Cancer (leukemia) question

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allie and newkitty

allie and newkitty

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Is it possible for a cat to have leukemia develop late in life, after having been tested negative for it twice, being vaccinated against it, never going outside and having contact with infected cats and not having abnormal blood work in that area (WBC, etc) until getting an infection?

Are there other leukemias besides the ones they vaccinate for?

Would bad bloodwork in this area (anemia, low plates, etc etc, possible blasts) HAVE to indicate leukemia or lymphoma?
 
It sounds like you are asking about Feline Leukemia (FeLV). FeLV is something different than what one normally thinks about from the term leukemia. It is a not a blood cancer. It is a retrovirus infection, which attacks the immune system. That compromised immune system makes the cat susceptible to various illnesses, and they are more likely to develop some cancers. There is great info at http://www.vet.cornell.edu/fhc/brochures/felv.html .

A cat that tests positive for on the quick FeLV test may still clear the infection! It's only if the cat then tests positive on the expensive/sensitive ELISA test that indicates that the cat has a permanent FeLV infection (in the bone marrow).

Can you give some more info about the symptoms, bloodwork, what the vet said, etc?

laur
 
Hi Allie

You'll have to be more specific about the blood work results before I can answer that last question.

I assume you're talking about the viral infection, FeLV. It is possible for a cat to test negative for FeLV and have a dormant infection, though this is an unlikely scenario. The cat would have had to have contact with an infected cat at some point, of course. The cat can suppress the infection to such an extent that it is no longer found in the blood, remaining only in bone marrow. A bone marrow test can sort this out and can also shed light on a lot of blood abnormalities. To test bone marrow, the cat is sedated and a needle is used to pull marrow out of a large bone and the marrow is looked at on slides and can be tested for FeLV antigen.

Hope this helps.
 
My vet was worried I would do this when I saw the words 'possible blasts' on the bottom of the bloodwork, but I have always been a trouble-borrower and it is very hard to wait on the cytology report and just worry about what the news might be.

Ok, so 2 weeks ago all of Newkitty's values had improved to within the normal ranges from her initial dx of Pyelonephritis with e coli dx 4-28, and 3 weeks of baytril.This bloodwork was done on a different machine, using more blood than the bloodworks previously. I have included ranges where I was given them.

Fecal occult blood test this week showed a +3 (heavy bleeding, but my vet thinks that may be hair or her IBD and transient & not the cause of the lower HCT). During the past week before this result came back, I gave 2 Adequan shots 4 days apart (they really helped too, so that sucks).

Last month's U/S showed signs of pancreatitis (pancreas visible, fat around it was highlighted indicating inflammation, a couple of dark but not enlarged lymph nodes in the area possibly also reacting to inflammation) and a cyst near the liver. Nothing that warranted a needle biopsy per the vet, also because she has not had diarrhea or vomiting (anti-jinx) and is not losing weight. Kidneys looked good, right size, well delineated. Nothing remarkable about her intestines, etc. We left the U/S feeling reassured. Snap test for Panc was elevated, no surprise there as she had had pancreatitis flares since 2004.

Here goes:

PLT aggregates detected

RBC 4.68 (5-10 LOW)
HCT 24.9 (30-35 LOW ) (done manually it was 29%...2 weeks ago done manually at a different vet, it was 30% and 29% done via the other way)

HGB 10.7 (9-15)
MCV 53.3 (41- 58)
MCH 23.0 (12-20 HIGH)
MCHC (just dashes, no numbers?? not marked out as abnormal though)
RDW 18.8 (17.3 -22)
%RETIC 1.0%
WBC 15.09 (5.5 - 19.50) (up from two week's ago's 12.48, but lower than when first dx'd with kidney infection on 4/28--which was then 18.13)
%NEU 57.8 (no ranges on these next few)
%LYM 20.5%
%MONO 12.5
%EOS 9.0
%BASO 0.1%
NEU 8.72 (2.50 -12.5)
LYM 3.09 (0.4-6.80)
MONO 1.89 (0.15-1.70 HIGH)
EOS 1.37 (0.10 -0.79 HIGH)
BASO 0.02 (0.10 - 0.79)
PLT 250 (175-600)
MPV 16.4 (no range given, but flagged as value out of range)
PDW 29.6%
PCT 0.4% (no range given but flagged as value out of range)

BUN 56 (16-36 HIGH)
CRE 2.6 (0.8 -2.4 HIGH)
BUN/CRE 22
TP 8.1 (5.7 -8.9)
ALB 3.2 (2.3-3.9)
GLOB 4.9 (2.8-5.1)
ALT 44 (12-130)
ALKP 170 (14-111) (over the years, we have seen this elevated numerous times)
NA 160 (155-160)
K 4.2 (3.5-5.8)
NA/K 38
Cl 123 (112-129)
Osm Calc 335

Smear showed 'possible baselet (sp?) cells, blasts?'

Her weight was 13.4 late last year when she was dx'd with arhtritis, when I cut back on her cypro and started feeding less. She has maintained at around 12lbs 11 oz since January.

How worried should I be?
 
If you'd like to do some reading on veterinary med, the previous edition of the Merck Veterinary Manual is online here.

As far as worrying goes, each human is different, too. Some of us worry a lot; some of us are calmer. If you're totally stressing out,these tips from Herbert Benson's The Relaxation Response may be helpful.
*********************************************************************************************************************************
Relaxation Breathing

Begin by sitting in a comfortable chair with good back support, or lying down. The key thing is to have your body pretty much straight between hips and shoulders so your lungs have room.

Now, breathe out completely. That way there will be room for a full breath in. If you start with half filled lungs, taking a deep breath in won't feel very large.

Pause.

Slowly, take a deep breath.

Pause.

Slowly, exhale.

Repeat, and establish a pattern of slow, deep breathing. Give yourself a good 20 minutes (turn off the phone, close the door) to get into this process. If done at bedtime, you may drift into sleep.

By slowing and deepening your breathing, you often cause the heart rate to slow and relax, muscle tightness to ease away, and blood pressure to decrease.
 
Hi Allie

Did someone really write the blood smear results with a question mark? A typical acute lymphocytic leukemia (not FeLV) in cat would show an increase in lymphocytes and there aren't any in this CBC. It is possible to have a board certified pathologist review the blood -- can you add that on? A technician can and should note unusual cells in the blood smear; at the lab we use, this automatically triggers a DVM pathologist review. I don't really understand the blood smear comment but if the technician saw lymphoblasts, the blood should be examined by a vet.

The PCV/hematocrit results are oddly discordant too. I wonder if you should just get a do-over CBC.
 
Jess & Earl said:
Hi Allie

Did someone really write the blood smear results with a question mark? A typical acute lymphocytic leukemia (not FeLV) in cat would show an increase in lymphocytes and there aren't any in this CBC. It is possible to have a board certified pathologist review the blood -- can you add that on? A technician can and should note unusual cells in the blood smear; at the lab we use, this automatically triggers a DVM pathologist review. I don't really understand the blood smear comment but if the technician saw lymphoblasts, the blood should be examined by a vet.

The PCV/hematocrit results are oddly discordant too. I wonder if you should just get a do-over CBC.
Click to expand...

Hi Jess, my vet wrote that for me so I would know what test she was requesting from the fancy lab. I just re-read it and what she has is: "Cytology RBC's: RBCs XXX...(can't read that word) Possible basket cells, blasts?" From the way she said it, she did the smear herself. She was gone a long time with the bloodwork. She sent off to the lab to have a pathologist read it--she stressed she is NOT saying anything is wrong at this time but just wants to be super careful. I had to drag the point of the test out of her (what she is ruling out). And she did not say leukemia, really, she just said the kind of cancer it would be in the bone marrow so I thought that meant leukemia.

She got a huge blood sample from the jugular, if that means anything.

Is LY% lymphocytes? On 4/28 (kidney infection dx), her lymphocytes were 22.8 (20-55), then on 5/12 they were 15.1, then on 5/19 they were 26.4, now they are down again.

Yes, it was weird that there was such a big discrepancy in the fancy machine one and higher on the manual one. At the other vet 2 weeks ago, we asked them to do it both ways and they were like 29.40% and 30%. Newkitty's blood can be very lipemic but she said there was clear serum, whatever that means.

I know I should just wait until the damn pathology is in but it is really hard not to worry.
 
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