Hi Deborah

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.

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.

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.

Amani

From: Felvtalk <felvtalk-boun...@felineleukemia.org> On Behalf Of Deborah 
Whorley
Sent: July 25, 2019 2:59 AM
To: felvtalk@felineleukemia.org
Subject: [Felvtalk] Chablis - seeking advise about giving Pred/Doxy/Winstrol 
with low WBC

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

CBC (21Jul2019)
NOTE: they did not repeat the analysis which, in hindsight, I should have 
insisted upon

Test    Result            Flag    Normal Range          Measure
RBC    5.11     L                 5.65 8.87                  M/μL
HCT    24.4    L                  37.3 61.7                       %
HGB    7.8                  L                  13.1 20.5                       
g/dL
MCV   47.7    L                   61.6 73.5                      fL
MCH   15.3    L                   21.2 25.9                      pg
MCHC             32.0                         32.0 37.9                  g/dL
RDW  23.6    H                  13.6 21.7                      %
%RETIC         0.2                                                              
                    %
RETIC            8.7                  L                   10.0 110.0            
    K/μL

WBC   * 2.39                      5.05 16.76                K/μL
%NEU            * 32.6                                                          
       %
%LYM            * 36.8                                                          
       %
%MONO * 28.5                                                                    
    %
%EOS             * 0.4                                                          
          %
%BASO          * 1.7                                                            
        %
NEU    --.--                             2.95 11.64             K/μL
BAND             * Suspected
LYM    * 0.88                     1.05 5.10                K/μL
MONO            * 0.68                     0.16 
1.12<x-apple-data-detectors://9>                   K/μL
EOS     * 0.01                     0.06 1.23                   K/μL
BASO  * 0.04                     0.00 0.10                   K/μL
nRBC  * Suspected
PLT                 * 182                      148 484          K/μL
MPV   17.6    H                 8.7 13.2                      fL
PDW   --.--                             9.1 19.4                             fL
PCT     0.32                            0.14 0.46               %
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