRNA gene sequence which showed 100 per cent identity to DNA sequences found in Swedish canine and equine granulocytotropic Ehrlichia strains. This is, to the best of the authors' knowledge, the first reported case of granulocytic ehrlichiosis in a cat.

PMID:
10092038
[PubMed - indexed for MEDLINE]

A paper I read about dogs and Erlichiosis says that they usually get leukemia about two years after recovery from the disease which is why the period of administration of doxycycline is now extended. (For those vets who know about it which aren't many.)
 
Feline erlichiosis its so rare that it is practically unheard of.
Ticks are the main vector, so exposure to the ticks is rule of a thumb
 
Ticks can be really nasty on cats or dogs.

They dig their way into the skin, and to remove them is quite an art. Just pulling leaves the head of the insect inside the animal and spreads toxins into the blood stream.

To extract a tick requires a twisting motion such that the tick lets go of the animals flesh and can be separated whole.

Does this ring any bells?
 
Herr Eisenheim said:
Feline erlichiosis its so rare that it is practically unheard of.
Ticks are the main vector, so exposure to the ticks is rule of a thumb

Yeah, I know. But the symptoms sound so close to what Sebastian suffered, it just rang a bell. May be the wrong bell, but it's worth a try and it can't hurt.

Added: You'll know pretty quick if this is the route, like within 12 hours or so there will be improvement. It can still take awhile for appetite to come back. For a couple of days we were syringe feeding sebastian with sardines run through the blender.
 
Just got off the phone with the vet on this. Her blood work doesn't support a diagnosis of this virus, but he also said if she doesn't come around tomorrow he's going to try doxycycline. It's not an attempt that would make her worse.

She's continued to slide today, and I'm taking her back in to hospital tomorrow. The vet hasn't given up hope here, and he's a decent guy. If there was no hope at all, he'd say so. (I'm counting on that part, because I'm not trusting my emotions right now.)

While we have ticks here, she never goes outside to get any, though it is not impossible. I do know at the nymph stages those little creeps are next to impossible to see. We live in a woods, etc.
 
Gimpy said:
Just got off the phone with the vet on this. Her blood work doesn't support a diagnosis of this virus, but he also said if she doesn't come around tomorrow he's going to try doxycycline. It's not an attempt that would make her worse.

She's continued to slide today, and I'm taking her back in to hospital tomorrow. The vet hasn't given up hope here, and he's a decent guy. If there was no hope at all, he'd say so. (I'm counting on that part, because I'm not trusting my emotions right now.)

While we have ticks here, she never goes outside to get any, though it is not impossible. I do know at the nymph stages those little creeps are next to impossible to see. We live in a woods, etc.

The blood work often doesn't support the diagnosis of this virus. Like I said, there was nothing in Sebastian's blood. I had to insist on trying the doxycycline.
 
I'd say try the doxycycline, and I would have insisted on starting today! Try to keep her hydrated, too. I hope she turns around soon! Cats are resilient, one day you think they're dying, the next they are up and eating.
 
Laura said:
The blood work often doesn't support the diagnosis of this virus. Like I said, there was nothing in Sebastian's blood. I had to insist on trying the doxycycline.

I asked for an advice here, and here are some ideas. First of all, yeah, ehrlichiosis is possible in cats, but the clinical picture includes anemia, low count of thrombocytes, hemorrhage, fever, apathy, neurological dysfunction, and arthritis. Also, doxycycline is of a tetracycline family that treats variety of bacterial diseases in cats, so no problem to use it, except for the fact that one of its significant side effects is liver damage, especially if used for long. But probably it could be remedied somehow, or at least taken for a short period of time at first to see if there is indeed an improvement.

But one of the best things you could do, and maybe in US it's more available and quicker than here, is to do an Immunofluorescent antibody test:
http://www.vetstream.com/canis/Content/Lab_test/lab00328
And according to this site, this test can detect antibodies for Ehrlichia as well, so if possible maybe worth a try for the most accurate diagnosis.

Hope the kitty will feel better soon!
 
Gympy, I remember you saying you use as safe cleaning products as possible, but do you use anything like Domestos toilet blocks? I'm asking because I know about a case when a dog's health deteriorated the same way as your cat's, suddenly and seriously, and it appeared the dog had happened to drink some water from the toilet with a hanging bleach block inside and the damage done to her system (mostly the stomach) was very bad. I'm not sure a cat could do it, but I thought I'd mention it just in case.

Hope your kitty will be a living proof of what Lilou said above and in a few days you'll be having fun together again.
 
Keit said:
But one of the best things you could do, and maybe in US it's more available and quicker than here, is to do an Immunofluorescent antibody test:
http://www.vetstream.com/canis/Content/Lab_test/lab00328
And according to this site, this test can detect antibodies for Ehrlichia as well, so if possible maybe worth a try for the most accurate diagnosis.

Another test you can do in order to diagnose exactly what you have is ELISA test, which is immunoferment analysis. And also polymerase chain reaction (PCR), which is used in diagnosing infections like Mycoplasma haemofelis, or as commonly referred to in US - Feline Infectious Anemia, and which is also treated with dexocycline.

It's possible that this is what you have. If so, dexocycline may help. Beside the usual symptoms of anemia (pale mucous membranes, fever, fatigue, depression, lethargy, tachycardia, decreased appetite), enlarged liver, spleen and lymph nodes can be also observed (though, you have hyperglycemia instead of hypo, so don't know). And sometimes it's difficult to diagnose in a simple blood test, but using PCR.
 
Possibility of Being said:
Gympy, I remember you saying you use as safe cleaning products as possible, but do you use anything like Domestos toilet blocks?

Nope. All our bathrooms are scrubbed by hand. She does tend to lick the bathtub, which is another reason we use vinegar to clean it. When the tub needs serious attention, the door is kept shut and I rinse it out thoroughly, wipe it out, etc.
 
Keit said:
Keit said:
But one of the best things you could do, and maybe in US it's more available and quicker than here, is to do an Immunofluorescent antibody test:
http://www.vetstream.com/canis/Content/Lab_test/lab00328
And according to this site, this test can detect antibodies for Ehrlichia as well, so if possible maybe worth a try for the most accurate diagnosis.

Another test you can do in order to diagnose exactly what you have is ELISA test, which is immunoferment analysis. And also polymerase chain reaction (PCR), which is used in diagnosing infections like Mycoplasma haemofelis, or as commonly referred to in US - Feline Infectious Anemia, and which is also treated with dexocycline.

It's possible that this is what you have. If so, dexocycline may help. Beside the usual symptoms of anemia (pale mucous membranes, fever, fatigue, depression, lethargy, tachycardia, decreased appetite), enlarged liver, spleen and lymph nodes can be also observed (though, you have hyperglycemia instead of hypo, so don't know). And sometimes it's difficult to diagnose in a simple blood test, but using PCR.

I think this is what he's doing today...more blood-work to suss out what's going on. She's had the ELISA test, but I don't remember what it turned up or if it even came in yet.

She threw up in my office in the night, but this morning before the alarm went off(4:45am), she came up on the bed to wake me like she normally does. She was bloody around her ears from being itchy, and when presented with food, she did try to eat it. Since then I've been able to give her the meds sent home with her to take, and she's eaten most of what I've given her.

She still has loose stool (smells to high heaven... enough to cross the eyes.) She wants to be cuddled and held, normal for morning.

I'm still taking her in this morning, because she did this same thing the day she came home, and crashed right after. I'm hoping this is a good sign though.
 
Gimpy said:
She threw up in my office in the night, but this morning before the alarm went off(4:45am), she came up on the bed to wake me like she normally does. She was bloody around her ears from being itchy, and when presented with food, she did try to eat it. Since then I've been able to give her the meds sent home with her to take, and she's eaten most of what I've given her.

She still has loose stool (smells to high heaven... enough to cross the eyes.) She wants to be cuddled and held, normal for morning.

Oh, so she has itchy ears, smelly stool...that kind of changes the picture. In this case the chances are good that it may have something to do with the liver. The smelly stool that is and vomiting. Also hyperglycemia. And itchy ears maybe an allergic reaction, unless it's ticks related. So poisoning may be something to consider after all, especially if she is recovering. Maybe it's a combination of causes. But Herr Eisenheim may have a better idea and more educated guess. Also, don't know what your veterinarian uses and maybe there is a natural alternative, but here they give Catosal injections as a metabolic enhancer in case of problems with liver, kidneys, urinary tract and other immune system related stuff.
_http://www.animalhealth.bayer.com/5336.0.htmlin
 
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